Costal cartilage resection with or without rib resection is the gold standard surgery for slipping rib syndrome. Minimally invasive restoration of normal anatomy via nonabsorbable sutures has been described in the adult population with encouraging results. We sought to assess the efficacy of minimally invasive sutured fixation of the hypermobile rib in the pediatric population. A retrospective review was performed at Mayo Clinic involving 31 pediatric patients diagnosed with slipped rib syndrome. Minimally invasive sutured open reduction internal fixation was performed between 2020 and 2022. The standardized Örebro Musculoskeletal Pain Screening Questionnaire was given at dedicated time points pre- and post-operatively to assess efficacy. Significance was determined via the Wilcoxon rank sum test. SRS was diagnosed clinically in 31 patients (24 females, 7 males, 1220 years-old). Symptoms were present for an average of 18.9 months and patients had seen an average of 4.7 specialists. Traumatic causes were identified in three patients and eight patients had hypermobility. At one month follow up, there were no surgical complications and patients reported significantly less pain (p < 0.001). Preoperative analgesics reduced by 80%. Ultimately, seven patients underwent a second operation; three patients underwent a third operation; one patient underwent five total operations. Recurrent pain was reported in six patients. Only nine patients followed-up at 1-year post-operation. Pediatric patients with SRS demonstrated an early positive response to suture fixation without costal cartilage excision. Reoperation and recurrent pain, however, remain significant in this population. Level IV. Case series with no comparison group.

中文翻译：

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微创缝合固定儿童肋骨滑脱的一年结果

肋软骨切除联合或不联合肋骨切除是治疗肋骨滑动综合征的金标准手术。通过不可吸收缝合线微创恢复正常解剖结构已在成年人中得到描述，并取得了令人鼓舞的结果。我们试图评估微创缝合固定过度活动肋骨在儿科人群中的疗效。梅奥诊所对 31 名被诊断患有肋骨滑脱综合征的儿科患者进行了回顾性审查。 2020 年至 2022 年间进行了微创缝合切开复位内固定术。在术前和术后的特定时间点进行了标准化的厄勒布鲁肌肉骨骼疼痛筛查问卷，以评估疗效。通过 Wilcoxon 秩和检验确定显着性。临床诊断SRS的患者31例（女性24例，男性7例，年龄1220岁）。症状平均持续 18.9 个月，患者平均看过 4.7 名专家。三名患者有外伤原因，八名患者活动过度。一个月随访后，没有出现手术并发症，患者报告疼痛明显减轻 (p < 0.001)。术前止痛药减少80%。最终，7名患者接受了第二次手术；三名患者接受了第三次手术；一名患者总共接受了五次手术。六名患者报告了复发性疼痛。只有 9 名患者在术后 1 年进行了随访。患有 SRS 的儿科患者对缝合固定（无需切除肋软骨）表现出早期积极反应。然而，再次手术和复发性疼痛在这一人群中仍然很严重。四级。无对照组的病例系列。