Treatment for Rib Fractures

Phase-Based Estimates
3
Effectiveness
3
Safety
Spectrum Health Hospital, Grand Rapids, MI
Rib Fractures+4 More
Eligibility
18+
All Sexes
Eligible conditions
Rib Fractures

Study Summary

This study is evaluating whether ketamine or lidocaine may help reduce pain and improve breathing for patients with rib fractures.

See full description

Eligible Conditions

  • Rib Fractures
  • Fractures, Multiple
  • Fractures, Bone
  • Rib Trauma
  • Rib Fracture Multiple

Treatment Effectiveness

Effectiveness Estimate

3 of 3
This is better than 93% of similar trials

Study Objectives

This trial is evaluating whether Treatment will improve 9 secondary outcomes in patients with Rib Fractures. Measurement will happen over the course of 0-30 days post infusion.

Hour 72
Incentive Spirometry
Visual Analogue Numeric Pain Score
0-30 days post infusion
Use of Regional/Neuraxial anesthesia
0-30 days post-infusion
Respiratory Failure
0-72 hours post infusion
Adverse events
Hour 72
Oral Morphine Equivalent - Opioid Usage
Will capture retrospectively after patient's medical discharge
Hospital Length of Stay
In-Hospital mortality
Intensive Care Unit Length of stay

Trial Safety

Safety Estimate

3 of 3
This is better than 85% of similar trials

Trial Design

2 Treatment Groups

Lidocaine

This trial requires 74 total participants across 2 different treatment groups

This trial involves 2 different treatments. Treatment is the primary treatment being studied. Participants will all receive the same treatment. There is no placebo group. The treatments being tested are in Phase 4 and have been shown to be safe and effective in humans.

Lidocaine
Drug
Infusion initiation: 1 mg/kg/hr Max: 2 mg/kg/hr Recommended titration:0.25 mg/kg/hr* as needed every 4 hours based on pain scores ≥5 and physician order Dosing will be based on patient actual body weight (ABW) recorded as dosing weight on time of hospital admission.
Ketamine
Drug
Infusion initiation: 0.1 mg/kg/hr Max: 0.3 mg/kg/hr Recommended titration: 0.1 mg/kg/hr* as needed every 4 hours based on pain scores ≥5 and physician order Dosing will be based on patient actual body weight (ABW) recorded as dosing weight on time of hospital admission.

Trial Logistics

Trial Timeline

Approximate Timeline
Screening: ~3 weeks
Treatment: Varies
Reporting: 24-48; 48-72 hours post infusion
This trial has the following approximate timeline: 3 weeks for initial screening, variable treatment timelines, and roughly 24-48; 48-72 hours post infusion for reporting.

Closest Location

Spectrum Health Hospital - Grand Rapids, MI

Eligibility Criteria

This trial is for patients born any sex aged 18 and older. There are 4 eligibility criteria to participate in this trial as listed below.

Mark “yes” if the following statements are true for you:
Adults ≥ 18 years old
≥ 3 traumatic blunt rib fractures
Enrollment within 16 hours of being admitted to the hospital
Patients whom in the investigator's clinical judgement, would require escalated pain control regiments in the future and would potentially benefit from participation in this study in terms of pain control.

Patient Q&A Section

Please Note: These questions and answers are submitted by anonymous patients, and have not been verified by our internal team.

Can rib fractures be cured?

Add answer

Risk of death is similar in cases with healed fractures and patients who die without a fracture (HR 1.7). After adjusting for potential confounders, a reduced risk of death (HR 0.70) in patients with healed fractures is shown, which suggests a true relationship between healing and mortality.

Unverified Answer

What are the signs of rib fractures?

Add answer

An X-ray should be considered in the clinical assessment of the patient with a suspected thoracic injury or suspected rib fracture. We recommend that an X-ray be performed on an injured and painless side of the thorax. A radiograph of the ipsilateral ribs can be considered to be an unnecessary test unless there is suspicion of an fractures on the opposite side.

Unverified Answer

What are common treatments for rib fractures?

