4,903 results match your criteria Rib Fractures


Pain Scores in Geriatric vs Nongeriatric Patients With Rib Fractures.

JAMA Surg 2020 Jul 1. Epub 2020 Jul 1.

Division of General Surgery, Department of Surgery, Stanford University, Stanford, California.

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http://dx.doi.org/10.1001/jamasurg.2020.1933DOI Listing

[Trauma to the thoracic spine and chest].

Radiologe 2020 Jul;60(7):610-623

Universitätsklinik für Orthopädie und Unfallchirurgie, Medizinische Universität Wien, Wien, Österreich.

Background: The assessment of traumatic lesions to the chest and thoracic spine can pose a challenge for the emergency radiologist. Collaboration with the treating clinicians and knowledge of the patients' history and the trauma mechanism are essential.

Standard Radiological Methods: In case of minor trauma, digital radiography may be sufficient for diagnosis. Read More

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http://dx.doi.org/10.1007/s00117-020-00712-3DOI Listing

Intimate Partner Violence-Related Fractures in the United States: An 8 Year Review.

J Fam Violence 2019 Oct 3;34(7):601-609. Epub 2018 Oct 3.

University of Arkansas for Medical Sciences, College of Medicine.

Background: Fractures associated with intimate partner violence (IPV) are devastating injuries that can have lifelong implications. With exception to the facial region, there are very limited epidemiological reports describing the types and location of IPV-related fractures. The objective of this study is to review a national database and describe trends associated with IPV-related fractures. Read More

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http://dx.doi.org/10.1007/s10896-018-0007-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7318917PMC
October 2019

Prevalence and distribution of occult fractures on skeletal surveys in children with suspected non-accidental trauma imaged or reviewed in a tertiary Dutch hospital.

Pediatr Surg Int 2020 Jun 26. Epub 2020 Jun 26.

Amsterdam UMC, Department of Radiology and Nuclear Medicine, Emma Children's Hospital, University of Amsterdam, Meibergdreef 9, 1105AZ, Amsterdam, The Netherlands.

Purpose: The purpose of the study was to determine the rate of occult fractures (without clinical symptoms) per presenting clinical injury i.e., children presenting with a fracture, bruise, abusive head trauma and the types of fracture most likely to be found, in a series of infants and young children suspected of being victims of NAT. Read More

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http://dx.doi.org/10.1007/s00383-020-04706-zDOI Listing

In response to: A multicenter, prospective, controlled clinical trial of surgical stabilization of rib fractures in patients with severe, nonflail fracture patterns (Chest Wall Injury Society NONFLAIL).

J Trauma Acute Care Surg 2020 Jun 24. Epub 2020 Jun 24.

Department of Surgery, Division of Trauma and Surgical Critical Care, Kendall Regional Medical Center, Miami, FL, USA.

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http://dx.doi.org/10.1097/TA.0000000000002845DOI Listing

The effects of analgesic treatment and chest physiotherapy on the complications of the patients with rib fractures that arise from blunt chest trauma.

Ulus Travma Acil Cerrahi Derg 2020 Jun;26(4):531-537

Department of Thoracic Surgery, İstanbul University İstanbul Faculty of Medicine, İstanbul-Turkey.

Background: This prospective study aims to investigate the effect of chest physiotherapy and analgesic therapy on the possible complications of isolated rib fractures attributable to blunt thoracic trauma, such as hemothorax and pneumothorax.

Methods: Patients who presented to Çanakkale Onsekiz Mart University School of Medicine Hospital's Emergency Department and Thoracic Surgery outpatient clinics within the first 24 hours of the post-traumatic period and did not have additional intrathoracic complications at presentation with blunt thoracic trauma and who were diagnosed with isolated rib fractures were enrolled in this prospective research study. The groups were designated as the patients who would receive analgesic treatment only (Group A) and the patients who would receive chest physiotherapy and analgesic treatment together (Group B). Read More

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http://dx.doi.org/10.14744/tjtes.2019.26356DOI Listing

Traumatic myositis ossificans: multifocal lesions suggesting malignancy on FDG-PET/CT-a case report.

Skeletal Radiol 2020 Jun 25. Epub 2020 Jun 25.

Department of Oral Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-7-1 Sakamoto, Nagasaki, 852-8588, Japan.

Myositis ossificans (MO) is a benign soft-tissue lesion characterized by the heterotopic formation of the bone in skeletal muscles, usually due to trauma. MO is occasionally difficult to diagnose because of its clinical and radiological similarities with malignancy. We report a case of traumatic MO (TMO) in the masseter and brachial muscles of a 37-year-old man who presented with painless swelling in the left cheek and severe trismus. Read More

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http://dx.doi.org/10.1007/s00256-020-03521-wDOI Listing

Thoracic Spinal Stability and Motion Behavior Are Affected by the Length of Posterior Instrumentation After Vertebral Body Replacement, but Not by the Surgical Approach Type: An Study With Entire Rib Cage Specimens.

