Highlights & Basics
- Rib fractures may be due to blunt force injury, falls, nonaccidental trauma, aggressive CPR, or more rarely, severe coughing, athletic activities, or metastatic lesions and primary bone tumors.
- In young children, rib fractures are a result of child abuse 65% to 100% of the time.
- Assessment includes identification of the fracture itself and any concurrent injuries or complications. These include pneumothorax, hemopneumothorax, pulmonary contusions, and a flail chest, as well as possible nonthoracic injuries.
- Chest radiography is the first-line imaging modality in patients presenting with known or possible trauma, followed by a chest CT if needed.
- Treatment includes pain control; oxygen if indicated; respiratory physical therapy; and management of any underlying cause, concomitant injuries, and complications. Ventilatory support may be needed in patients who are unstable or have complications. Surgical stabilization is not required in most patients with simple rib fractures but may be considered in patients with multiple severely displaced fractures or those who fail to respond to nonoperative management.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
CT scan showing large left-sided pneumothorax
CXR depicting the same pneumothorax as shown on CT
CXR showing right first rib fracture
CXR showing multiple posterior left-sided rib fractures
Anteroposterior CXR multiple left-sided rib fractures with chest tube in place
CT scan showing bilateral posterior rib fractures
CT showing right anterolateral rib fracture
CT showing left posterior segmental rib fracture
Citations
American College of Surgeons. Best practices guidelines: management of chest wall injuries. Nov 2025 [internet publication].[Full Text]
American College of Radiology. ACR appropriateness criteria: rib fractures. 2018 [internet publication].[Full Text]
American College of Surgeons. ACS trauma quality programs: best practices guidelines for acute pain management in trauma patients. Nov 2020 [internet publication].[Full Text]
Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017 Mar;82(3):618-26.[Abstract][Full Text]
Pieracci FM, Majercik S, Ali-Osman F, et al. Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury. 2017 Feb;48(2):307-21.[Abstract]
1. Abdelsattar ZM, Ishitani MB, Kim BD. Surgical stabilization of rib fractures in a 6-year-old child after blunt trauma. Ann Thorac Surg. 2017 Dec;104(6):e439-441.[Abstract][Full Text]
2. Burkow J, Holste G, Otjen J, et al. High sensitivity methods for automated rib fracture detection in pediatric radiographs. Sci Rep. 2024 Apr 10;14(1):8372.[Abstract][Full Text]
3. Darling SE, Done SL, Friedman SD, et al. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures. Pediatr Radiol. 2014 Oct;44(10):1230-6.[Abstract]
4. Barsness KA, Cha ES, Bensard DD, et al. The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children. J Trauma. 2003 Jun;54(6):1107-10.[Abstract]
5. Cadzow SP, Armstrong KL. Rib fractures in infants: red alert! the clinical features, investigations and child protection outcomes. J Paediatr Child Health. 2000 Aug;36(4):322-6.[Abstract]
6. Paine CW, Fakeye O, Christian CW, et al. Prevalence of abuse among young children with rib fractures: a systematic review. Pediatr Emerg Care. 2019 Feb;35(2):96-103.[Abstract][Full Text]
7. Brennan B, Henry MK, Altaffer A, et al. Prevalence of abuse and additional injury in young children with rib fractures as their presenting injury. Pediatr Emerg Care. 2021 Dec 1;37(12):e1451-6.[Abstract]
8. Feldman KW. Rib fractures: elusive, but important. Lancet Child Adolesc Health. 2018 Nov;2(11):769-70.[Full Text]
9. Maguire SA, Kemp AM, Lumb RC, et al. Estimating the probability of abusive head trauma: a pooled analysis. Pediatrics. 2011 Sep;128(3):e550-64.[Abstract]
