Abstract
Trauma is increasing across the globe and for thoracic trauma, rib fracture fixation can improve outcomes and speed recovery. Rib fracture patterns are varied and unique. The recent guidelines have indications for fixation based on number and displacement of ribs fractures, however not all patients who require rib fixation are indicated by this. The location of rib fractures is not included in much of the research into the benefits of rib fixation, however a review of the literature has indicated that both the superoinferior and mediolateral location of rib fractures affects patients’ outcomes. Following this the locations on the chest wall that move most have been mapped in fit and well males, during various respiratory maneuvers, and five years of thoracic trauma patients’ rib fracture patterns and outcomes have been audited. This has shown that the greatest movement of the chest wall is in an oblique direction between superoanterior and inferoposterior. The fracture locations most associated with requiring rib fixation in both isolated thoracic trauma and multitrauma patients were posterior and lateral. These results suggest that rib fractures in areas of the chest wall that move most are likely to require rib fixation. Validation of the chest wall movement mapping techniques should be established and mapping should be completed in a more varied group of participants. Further to this, a multicenter audit into rib fracture patterns and the effect this has on outcomes is required to progress research in this area.