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At least 163 records · Page 9Linked to original sources
PubMed2001

Examination of variation in sternal rib end morphology relevant to age assessment.

The morphology of the sternal end of the right fourth rib has been proffered as an accurate age assessor in skeletonized individuals of both sexes. This technique was tested for its applicability on left and right II, III, V-IX. Tests were performed between phase scores obtained from right and left ribs; right rib IV phase scores and scores obtained from the others in the right rib series; and between right rib IV scores and a composite score composed of the average of an individual's phase scores (omitting rib IV). Left ribs IV-IX were found not to vary significantly from their right counterparts. Although only right rib II was found to vary significantly from rib IV, use of the other ribs in the series should be undertaken with caution due to questions concerning their statistical significance. A composite score is therefore recommended for use instead.

Adolescent↗
PubMed2000

[Comparison of several rib rings with intercostal muscles for tracheal replacement in dogs].

OBJECTIVE: To compare the effect of several types of rib rings with intercostal muscles for the replacement of trachea in thorax. METHODS: The surface layer of the third rib of dogs were ripped off and curved into triangular, quadrilateral and polygonal form. These three types of rib rings with intercostal muscles were used to replace a segment of trachea in thorax. RESULTS: The stability of triangular rib ring was very well, but stricture of ring were often happened because of its smaller internal diameter. These stability of quadrilateral rib ring was the worst. The polygonal rib ring presented the biggest diameter and good stability compared to the other two kinds of rings. If silicone tube was supplemented in the polygonal rib ring, the quality of artificial trachea was excellent. CONCLUSION: The rib rings with intercostal muscles are successfully used for replacing the defect of trachea in canine thorax. The polygonal rib rings have the best quality in the three types of rib ring for tracheal replacement.

Animals↗
PubMed1985

[Differentiation of human and nonhuman primate ribs].

The ribs of 9 human beings and 6 animal-primates (4 Pongidae and 2 Cercopithecidae of 2 different species) had been examined metrically with regard to their relative dimensions and proportions. Special care was taken as well of the differentiation of single ribs of one individual as of interspecific differentiation. Generally the Pongidae show the greatest relative-dimensions. This concerns both the diameter as the length. The individuals of the genus Homo have medium-sized dimensions, while the Cercopithecidae have the smallest. In this way a first grouping of the measurements becomes possible. As for the rib-diameter Homo concurs more with the Pongidae than with the Cercopithecidae. At first from the rib-proportions resulted an indication to special similarity between the Pongidae and recent man from whom the Cercopithecidae distinctively differ as it is shown by the indices angulus-sternal end/tuberculum-angulus. A divariate presentation of the measurements of this index, however, proves that Homo concerning the single measurements occupies an intermediate position between the Pongidae and the Cercopithecidae in this case, too (Fig. 5). The examination of the craniocaudal trend of different ribmeasurements (length, depth and area of the rib-arc) produced a special similarity of the 4 upper ribs between the Pongidae and Homo. In the region of the lower chest a great conformity between the Pongidae and the Cercopithecidae became obvious in this respect. A different trend shows up in Homo - probably as an expression of the transformation-process in the human chest. The intraspecific morphometric discrimination of the single ribs proves to be especially difficult, above all between the 7th to 10th rib, if the ribs of an individual are not completely present. It is, however, possible in some cases by means of some measurements and indices of these ribs.

Adult↗
PubMed1998

The fibrinogen RIBS-I epitope (gamma373-385) appears proximate to the gamma408-411 adhesive domain but is not involved in interaction between receptor-bound or surface-adsorbed fibrinogen and platelet GPIIbIIIa.