10. Sanchez TR, Grasparil AD, Chaudhari R, et al. Characteristics of rib fractures in child abuse-the role of low-dose chest computed tomography. Pediatr Emerg Care. 2018 Feb;34(2):81-3.[Abstract]
11. Kriss S, Thompson A, Bertocci G, et al. Characteristics of rib fractures in young abused children. Pediatr Radiol. 2020 May;50(5):726-33.[Abstract]
12. Barber I, Perez-Rossello JM, Wilson CR, et al. The yield of high-detail radiographic skeletal surveys in suspected infant abuse. Pediatr Radiol. 2015 Jan;45(1):69-80.[Abstract]
13. Haney S, Scherl S, DiMeglio L, et al. Evaluating young children with fractures for child abuse: clinical report. Pediatrics. 2025 Feb 1;155(2):e2024070074.[Abstract][Full Text]
14. Bulloch B, Schubert CJ, Brophy PD, et al. Cause and clinical characteristics of rib fractures in infants. Pediatrics. 2000 Apr;105(4):E48.[Abstract]
15. Högberg U, Thiblin I. Rib fractures in infancy, case-series and register case-control study from Sweden. J Pediatr Endocrinol Metab. 2021 Mar 26;34(3):363-372.[Abstract]
16. Sharma OP, Oswanski MF, Jolly S, et al. Perils of rib fractures. Am Surg. 2008 Apr;74(4):310-4.[Abstract]
17. Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003 Jul;24(1):133-8.[Abstract][Full Text]
18. Ekestubbe L, Forssten MP, Cao Y, et al. Morbidity prediction in conservatively managed rib fracture patients. Eur J Trauma Emerg Surg. 2025 Apr 29;51(1):184.[Abstract][Full Text]
19. Siris ES, Brenneman SK, Barrett-Connor E, et al. The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50-99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int. 2006;17(4):565-74.[Abstract]
20. Palvanen M, Kannus P, Niemi S, et al. Epidemiology of minimal trauma rib fractures in the elderly. Calcif Tissue Int. 1998 Mar;62(3):274-7.[Abstract]
21. Holcomb JB, McMullin NR, Kozar RA, et al. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003 Apr;196(4):549-55.[Abstract]
22. Marini CP, Petrone P, Soto-Sánchez A, et al. Predictors of mortality in patients with rib fractures. Eur J Trauma Emerg Surg. 2021 Oct;47(5):1527-34.[Abstract]
23. Keel M, Meier C. Chest injuries - what is new? Curr Opin Crit Care. 2007 Dec;13(6):674-9.[Abstract]
24. Liman ST, Kuzucu A, Tastepe AI, et al. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003 Mar;23(3):374-8.[Abstract][Full Text]
25. Pettiford BL, Luketich JD, Landreneau RJ. The management of flail chest. Thorac Surg Clin. 2007 Feb;17(1):25-33.[Abstract]
26. Peek J, Ochen Y, Saillant N, et al. Traumatic rib fractures: a marker of severe injury. A nationwide study using the National Trauma Data Bank. Trauma Surg Acute Care Open. 2020;5(1):e000441.[Abstract][Full Text]
27. Prins JTH, Van Lieshout EMM, Van Wijck SFM, et al. Chest wall injuries due to cardiopulmonary resuscitation and the effect on in-hospital outcomes in survivors of out-of-hospital cardiac arrest. J Trauma Acute Care Surg. 2021 Dec 1;91(6):966-75.[Abstract]
28. Kralj E, Podbregar M, Kejžar N, et al. Frequency and number of resuscitation related rib and sternum fractures are higher than generally considered. Resuscitation. 2015 Aug;93:136-41.[Abstract][Full Text]
29. Hoke RS, Chamberlain D. Skeletal chest injuries secondary to cardiopulmonary resuscitation. Resuscitation. 2004 Dec;63(3):327-38.[Abstract]
30. Badawy M, Solomon N, Elsayes KM, et al. Nonaccidental injury in the elderly: what radiologists need to know. Radiographics. 2022 Sep-Oct;42(5):1358-76.[Abstract][Full Text]
31. Kavak RP, Özdemir M. Radiological appearance of physical elder abuse. Eur Geriatr Med. 2019 Dec;10(6):871-8.[Abstract]
32. Xu DL, Zhang XT, Wang GH, et al. Clinical features of pathologically confirmed metastatic bone tumors: a report of 390 cases [in Chinese]. Ai Zheng. 2005 Nov;24(11):1404-7.[Abstract]
33. Aydoğdu K, Findik G, Agackiran Y, et al. Primary tumors of the ribs; experience with 78 patients. Interact Cardiovasc Thorac Surg. 2009 Aug;9(2):251-4.[Abstract][Full Text]
