Surgical Stabilization of Rib Fracture in an 80-year-old Female with Osteogenesis Imperfecta

Keywords: Osteogenesis Imperfecta, Rib Fracture, Surgical Stabilization of Rib Fractures (SSRF)

Background and Conclusions: Background

An 80-year-old female patient with osteogenesis imperfecta underwent successful surgical stabilization of rib fractures.

Summary

Our patient is an 80-year-old female with osteogenesis imperfecta who presented with fracture of ribs 7-12 on her right side. She was initially treated with conservative management including pain management, chest tube placement, and oxygen therapy. She did not do well with conservative management and underwent surgical stabilization of ribs 7-10utilizing a combination of titanium plates and screws with Arthrex Fibertape®. Conventional treatment of flail chest involved conservative therapy. New evidence suggests surgical stabilization of rib fracture (SSRF) reduces length of stay in the intensive care unit and decreased rates of pneumonia. Patients with osteoporosis and osteogenesis imperfecta are not generally considered candidates for SSRF. This report emphasizes the need to reevaluate which patients are candidates for SSRF.

Conclusions

Therapeutic options for adults with osteogenesis imperfecta are limited. Historically, surgical stabilization of rib fractures has not been performed in this patient population. Surgical stabilization of rib fractures may be a therapeutic option for highly selected patients with osteogenesis imperfecta, benefits are felt to outweigh the risks.