Inclusion criteria | Exclusion criteria |
---|---|
• At least 2 rib fractures • At least 1 dislocated rib fracture • Fractures accessible to surgery • Thoracic trauma no more than 2 days prior to screening for inclusion • Thoracic epidural analgesia • Written informed consent | • Any other concomitant fractures excepted clavicle fracture • Respiratory distress syndrome according to the Berlin definition [14] • Presence of >1.5 l of blood drained from the pleural space • Hemostasis disorder defined by any of the following criteria: - Platelet count < 70,000/mm3, - International normalized ratio (INR) > 1.2 (prothrombin < 70%) - activated partial thromboplastin time (aPTT) ≥ 60 s - drugs such as: P2Y12 antagonists (clopidogrel, prasugrel) and glycoprotein IIb/IIIa antagonists (abciximab, tirofiban) • Pathological rib fracture due to metastasis • Hemodynamic instability: systolic blood pressure < 100 mmHg and heart rate > 100 beats per minute • Neurologic disorder: Glasgow Coma Score < 13 in the initial 24 h, or intracerebral, epidural, subdural, or subarachnoid hemorrhages, or cerebral contusion • Titanium allergy • Known or suspected non-compliance to medical therapy due to drug or alcohol abuse • Age <18 years old • Women known to be pregnant or breast feeding thus contraindicating surgery • Inability to follow the procedures of the study, e.g., due to language problems, psychological disorders, dementia, etc. |