Thoracoscopic internal fixation, open surgical internal fixation, and conservative treatment of rib fractures: differences in postoperative rehabilitation and chest volume (a randomized controlled trial)
- Journal
- European journal of trauma and emergency surgery : official publication of the European Trauma Society (Q1)
- Published
- 31 August 2026
- Study design
- Randomized controlled trial
- Evidence level
- Level 1, High (CEBM 1b)
- Authors
- Tong Li, Pile Zhao, Wei Li, Bingchun Liu
- PMID
- 42671473
- DOI
- 10.1007/s00068-026-03320-3
Why clinicians should know about it
- Picked for Orthopedics and Sports Medicine (top studies of the week, 6 September 2026): Thoracoscopic vs open fixation of rib fractures, RCT
- Picked for Surgery (top studies of the week, 6 September 2026): Thoracoscopic rib fixation vs open vs conservative treatment
Abstract
BACKGROUND: Currently, the standard treatment for multiple rib fractures is still under debate. This study explores the efficacy of three treatments (thoracoscopic internal fixation, open surgical internal fixation and conservative treatment) for multiple rib fractures and their influence on thoracic cavity volume and postoperative rehabilitation. METHODS: Patients with multiple rib fractures admitted to Weifang People's Hospital of Shandong Province from March 2019 to March 2021 were enrolled in this study. The thoracic volume changes before and after treatment were measured by three-dimensional computed tomography (CT) reconstruction. Twenty-seven patients in the open operation group underwent internal fixation with the rib cage, and 24 patients in the non-internal fixation group underwent external fixation with the chest band. The recovery of multiple rib fractures was evaluated by comparing the difference in thoracic volume before and after treatment, the incidence of related complications and the Comprehensive Assessment of Generic Quality of Life Inventory-74 (GQOLI-74) score one month after the operation. RESULTS: After 12 months of follow-up, thoracic volume was significantly different between the thoracoscopic and open fixation groups (P < 0.001). One month after the thoracoscopic internal fixation of rib fractures, the scores of physical function, psychological function and social function were better than those in the open operation internal fixation group and the chest band external fixation group and the differences were statistically significant (P < 0.001). CONCLUSIONS: Compared with conservative treatment, both surgeries restore thoracic volume and improve early quality of life. Thoracoscopic fixation causes less trauma and better short-term rehabilitation than open surgery, with equivalent thoracic recovery and complication rates.
Abstract as published, via PubMed.
For healthcare professionals. The summary is generated by AI from the published abstract, and the evidence level is assigned automatically from the study design on the Oxford CEBM hierarchy. Neither is medical advice. Read the full paper before changing practice.