The carboxyl terminus of the fibrinogen (Fg) gamma chain (gamma400-411) is necessary and sufficient to support platelet aggregation and adhesion. However, a monoclonal antibody (mAb) to the Fg RIBS-I epitope (gamma373-385), the anti-Fg-RIBS-I, which binds only to platelet-bound or surface-adsorbed Fg but not soluble Fg, inhibits platelet aggregation. In this study, we showed that this same antibody also inhibits the adhesion of platelets to Fg-coated polystyrene beads. We then investigated the mechanisms by which the anti-Fg-RIBS-I antibody inhibits platelet aggregation and adhesion. The Fg RIBS-I epitope does not interact with platelet GPIIbIIIa, since recombinant Fg missing the last four amino acids, the Ala-Gly-Asp-Val, on the carboxyl terminus of its gamma chains supports neither platelet aggregation nor adhesion to surfaces, nor GPIIbIIIa binding, while it binds anti-Fg-RIBS-I normally. Purified, soluble GPIIbIIIa (265 kDa) inhibits the binding of both the anti-Fg-RIBS-I and 4A5 (a mAb specific to gamma408-411 of Fg), however, peptide G13 (1.5 kDa), corresponding to the Fg gamma chain binding domain on GPIIba (GPIIb300-312), only inhibits the binding of 4A5, and does not affect the binding of the anti-Fg-RIBS-I to Fg. The anti-Fg-RIBS-I reduces the on-rate of the 4A5 binding to Fg with no measurable changes in the dissociation of the Fg-bound 4A5. These data indicate that the inhibition of platelet aggregation and adhesion by the anti-Fg-RIBS-I antibody is due to the steric hindrance of the Fg gamma400-411 to platelet GPIIbIIIa. Thus the Fg RIBS-I epitope (gamma373-385) does not appear to be involved in direct interaction with platelet GPIIbIIIa, leaving the gamma408-411 of Fg as the sole domain mediating platelet aggregation and adhesion.

Antibodies, Monoclonal↗
PubMed1997

Induction of donor specific transplantation tolerance to cardiac allografts following treatment with nondepleting (RIB 5/2) or depleting (OX-38) anti-CD4 mAb plus intrathymic or intravenous donor alloantigen.

The nondepleting monoclonal antirat CD4 antibody, RIB 5/2, has been shown to modulate, but not eliminate, the CD4+ T cells and to prolong survival of rat skin, renal, or cardiac allografts when serially administered after transplantation. In the present study, we compared the efficacy of recipient pretreatment with a single dose of nondepleting RIB 5/2 or depleting OX-38 anti-CD4 monoclonal antibody plus donor alloantigen given intravenously or intrathymically 21 days before transplantation on the survival of completely MHC-mismatched rat cardiac allografts. Intraperitoneal injection of a single dose (20 mg/kg) of RIB 5/2 resulted in a decrease in CD4 surface molecule expression on peripheral CD4+ T cells without cell elimination as shown by FACS analysis. The nonspecific effect of a single dose of RIB 5/2 mAb had resolved by 21 days after treatment as evidenced by the almost complete recovery of normal surface CD4 molecule expression. Cardiac allografts transplanted immediately or 21 days after a single dose of RIB 5/2 alone were uniformly acutely rejected. On the other hand, recipients treated with depleting anti-CD4 OX-38 (20 mg/kg) acutely rejected cardiac allografts transplanted 21 days later, but indefinitely accepted all grafts transplanted on the same day. In contrast, combined treatment with i.v. donor splenocytes (25 x 10(6)) plus nondepleting RIB 5/2, but not with depleting anti-CD4 mAb, OX-38, resulted in survival for more than 100 days in 75% of recipients of donor specific, but not third party, cardiac allografts transplanted 21 days later. Irradiation (3000 rads) of the i.v. donor splenocytes combined with RIB 5/2 abrogated their tolerizing effect. When donor antigen was given intrathymically, both RIB 5/2 and OX-38 resulted in indefinite tolerance to cardiac allografts transplanted 21 days later. The failure of exogenous administration of high dose (180,000 IU/injection) rIL-2 for 10 days to reverse the unresponsiveness of i.v. SC plus RIB 5/2 pretreatment suggests that this tolerant state is not due to a deficiency of IL-2. In vitro studies showed marked inhibition of MLC responsiveness and cytolytic T cell activity in tolerant recipients that cannot be reversed by the addition of IL-2. Thus, pretransplant intravenous donor alloantigen combined with a dose of nondepleting anti-CD4 mAb, RIB 5/2, which alone has no significant effect, induced donor specific cardiac allograft tolerance.

