Details

Autor(en) / Beteiligte

• Luceri, Robert E.
• Glass, Nina E.
• Bailey, Joanelle A.
• Sifri, Ziad C.
• Kunac, Anastasia
• Bonne, Stephanie L.
• Yonclas, Peter P.
• Mosenthal, Anne C.
• Livingston, David H.

Titel

First rib fracture: A harbinger of severe trauma?

Ist Teil von

• The American journal of surgery, 2018-10, Vol.216 (4), p.740-744

Ort / Verlag

United States: Elsevier Inc

Erscheinungsjahr

2018

Link zum Volltext

Quelle

MEDLINE

Beschreibungen/Notizen

• Prior to routine CT scanning, first rib fractures (FRFs) were considered a harbinger of great vessel injuries. We hypothesized FRFs identified on screening CXR have significant associated injuries, while those identified on CT alone do not. We reviewed adult blunt thoracic trauma patients 2014–2015 to identify all FRFs and then tabulated demographics, injury characteristics, and outcomes. Of 429 patients with chest trauma, 56 had a FRF. CXR diagnosed 20% and CT 80%. Those diagnosed on CXR were older (61 vs 48 p = 0.03), had more severe chest trauma (45% vs 13% chest AIS>3, p = 0.029), longer ICU stays (10 vs 4 days, p = 0.046), and risk for intubation (73% vs 27%, p = 0.011). There was only one major vascular injury in each group. Most FRF patients had associated injuries, including 82% with pelvic fractures. Widespread use of CT scanning has resulted in a 5-fold increase in FRF diagnoses. While vascular injuries are not common, especially when identified on initial CXR, FRFs correlate with morbidity and associated injuries. •First rib fractures are seen 5 times more in the era of widespread use of CT scan.•First rib fractures are not a harbinger of great vessel injury.•When seen on CXR, FRFs are associated with morbidity and associated injuries.