The significance of first rib fractures in children

Nicholas Hamilton, Brian T. Bucher, Martin S. Keller

Research output: Contribution to journalArticle

13 Citations (Scopus)

Abstract

Purpose: The purpose of the study was to determine if first rib fractures are associated with an increased incidence of thoracic vascular injury in pediatric patients. Methods: The medical records of all children diagnosed with a first rib fracture or a central vascular injury after blunt trauma treated at a state-designated level 1 pediatric trauma center from 2000 to 2009 were reviewed. Results: Thirty-three children (0.27% of patients; mean age, 10.9 ± 0.9 years) were identified with either a first rib fracture or thoracic vascular injury owing to blunt trauma. Thirty-two children had a first rib fracture, and only 1 child (3%) had significant thoracic vascular injury. Mediastinal abnormalities (indistinct aortic knob) were identified in 3 children, 2 with first rib fracture on initial chest radiograph. Despite a normal cardiovascular examination result, 25 (74%) children with a normal mediastinum on screening chest radiograph underwent computed tomography. No child with a normal mediastinum on initial chest radiograph was found to have associated intrathoracic injuries requiring further intervention. In children with first rib fractures and a normal mediastinum by screening chest x-ray, the negative predictive value for thoracic vascular injury was 100%. Conclusions: Children with first rib fractures without mediastinal abnormality on chest radiograph require no further workup for thoracic vascular injury.

Original languageEnglish (US)
Pages (from-to)169-172
Number of pages4
JournalJournal of Pediatric Surgery
Volume46
Issue number1
DOIs
StatePublished - Jan 2011
Externally publishedYes

Fingerprint

Rib Fractures
Vascular System Injuries
Thoracic Injuries
Thorax
Mediastinum
Wounds and Injuries
Pediatrics
Trauma Centers
Medical Records
Tomography
X-Rays

Keywords

  • Pediatric trauma
  • Rib fractures
  • Vascular injury

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

The significance of first rib fractures in children. / Hamilton, Nicholas; Bucher, Brian T.; Keller, Martin S.

In: Journal of Pediatric Surgery, Vol. 46, No. 1, 01.2011, p. 169-172.

Research output: Contribution to journalArticle

Hamilton, Nicholas ; Bucher, Brian T. ; Keller, Martin S. / The significance of first rib fractures in children. In: Journal of Pediatric Surgery. 2011 ; Vol. 46, No. 1. pp. 169-172.
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