Animals↗
PubMedDate not supplied

Influence of a novel platinum compound--cis-dichloro (dimethylsulphoxide) (1-beta-D-rybofuranosyl-1,2,4-triazolo-3-arboxyamide) platinum (II)--"Pt-rib-1"--on cell cycle and apoptosis in ClS91 and B16 mouse melanoma in vitro.

Cisplatin has a significant role in the treatment of selected human tumors including advanced melanoma, but new platinum compounds are still in focus of search for better properties. Modern drug design is often based on studies detecting the abilities of tested drug to induce apoptosis and disturb cell cycle. Aim of the study was to establish the influence of a platinum complex Pt-rib-1 on cell cycle and apoptosis occurrence in mouse melanoma B16 and ClS91 cells. Pt-rib-1 is a ribavirin derivative. previously characterized and described as cytotoxic to B16 and ClS91 mouse melanoma cells in vitro. The new platinum complex (Pt-rib-1); cis- dichloro (dimethylsulphoxide) (1- beta- D-ribofuranosyl- 1,2,4-triazolo -3- carboxyamide) platinum (II) was supplied. Cisdiaminodichloroplatinum (II), (cisplatin) was used in control groups. To detect apoptotic and necrotic cells, Annexin V- conjugated with fluorescein isothiocyanate (Annexin V-FITC, Immunotech) and propidium iodide (IP, Immunotech) were used. Apoptosis detection were done using fluorescence microscopy and flow cytometry. The total DNA content within the cell indicated phase of the cell cycle. DNA content was measured using flow cytometry. Values given represent the mean from three determinations. Results were presented as mean +/- standard deviation (SD). Statistical analysis was done using t-Student test. There were 70.4% of apoptotic cells in the ClS91 culture after 24 h incubation with Pt-rib-1 at a concentration of 2.04 x 10(-3) M (4 x IC50). In B16 group, 83.2 per cent of apoptotic cells was found after 24h incubation with Pt-rib-1 at high concentration (2.30 x 10(-3) M). A 24-h experiment shows a threshold at a concentration higher than 3 x IC50 responsible for apoptosis induction in B16 and ClS91 cells. After 48 h incubation with Pt-rib-1 the per cent of apoptotic cells increased gradually with rising concentrations of Pt-rib-1 up to a final concentration of 2.04 x 10(-3) M and 0.92 x 10(-3) M in ClS91 and B16 groups, respectively. Cell accumulation was observed in S phase after 48 h incubation with Pt-rib-1. The per cent of cells in S phase increased from 31 to 51.1% and 38.8 to 50.0% in ClS91 and B16 culture, respectively. There were no B16 and ClS91 cells in G2/M phase after incubation with higher concentrations of Pt-rib-1 (from 0.2 to 2.0 x 10(-5) M/dm3). Pt-rib-1 partially exhibits action of cisplatin. which has no specific influence on cell cycle and ribavirin. probably responsible for DNA synthesis delay.

Animals↗
PubMed1999

Sonography compared with radiography in revealing acute rib fracture.

