Rib Fractures in Multiple Trauma Patients

Introduction & Thoracic trauma is one of the leading causes of morbidity and mortality in trauma patients and rib fracture due to blunt trauma to the chest wall, is the most common etiology. This study analyzed the correlation between rib fracture and prognosis of multiple trauma patients.
One hundred eighty four trauma patients suffering from rib fracture due to blunt trauma were studied. Demographic data, injury characteristics, rib fracture characteristics as well as associated injuries and injury severity score (ISS) were recorded. Rib fracture was classified according to location (left, right, and bilateral), and level (upper rib fracture [1-2nd rib], middle rib fracture [3-8th rib], and lower rib fracture [9-12th rib]), also categorized as lateral and posterolateral.
Rib fracture was posterolateral (69.6%) and lateral (30.4%), upper (4.3%), middle (92.4%) and lower (3.3%). Patients with posterolateral fracture had significantly more complications which led to airway intubation and more intensive care support, higher ISS and associated with pelvic and clavicular fracture. Upper rib fractures were associated with more length-of-stay (LOS) and lower rib fractures with more abdominal trauma and lumbar/thoracolumbar vertebral fractures. A significantly positive correlation was seen between number of fractured ribs and ISS, hospital and ICU LOS. There were no complications during 2 months follow-up.
Upper ribs’ fractures are associated with severe trauma, and require more hospitalization and ICU support considering more surgical and medical complications. Morbidity is higher in Posterolateral fractures and the patients need more medical care.