Add answer

Rib fractures are uncommon and relatively minor injuries, and patients do not commonly travel to specialized centers for their treatment, which is widely available in the community. However, rib fractures are potentially serious injuries requiring the expertise of a medical professional who manages the injuries on a medical emergency basis. The authors believe that patients with rib fractures will ultimately go to hospitals that recognize the potential for life-threatening injuries and have the staff trained and equipped to manage the injury and to render all medically necessary treatment in an efficient manner. Primary care physicians should be aware of the potential for rib fractures, because they may be treated as minor injuries that heal on their own, or they may even result in a missed diagnosis of a life-threatening illness.

Unverified Answer

What is rib fractures?

Add answer

There is a growing number of rib fractures presenting to the emergency department. They are not always associated with recent trauma or with rib fractures. Therefore, the diagnosis of a rib fracture is rarely missed by a hospitalist.

Unverified Answer

What causes rib fractures?

Add answer

There is a higher incidence of rib fractures, particularly those caused by high speed movement. The incidence of vertebral fractures and pelvic fractures are similar to those in Western countries. As a result of bone remodelling, women had more fractures than men. The increased fracture incidence in women may reflect the higher bone density of women, possibly due to the higher estradiol levels seen in early pregnancy.

Unverified Answer

How many people get rib fractures a year in the United States?

Add answer

About 1 million Americans sustain rib fractures a year. Most of these patients will have been older than 65, and the mean age of rib fractures on a year is between 60 and 69 years. Women are more susceptible, especially in the 30-49 year age group, to rib fractures and fractures to the clavicles and thoracic spine. The incidence of pneumothoraces is also greater in women (9% versus 3%. The mean age for women with pneumothoraces is 59 years and for men 46 years. In these reports rib fractures account for 50% of acute fractures in children and teens and 12% of all fractures.

Unverified Answer

Does rib fractures run in families?

Add answer

The present study was designed to evaluate the hypothesis that (1) other types of fractures in the same individual increase their risk for the same type of fractures and (2) individuals with rib fractures are more likely than control cohorts to develop fractures in other locations. Although our findings supported the first hypothesis concerning the frequency of fracture recurrence for the same fracture type and also provided support for the second hypothesis, only the second type of recurrence was significantly increased. Results from a recent clinical trial did not support the hypothesis of an increased incidence of rib fracture recitation.

Unverified Answer

Does treatment improve quality of life for those with rib fractures?

Add answer

The QOL was not improved by the treatment, but some pain reduction was observed. Overall, rib fractures carry an excellent prognosis with pain management being the main determinant of patient outcome.

Unverified Answer

Who should consider clinical trials for rib fractures?

Add answer

Patients who are older, have preoperative cognitive impairment, or have other pre-existing medical problems do not seem to be good candidates for clinical trials requiring rib reconstruction.

Unverified Answer

Has treatment proven to be more effective than a placebo?

Add answer

There is no difference in fracture healing in a rabbit model treated with either an experimental or a control group. However, the combination of morphine and paracetamol resulted in more bone formation, with larger cortical dimensions and trabecular dimensions than other groups. The combination of morphine and paracetamol is not an alternative treatment to a placebo, and is potentially more harmful.

Unverified Answer

Is treatment typically used in combination with any other treatments?

Add answer

Because most patients received treatment for the primary condition, data on the treatment being given after fracture for fractures of the head and neck are available for only 10% of the cases. Treatment for fractures is less usual when considering other treatments, except that in the large majority of cases, patients were treated for the condition or were in a clinical trial with which it was possible to make those decisions.

Unverified Answer

What is the average age someone gets rib fractures?

Add answer

Rib fractures are more common among young children and young adults, not children and elderly people. Recent findings shows one in fourteen children are reported to have rib fractures in emergency departments. Furthermore, rib fracture treatment was rarely undertaken in this study and most fractured ribs were treated conservatively. There are many options for children with rib fractures such as analgesic painkilling medications, splinting, traction, and casting. However, the best treatment option is dictated by various factors such as the child's age, physical examination, medical history, and the cost and duration of treatment. To achieve maximum patient safety and best outcomes, all rib fractures should be accurately diagnosed and treated under a clear clinical pathway.

Unverified Answer
See if you qualify for this trial
Get access to this novel treatment for Rib Fractures by sharing your contact details with the study coordinator.