OBJECTIVE: This study was undertaken to compare the sensitivities of sonography and radiography for revealing acute rib fracture. SUBJECTS AND METHODS: Chest radiography and rib sonography were performed on 50 patients with suspected rib fractures. Sonography was performed with a 9- or 12-MHz linear transducer. Fractures were identified by a disruption of the anterior margin of the rib, costochondral junction, or costal cartilage. The incidence, location, and degree of displacement of fractures revealed by radiography and sonography were compared. Sonography was performed again after 3 weeks in 37 subjects. RESULTS: At presentation, radiographs revealed eight rib fractures in six (12%) of 50 patients and sonography revealed 83 rib fractures in 39 (78%) of 50 patients. Seventy-four (89%) of the 83 sonographically detected fractures were located in the rib, four (5%) were located at the costochondral junction, and five (6%) in the costal cartilage. Repeated sonography after 3 weeks showed evidence of healing in all reexamined fractures. Combining sonography at presentation and after 3 weeks, 88% of subjects had sustained a fracture. CONCLUSION: Sonography reveals more fractures than does radiography and will reveal fractures in most patients presenting with suspected rib fracture. Further scientific studies are needed to clarify the appropriate role for sonography in rib fracture detection.

Adult↗
PubMed2005

High-resolution sonography of the rib: can fracture and metastasis be differentiated?

OBJECTIVE: Our aim was to evaluate whether high-resolution sonography can provide additional information concerning rib lesions compared with radiography or bone scintigraphy. MATERIALS AND METHODS: Fifty-eight patients with high-uptake rib lesions seen on bone scintigraphy were selected. Radiography and rib high-resolution sonography were performed on these patients. High-resolution sonography was performed using a linear 5-12 MHz transducer. By means of clinical history, histopathologic examination, and follow-up observation, these patients were classified into rib fracture (n = 37), rib metastasis (n = 18), or unknown (n = 3) groups. High-resolution sonography images of the 55 proven cases were reviewed for the presence of five representative findings: cortical disruption, callus formation, cortical deformity, mass, or bone destruction. The frequencies of these findings were compared between the groups with fracture and metastasis. RESULTS: Rib lesions were matched by bone scintigraphy and high-resolution sonography in 53 (96%) of 55 patients and by bone scintigraphy and plain radiography in 23 (42%) of 55 patients. High-resolution sonography revealed 17 (94%) of 18 patients with metastasis and 36 (97%) of 37 patients with rib fractures. Metastatic lesions were seen as mass formation (n = 13) and irregular bone destruction (n = 7) on high-resolution sonography. Fracture was seen as cortical disruption with or without hematoma (n = 17), callus formation (n = 9), or cortical deformity, such as angling or stepping (n = 12). CONCLUSION: High-resolution sonography of the ribs is a useful method of characterizing rib lesions in patients who have hot-uptake lesions on bone scintigraphy.

Adult↗
PubMed1989

The rudimentary first rib. A cause of thoracic outlet syndrome with arterial compromise.

The symptoms of thoracic outlet syndrome are neurologic, not vascular, in more than 95% of cases. Subclavian artery compression is usually related to cervical ribs; however, congenitally abnormal first ribs may also produce vascular compromise. We review our two cases of thoracic outlet syndrome associated with significant subclavian artery compression caused by rudimentary first ribs and the prior literature emphasizing the mechanism of injury, diagnostic features, and treatment. Transaxillary resection of the first and second ribs was curative in both cases. The operative specimens demonstrated fusion of the rudimentary first rib to the second rib, with compression of the subclavian artery by a large first-rib exostosis. Patients with thoracic outlet syndrome and a rudimentary first rib should be examined for substantial vascular compromise, and, if it is found, the abnormal first and second rib complex should be resected early without prolonged conservative measures.

Adult↗
PubMed2000

Evolutionary mechanisms of rib loss in anurans: a comparative developmental approach.

