{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T00:43:39Z","timestamp":1777596219492,"version":"3.51.4"},"reference-count":43,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2021,5,23]]},"published-print":{"date-parts":[[2021,6]]},"abstract":"<jats:p>The gold standard for rib fracture nonunion management remains a matter of debate. Operative treatment of rib fracture nonunion has become increasingly popular. A 69-year-old man was operatively treated with intercostal neurectomy of the left eighth rib to resolve chronic thoracic pain following a rib fracture nonunion. After the intervention, the patient developed a flank bulge which was most likely due to the intercostal neurectomy, causing partial denervation of the abdominal musculature. Although the pain at the nonunion site decreased after the operative intervention, the patient still experienced severe pain during daily activities and reported poor quality of life due to the flank bulge. Physiotherapy and an abdominal belt did not improve this flank bulge. When considering operative neurectomy of the intercostal nerves of ribs 7\u201312 to resolve chronic pain due to rib fracture nonunion, the treating surgeon should be aware of this debilitating complication.<\/jats:p>","DOI":"10.1136\/bcr-2021-242041","type":"journal-article","created":{"date-parts":[[2021,6,11]],"date-time":"2021-06-11T10:40:13Z","timestamp":1623408013000},"page":"e242041","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":3,"title":["Abdominal flank bulge following intercostal neurectomy for symptomatic rib fracture nonunion"],"prefix":"10.1136","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5782-9520","authenticated-orcid":false,"given":"Jonne T H","family":"Prins","sequence":"first","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mathieu M E","family":"Wijffels","sequence":"additional","affiliation":[{"name":"Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center, Rotterdam, Zuid-Holland, The Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2021,6,11]]},"reference":[{"key":"2025082702421848000_14.6.e242041.1","doi-asserted-by":"publisher","DOI":"10.2106\/JBJS.I.00696"},{"key":"2025082702421848000_14.6.e242041.2","doi-asserted-by":"publisher","DOI":"10.1016\/j.surg.2005.07.022"},{"key":"2025082702421848000_14.6.e242041.3","doi-asserted-by":"crossref","first-page":"1023","DOI":"10.1007\/s00113-015-0026-7","article-title":"[Bony injuries of the thoracic cage in multiple trauma : Incidence, concomitant injuries, course and outcome] Knocherne Verletzung der Brustwand beim Polytrauma : Inzidenz, Begleitverletzungen, Verlauf und 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