Ask to take part

Contact the study team using the details below to take part. If there are no contact details below please ask your doctor in the first instance.

Contact Information:

Prof Benjamin Ollivere
+44 (0)1158 231115
Benjamin.Ollivere@nottingham.ac.uk


Mr Nicholas Beale
+44 (0)1865 613756
orif@ndorms.ox.ac.uk


More information about this study, what is involved and how to take part can be found on the study website.

Study Location:

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Be Part of Research - Trial Details - The Operative Rib Fixation (ORiF) study

The Operative Rib Fixation (ORiF) study

Medical Conditions

Rib fractures


This information is provided directly by researchers, and we recognise that it isn't always easy to understand. We are working with researchers to improve the accessibility of this information. In some summaries, you may come across links to external websites. These websites will have more information to help you better understand the study.


Rib fractures are a common injury. They usually occur as a result of a serious injury, such as those suffered in a road traffic accident or falling from a height. They can also occur in less traumatic accidents, often in elderly people who have fragile bones. Rib fractures are painful and can cause problems with breathing. Lung tissue sits just underneath the ribs and when a fracture occurs, the lungs are also often injured. As a result, rib fractures can lead to problems such as pneumonia, pulmonary effusions (the build-up of fluid in the lungs due to swelling), and some patients can even die as a result of the injury. Most rib fractures are treated without the need for an operation. Doctors use supportive treatments such as pain relief and physiotherapy to help patients recover. Fractures in other bones are usually fixed with an operation that secures the broken bones using metal plates and screws. Recently surgeons have found that some rib fractures can also be fixed in this way. They have also found patients are recovering better with an improvement to their quality of life. However, surgery always carries some risk, especially in patients who have had major injuries. It is not known whether surgical treatment, and its risks, is better than the current non-operative/supportive treatments. The aim of this study is to compare rib fixation with plates and screws to the supportive treatments currently available in the NHS.

Start dates may differ between countries and research sites. The research team are responsible for keeping the information up-to-date.  

The recruitment start and end dates are as follows:

01 Apr 2019 31 Jul 2024

Participants are randomly allocated to receive either supportive treatments, as is the standard care, or to also undergo an operation to stabilise their rib fractures. Patient outcomes (survival after the injury and quality of life, among other things) and also the cost of treatment to the NHS are measured up until study completion at 12 months. Most of the information is routinely collected in hospitals through an existing system, but some other details are collected directly from patients by specialist research nurses at routine visits to the clinic.


Patients with three or more rib fractures suitable for surgical repair and one or more of the following: clinical flail chest, breathing difficulty requiring support, and uncontrollable pain using standard modalities

You can take part if:



You may not be able to take part if:


1. Aged under 16 years2. Thoracic injury requiring emergent operative or interventional radiology3. Cannot be operated on within 72 hours as deemed unfit for surgery

Added 06/10/2021:4. Unwilling or unable to comply with protocol follow up requirements5. Any other significant disease or condition which, in the opinion of the local research team, may influence the results of the trial or the patient’s ability to participate in the trial


Below are the locations for where you can take part in the trial. Please note that not all sites may be open.

  • Glenfield Hospital
    Groby Road
    Leicester
    LE3 9QP
  • Southmead Hospital
    Southmead Road Westbury-on-trym
    Bristol
    BS10 5NB
  • University Hospital of Wales
    Heath Park
    Cardiff
    CF14 4XW
  • St. Mary's Hospital
    Imperial College Healthcare NHS Trust Praed Street
    London
    W2 1NY
  • Hull Royal Infirmary
    Anlaby Road
    Hull
    HU3 2JZ
  • Derriford Hospital
    Derriford Road Derriford
    Plymouth
    PL6 8DH
  • Kings College Hospital
    Denmark Hill
    London
    SE5 9RS
  • Manchester Royal Royal Infirmary
    Cobbett House Oxford Road
    Manchester
    M13 9WL
  • Bristol Royal Infirmary
    Marlborough Street
    Bristol
    BS2 8HW
  • The James Cook University Hospital
    South Tees Hospitals NHS Foundation Trust Marton Road
    Middlesbrough
    TS4 3BW
  • Queen's Medical Centre
    Nottingham University Hospitals NHS Trust Derby Road
    Nottingham
    NG7 2UH
  • John Radcliffe Hospital
    Oxford University Hospitals NHS Foundation Trust Headley Way
    Oxford
    OX3 9DU
  • Queen Elizabeth Hospital
    University Hospitals Birmingham NHS Foundation Trust Mindelsohn Way
    Birmingham
    B15 2GW
  • Morriston Hospital
    Swansea Bay University Health Board Morriston
    Swansea
    SA6 6NL
  • Royal London Hospital
    Barts Health NHS Trust Whitechapel Road
    London
    E1 1FR
  • Aintree University Hospital
    Liverpool University Hospitals NHS Foundation Trust Lower Lane
    Liverpool
    L9 7AL
  • Aberdeen Royal Infirmary
    Grampian Health Board Summerfield House 2 Eday Road
    Aberdeen
    AB15 6RE

Both supportive management and operative rib fixation are already routinely carried out in the NHS. However, surgery always carries some risk, especially in patients who have experienced major injuries. Although there is some evidence to suggest a reduced length of hospital stay and improved quality of life in some patients who undergo operative rib fixation, a benefit cannot be guaranteed to those who take part in this study. The results from the study are likely to benefit future patients with multiple rib fractures, as it is not known whether the surgery, and its risks, are better than the current non-operative, supportive treatments.

Prof Benjamin Ollivere
+44 (0)1158 231115
Benjamin.Ollivere@nottingham.ac.uk


Mr Nicholas Beale
+44 (0)1865 613756
orif@ndorms.ox.ac.uk



More information about this study, what is involved and how to take part can be found on the study website.


The study is sponsored by Nottingham University Hospitals NHS Trust and funded by Health Technology Assessment Programme.




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Read full details for Trial ID: ISRCTN10777575

Or CPMS 40063

Last updated 27 February 2025

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