ABSTRACT The presence of free ribs is presumed to be a primitive morphological character observed only in a few families of Recent anurans, whereas the absence of ribs has been considered to be a derived condition that is widespread within this order. A comparative study of rib development based on representatives of several anuran lineages (Alytes, Bombina, Bufo, Discoglossus, Hyla, Pelobates, Pelodytes, Rana, and Xenopus) reveals a previously undetected diversity of developmental features in the formation and interaction between neural arches and ribs. The absence of free ribs at premetamorphic or later stages is verified in some groups, but we present for the first time evidence of the existence of larval rib rudiments in others, both in the anterior (Rana, Hyla) and posterior (Bufo, Discoglossus, Pelobates) presacral regions. Heterochrony seems to have played a major role in the processes underlying rib reduction. The intracolumnar differences between anterior (V(2)-V(4)) and posterior (V(5)-V(8)) regions are based on perturbations in the timing of early differentiation. Furthermore, a clear shift in the relative timing of ossification among evolutionary lineages was detected. In this respect Xenopus has a highly derived condition. The use of the morphological character of "rib loss" in phylogenetic analyses must be reconsidered due to the different convergent developmental paths described here. The phylogenetic analysis of a "sequence units" matrix of rib development is compared with current anuran phylogenies. Some evolutionary information appears to be clearly present in the ontogenetic data of this "missing morphology," but its value for evolutionary inferences is rather limited.

Animals↗
PubMed1989

Rib cage asymmetry in idiopathic scoliosis.

Seventy-one patients attending a scoliosis clinic and 10 control subjects were studied by a stereoradiographic three-dimensional reconstruction of the spine and rib cage. The symmetry of each rib pair (at each anatomic level) was described by measurements of rib arc length, chord length, enclosed area, maximum curvature, and frontal and lateral angulations. Patients were divided into four groups: 19 with a single right thoracic curve, 15 with a single left lumbar or thoracolumbar curve, 22 with double curves, and 15 with a curve with less than 10 degrees Cobb angle. In the control group and the group with minimal scoliosis, there was no statistically significant rib asymmetry. Among the patients with scoliosis, 11 of 19 patients with right single thoracic curves had rib arc lengths greater on the right side at the curve apex, and nine of 15 patients with left lumbar scoliosis had longer ribs on the left side in the corresponding region of the thoracic spine. Eleven of 22 patients with double curves had symmetrical rib lengths (within +/- 3%), the other 11 had ribs longer on the left. These proportions should not have occurred by chance (p less than 0.001). The mean rib length difference in patients with single thoracic curves was 1.39% (right longer than left), in single lumbar curves it was 3.57% (left longer than right), and in double curves 3.18% (left longer than right). These differences between the groups of patients and control subjects were statistically significant (p less than 0.01).(ABSTRACT TRUNCATED AT 250 WORDS)

Adolescent↗
PubMed2001

Inductive signals from the somatopleure mediated by bone morphogenetic proteins are essential for the formation of the sternal component of avian ribs.

The posterior five pairs of avian ribs are composed of vertebral and sternal components, both derived from the somitic mesoderm. For the patterning of the rib cartilage, inductive signals from neighboring tissues on the somitic mesoderm have been suggested to play critical roles. The notochord and surface ectoderm overlying the somitic mesoderm are essentially required for the development of proximal and distal regions of the ribs, respectively. Involvement of the somatopleure in rib development has already been suggested but is less understood than those of the notochord and surface ectoderm. In this study, we reinvestigated the role of the somatopleure during rib development. We first identified the chicken homologue of the mouse Mesenchymal forkhead-1 (cMfh-1) gene based on sequence similarities. cMfh-1 was observed to be expressed in the nonaxial mesoderm, including the somitic mesoderm, and, subsequently, in cartilage forming the ribs, vertebrae, and appendicular skeletal system. In the interlimb region, corresponding to somites 21-25 (or 26), cMfh-1-positive somitic mesoderm was seen penetrating the somatopleure of E4 embryos, and cMfh-1 was used as a molecular marker demarcating prospective rib cartilage. A series of experiments affecting the penetration of the somitic mesoderm into the somatopleure was performed in the present study, resulting in defects in sternal rib formation. The inductive signals emanating from the somatopleure mediated by BMP family proteins were observed to be essentially involved in the ingrowth of the somitic mesoderm. BMP4 alone, however, could not completely replace inductive signals from the somatopleure, suggesting the involvement of additional signals for rib formation.

