# Trends in surgical stabilization of rib fractures: A contemporary literature review

## TL;DR

This review examines recent trends in surgical stabilization of rib fractures, highlighting the need for better study designs and consistent outcome reporting.

## Contribution

The paper provides a comprehensive overview of SSRF literature, identifying gaps in study design and outcome reporting.

## Key findings

- Most SSRF studies are retrospective cohort studies, with few randomized controlled trials.
- Hospital outcomes like length of stay and ICU stay are frequently reported, but patient-reported outcomes are less common.
- Device and procedural details are inconsistently reported, limiting comparability across studies.

## Abstract

Blunt chest trauma leading to rib fractures is a common injury, accounting for 20 % of thoracic trauma cases. Surgical Stabilization of Rib Fractures (SSRF) has gained popularity due to advancements in surgical techniques and multidisciplinary care, resulting in improved patient outcomes. Despite a growing body of literature on SSRF, inconsistencies in study design and outcome reporting limit the synthesis of findings and the establishment of clear clinical guidelines. This scoping review aims to provide an overview of the existing SSRF literature, identifying prevalent trends and reported outcomes.

A systematic scoping review was conducted following Arksey and O'Malley's framework and the Preferred Reporting Items for Scoping Reviews (PRISMA) guidelines. The study was registered with Open Science Framework (8V9KN). A comprehensive search of MEDLINE, EMBASE, CINAHL, and Cochrane CENTRAL was performed from inception to March 1, 2025. Studies were included if they reported on SSRF for blunt chest trauma in human patients. Data extraction focused on study characteristics, patient demographics, reported outcomes, and methodological rigor.

A total of 1462 articles were screened, with 185 studies meeting the inclusion criteria. The majority (N = 162, 88 %) were published between 2015 and 2025, with the highest number in 2022. Most studies (N = 144, 78 %) employed a cohort study design, predominantly retrospective (N = 115, 80 %), while randomized controlled trials (RCTs) constituted only 8 % (N = 15). Hospital outcomes, including length of stay (N = 112) and ICU stay (N = 97), were the most frequently reported measures. Complications were documented in 124 studies, with pneumonia (N = 90) and mortality (N = 94) being the most common. Patient-reported outcomes (PROMs) were included in 60 studies (32 %), with pain (N = 46, 78 %) and quality of life (N = 23, 39 %) as key measures. Device and procedural details were reported in 70 studies (38 %), with 62 using the same device. However, variations in outcome measurement and a predominance of retrospective designs limit comparability.

SSRF literature has expanded significantly over the past decade, yet inconsistencies in study design and outcome reporting hinder the development of standardized clinical guidelines. Future research should prioritize prospective, multi-center trials with uniform reporting standards to enhance the reliability and applicability of findings.

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