Randomized Control Trial, Cryoablation as an Adjunct to Surgical Stabilization of Rib Fractures

Inclusion Criteria:

• The patient is admitted to the trauma service.

• The patient has multiple displaced rib fractures (≥2 ribs), offered fixation, andconsents to SSRF

• The patient is not being treated for chronic pain

• The patient is >18 years of age.

• Surgery anticipated <120 hours from injury

Exclusion Criteria:

• Age < 18 years or ≥ 80 years

• Flail chest: either radiographic or clinical. Radiographic flail chest is defined onCT chest as ≥ 2 ribs each fractured in ≥ 2 places. Clinical flail is defined asvisualization of a segment of chest wall with paradoxical motion on physical exam.

• Moderate or severe traumatic brain injury (Intra-cranial hemorrhage visualized on CThead with GCS at the time of consideration for enrollment < 12)

• Prior or expected emergency exploratory laparotomy during this admission

• Prior or expected emergency thoracotomy during this admission

• Prior or expected emergency craniotomy during this admission

• Spinal cord injury

• Pelvic fracture that has required, or is expected to require, operative interventionduring this admission

• The patient was unable to accomplish activities of daily living independently priorto injury (e.g., dressing, bathing, preparing meals)

• The patient is incarcerated

• The patient is known to be pregnant

• Unable to perform Video Assisted Thoracoscopy (VATS) at time of SSRF due to lungisolation or previous pathology