34. Muñoz-Bermúdez R, Abella E, Zuccarino F, et al. Successfully non-surgical management of flail chest as first manifestation of multiple myeloma: a case report. World J Crit Care Med. 2019 Sep 11;8(5):82-6.[Abstract][Full Text]
35. Dragoni S, Giombini A, Di Cesare A, et al. Stress fractures of the ribs in elite competitive rowers: a report of nine cases. Skeletal Radiol. 2007 Oct;36(10):951-4.[Abstract]
36. Kawahara H, Baba H, Wada M, et al. Multiple rib fractures associated with severe coughing - a case report. Int Orthop. 1997;21(4):279-81.[Abstract][Full Text]
37. Low S, Kern M, Atanda A. First-rib stress fracture in two adolescent swimmers: a case report. J Sports Sci. 2015 Nov 5;34(13):1266-70.[Abstract]
38. Gerrie BJ, Harris JD, Lintner DM, et al. Lower thoracic rib stress fractures in baseball pitchers. Phys Sportsmed. 2015 Nov 26;44(1):93-6.[Abstract]
39. Smoljanović T, Bojanić I, Troha I, et al. Rib stress fractures in rowers: three case reports and review of literature [in Croatian]. Lijec Vjesn. 2007 Oct-Nov;129(10-11):327-32.[Abstract]
40. Gupta A, Jamshidi M, Rubin JR. Traumatic first rib fracture: is angiography necessary? A review of 730 cases. Cardiovasc Surg. 1997 Feb;5(1):48-53.[Abstract]
41. Poole GV. Fracture of the upper ribs and injury to the great vessels. Surg Gynecol Obstet. 1989 Sep;169(3):275-82.[Abstract]
42. Sammy IA, Chatha H, Lecky F, et al. Are first rib fractures a marker for other life-threatening injuries in patients with major trauma? a cohort study of patients on the UK Trauma Audit and Research Network database. Emerg Med J. 2017 Apr;34(4):205-11.[Abstract][Full Text]
43. Assenza M, Centonze L, Valesini L, et al. Traumatic subclavian arterial rupture: a case report and review of literature. World J Emerg Surg. 2012 Jun 18;7(1):18.[Abstract][Full Text]
44. Williams A, Bigham C, Marchbank A. Anaesthetic and surgical management of rib fractures. BJA Educ. 2020 Oct;20(10):332-40.[Abstract][Full Text]
45. Al-Hassani A, Abdulrahman H, Afifi I, et al. Rib fracture patterns predict thoracic chest wall and abdominal solid organ injury. Am Surg. 2010 Aug;76(8):888-91.[Abstract]
46. Brasel KJ, Moore EE, Albrecht RA, et al. Western Trauma Association critical decisions in trauma: management of rib fractures. J Trauma Acute Care Surg. 2017 Jan;82(1):200-3.[Abstract][Full Text]
47. Kemp AM, Dunstan F, Harrison S, et al. Patterns of skeletal fractures in child abuse: systematic review. BMJ. 2008 Oct 2;337:a1518.[Abstract][Full Text]
48. Bensen R, Adachi JD, Papaioannou A, et al. Evaluation of easily measured risk factors in the prediction of osteoporotic fractures. BMC Musculoskelet Disord. 2005 Sep 5;6:47.[Abstract][Full Text]
49. Kent R, Woods W, Bostrom O. Fatality risk and the presence of rib fractures. Annu Proc Assoc Adv Automot Med. 2008 Oct;52:73-82.[Abstract]
50. Ziegler DW, Agarwal NN. The morbidity and mortality of rib fractures. J Trauma. 1994 Dec;37(6):975-9.[Abstract]
51. American College of Surgeons. Best practices guidelines: management of chest wall injuries. Nov 2025 [internet publication].[Full Text]
52. Athanassiadi K, Gerazounis M, Theakos N. Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg. 2004 Aug;26(2):373-6.[Abstract][Full Text]
53. Sermonesi G, Bertelli R, Pieracci FM, et al. Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper. World J Emerg Surg. 2024 Oct 18;19(1):33.[Abstract][Full Text]
54. American College of Radiology. ACR appropriateness criteria: rib fractures. 2018 [internet publication].[Full Text]
55. American College of Surgeons; Trauma Quality Improvement Program. Best practices guidelines in imaging. Oct 2018 [internet publication].[Full Text]
56. Livingston DH, Shogan B, John P, et al. CT diagnosis of rib fractures and the prediction of acute respiratory failure. J Trauma. 2008 Apr;64(4):905-11.[Abstract]
