Search PubMed⌕ Search

SEARCH · Search PubMed

Results for “RIB FRACTURES”

Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.

Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.

At least 451 records · Page 25Linked to original sources
PubMed1979

[Residual lesions after serial fracture of ribs (author's transl)].

Follow-up examinations at regular intervals to recognize trauma-induced lesions are as essential for persons who have suffered a chest trauma as they are for cases of injury to the limbs. A classification into three groups according to the number of broken ribs relates satisfactorily with thoraco-pulmonary complications and residual damage. Injuries in group 1 leave practically no permanent damage; in group 2 they are apt to be followed by residual respiratory impairment while in group 3 the likelihood of permanent impairment of lung function is very high. Spirometry, roentgenography and fluoroscopy, and lung scanning are of special diagnostic value in assessing late sequelae of multiple rib fractures. Gas analyses are of little value. They would provide more accurate information if performed during exercise under standard conditions.

Adult↗
PubMed2001

Clinical pathways--can they be used in trauma care. An analysis of their ability to fit the patient.

This study prospectively evaluated the appropriateness and ability of clinical pathways to fit trauma patients in five key conditions, severe head injury, fractured ribs, fractured pelvis, fractured femur and blunt abdominal trauma, who were admitted to a single Level 1 Trauma Centre, between February and July 1999. Each pathway consisted of 14 elements of care divided into observable outcomes. Failure to achieve an outcome resulted in a variance or deviation from the pathway, which was assessed by the number of non-applicable variances. Appropriateness of clinical pathways was assessed by the applicability index (the number of non-applicable variances divided by the potential variances). Critical mismatches occurred when non-applicable variances exceeded 50% of potential variances. 146 patients, with the mean age 41.9 years (S.D. 20.7), mean ISS 11.1 (S.D. 10.7) were enrolled; 18 with severe head injury, 59 with fractured ribs, 13 with fractured pelvis, 20 with fractured femur and 36 with blunt abdominal trauma. Critical mismatch occurred in seven patients. Applicability indexes were 87 for head, 93 for ribs, 92 for blunt abdominal trauma, 91 for femur and 92 for the pelvic pathway. Patient assessment, pain management, skin integrity and patient education were the most appropriate key elements of care, discharge planning, patient satisfaction, treatment and activity were least applicable. This study identified, for the first time, that clinical pathways are clinically appropriate for major trauma conditions.

Abdominal Injuries↗
PubMed1995

Homicidal cardiac lacerations in children.

We report six cases of intentionally inflicted cardiac laceration. The victims ranged in age from 9 weeks to 2 1/2 years. Five victims were girls and in five cases the right atrium was lacerated. The left ventricle was lacerated in the other case. In the three cases with a confession, one victim each was struck with a fist, stomped, and kicked. Four patients had rib fractures, with at least two fractures in each case. Cardiac rupture from blunt trauma most commonly results from compression of the heart between the sternum and vertebral column, but may also occur from compression of the abdomen or legs, deceleration, blast injury, puncture of the heart by a fractured rib, and rupture through a resolving contusion. Accidentally acquired cardiac lacerations usually result from motor vehicle accidents or similarly severe forces. In children there are neither well documented cases of cardiac laceration nor of rib fractures from cardiopulmonary resuscitation. Cardiac lacerations, as with other types of severe trauma acquired at home, are almost never accidental.

Cardiopulmonary Resuscitation↗
PubMed1998

[Intraabdominal organ injury due to blunt chest trauma--report of two cases].

Two cases of intraabdominal organ injuries due to blunt chest trauma are reported. A 58-year-old man was admitted to our hospital with multiple rib fractures, hemopneumothorax and left flail chest. An emergency operation was performed and intraoperative findings revealed that the fractured rib was penetrating through the diaphragm to the stomach. A 52-year-old woman was admitted to our hospital with left multiple rib fractures and hemopneumothorax. Her treatment included chest tube drainage, but a week after admission, intraabdominal bleeding occurred due to a ruptured spleen, necessitating an emergency operation (splenectomy). Blunt chest trauma injury is usually accompanied by multisystem injury. Therefore, it is important to detect intraabdominal injury during an emergency operation and the follow-up period.

Emergencies↗
PubMed1983

Bilateral fracture of the first ribs.

