Relation Between Injury Severity and Fractures of the First and/or Second Ribs in Blunt Chest Trauma at a
Ashraf F Hefny1,2, Sara E Aldhaheri1, Fatima Aldhaheri1
1Department of Surgery, College of Medicine and Health Sciences, UAE University, Al Ain, UAE, uaeu.ac.ae.
Objective:
Trauma is a major global health concern that contributes significantly to morbidity and mortality worldwide. Road traffic collisions (RTCs) are the most common cause of blunt chest trauma (BCT). First and/or second rib fractures (FSRFs) are often indicative of high-energy trauma. This study investigated the incidence, mechanisms of injury, management, and outcomes of FSRF in patients with BCT at a community-based hospital.
Methods:
Data were retrospectively collected from all patients with BCT admitted to Al Ain Hospital between December 2014 and January 2020. Data for patients with FSRF were specifically reviewed. Information was obtained from the Al Ain Hospital Trauma Registry, which included all patients of all age groups who were admitted to the hospital or died in the emergency department during the study period.
Results:
During the study period, 958 patients with BCT were admitted to our institution, of whom 86 (9%) had FSRF. The most common mechanism of trauma was RTC in 62 (72.1%) patients. Patients with FSRF had significantly higher injury severity scores than those of patients with BCT without FSRF. Three patients with FSRF died (overall mortality, 3.5%) compared with 17 (1.9%) patients without FSRF. This difference was not statistically significant (p = 0.341, chi-squared test).
Conclusions:
This study is consistent with previous reports demonstrating that FSRFs are associated with high-energy trauma and potentially serious intrathoracic and extrathoracic injuries. The importance of these fractures in blunt trauma should be recognized to endorse close monitoring and timely therapeutic intervention, which is supported by existing literature.
Related Concept Videos
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:24Flail Chest-I
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
01:27Fractures: Bone Repair
Minor fractures with no bone displacement are treated by immobilizing the fractured bone using a cast or splint. However, in the case of fractures with displaced bones, the broken bones are repositioned before immobilization to ensure successful healing without deformation and loss of function. The realignment of fractured bone ends is performed through a process called reduction. If the procedure...
01:17The Thoracic Cage: Sternum
The sternum is the elongated bony structure on the anterior side of the thoracic cage. It consists of three parts: the manubrium, the body, and the xiphoid process.
01:20The Thoracic Cage: Ribs
Parts of a Typical Rib
A typical rib has a head, neck, and body. The posterior end of the rib is called the head, followed by a narrow neck. The head articulates primarily with the costal facet...
01:21Aneurysm II: Clinical Manifestations and Diagnostic Studies