57. Guerrero-López F, Vázquez-Mata G, Alcázar-Romero PP, et al. Evaluation of the utility of computed tomography in the initial assessment of the critical care patient with chest trauma. Crit Care Med. 2000 May;28(5):1370-5.[Abstract]
58. American Academy of Pediatrics - Section on Orthopaedics and the Pediatric Orthopaedic Society of North America. Five things physicians and patients should question. Choosing Wisely, an initiative of the ABIM Foundation. 2022 [internet publication].[Full Text]
59. National Institute for Health and Care Excellence. Major trauma: assessment and initial management. Feb 2016 [internet publication].[Full Text]
60. Brody AS, Frush DP, Huda W, et al. Radiation risk to children from computed tomography. Pediatrics. 2007 Sep;120(3):677-82.[Abstract][Full Text]
61. Hurley ME, Keye GD, Hamilton S. Is ultrasound really helpful in the detection of rib fractures? Injury. 2004 Jun;35(6):562-6.[Abstract]
62. Stengel D, Leisterer J, Ferrada P, et al. Point-of-care ultrasonography for diagnosing thoracoabdominal injuries in patients with blunt trauma. Cochrane Database Syst Rev. 2018 Dec 12;(12):CD012669.[Abstract][Full Text]
63. Talbot BS, Gange CP Jr, Chaturvedi A, et al. Traumatic Rib Injury: patterns, imaging pitfalls, complications, and treatment. Radiographics. 2017 Mar-Apr;37(2):628-51.[Abstract]
64. American College of Radiology. ACR appropriateness criteria. Suspected physical abuse - child. 2016 [internet publication].[Full Text]
65. Kim W, Song J, Moon S, et al. Characteristics of rib fracture patients who require chest computed tomography in the emergency department. BMC Emerg Med. 2023 Mar 22;23(1):33.[Abstract][Full Text]
66. Battle C, Pelo C, Hsu J, et al. Expert consensus guidance on respiratory physiotherapy and rehabilitation of patients with rib fractures: an international, multidisciplinary e-Delphi study. J Trauma Acute Care Surg. 2023 Apr 1;94(4):578-83.[Abstract][Full Text]
67. Kishawi SK, Ho VP, Bachman KC, et al. Are we underestimating the morbidity of single rib fractures? J Surg Res. 2021 Dec;268:174-80.[Abstract][Full Text]
68. Reeder MT, Dick BH, Atkins JK, et al. Stress fractures: current concepts of diagnosis and treatment. Sports Med. 1996 Sep;22(3):198-212.[Abstract]
69. American College of Surgeons. ACS trauma quality programs: best practices guidelines for acute pain management in trauma patients. Nov 2020 [internet publication].[Full Text]
70. Karmakar MK, Ho AM. Acute pain management of patients with multiple fractured ribs. J Trauma. 2003 Mar;54(3):615-25.[Abstract]
71. Burton SW, Riojas C, Gesin G, et al; PRIMUM Group. Multimodal analgesia reduces opioid requirements in trauma patients with rib fractures. J Trauma Acute Care Surg. 2022 Mar 1;92(3):588-96.[Abstract][Full Text]
72. Martin TJ, Eltorai AS, Dunn R, et al. Clinical management of rib fractures and methods for prevention of pulmonary complications: a review. Injury. 2019 Jun;50(6):1159-65.[Abstract]
73. Yang Y, Young JB, Schermer CR, et al. Use of ketorolac is associated with decreased pneumonia following rib fractures. Am J Surg. 2014 Apr;207(4):566-72.[Abstract][Full Text]
74. Bulger EM, Edwards T, Klotz P, et al. Epidural analgesia improves outcome after multiple rib fractures. Surgery. 2004 Aug;136(2):426-30.[Abstract]
75. Peek J, Smeeing DPJ, Hietbrink F, et al. Comparison of analgesic interventions for traumatic rib fractures: a systematic review and meta-analysis. Eur J Trauma Emerg Surg. 2018 Feb 6;45(4):597-622.[Abstract][Full Text]
76. Carrier FM, Turgeon AF, Nicole PC, et al. Effect of epidural analgesia in patients with traumatic rib fractures: a systematic review and meta-analysis of randomized controlled trials. Can J Anaesth. 2009 Mar;56(3):230-42.[Abstract]
