Risk factor analysis for delayed displacement after open reduction and internal fixation of multiple rib fractures
Zhang Jihui
Dong Guangqi
Gong Hao
Xia Honggang
Zhu Pengzhi
Wang Dongbin
Abstract：Objective To identify the risk factors for delayed displacement after surgeries for multiple rib fractures to develop better surgical strategies and to improve patient outcomes.Methods A retrospective analysis was conducted on 105 patients who underwent open reduction and internal fixation for multiple rib fractures at Tian-jin Hospital from Jan.2021 to Dec.2023,during which a total of 347 patients received rib fractures,with 39 pa-tients excluded for a single rib with>3 fracture sites,12 patients excluded for rib cartilage fractures,35 patients ex-cluded for bilateral rib fractures,and 156 patients excluded for fractures involving the 1st-2nd or 11th-12th ribs.There were 70 males and 35 females,with the mean age of 60.4 years(range,35-95 years).According to whether delayed displacement occurred after surgery,patients were divided into non-displacement group(46 cases)and displacement group(59 cases).Data collected included demographic information,mechanisms of injury,number and type of rib fractures,and surgical details,etc..Univariate and multivariate logistic regression analyses were used to identify in-dependent risk factors for delayed displacement of multiple rib fractures after surgery.Results Among the 105 pa-tients with multiple rib fractures,59 experienced delayed displacement postoperatively,with an incidence of 56.2%.The displacement group showed significantly more rib fracture sites[8(6,10)vs.7(5,9)],more non-displaced rib sites before surgery[4(3,6)vs.3(2,4)],and more single ribs with two fracture sites[3(1,4)vs.1(0,3)](all P<0.05),but much less single ribs with one fracture site[2(1,4)vs.3(2,5),P<0.05].The displacement group also showed a much lower rate of total fixation rate[53.9%(42.9%,66.7%)vs.66.7%(50.0%,80.0%,P<0.05]and significantly more single ribs with two fracture sites not fully fixed[2(1,3)vs.1(0,2),P<0.05].Risk factors for delayed displacement included the number of single ribs with two fracture sites,the number of single ribs with two fracture sites not fully fixed,total fracture sites,overall fixation rate,and the number of non-displaced fractures.Multivariate logistic regression analysis showed that the number of non-displaced fractures was an inde-pendent risk factor for delayed displacement of multiple rib fractures(OR:1.676,95%CI:1.135-2.477).Conclu-sion The number of non-displaced fractures is an independent risk factor for delayed displacement of multiple rib fractures.During surgical intervention for multiple rib fractures,attention should be paid to non-displaced rib frac-tures in terms of number and fixation sufficiency,to prevent delayed displacement postoperatively and improve pa-tient outcomes.
Keywords：Multiple fib fracturesPostoperative delayed displacementSurgical fixation
Publication Date：2025-11-15
Online Publishing Date：2025-12-09(First online date of this platform, not the publication date of the document)
Pages：6( 844-849 )