Amino Acid Sequence↗
PubMed1998

[Surgical stabilization of multiple rib fractures successfully achieved with the use of long metalic plates].

Surgical stabilization of multiple rib fractures in 5 male patients was successfully achieved with the use of orthopedic A-O metalic plates, which are called reconstruction plates. In each patient, we prevented deformity of the rib cage and flail chest which frequently occurs after multiple rib fractures. Three of these patients received emergency operations because of severe hemopneumothorax and flail chest due to crushing injuries to the chest. They were treated by the standard thoracotomy, hemostasis of intrapleural bleeding, and stabilization of fractured ribs with reconstruction plates, in addition two of the patients underwent a single lobectomy to control the pulmonary hemorrhage. Another two patients were treated with mechanical ventilation and closed-tube thoracotomy following the chest trauma because their thoracic bleeding from drainage tubes was tolerable. But flail chest and respiratory insufficiency did not improve, in spite of positive controlled ventilation as a mode of internal pneumatic stabilization. Then surgical stabilization of the fractured ribs with these plates was carried out ten to twelve days after the accidents in each case. All patients tolerated the surgical procedures well and were successfully removed from the respirator, demonstrating complete stability of the chest wall. The long metal reconstruction plates with many perforations were very useful for the external fixation of segmentary fractured ribs as an external brace. This was because they were long enough to cover the whole length of the fractured ribs and moderately soft enough to be appropriately bent or twisted by hand at the time of operation. Moreover a number of holes in it allowed the suture to pass through the plate and rib, avoiding displacement of the prosthesis. This is the first report which describes the usefulness of orthopedic reconstruction plates for the stabilization of multiple rib fractures.

Adult↗
PubMed2002

Rib fractures after chest physiotherapy for bronchiolitis or pneumonia in infants.

BACKGROUND: The reported causes of rib fractures in infants are: child abuse, accidental injury, cardiopulmonary resuscitation, bone fragility, birth trauma and severe cough. OBJECTIVE: To report chest physiotherapy (CPT) as a new cause of rib fractures in five infants. MATERIALS AND METHODS: We retrospectively identified all infants with rib fractures after CPT for bronchiolitis or pneumonia over a 4-year period in two paediatric and one paediatric radiology units in three university hospitals in Paris. RESULTS: Five boys were identified. Their median age was 3 months. None had any other potential cause of rib fractures. The indication for CPT was bronchiolitis in four cases and pneumonia in one. The median number of rib fractures was four (range 1-5). Fractures were located between the 3rd and 8th ribs; they were lateral in four patients and posterior in one; they were unilateral in four patients and bilateral in one. Evolution was favourable in all cases. The prevalence of rib fractures after CPT during the study period was estimated at 1 in 1,000 infants hospitalised for bronchiolitis or pneumonia. CONCLUSIONS: CPT should be considered a potential, but very rare cause of rib fractures in infants. It can be of clinical relevance when rib fractures are the only feature suggestive of child abuse.

Bronchiolitis↗
PubMed1985

Mechanical coupling between the ribs and sternum in the dog.

We measured the axial (cranio-caudal) displacements of the sternum and the second and seventh bony ribs using linear displacement transducers in five supine anesthetized dogs during passive inflation and deflation, during quiet breathing and static inspiratory efforts before and after bilateral phrenicotomy, and during tetanic stimulation of either the sternocleidomastoids or the sternal fibers of the rectus abdominis. Quiet inspiration before and after phrenicotomy was always associated with a caudal displacement of the sternum and a cranial displacement of the seventh rib; the second rib, however, was either motionless or also showed an inspiratory caudal displacement. During static inspiratory efforts, the second rib was always moving in concert with the sternum in the caudal direction, while the seventh rib, in particular after phrenicotomy, usually moved in the cranial direction. Finally, for any given axial (cranial or caudal) displacement of the sternum, stimulation of the sternocleidomastoid or rectus abdominis muscles invariably caused the second rib to move disproportionately more than the seventh. These results indicate that the upper ribs are more tightly linked to the sternum than the lower ribs. This presumably results from the fact that the costal cartilages increase in length from above downwards, and it implies that the upper portion of the rib cage behaves more as a unit with the sternum than the lower portion.