77. Cheng YJ. Lidocaine skin patch (Lidopat® 5%) is effective in the treatment of traumatic rib fractures: a prospective double-blinded and vehicle-controlled study. Med Princ Pract. 2016;25(1):36-9.[Abstract][Full Text]
78. Johnson M, Strait L, Ata A, et al. Do lidocaine patches reduce opioid use in acute rib fractures? Am Surg. 2020 Sep;86(9):1153-8.[Abstract]
79. Oncel M, Sencan S, Yildiz H, et al. Transcutaneous electrical nerve stimulation for pain management in patients with uncomplicated minor rib fractures. Eur J Cardiothorac Surg. 2002 Jul;22(1):13-7.[Abstract][Full Text]
80. Hsu JR, Mir H, Wally MK, et al; Orthopaedic Trauma Association Musculoskeletal Pain Task Force. Clinical practice guidelines for pain management in acute musculoskeletal injury. J Orthop Trauma. 2019 May;33(5):e158-82.[Abstract][Full Text]
81. Finneran JJ 4th, Kobayashi L, Costantini TW, et al. Ultrasound-guided percutaneous cryoneurolysis for the treatment of pain after traumatic rib fracture: a randomized, active-controlled, participant- and observer-masked study. Anesthesiology. 2025 Mar 1;142(3):532-45.[Abstract][Full Text]
82. Cha PI, Min JG, Patil A, et al. Efficacy of intercostal cryoneurolysis as an analgesic adjunct for chest wall pain after surgery or trauma: systematic review. Trauma Surg Acute Care Open. 2021;6(1):e000690.[Abstract][Full Text]
83. Vossler JD, Zhao FZ. Intercostal nerve cryoablation for control of traumatic rib fracture pain: a case report. Trauma Case Rep. 2019 Oct;23:100229.[Abstract][Full Text]
84. Mukherjee K, Schubl SD, Tominaga G, et al. Non-surgical management and analgesia strategies for older adults with multiple rib fractures: a systematic review, meta-analysis, and joint practice management guideline from the Eastern Association for the Surgery of Trauma and the Chest Wall Injury Society. J Trauma Acute Care Surg. 2023 Mar 1;94(3):398-407.[Abstract]
85. Nakitende D, Gottlieb M, Ruskis J, et al. Ultrasound for confirmation of thoracostomy tube placement by emergency medicine residents. Trauma (United Kingdom). 2015;19(1):35‐8.
86. Asciak R, Bedawi EO, Bhatnagar R, et al. British Thoracic Society clinical statement on pleural procedures. Thorax. 2023 Jul;78(suppl 3):s43-68.[Abstract][Full Text]
87. Jenkins JA, Gharahbaghian L, Doniger SJ, et al. Sonographic identification of tube thoracostomy study (SITTS): confirmation of intrathoracic placement. West J Emerg Med. 2012 Sep;13(4):305-11.[Abstract][Full Text]
88. Chest trauma. In: Hess DR, Kacmarek RM, eds. Essentials of mechanical ventilation. 4th ed. New York: McGraw-Hill Education; 2018.
89. Voggenreiter G, Neudeck F, Aufmkolk M, et al. Operative chest wall stabilization in flail chest--outcomes of patients with or without pulmonary contusion. J Am Coll Surg. 1998 Aug;187(2):130-8.[Abstract]
90. Dehghan N, de Mestral C, McKee MD, et al. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg. 2014 Feb;76(2):462-8.[Abstract]
91. Simon B, Ebert J, Bokhari F, et al; Eastern Association for the Surgery of Trauma. Management of pulmonary contusion and flail chest: an Eastern Association for the Surgery of Trauma practice management guideline. J Trauma Acute Care Surg. 2012 Nov;73(5 Suppl 4):S351-61.[Abstract][Full Text]
92. Leinicke JA, Elmore L, Freeman BD, et al. Operative management of rib fractures in the setting of flail chest: a systematic review and meta-analysis. Ann Surg. 2013 Dec;258(6):914-21.[Abstract]
93. Marasco SF, Davies AR, Cooper J, et al. Prospective randomized controlled trial of operative rib fixation in traumatic flail chest. J Am Coll Surg. 2013 May;216(5):924-32.[Abstract]
94. Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017 Mar;82(3):618-26.[Abstract][Full Text]
95. Schuurmans J, Goslings JC, Schepers T. Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review. Eur J Trauma Emerg Surg. 2017 Apr;43(2):163-8.[Abstract][Full Text]
