Open reduction and internal fixation of rib fractures in polytrauma patients with flail chest

Lori Defreest, Marcel Tafen, Avinash Bhakta, Ashar Ata, Stephen Martone, Owen Glotzer, Kevin Krautsak, Carl Rosati, Steven C. Stain, Daniel J. Bonville

Research output: Contribution to journalArticlepeer-review

30 Scopus citations


Background Open reduction and internal fixation (ORIF) of fractured ribs for flail chest is safe and effective but who is most likely to benefit is unknown. Our purpose is to compare ORIF with nonoperative management (NOM) in polytrauma patients. Methods Albany Medical Center Hospital Trauma Registry was queried for adult patients with flail chest admitted over 7 years. Results Eighty-six patients with radiographic flail chest were identified who met inclusion criteria. The 41 ORIF and 45 NOM patients had similar demographics and injury severity. Hospital length of stay and intensive care unit length of stay were significantly longer in the ORIF group than that of the NOM group. There was a trend toward longer time on the ventilator in the ORIF group. Conclusions In this retrospective study, patients treated by ORIF had longer hospitalization and ventilator duration. Future studies should be designed to optimally identify patients who are most likely to benefit from ORIF.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalAmerican Journal of Surgery
Issue number4
StatePublished - Apr 1 2016


  • Flail chest
  • Nonoperative management
  • Open reduction and internal fixation
  • ORIF
  • Rib fractures
  • Surgical stabilization

ASJC Scopus subject areas

  • Surgery


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