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First and second rib fractures a twenty five year experience

Author: 
Efstathios K. Metaxas, Konstantinos Tzelepis, Ioannis Stamatatos, Stavroula Amanetopoulou, Dimitrios Tsiftsis, Aristotelis K. Stefoudis, Dimitrios Klapsakis, Eleni Alexandra Maniotis, Lazaros Tsiatsios Dimitris Broutas, Stylianos Zaragkas and Athanasios S
Subject Area: 
Health Sciences
Abstract: 

Background: To determine the importance of first and second rib fractures upon the causes, sex, age groups, associated injuries, morbidity and mortality. Methods:In a 25 year period a retrospective study took place. Thirty one (31) patients diagnosed with first and second rib fractures in General Hospital of Nicaea-Piraeus Agios Panteleimon Thoracic Surgery Department. Results:Between the years 1995 to 2020 (25years) 31patients diagnosed with first and second rib fractures, 22 male (70,96 %) and 9 female (29,032 %), aged 26-79 years mean age 44 years. Aetiologic Factors. Traffic accident reported 28 (90,322%) patients, fall from high 3(9,677%) patients. Associated injuries. Rib fractures(medium and lower)25, Sternal fractures 5, Flail chest13, Pneumohaemothorax 19, Scapula bone fracture 11, Lung Contusion 23, Pneumomesopmeumonium 1, Haemopericardium 1, Diaphragmatic ruptures 3, Haemoperitoneum 14, Head injuries 3,Vertebral fractures7, Kidney injury – nephrectomy 1, Pelvis fractures 3, Upper extremities fractures 11, Lower extremities fractures 4.Conclusion. Most of the patients underwent chest drain insertion for Pneumohaemothorax. Otherwise conservative treatment for the majority of the patients, analgesic and anti-inflammatory medication, nebulizers, low molecular heparin, monitoring physiotherapy and early mobilization. The patients’ hospital stay and the results of the treatment were determined mostly by the gravidity of the associated injuries and the early diagnosis and management. Multi trauma patients required intensive care unit required longer stay in the hospital. There is no doubt about first and second rib fractures and associated injuries that the successful management needs to be done by a properly trained and experienced team.Attention should be given to collaboration to other specialties in the hospital like, general surgeons, neurosurgeons, orthopaedics for the management when operation required. Computer Ct Angiography (with contrast) and 3D Reconstruction = The Gold Standard. No major vascular trauma was noticed.

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