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A major study into effective treatment for broken ribs is being supported by researchers and surgeons in Nottingham who will analyse data and samples from over 100 surgeical patients to understand why patients undergoing surgery have better outcomes.

The ORiF research study is studying the potential benefit of performing surgery to repair broken ribs. Now the companion OPERA study, being delivered through a collaboration between Orthopaedic surgeons at Nottingham University Hospitals NHS Trust, the British Orthopaedic Association and the Musculoskeletal Theme of the Nottingham Biomedical Research Centre, will enable detailed analysis of samples from 108 injured patients who are taking part in the ORiF study.

The OPERA (Orif Procedure mEchanisms of Rib fixation) study will measure the levels of chemical imbalances in patients being treated for broken ribs to see if the effect of reducing pain and hypoxia from surgery reduces inflammation as well. 

Broken ribs are a serious injury affecting both young and older people and usually caused by a serious accident such as a car crash. They cause pain and difficulties in breathing. 

Both pain and loss of oxygen (hypoxia) cause a response in the body which results in excessive inflammation. When patients can’t breathe deeply or cough, they are more likely to get a chest infection. 

Our bodies normally release chemicals into our blood to fight infection or heal injuries. When the levels of these chemicals are too high it can cause organ failure or death. This is called “systemic inflammatory response syndrome” (SIRS) and is common in severely injured patients. Some patients also lose a large amount of muscle and these people seem more likely to perish. 

The study will help researchers understand what molecules are altered when surgery is performed to repair a person’s broken ribs which help to prevent serious illness or even death. It will identify who develops a chemical imbalance after broken ribs, and who does better after surgery.

This embedded study will use biological data, data from the ORiF study and a large national dataset of injuries. It will measure substances produced by blood cells during healing and muscle loss and looking at scans performed during the care of these patients to assess their muscles.

It will also measure the types of bacteria present within the gut and a substance produced by harmful bacteria to measure leakiness to discover if bacteria are moving from the gut. The study will make comparisons between people with broken ribs who receive an operation, and those who don’t. 

Statistical modelling will also show which of the things being measured are important, and how they may affect patients’ recovery. This will allow the development of targeted new treatments to go with surgery.