Comparison of the Effectiveness in Pain Reduction and Pulmonary Function Between a Rib Splint Constructed in the ER and a Manufactured Rib Splint

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 May 26

PMID 29794759

Citations 2

Authors

Yoonje Lee

Sang-Hyun Lee

Changsun Kim

Hyuk Joong Choi

Affiliations

Soon will be listed here.

Abstract

Background: In the treatment of patients with rib fractures (RFs), pain reduction is the most important consideration. Various studies have examined the effectiveness of treatments administered to RF patients, such as lidocaine patches, IV drugs, nerve blockers, and surgery. In this study, we evaluated the difference in the effectiveness in pain reduction between 2 groups of RF patients: 1 group who received a rib splint constructed in the ER (ER splint) and another group who received a Chrisofix Chest Orthosis (CCO) manufactured rib splint.

Methods: A pilot study for a prospective randomized clinical trial was conducted to compare subjects using the CCO (Group A) with those using the ER splint (Group B) before and after the intervention. The primary outcome was difference in the level of pain based on the visual analogue scale (VAS) and the pulmonary function (PF) variables between before and after intervention in each group during forceful and resting respiration.

Results: A total of 24 subjects were enrolled in this study. The VAS results showed that the intervention was significantly effective in each group (before vs after: Group A resting: 8.50 ± 1.05 vs 4.17 ± 1.33, P < .001; Group A forceful: 9.83 ± 0.41 vs 7.17 ± 0.75, P < .001; Group B resting: 8.83 ± 1.60 vs 4.50 ± 1.38, P < .001; and Group B forceful: 9.67 ± 0.82 vs 7.33 ± 1.51, P = .003). The PF variables showed that the intervention was significantly effective in each group (before vs after: Group A, FVC: 2.74 ± 0.92 vs 3.35 ± 0.99, P < .001; FEV1: 2.16 ± 0.74 vs 2.57 ± 0.78, P = .001; PEF: 235.30 ± 43.06 vs 319.00 ± 51.58, P = .004; and Group B, FVC: 2.02 ± 0.49 vs 2.72 ± 0.62, P < .001; FEV1: 1.27 ± 0.25 vs 1.91 ± 0.37, P < .001; PEF: 216.67 ± 67.49 vs 300.33 ± 87.79, P = .003).

Conclusion: Applying either the CCO or the ER splint to RF patients effectively reduced pain, and no significant differences in pain level were observed between these 2 techniques.

Citing Articles

K-Rod: An Innovative Method of Personalized Rib Splinting for Expeditious Management of Flail Chest in Acute Care Settings.

Lin C, Yeh Y, Lin Y, Chen C Medicina (Kaunas). 2023; 59(1).

PMID: 36676700 PMC: 9865151. DOI: 10.3390/medicina59010076.

The benefits of early rib fixation for clinical outcomes of flail chest patients in intensive care unit.

Agababaoglu I, Ersoz H Turk Gogus Kalp Damar Cerrahisi Derg. 2020; 28(2):331-339.

PMID: 32551164 PMC: 7298373. DOI: 10.5606/tgkdc.dergisi.2020.18439.

References

Karmakar M, Ho A . Acute pain management of patients with multiple fractured ribs. J Trauma. 2003; 54(3):615-25. DOI: 10.1097/01.TA.0000053197.40145.62. View

Kieninger A, Bair H, Bendick P, Howells G . Epidural versus intravenous pain control in elderly patients with rib fractures. Am J Surg. 2005; 189(3):327-30. DOI: 10.1016/j.amjsurg.2004.11.022. View

Zink K, Mayberry J, Peck E, Schreiber M . Lidocaine patches reduce pain in trauma patients with rib fractures. Am Surg. 2011; 77(4):438-42. DOI: 10.1177/000313481107700419. View

Hwang E, Lee Y . Effectiveness of intercostal nerve block for management of pain in rib fracture patients. J Exerc Rehabil. 2014; 10(4):241-4. PMC: 4157932. DOI: 10.12965/jer.140137. View

Holcomb J, McMullin N, Kozar R, Lygas M, Moore F . Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003; 196(4):549-55. DOI: 10.1016/S1072-7515(02)01894-X. View

Solak O, Oz G, Kokulu S, Solak O, Dogan G, Esme H . The effectiveness of transdermal opioid in the management multiple rib fractures: randomized clinical trial. Balkan Med J. 2014; 30(3):277-81. PMC: 4115904. DOI: 10.5152/balkanmedj.2013.8191. View

Nakae H, Yokoi A, Kodama H, Horikawa A . Comparison of the Effects on Rib Fracture between the Traditional Japanese Medicine Jidabokuippo and Nonsteroidal Anti-Inflammatory Drugs: A Randomized Controlled Trial. Evid Based Complement Alternat Med. 2012; 2012:837958. PMC: 3409613. DOI: 10.1155/2012/837958. View

Brasel K, Guse C, Layde P, Weigelt J . Rib fractures: relationship with pneumonia and mortality. Crit Care Med. 2006; 34(6):1642-6. DOI: 10.1097/01.CCM.0000217926.40975.4B. View

Nirula R, Allen B, Layman R, Falimirski M, Somberg L . Rib fracture stabilization in patients sustaining blunt chest injury. Am Surg. 2006; 72(4):307-9. DOI: 10.1177/000313480607200405. View

10.

Hashemzadeh S, Hashemzadeh K, Hosseinzadeh H, Aligholipour Maleki R, Golzari S, Golzari S . Comparison thoracic epidural and intercostal block to improve ventilation parameters and reduce pain in patients with multiple rib fractures. J Cardiovasc Thorac Res. 2013; 3(3):87-91. PMC: 3825332. DOI: 10.5681/jcvtr.2011.019. View

11.

Ingalls N, Horton Z, Bettendorf M, Frye I, Rodriguez C . Randomized, double-blind, placebo-controlled trial using lidocaine patch 5% in traumatic rib fractures. J Am Coll Surg. 2010; 210(2):205-9. DOI: 10.1016/j.jamcollsurg.2009.10.020. View

12.

Bayouth L, Safcsak K, Cheatham M, Smith C, Birrer K, Promes J . Early intravenous ibuprofen decreases narcotic requirement and length of stay after traumatic rib fracture. Am Surg. 2013; 79(11):1207-12. View

13.

Nirula R, Mayberry J . Rib fracture fixation: controversies and technical challenges. Am Surg. 2010; 76(8):793-802. View

14.

Kerr-Valentic M, Arthur M, Mullins R, Pearson T, Mayberry J . Rib fracture pain and disability: can we do better?. J Trauma. 2003; 54(6):1058-63; discussion 1063-4. DOI: 10.1097/01.TA.0000060262.76267.EF. View

15.

ZIEGLER D, Agarwal N . The morbidity and mortality of rib fractures. J Trauma. 1994; 37(6):975-9. DOI: 10.1097/00005373-199412000-00018. View