96. Pieracci FM, Majercik S, Ali-Osman F, et al. Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury. 2017 Feb;48(2):307-21.[Abstract]
97. Lucena-Amaro S, Cole E, Zolfaghari P. Long term outcomes following rib fracture fixation in patients with major chest trauma. Injury. 2022 Sep;53(9):2947-52.[Abstract]
98. National Institute for Health and Care Excellence. Insertion of metal rib reinforcements to stabilise a flail chest wall. Oct 2010 [internet publication].[Full Text]
99. Wang Z, Jia Y, Li M. The effectiveness of early surgical stabilization for multiple rib fractures: a multicenter randomized controlled trial. J Cardiothorac Surg. 2023 Apr 10;18(1):118.[Abstract][Full Text]
100. Owattanapanich N, Lewis MR, Benjamin ER, et al. Surgical rib fixation in isolated flail chest improves survival. Ann Thorac Surg. 2022 Jun;113(6):1859-65.[Abstract][Full Text]
101. Sawyer E, Wullschleger M, Muller N, et al. Surgical rib fixation of multiple rib fractures and flail chest: a systematic review and meta-analysis. J Surg Res. 2022 Aug;276:221-34.[Abstract][Full Text]
102. Peuker F, Hoepelman RJ, Beeres FJP, et al. Nonoperative treatment of multiple rib fractures, the results to beat: International multicenter prospective cohort study among 845 patients. J Trauma Acute Care Surg. 2024 May 1;96(5):769-76.[Abstract][Full Text]
103. Hietbrink F, Houwert RM, van Wessem KJP, et al. The evolution of trauma care in the Netherlands over 20 years. Eur J Trauma Emerg Surg. 2020 Apr;46(2):329-35.[Abstract][Full Text]
104. Bulger EM, Arneson MA, Mock CN, et al. Rib fractures in the elderly. J Trauma. 2000 Jun;48(6):1040-6.[Abstract]
105. Dehghan N, Mah JM, Schemitsch EH, et al. Operative stabilization of flail chest injuries reduces mortality to that of stable chest wall injuries. J Orthop Trauma. 2018 Jan;32(1):15-21.[Abstract]
106. Van Vledder MG, Kwakernaak V, Hagenaars T, et al. Patterns of injury and outcomes in the elderly patient with rib fractures: a multicenter observational study. Eur J Trauma Emerg Surg. 2019 Aug;45(4):575-83.[Abstract][Full Text]
107. Brasel KJ, Guse CE, Layde P, et al. Rib fractures: relationship with pneumonia and mortality. Crit Care Med. 2006 Jun;34(6):1642-6.[Abstract]
108. Kerr-Valentic MA, Arthur M, Mullins RJ, et al. Rib fracture pain and disability: can we do better? J Trauma. 2003 Jun;54(6):1058-63.[Abstract]
109. Marasco S, Lee G, Summerhayes R, et al. Quality of life after major trauma with multiple rib fractures. Injury. 2014 Jun 21;46(1):61-5.[Abstract]
110. Choi J, Khan S, Hakes NA, et al. Prospective study of short-term quality-of-life after traumatic rib fractures. J Trauma Acute Care Surg. 2021 Jan 1;90(1):73-8.[Abstract]
111. Choi J, Khan S, Sheira D, et al. Prospective study of long-term quality-of-life after rib fractures. Surgery. 2022 Jul;172(1):404-9.[Abstract]
112. Prunet B, Bourenne J, David JS, et al. Patterns of invasive mechanical ventilation in patients with severe blunt chest trauma and lung contusion: a French multicentric evaluation of practices. J Intensive Care Soc. 2018 Apr 3;20(1):46-52.[Abstract][Full Text]
113. Ho ML, Gutierrez FR. Chest radiography in thoracic polytrauma. AJR Am J Roentgenol. 2009 Mar;192(3):599-612.[Abstract][Full Text]
114. Zuidem W. Angle stable plate osteosynthesis for non-union of rib fractures. 2007 [internet publication].[Full Text]
115. British Orthopaedic Association. British Orthopaedic Association standards for trauma (BOASTs): rehabilitation and communication with trauma patients. Aug 2016 [internet publication].[Full Text]
116. Forrester JD, Faliks B, Cardarelli C, et al. Surgical Infection Society-Chest Wall Injury Society recommendations for management of surgical site or implant-related infections after surgical stabilization of traumatic rib or sternal fractures. Surg Infect (Larchmt). 2023 Jun;24(5):414-24.[Abstract][Full Text]