Fractures of the first rib are uncommon. Bilateral fractures of the first rib are still rarer. A case of bilateral fracture of the first rib due to indirect trauma is reported because of its rarity. Pain at the base of the neck was the presenting symptom in our case and analgesia was the only treatment.

Adult↗
PubMed1991

[Physical capacity following blunt thoracic trauma].

In order to extend the knowledge of possibility of action after blunt thoracic injuries 43 patients with largely isolated collar-bone fractures, rib and serial rib fractures as well as vertebral column fractures were questioned about their posttraumatic possibility of action. Essential result: In general, there is a close correlation between the acuteness of pain, the patient's judgment of severity of the injury and the extent of his ability to act during the first posttraumatic minutes. In the further course the ability to act was limited by the extent and the developmental speed of the hematothorax and/or pneumothorax, unless it was primarily limited or completely missing due to pain. Casualties having sustained collar-bone fractures were fully able to act except for a considerably diminished arm-swing. Patients with vertebral column fractures mostly remained lying at the place of accident for fear of a deterioration of the injury sustained and because of severe pain. The casualties' deliberate behavior was the predominant posttraumatic feature. In view of the various forms of rib and/or serial rib fractures with and without a hematothorax/pneumothorax there was a varying posttraumatic clinical picture ranging from freedom from pain to severe pain and non-restricted possibility of action to complete inability to act.

Arousal↗
PubMed1991

[The mechanism of fatigue fracture of the ribs].

To elucidate the mechanism of fatigue-rib-fracture, 8 rib-fractured cases were investigated. In assuming the M. serratus anterior (MSA) as the major cause from the anatomical muscle route, EMG was taken, and three-dimensional resultant forces from the muscles around the shoulder of a fresh cadaver were estimated. Most fractures were found in the sixth or seventh ribs, with a tendency to occur along the posterolateral segment. Biomechanical analysis revealed 12 and 62 kg forces applied on the scapulo-thoracic joint and gleno-humeral joint respectively by adding 90 degrees-anterior-elevation under no load. The maximum muscle-force of MSA occurring at 90 degrees-anterior-elevation was 1.2 kg in the sixth serratus in our study. These data were supported by the results with EMG. The stress on the ribs were calculated by two-dimensional finite element method, using the data. The maximum compressive stress on one rib was 4.75 kg/mm2 when 13.0 kg of MSA-force was added. In considering the limit of fatigue endurance of bones, these results suggest that muscle-force which causes fatigue fracture of ribs arises from lifting an object weighing more than 20 kg.

Adolescent↗
PubMed1981

Stabilization of flail chest by compression osteosynthesis--experimental and clinical results.

It has been demonstrated that the impaired ventilatory parameters can be normalized after early stabilization of flail chest. Most methods for operative fixation, however, have given disappointing results and only plate fixation procedures have been effective. The experimental results of osteosynthesis with dynamic compression plates are presented and demonstrate the superiority of compression osteosynthesis in rib fractures. Compression osteosynthesis resulted in a primary fracture healing with stable fragments after 14 days, whereas conventional plate fixation techniques required a much longer time and showed secondary fracture healing. The benefits of compression osteosynthesis could also be demonstrated in 10 patients with traumatic flail chest. Osteosynthesis resulted in marked pain relief, immediate stabilization of the chest wall, and a shorter time of intubation. Not all fractured ribs need stabilization, dorsal fractures are well fixed by the strong erector muscles, and in the lateral position only ribs III to VII need to be considered. Reasonable stabilization may be achieved with fixation of every second rib. In patients with bilateral rib serial fractures subcutaneous implantation of one or 2 rib struts is recommended--good results were obtained in 12 patients. The indication for operative stabilization of flail chest should be restricted to: 1. Patients with severe ventilatory restriction due to chest wall paradox alone. 2. Flail chest combined with intra-thoracic lesions which require thoracotomy. 3. Flail chest combined with lesions which require a prone position for surgical exploration. 4. Respiratory distress patients when the unstable chest wall interferes with mechanical ventilation or with underlying organs.

Adolescent↗
PubMed2004

Frequency of rib and sternum fractures associated with out-of-hospital cardiopulmonary resuscitation is underestimated by conventional chest X-ray.

