Traumatic rib fractures are common injuries following blunt chest trauma, often requiring chest tube insertion to manage complications such as pneumothorax or haemothorax. However, chest tube placement can lead to intercostal nerve injury, resulting in intercostal neuralgia-a debilitating condition characterized by chronic, neuropathic pain along the intercostal nerves. Despite its clinical significance, the incidence, risk factors, and long-term outcomes of intercostal neuralgia in this patient population remain poorly understood.
Chronic pain following thoracic trauma, including intercostal neuralgia, has been shown to significantly impair quality of life and functional outcomes, leading to prolonged disability and increased healthcare utilization. Current literature highlights the need for better understanding and management of this condition, particularly in patients undergoing invasive procedures such as chest tube insertion. This study aims to prospectively evaluate the development of intercostal neuralgia in patients with chest tube insertion following traumatic rib fractures.
Adults (≥18 years) with traumatic rib fractures requiring chest tube insertion
Chest tube or pigtail insertion performed during their initial hospitalization for trauma
Patients with spinal cord injury
Inability to complete follow-up assessments (e.g., language barriers, lack of telephone access)
Patients with traumatic brain injury
Patients with spinal cord injury
Patients with acute traumatic rib fractures requiring chest tube insertion for management.
Cohort
Prospective
Chest tube insertion
Procedure/SurgeryInsertion of chest tube
Incidence of intercostal neuralgia
To determine the incidence of intercostal neuralgia in patients undergoing chest tube insertion after traumatic rib fractures. Presence of neuropathic pain to be assessed using S-LANSS (score of 12 or more suggests pain of predominantly neuropathic origin)
Assess the impact of intercostal neuralgia on quality of life and functional outcomes
Assess the impact of intercostal neuralgia on quality of life using EQ-5D-5L (assesses 5 dimensions, with 1 indicating 'no problems' and 5 indicating 'extreme problems')
Assess the impact of intercostal neuralgia on quality of life and functional outcomes
Assess the impact of intercostal neuralgia on quality of life using Promis 6a Sleep questionnaire (scale 1 to 5, with higher numbers indicating poor outcomes and lower numbers indicating good outcomes)
Assess the impact of intercostal neuralgia on medication use
Determine the impact of intercostal neuralgia on medication use including opioids and anti-neuropathic medications by collection and assessment of quantity of medications taken for pain relief related to intercostal neuralgia.
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