Fracture of the Second Rib: An Indirect Sign of Serious Trauma Like Fracture of the First Rib?

• Published in: Journal of chest surgery Vol. 56; no. 6; pp. 431 - 434
• Main Authors: Tsimpinos, Michail, Chrysikos, Dimosthenis, Demesticha, Theano, Piagkou, Maria, Troupis, Theodoros
• Format: Journal Article
• Language: English
• Published: The Korean Society for Thoracic and Cardiovascular Surgery 05-11-2023; Korean Society for Thoracic & Cardiovascular Surgery; 대한심장혈관흉부외과학회
• Subjects: aorta; Clinical Research; heart injuries; ribs; thorax; traffic accidents; 흉부외과학
• ISSN: 2765-1606; 2765-1614
• DOI: 10.5090/jcs.23.072

Background: The first 3 ribs are anatomically well-protected, shielded by the large thoracic muscles, the shoulder girdle, and the arm. A significant force is required to fracture these ribs; thus, such fractures suggest a high-energy trauma and are associated with injuries to vital organs of the thorax, such as the aorta, the heart, the lungs and the great vessels. Methods: A retrospective analysis was conducted over a 10-year period at a single hospital. The study assessed patients with fractures of the second rib, including their concurrent injuries and the overall severity of their trauma. Results: Among the 76 patients included in the study, the average age was 47.35 years, 81.5% were men, and 19.5% were women. Thirteen patients (17.1%) survived their injuries. The most common causes of injury were road traffic accidents (63%) and pedestrian injuries (22%). The patients who did not survive sustained injuries to an average of 5 additional organs, while survivors had injuries to an average of 2.07 additional organs. Left rib fractures were the most frequently observed (46%). The most serious concurrent injuries reported were to the aorta (5.26%), heart (10.52%), lung (52.36%), head (57.89%), liver (30.2%), spleen (26.31%), and kidney (17.1%). Conclusion: As indicators of serious injury to vital endothoracic organs, isolated fractures of the second rib should be considered equal to first rib fractures in clinical importance.