| Objective: To systematically review the efficacy of conservative treatment and open reduction and internal fixation for multiple rib fractures.Methods: We searched WanFang Data,CNKI,VIP Data,PubMed,EMbase,The Cochrane Library and Web of Science from inception to December 2017 to collect studies about conservative treatment and open reduction and internal fixation for multiple rib fractures.Two reviewers independently screened the literature,extracted data,and assessed the risk of bias of included studies.RevMan 5.3 software was used for meta-analysis.Results: A total of 16 studies were included,involving 1 374 patients,723 patients in the surgical group and 651 patients in the conservative group.The meta-analysis showed that the length of stay in the ICU(MD=–3.41,95%CI –4.92 to –2.43,P<0.000 01),total length of stay(MD=–7.60,95 %CI–10.67 to–4.53,P<0.000 01),incidence of pulmonary arylene(OR=0.29,95%CI 0.19 to 0.43,P<0.000 01),incidence of lung infections(OR=0.26,95%CI 0.19 to 0.37,P<0.000 01),incidence of chest wall malformation(OR=0.03,95%CI 0.01 to 0.14,P<0.0.000 01)in the surgical group were superior to the conservative group.Conclusion: Compared with conservative treatment,open reduction and internal fixation can significantly improve the recovery time of patients with multiple rib fractures,reduce the hospitalization time,the incidence of perioperative complications,significantly improve the prognosis of patients,and is more conductive to the rehabilitation of patients. |