Animals↗
PubMed1994

Intercostal variation at the sternal end of the rib.

The human rib has proven to be an important site for the assessment of age at death in the adult skeleton. The rib phase method, featuring race and sex specific standards developed by two of the authors (Işcan and Loth), is proving successful in paleodemography and forensic anthropology. However, as the authors pointed out in earlier publications, it is not always possible to isolate the fourth rib upon which the standards are based. This can be a factor because although a certain degree of intercostal variation does exist, its extent has not been quantified in a modern forensic population. Therefore the purpose of this paper is to determine if standards from the fourth rib can be used for adjacent ribs 3 and 5. Ribs 3, 4, and 5 were collected at autopsy from recent medical examiner's cases of known age, sex and race. The sample consists of 135 white males and females of age range 3-99 years. Each rib was assigned to an age phase using the established standards. The results of this analysis indicated that > 79% of cases, all three ribs fell into the same phase, and intercostal differences were within one phase for 98% of the sample. It may thus be concluded that age can also be assessed from these adjacent ribs using the present standards.

Adolescent↗
PubMed1990

A randomized clinical trial of rib belts for simple fractures.

The authors present a pilot study in which 20 patients with simple rib fractures were randomized prospectively into two treatment groups. One group received ibuprofen and the other group ibuprofen plus a rib belt for analgesia. There were no statistically significant differences observed in pulmonary function testing between the groups at initial visit, 48 hours, or 5 days. Atelectasis developed in four patients, two in each treatment group; there were no cases of pneumonitis. Patients with displaced rib fractures experienced a higher rate of hemo- or pneumothorax than did those with nondisplaced fractures (5/10 v 1/10). Patients with displaced fractures who used rib belts experienced a higher rate of hemothorax than those using oral analgesia alone (4/6 v 1/4). Patients using rib belts uniformly reported a significant amount of additional pain relief. The clinician can use a rib belt to provide additional comfort to the patient with fractured ribs without apparent additional compromise to respiratory parameters. A further study stratifying displaced and nondisplaced fractures has been initiated to clarify the possible contributing roles of displaced rib fractures and the rib belt in patients with displaced fractures.

Adolescent↗
PubMed2006

Vascular thoracic outlet syndrome. Longer posterior rib stump causes poor outcome.

OBJECTIVE: To assess the role of the relative length of the posterior rib stump in outcome after transaxillary first rib resection for thoracic outlet syndrome. METHODS: All patients with a transaxillary first rib resection between January 1990 and February 2004 were selected. Relative rib stump length was calculated by dividing the length of the posterior rib stump by the height of the 10th thoracic vertebra. Measurements were made on postoperative X-rays. Outcome was defined as excellent, good, fair, or poor. RESULTS: Surgical outcome was excellent in 11 procedures (28.2%), good in 12 procedures (30.8%), fair in 9 (23.1%), and poor in 7 procedures (17.9%). Correlation of the outcome with the relative rib stump length gives a coefficient of .374 (P=.02). After exclusions of 3 patients with other medical conditions explanatory for remaining pain in the operated limb, the correlation coefficient was .614 (P<.01). CONCLUSION: The relative length of the posterior rib stump is correlated with the outcome after transaxillary first rib resection in patients with thoracic outlet syndrome. First rib resection in patients with proven vascular compression should be as close as possible to the articulation with the transverse process, without injuring the brachial plexus.

Adult↗