1/125. Fracture of the first rib.Fifteen cases of isolated fracture of the first rib are submitted. The mechanism of the fracture is discussed. It proved compatible with the descriptions in the literature, caused either by direct trauma to the shoulder, a sudden violent contraction of juxtacostal muscles; or else it was a chance finding, without any history of trauma and as such interpreted as a fatigue fracture. A case of Horner's syndrome complicating a fracture of the first rib is also described.- - - - - - - - - - ranking = 1keywords = fracture (Clic here for more details about this article) |
2/125. Injury to the first rib synchondrosis in a rugby footballer.Injuries to the first rib synchondrosis are uncommon in sport. The potential for serious complications following posterior displacement is similar to that seen with posterior sternoclavicular joint dislocation. Clinical examination and plain radiography may not provide a definitive diagnosis. Computerised tomography is the most appropriate imaging modality if this injury is suspected. Posterior dislocation of the first rib costal cartilage with an associated fracture of the posterior sternal aspect of the synchondrosis has not been previously reported.- - - - - - - - - - ranking = 0.25keywords = fracture (Clic here for more details about this article) |
3/125. Delayed traumatic hemothorax on ticlopidine and aspirin for coronary stent.A 64-year-old man presented with worsening dyspnea on exertion and hemothorax of the left chest 7 days after discharge from the hospital on ticlopidine and aspirin after coronary stent placement to his left circumflex artery. He had suffered traumatic rib fractures to the seventh, eighth, and ninth left ribs 28 days before this presentation and 21 days before starting the ticlopidine. Results of chest radiography at discharge 7 days earlier while on aspirin and after brief IV heparin had been negative except for minimal atelectasis and rib fractures barely visible on posteroanterior view. The delayed hemothorax had lowered the peripheral blood hematocrit to 23% and required tube thoracostomy drainage and blood transfusion. The delayed traumatic hemothorax in this case occurred on treatment with ticlopidine and did not recur with continuation of aspirin alone.- - - - - - - - - - ranking = 0.5keywords = fracture (Clic here for more details about this article) |
4/125. association of posterior rib fractures with exaggerated kyphosis and sternal collapse.The ribs, sternum, and vertebrae all play an important role in stabilizing the thorax. Failure of one of these components places additional stress on the other supporting structures. We present a case of a 62-year-old man with multiple myeloma and osteopenia who sustained fractures to all three components.- - - - - - - - - - ranking = 1.25keywords = fracture (Clic here for more details about this article) |
5/125. Thoracic paravertebral block: radiological evidence of contralateral spread anterior to the vertebral bodies.We report contralateral spread of contrast medium anterior to the vertebral bodies after injection of contrast through a thoracic paravertebral catheter that was used to manage pain in a patient with multiple fractured ribs. We review the literature and propose that the anatomical basis for this observation is spread in the extrapleural compartment of the thoracic paravertebral space along the subserous fascial plane.- - - - - - - - - - ranking = 0.25keywords = fracture (Clic here for more details about this article) |
6/125. rib fractures induced by coughing: an unusual cause of acute chest pain.We report three patients with stress fractures of the ribs induced by coughing. Standard radiographs of the chest and ribs did not reveal evidence of rib fractures in any of the patients. Bone scintigraphy, performed 1 to 2 weeks after initial onset of symptoms, showed a focal area of increased uptake along the chest wall in all cases. Thin section angulated helical CT directly visualized the subtle rib fractures. Initial diagnosis of a cough-induced fracture of the rib may be difficult because of the associated underlying disorder, and unnecessary examinations are commonly performed. Identification of a cough-induced fracture of the rib using helical CT may be clinically important to avoid unnecessary concern and additional examinations.- - - - - - - - - - ranking = 2.25keywords = fracture (Clic here for more details about this article) |
7/125. reflex sympathetic dystrophy in hypophosphataemic osteomalacia with femoral neck fracture: a case report.We report a male patient who presented with suspicion of skeletal metastases based upon an abnormal 99-mTc bone scan, which showed increased uptake at both femoral heads, left femoral neck, and several ribs. The images also suggested reflex sympathetic dystrophy, subcapital fracture of the left femur, and rib fractures. A diagnosis of hypophosphataemic osteomalacia was finally made.- - - - - - - - - - ranking = 1.5keywords = fracture (Clic here for more details about this article) |
8/125. rib fractures in infants: red alert! The clinical features, investigations and child protection outcomes.OBJECTIVE: To examine clinical features, investigation methods and outcomes of infants with rib fractures. METHODOLOGY: All infants aged 2 years or younger who presented over a 5-year period with documented rib fractures were identified from the medical records database of a tertiary referral paediatric hospital and data collected by retrospective chart review. Additional data regarding notifications and placements were obtained from the Department of Families Youth and Community Care, queensland. RESULTS: rib fractures were attributed to child abuse in 15 of 18 infants identified. The initial presentation in the abused infants was most often as a result of intracranial pathology and limb fractures. In four cases the rib fractures were incidental findings when abuse had not been suspected. Bone scintigraphy revealed eight previously undetected rib injuries in four cases. In three cases of abuse, the rib fractures were an isolated finding. Three of the infants with inflicted rib injuries were discharged home. In one such infant a significant re-injury occurred. Three returned home with implicated adults no longer in residence, and nine spent a mean period of 12 months in foster care. CONCLUSIONS: rib fractures in infancy are usually caused by severe physical abuse. Accidental rib fractures are rare in infants and result from massive trauma. rib fractures, multiple or single, may occur in isolation in abused infants. The implications of such injuries must be recognized to ensure appropriate, safe and consistent child protection outcomes. Bone scintigraphy is more sensitive than radiographs in the detection of acute rib fractures and should be performed in all cases of suspected infant abuse.- - - - - - - - - - ranking = 3.5keywords = fracture (Clic here for more details about this article) |
9/125. Chest compressions in an infant with osteogenesis imperfecta type II: No new rib fractures.The case report of a newborn female with osteogenesis imperfecta type II who underwent cardiopulmonary resuscitation (CPR) with manual chest compressions for several minutes is presented. Chest radiographs taken before and after the chest compressions were administered were reviewed by several radiologists from 3 different hospitals and demonstrated no new radiographically visible rib fractures. collagen analysis, the patient's clinical appearance, and clinical course, as well as a consultant's opinion aided in confirmation of the diagnosis of osteogenesis imperfecta type II. A review of 4 previous studies concerning rib fractures and CPR is included. This unique case supports previous articles that have concluded that rib fractures rarely, if ever, result from CPR in pediatrics, even in children with a lethal underlying bone disease, such as osteogenesis imperfecta type II. cardiopulmonary resuscitation, chest compressions, osteogenesis imperfecta, rib fractures, bone disease.- - - - - - - - - - ranking = 2.0007083796734keywords = fracture, compression (Clic here for more details about this article) |
10/125. Spontaneous rib fracture during pregnancy. A case report and review of the literature.No studies have demonstrated a direct relationship between pregnancy and rib fracture. A case of spontaneous rib fracture in the third trimester presents the opportunity to examine factors unique to pregnancy that may predispose the patient to stress fractures of the lower ribs. A 28-year old woman in week 31 of her pregnancy presented with the chief complaint of acute onset of right upper quadrant pain. A chest radiograph demonstrated a minimally displaced fracture of the right 10th rib. During pregnancy, the enlarging uterus causes certain opposing muscular forces to act on the ribs, making them more susceptible to fracture after minimal trauma or after repeated stresses such as a chronic cough.- - - - - - - - - - ranking = 2.25keywords = fracture (Clic here for more details about this article) |
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