OBJECTIVE: Fractured ribs and sternum are frequent complications of thoracic compression during CPR in adults. This study was conducted to determine whether findings of plain chest radiography (CXR) correlate with post-mortem findings in patients who underwent cardiopulmonary resuscitation (CPR) after out-of-hospital cardiac arrest. METHODS: CXR findings and autopsy results of CPR-related chest injuries comprising rib and sternum fractures were compared prospectively in 19 patients. RESULTS: Fractures were diagnosed in nine of 19 patients by means of radiology and in 18 of 19 patients by autopsy (rib fractures in 6/19 versus 17/19, P=0.002; sternum fractures in 5/19 versus in 9/19, P=0.227. The total number of isolated bone fractures detected by CXR was 18 (12 rib and six sternum fractures) and by autopsy 92 (83 rib and nine sternum fractures). The majority of rib fractures was located in the anterior part of the thoracic cage. Sternum fractures predominantly occurred in the lower third. Eight of 19 patients received either thrombolytic or antithrombotic treatment during CPR but no major bleeding complication associated with CPR was detected by autopsy. CONCLUSIONS: The findings of this study indicate that fractures associated with CPR are underreported in conventional radiographic investigations. No major bleeding complications related to CPR-associated fractures was detected.

Adult↗
PubMed2001

Trauma case management and clinical pathways: prospective evaluation of their effect on selected patient outcomes in five key trauma conditions.

BACKGROUND: This study evaluated the implementation of clinical pathways and case management between July 1998 and July 1999 in five key trauma conditions: severe head injury, fractured ribs, fractured pelvis, blunt abdominal trauma, and fractured femurs presenting to a single trauma service. METHODS: Thirteen key elements of care with expected outcomes were defined for each key trauma condition. Deviations from expected outcome were defined as variances. Attainment of the expected outcomes was measured before (stage 1) and after introduction (stages 2 and 3) of clinical pathways and case management. Nonattained outcomes were quantified and categorized into time of occurrence, and relationship to staff, patient, or system. RESULTS: Two hundred thirty-five patients were studied, with a mean age of 41.8 (SD, 20.6) years and mean Injury Severity Score (ISS) of 11.7 (SD, 11.0). The mean number of observed variances per patient for stage 1 was 51.7 (SD, 43.5); stage 2, 42.3 (SD, 32.9); and stage 3, 23.2 (SD, 21.7) (p = 0.0001 for both stage 1 and stage 2 compared with stage 3). There was a significant improvement in outcomes achieved from stage 1 (92.7%; 95% confidence interval, 92.5-92.9%), to stage 3 (96.7%; 95% confidence interval, 96.5-96.9%). Of the total number of variances seen, 0.2% related to system errors, 25% related to patient factors, and 75.8% related to staff. The proportion of staff-related variances was significantly reduced in stage 3. CONCLUSION: Clinical pathways and case management identified areas in need of remedial action and improved the delivery of patient care to our trauma population. It has set a template for the future management of our trauma service.

Abdominal Injuries↗
PubMed1990

An unusual case of sudden death in an alcohol addict.

The sudden and unexpected death of a 40-year-old female alcohol addict is described. At the autopsy recent rib fractures were found. The extremity of one fractured rib had caused a massive haemorrhage by erosion of a coronary artery.

Accidental Falls↗
PubMed2004

Rib stress fractures.

The ribs are an uncommon site of stress fracture. Typical locations are the first rib anterolaterally, the fourth through ninth ribs laterally and posterolaterally, and the posteromedial upper ribs. Muscular forces are predominantly responsible for these fractures. This article reviews the mechanisms of injury in various activities and illustrates the scintigraphic appearance of rib stress fractures.

Athletic Injuries↗
PubMed1998

Use of 3.5-mm acetabular reconstruction plates for internal fixation of flail chest injuries.

The technique of using 3.5-mm acetabular reconstruction plates for multiple rib fractures with cerclage wires has been successful. We modified it by securing the reconstruction plates to the fractured ribs with cortical screws using the standard AO-ASIF (Arbeitsgemeindschaft fur Osteosynthesefragen [Association for the Study of Internal Fixation]) group technique. Our method for the internal fixation of the unstable chest wall is described. It is relatively simple and provides uniform results.

Bone Plates↗