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Two-center retrospective study comparing intramedullary and plate fixation for rib fractures on safety and cost-effectiveness

Eur J Orthop Surg Traumatol. 2025 Oct 11;35(1):431. doi: 10.1007/s00590-025-04518-8.

ABSTRACT

OBJECTIVE: This retrospective study aimed to compare the safety and cost-effectiveness of intramedullary fixation versus plate fixation in patients with rib fractures. Each technique was performed at a separate hospital center.

METHODS: We retrospectively reviewed consecutive patients who underwent surgical fixation for rib fractures from February 2021 to January 2024. Eligible patients had fractures meeting surgical criteria and were treated with either intramedullary or plate fixation. Intraoperative parameters, postoperative outcomes, and costs were compared between the two groups.

RESULTS: A total of 89 patients were included, with 45 receiving intramedullary fixation and 44 receiving plate fixation. Baseline characteristics were similar between the groups. Intraoperative and postoperative outcomes-including operative time, hospital stay, drain removal, complications, healing rates, and pain scores-were comparable. Notably, intramedullary fixation was significantly less expensive than plate fixation.

CONCLUSION: Intramedullary fixation offers similar safety and efficacy to plate fixation for rib fractures while providing a clear cost advantage, suggesting potential economic benefits for healthcare systems.

PMID:41076490 | DOI:10.1007/s00590-025-04518-8

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