Radiographic evaluation of rib fractures

A prospective study of 100 radiographs performed for possible rib fracture due to blunt trauma was conducted to determine if some of the films routinely obtained should be eliminated for medical or economic reasons. Of the 100 patients evaluated for fracture, 29 fractures were detected radiographically. The physical findings of fracture are seen to be nonspecific, and the clinical impression of the likelihood of fracture is unreliable. Therapy is symptomatic, aimed at relief of pain, and except for the complications of fractures, therapy does not differ significantly in patients with and without fractures. The complications of fractures that may influence therapy were seen in 13 of the 29 patients with fractures. All 13 complications were detected by the posteroanterior chest film while only three were seen on the rib films. Radiographs obtained solely to detect fractures are not warranted, but a posteroanterior chest film is necessary to assess pleural or pulmonary complication of chest trauma.