Operative Treatment of Flail Chest Injuries Does Not Reduce Pain or In-Hospital Opioid Requirements

• DOI: 10.2106/jbjs.24.01099
• Publication Date: 2025-03-07T19:00:48Z
• Authors: Niloofar Dehghan; Jessica McGraw-He...; Christine Schemitsch; Aaron Nauth; Jennifer Hidy; Milena Vicente; Emil H. Schemitsch; Richard Jenkinson; Hans Kreder; Michael D. McKee
• Keywords: Flail Chest

A previous randomized controlled trial (RCT) evaluating operative versus nonoperative treatment of acute flail chest injuries revealed more ventilator-free days in operatively treated patients who had been ventilated at the time randomization. It has suggested that surgery for these may also improve a patient's pain and function. Our goal was to perform secondary analysis RCT evaluate postinjury opioid requirements with nonoperatively unstable wall injuries. We analyzed data from multicenter conducted 2011 2019. Patients sustained acute, were or treatment. In-hospital medication logs evaluated, daily morphine milligram equivalents (MMEs) calculated. The patients' symptoms assessed, including generalized pain, tightness, shortness breath. Additionally, completed 36-Item Short Form Health Survey (SF-36), they followed 1 year postinjury. In original trial, 207 analyzed: 99 received treatment, 108 There no significant differences usage between 2 groups any examined points (p = 0.477). breath groups. SF-36 scores. This does not reduce in-hospital requirements. reductions scores similar both Further work is needed identify those most likely benefit Therapeutic Level I. See Instructions Authors complete description levels evidence.