Outcomes of anterior versus posterior rib fractures and surgical treatment: analysis of 249 patients
- 1Division of Thoracic Surgery, Department of Surgery, Changhua Christian Hospital
- 2Epidemiology and Biostatistics Center, Changhua Christian Hospital
- 3Doctoral Program in Translational Medicine, National Chung Hsing University
Abstract
Background Traditionally, rib fracture severity has been quantified by fracture count and radiographic displacement. However, emerging evidence indicates that the outcomes following rib fractures widely vary and are not fully explained by injury burden alone. Whether anterior and posterior fracture locations lead to distinct recovery patterns remains unclear. Methods A prospective longitudinal cohort study involving patients with traumatic rib fractures was conducted. Fractures were classified as anterior or posterior based on radiographic location. Pain intensity and functional status were serially evaluated for up to 3 months. Multivariable analyses were conducted with adjustment for age, body mass index, injury severity score, fracture number, displacement severity, associated injuries, and surgical stabilization of rib fractures (SSRF). Results Fracture displacement severity and the number of fracture ribs independently predicted higher pain intensity. After adjustment, anterior and posterior fractures exhibited comparable pain trajectories over time. However, posterior fractures were linked to greater functional status improvement from 1 to 3 months. Surgical stabilization might be associated with greater early pain reduction and higher early functional scores but did not alter the long-term recovery slope. Early health status on day 14 strongly predicted 3-month outcomes, independent of baseline injury severity. Conclusions The number of fracture ribs and displacement severity appear to reflect injury intensity, whereas fracture location may influence physiologic consequences. Posterior fractures show similar pain levels to anterior fractures but somewhat greater functional recovery.
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BibTeX
@article{cheng2026outcomes,
title = {{Outcomes of anterior versus posterior rib fractures and surgical treatment: analysis of 249 patients}},
author = {Ya-Fu Cheng and Chang-Lun Huang and Yu-Jun Chang and Ching-Yuan Cheng and Chia-Che Chang and Bing-Yen Wang},
journal = {World Journal of Emergency Surgery},
year = {2026},
month = jul,
doi = {10.1186/s13017-026-00715-w},
url = {https://doi.org/10.1186/s13017-026-00715-w},
note = {CC BY},
}
RIS
TY - JOUR
TI - Outcomes of anterior versus posterior rib fractures and surgical treatment: analysis of 249 patients
AU - Ya-Fu Cheng
AU - Chang-Lun Huang
AU - Yu-Jun Chang
AU - Ching-Yuan Cheng
AU - Chia-Che Chang
AU - Bing-Yen Wang
PY - 2026
DA - 2026/07/01
JO - World Journal of Emergency Surgery
DO - 10.1186/s13017-026-00715-w
UR - https://doi.org/10.1186/s13017-026-00715-w
AB - Background Traditionally, rib fracture severity has been quantified by fracture count and radiographic displacement. However, emerging evidence indicates that the outcomes following rib fractures widely vary and are not fully explained by injury burden alone. Whether anterior and posterior fracture locations lead to distinct recovery patterns remains unclear. Methods A prospective longitudinal cohort study involving patients with traumatic rib fractures was conducted. Fractures were classified as anterior or posterior based on radiographic location. Pain intensity and functional status were serially evaluated for up to 3 months. Multivariable analyses were conducted with adjustment for age, body mass index, injury severity score, fracture number, displacement severity, associated injuries, and surgical stabilization of rib fractures (SSRF). Results Fracture displacement severity and the number of fracture ribs independently predicted higher pain intensity. After adjustment, anterior and posterior fractures exhibited comparable pain trajectories over time. However, posterior fractures were linked to greater functional status improvement from 1 to 3 months. Surgical stabilization might be associated with greater early pain reduction and higher early functional scores but did not alter the long-term recovery slope. Early health status on day 14 strongly predicted 3-month outcomes, independent of baseline injury severity. Conclusions The number of fracture ribs and displacement severity appear to reflect injury intensity, whereas fracture location may influence physiologic consequences. Posterior fractures show similar pain levels to anterior fractures but somewhat greater functional recovery.
SN - 1749-7922
ER -