Bilateral First Rib Fractures in Blunt Trauma Patients: A Retrospective Study
Ashraf Fathi Hefny1,2, Nirmin A Mansour3, Mai A Fathi4
1Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, United Arab Emirates.
Journal of Emergencies, Trauma, and Shock
|April 28, 2025
Summary
Bilateral first rib fractures (BFRF) are rare in blunt trauma, often caused by high-energy impacts. Associated injuries, not the fracture itself, are the primary cause of morbidity in these patients.
Area of Science:
- Trauma Surgery
- Orthopedic Surgery
- Emergency Medicine
Background:
- Unilateral first rib fractures can cause severe complications like brachial plexus or vascular injury.
- Bilateral first rib fracture (BFRF) is an exceptionally rare injury pattern in blunt trauma.
- Understanding BFRF is crucial for effective trauma management.
Purpose of the Study:
- To determine the incidence of BFRF in blunt trauma patients.
- To analyze the mechanisms of injury, management strategies, and patient outcomes for BFRF.
- To compare the complication profile of BFRF with unilateral first rib fractures.
Main Methods:
- Retrospective data collection of blunt trauma patients with BFRF from December 2014 to January 2017.
- Inclusion criteria: blunt trauma patients admitted with BFRF.
- Data points: demography, injury mechanism, injury severity, associated injuries, management, and outcomes.
Main Results:
- BFRF occurred in 12 (0.25%) of 4779 blunt trauma patients.
- Mean age was 29 years; common mechanisms included road traffic collisions and falls from height.
- Lung contusions were the most frequent associated thoracic injury; no fatalities were reported.
Conclusions:
- BFRF is a rare consequence of high-energy blunt trauma.
- Vascular or brachial plexus injuries are less common in BFRF than in unilateral fractures.
- Associated injuries are the main drivers of morbidity, not the BFRF itself.
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