{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,31]],"date-time":"2026-07-31T18:13:31Z","timestamp":1785521611166,"version":"3.56.0"},"reference-count":16,"publisher":"Springer Science and Business Media LLC","issue":"4","license":[{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T00:00:00Z","timestamp":1773878400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Bursa Uludag University"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Updates Surg"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    The role of surgical stabilization of rib fractures (SSRF) in older adults remains uncertain, particularly regarding functional recovery and long-term pain. This study examined whether chronological age influences postoperative outcomes and evaluated the performance of injury-severity scoring systems in geriatric patients undergoing SSRF. This retrospective cohort included 524 adults who underwent SSRF between 2012 and 2023. Patients were stratified into non-geriatric (&lt;\u200965 years,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009331) and geriatric (\u2265\u200965 years,\n                    <jats:italic>n<\/jats:italic>\n                    \u2009=\u2009193) groups. Demographics, injury characteristics, perioperative outcomes, pain trajectories, and functional recovery were compared. Predictors of postoperative complications and chronic pain were assessed using univariate and multivariate logistic regression. Correlations between clinical outcomes and RibScore, AIS-Thorax, and BPC18 were analyzed using Spearman coefficients. Geriatric patients were more often injured by low-energy falls and had higher rates of pulmonary contusion (74.6% vs. 63.9%) yet demonstrated complication rates similar to younger adults (14.0% vs. 12.7%,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.696). Pain trajectories were comparable across all follow-up intervals. Functional recovery was slower in older adults, who required an additional month to return to baseline activity (median 3 vs. 2 months,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). The number of fractured ribs on the operated side independently predicted postoperative complications (OR 1.863, 95% CI 1.396\u20132.487,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001), whereas age was not an independent predictor. Longer time-to-surgery (OR 1.341,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.001), longer hospitalization (OR 1.059,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.044), and postoperative complications (OR 1.941,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.036) independently predicted chronic pain. AIS-Thorax showed the strongest correlations with clinical outcomes, while all three scoring systems demonstrated weak associations with postoperative pain. In appropriately selected patients, SSRF provides comparable safety and pain recovery across age groups. Although functional recovery is slower in older adults, overall outcomes remain favorable. These findings support shifting from age-based to physiology-based decision-making for SSRF.\n                  <\/jats:p>","DOI":"10.1007\/s13304-026-02597-8","type":"journal-article","created":{"date-parts":[[2026,3,19]],"date-time":"2026-03-19T12:51:10Z","timestamp":1773924670000},"page":"1757-1763","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Surgical stabilization of rib fractures in older adults: a retrospective cohort study"],"prefix":"10.1007","volume":"78","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2228-6439","authenticated-orcid":false,"given":"Erhan","family":"\u00d6zer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Teoman","family":"Ekim","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2026,3,19]]},"reference":[{"issue":"6","key":"2597_CR1","doi-asserted-by":"publisher","first-page":"1040","DOI":"10.1097\/00005373-200006000-00007","volume":"48","author":"EM Bulger","year":"2000","unstructured":"Bulger EM, Arneson MA, Mock CN, Jurkovich GJ (2000) Rib fractures in the elderly. J Trauma - Injury Infect Crit Care 48(6):1040\u20131046","journal-title":"J Trauma - Injury Infect Crit Care"},{"key":"2597_CR2","doi-asserted-by":"crossref","unstructured":"Qureshi I, Kharel R, Mujahid N, Neupane I (2023) Rib Fracture Management in Older Adults: A Scoping Review. J Brown Hosp Med. ;2(3)","DOI":"10.56305\/001c.82211"},{"key":"2597_CR3","doi-asserted-by":"publisher","first-page":"295","DOI":"10.1016\/j.bone.2018.08.016","volume":"116","author":"HT Mai","year":"2018","unstructured":"Mai HT, Tran TS, Ho-Le TP, Pham TT, Center JR, Eisman JA et al (2018) Low-trauma rib fracture in the elderly: Risk factors and mortality consequence. Bone 116:295\u2013300","journal-title":"Bone"},{"issue":"2","key":"2597_CR4","doi-asserted-by":"publisher","first-page":"161","DOI":"10.1093\/ageing\/afz157","volume":"49","author":"R Coary","year":"2020","unstructured":"Coary R, Skerritt C, Carey A, Rudd S, Shipway D (2020) New horizons in rib fracture management in the older adult. Age Ageing 49(2):161\u2013167","journal-title":"Age Ageing"},{"key":"2597_CR5","doi-asserted-by":"publisher","first-page":"221","DOI":"10.1016\/j.jss.2022.02.055","volume":"276","author":"E Sawyer","year":"2022","unstructured":"Sawyer E, Wullschleger M, Muller N, Muller M (2022) Surgical Rib Fixation of Multiple Rib Fractures and Flail Chest: A Systematic Review and Meta-analysis. J Surg Res 276:221\u2013234","journal-title":"J Surg Res"},{"issue":"1","key":"2597_CR6","first-page":"1","volume":"19","author":"G Sermonesi","year":"2024","unstructured":"Sermonesi G, Bertelli R, Pieracci FM, Balogh ZJ, Coimbra R, Galante JM et al (2024) Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper. World J Emerg Surg 2024 19(1):1\u201335","journal-title":"World J Emerg Surg 2024"},{"issue":"3","key":"2597_CR7","doi-asserted-by":"publisher","first-page":"357","DOI":"10.1097\/SLA.0000000000005950","volume":"278","author":"DE Meyer","year":"2023","unstructured":"Meyer DE, Harvin JA, Vincent L, Motley K, Wandling MW, Puzio TJ et al (2023) Randomized Controlled Trial of Surgical Rib Fixation to Nonoperative Management in Severe Chest Wall Injury. Ann Surg 278(3):357\u2013365","journal-title":"Ann Surg"},{"issue":"1","key":"2597_CR8","doi-asserted-by":"publisher","first-page":"205","DOI":"10.1007\/s00068-020-01526-7","volume":"48","author":"W Duong","year":"2022","unstructured":"Duong W, Grigorian A, Nahmias J, Farzaneh C, Christian A, Dolich M et al (2022) An increasing trend in geriatric trauma patients undergoing surgical stabilization of rib fractures. 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Written informed consent was obtained from all patients or their legal representatives. The study was conducted in accordance with the principles of the Declaration of Helsinki.","order":2,"name":"Ethics","label":"Ethics approval","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Not applicable.","order":3,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}}]}}