Comparison of the effectiveness in pain reduction and pulmonary function between a rib splint constructed in the ER and a manufactured rib splint

Abstract

Background: In the treatment of patients with rib fractures (RFs), pain reduction is the most important consideration. Various studies have examined the effectiveness of treatments administered to RF patients, such as lidocaine patches, IV drugs, nerve blockers, and surgery. In this study, we evaluated the difference in the effectiveness in pain reduction between 2 groups of RF patients: 1 group who received a rib splint constructed in the ER (ER splint) and another group who received a Chrisofix Chest Orthosis (CCO) manufactured rib splint.

Methods: A pilot study for a prospective randomized clinical trial was conducted to compare subjects using the CCO (Group A) with those using the ER splint (Group B) before and after the intervention. The primary outcome was difference in the level of pain based on the visual analogue scale (VAS) and the pulmonary function (PF) variables between before and after intervention in each group during forceful and resting respiration.

Results: A total of 24 subjects were enrolled in this study. The VAS results showed that the intervention was significantly effective in each group (before vs after: Group A resting: 8.50 ± 1.05 vs 4.17 ± 1.33, P < .001; Group A forceful: 9.83 ± 0.41 vs 7.17 ± 0.75, P < .001; Group B resting: 8.83 ± 1.60 vs 4.50 ± 1.38, P < .001; and Group B forceful: 9.67 ± 0.82 vs 7.33 ± 1.51, P = .003). The PF variables showed that the intervention was significantly effective in each group (before vs after: Group A, FVC: 2.74 ± 0.92 vs 3.35 ± 0.99, P < .001; FEV1: 2.16 ± 0.74 vs 2.57 ± 0.78, P = .001; PEF: 235.30 ± 43.06 vs 319.00 ± 51.58, P = .004; and Group B, FVC: 2.02 ± 0.49 vs 2.72 ± 0.62, P < .001; FEV1: 1.27 ± 0.25 vs 1.91 ± 0.37, P < .001; PEF: 216.67 ± 67.49 vs 300.33 ± 87.79, P = .003).

Conclusion: Applying either the CCO or the ER splint to RF patients effectively reduced pain, and no significant differences in pain level were observed between these 2 techniques.