Study Summary

Two hundred and eleven patients with unstable chest wall injuries were randomized to receive either operative treatment with surgical fixation (n=111) or nonoperative management (n=100). The primary outcome of interest was daily in-hospital opioid use, measured in morphine milligram equivalents (MMEs). Secondary outcomes included generalized pain, chest wall pain, chest wall tightness, shortness of breath, and SF-36 physical and mental health scores. Outcomes were assessed at multiple time points up to 12 months postinjury. Overall, the results of the study revealed no significant difference in in-hospital opioid use or pain scores between the two groups. SF-36 scores were also similar at all time points. These findings suggest that operative treatment of flail chest injuries does not provide additional benefit for pain control or functional recovery compared with nonoperative treatment.