What is the incidence of rib fractures with cardiac surgery?

From the Research

Rib fractures occur in approximately 35.0% of cases after median sternotomy in cardiac surgery, as reported in the most recent study 1. The incidence of rib fractures with cardiac surgery is a significant concern, as it can lead to increased morbidity and mortality.

• The risk of rib fractures increases in elderly patients, those with osteoporosis, or when excessive force is applied during the procedure.
• In minimally invasive cardiac surgeries, which access the heart through smaller incisions between the ribs, the risk of rib fracture is lower but still present.
• Rib fractures during heart surgery typically heal within 6-8 weeks, and while painful, they generally don't cause long-term complications.
• The benefit of the life-saving cardiac procedure far outweighs the temporary discomfort of healing ribs.
• Pain management strategies, including medication and physical therapy, are routinely provided to help patients manage discomfort during recovery. The most recent study 1 found that the incidence of brachial plexus injury and upper rib fractures after median sternotomy was 0.95% and 35.0%, respectively.
• The usage of asymmetric sternal retractors to harvest left internal thoracic artery (LITA) significantly affected the side of fracture.
• Sternal retractors utilized during open-heart surgeries through median sternotomy may cause rib fractures and brachial plexus injury, so operators should be aware of these complications. It is essential to note that the incidence of rib fractures can vary depending on the type of cardiac surgery and the patient's underlying conditions.
• A study published in 2023 1 provides the most recent and highest quality evidence on the incidence of rib fractures with cardiac surgery.
• This study found that rib fractures occur in approximately 35.0% of cases after median sternotomy in cardiac surgery.
• The study also highlights the importance of awareness of these complications among operators and the need for proper pain management strategies to help patients manage discomfort during recovery.