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Results for “RIB FRACTURES”

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PubMed1995

Inflicted skeletal injury: a postmortem radiologic-histopathologic study in 31 infants.

OBJECTIVE: The objective of this postmortem study was to use high-detail skeletal surveys, specimen radiography, and histopathologic analysis to determine the number, distribution, and age of inflicted skeletal injuries in infants studied at the University of Massachusetts Medical Center from 1984 to 1994. MATERIALS AND METHODS: Thirty-one infants (average age, 3 months) who died with inflicted skeletal injuries were studied with high-detail skeletal surveys and specimen radiography and histopathologic analysis. The distribution and number of fractures was determined for each technique, and dating was performed on the basis of radiologic and histologic criteria. The skull fractures noted in 13 cases were excluded from the numerical analysis. RESULTS: The radiologic-histopathologic correlation revealed 165 fractures involving the ribs in 84 (51%), long bones in 72 (44%), bones of the hands and feet in 6 (4%), clavicles in 2 (1%), and spine in 1 (< 1%). Of the 72 long bone fractures, the metaphyses were involved in 64 (89%, or 39% of the total), and the shaft was involved in 8 (11%, or 5% of the total). One hundred sixteen fractures were healing, 36 were acute, and 13 were of indeterminate age. In all but two infants, at least one healing fracture was present. Of fractures diagnosed histopathologically, specimen radiography increased the yield of fractures noted on skeletal survey from 58% to 92%. CONCLUSION: Most infants who die with inflicted injury have fractures at multiple sites. Metaphyseal and rib fractures are much more common than long bone shaft injuries, the opposite of the pattern found in older children. Because most abused infants who die have evidence of healing fractures at the time of autopsy, aggressive radiologic efforts to identify these injuries in living as well as in decreased infants appear justified.

Autopsy↗
PubMed1951

Cough fracture.

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Cough↗
PubMed1993

[Injuries of the thoracic skeleton].

Injuries of the thoracic skeleton are an important indicator of other, relevant traumatic changes after a polytrauma. Most fractures occur in the ribs, followed by fractures of the clavicle, the scapula and the sternum. Because of their high kinetic energy, car accidents are the main reason for thoracic fractures. The basic radiologic tool is the a.p. projection of the thorax in supine position; in addition, other conventional x-ray examinations or computed tomography are performed. Most thoracic fractures are treated conservatively, only in few cases (instability of the thorax, risk of pseudoarthrosis, incongruence of joint surfaces) surgical procedures are used.

Clavicle↗
PubMed1995

Traumatic bronchial rupture--a case report.

Traumatic bronchial rupture is a rarity. Its incidence is about 1.5% to 3% in most series of blunt chest trauma. We report a patient who presented after a road traffic accident with an apparently persistent pneumothorax which failed to respond to emergency treatment. This was later discovered to be due to a traumatic bronchial rupture. It is difficult to diagnose traumatic bronchial rupture, the main reason being that it is often not considered by doctors caring for the patient with blunt chest trauma in the Accident and Emergency Department. Failure to recognise this condition contributes to its high mortality. The authors would like to recommend that emergency bronchoscopy be carried out in patients with blunt chest trauma to exclude this potentially treatable condition. This is especially so if there are suggestive clinical features, such as the presence of extensive and spreading subcutaneous emphysema, pneumomediastinum, pneumothorax, haemoptysis, fractures of the first two ribs and respiratory distress. A history of massive blunt force to the chest wall as a mechanism of injury should also prompt the trauma team to consider the need for emergency bronchoscopy.

Accidents, Traffic↗
PubMed1979

[Pleural adhesions and deformation of the chest wall (author's transl)].

Deformation of the chest wall and pleural adhesions are some of the sequelae of chest trauma with fractures of ribs. If sufficiently extensive these lesions may result in restrictive disturbances of ventilation and partial respiratory insufficiency. In these cases marked improvement in function and perfusion can be obtained by decortication at an early stage. Follow-up examinations of 37 patients who had sustained fractures of more than 4 ribs revealed restrictive respiratory impairment in only three cases. Hypoxia was present in 11, but a causal connection with the trauma could be ascertained in only 4 persons. For assessing the extent of the lesions and the indications for decortication perfusion scanning is a "must", as it will show up pathological changes at a time when the gaseous exchange and lung function still appear normal. There seems to be no correlation between the radiological extent of the adhesions or the deformation of the thorax and the extent of changes in lung function and blood gases.

Blood Gas Analysis↗