Front Bioeng Biotechnol 2020 9;8:572. Epub 2020 Jun 9.

Institute of Orthopaedic Research and Biomechanics, Trauma Research Centre Ulm, Ulm University Medical Center, Ulm, Germany.

Spinal tumors and unstable vertebral body fractures usually require surgical treatment including vertebral body replacement. Regarding primary stability, however, the best possible treatment depends on the spinal region. The purpose of this study was to evaluate the effects of instrumentation length and approach size on thoracic spinal stability including the entire rib cage. Read More

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http://dx.doi.org/10.3389/fbioe.2020.00572DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7295896PMC

A case of colon necrosis resulting from a delayed traumatic diaphragmatic hernia.

J Surg Case Rep 2020 Jun 17;2020(6):rjaa101. Epub 2020 Jun 17.

Department of Thoracic Surgery, Ambroise Pare, Mons, Belgium.

We present the case of a 71 years old woman who came at the emergency room for abdominal pain and symptoms of occlusion. The scanner demonstrated a colonic occlusion resulting from an incarceration, diagnosed as a hernia of Bochdalek. But two old rib fractures and a past history of a fall directed us to the diagnostic of delayed diaphragmatic rupture. Read More

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http://dx.doi.org/10.1093/jscr/rjaa101DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7299604PMC

How does the implementation of a patient pathway-based intervention in the acute care of blunt thoracic injury impact on patient outcomes? A systematic review of the literature.

Injury 2020 Jun 4. Epub 2020 Jun 4.

Florence Nightingale Faculty of Nursing, Midwifery and Palliative Care, King's College London, James Clerk Maxwell Building, 57 Waterloo Road, London, SE1 8WA, UK. Electronic address:

Background: Blunt thoracic injury is present in around 15% of all major trauma presentations. To ensure a standardised approach to the management of physical injury, patient pathway-based interventions have been established in many healthcare settings. It currently remains unclear how these complex interventions are implemented and evaluated in the literature. Read More

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http://dx.doi.org/10.1016/j.injury.2020.06.002DOI Listing

Traumatic rib head subluxation through the intervertebral foramen causing spinal cord contusive injury in a cat.

JFMS Open Rep 2020 Jan-Jun;6(1):2055116920929260. Epub 2020 Jun 8.

Dovecote Veterinary Hospital, Derby, UK.

Case Summary: A 4-year-old cat involved in a road traffic accident presented with paraparesis, which was worse on the right-hand side. Neurolocalisation was to the T3-L3 spinal cord segments. Survey radiographs showed rib fractures but no definitive diagnosis for the paraparesis. Read More

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http://dx.doi.org/10.1177/2055116920929260DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7285950PMC

Traumatic rib fractures: a marker of severe injury. A nationwide study using the National Trauma Data Bank.

Trauma Surg Acute Care Open 2020 10;5(1):e000441. Epub 2020 Jun 10.

Department of Orthopaedic Surgery, Harvard Medical School Orthopedic Trauma Initiative, Massachusetts General Hospital, Boston, Massachusetts, USA.

Background: In recent years, there has been increasing interest in the treatment of patients with rib fractures. However, the current literature on the epidemiology and outcomes of rib fractures is outdated and inconsistent. Furthermore, although it has been suggested that there is a large heterogeneity among patients with traumatic rib fractures, there is insufficient literature reporting on the outcomes of different subgroups. Read More

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http://dx.doi.org/10.1136/tsaco-2020-000441DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7292040PMC

Late traumatic diaphragmatic rupture complicated by haemothorax and strangulation of the stomach: A case report.

J Int Med Res 2020 Jun;48(6):300060520930864

Peking Union Medical College Hospital, Beijing, China.

Traumatic diaphragmatic rupture (TDR) is an uncommon but life-threatening condition often caused by blunt or penetrating trauma. Symptoms may appear late resulting in delayed or missed diagnosis. We report here a case of a 28-year-old man who presented with left subcostal pain and vomiting after recently binge drinking alcohol. Read More

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http://dx.doi.org/10.1177/0300060520930864DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7298431PMC

SURGICAL STABILIZATION OF MULTIPLE RIB FRACTURES AND MULTIPLE LONG BONE FRACTURES OF LOWER EXTREMITIES IN POLYTRAUMA PATIENTS.

Georgian Med News 2020 Apr(301):28-34

2Shupyk National Medical Academy of Postgraduate Education, Kyiv; 3Kyiv City Clinical Hospital №17, Ukraine.

Objectives - determine the impact of rib osteosynthesis on the incidence of complications development and mortality in patients with multiple rib fractures and multiple long bone fractures of lower extremities. A prospective controlled trial was conducted from June 2015 to December 2019, and included adult patients with polytrauma, Injury Severity Score (ISS) ≥18p, multiple long bone fractures of lower extremities, one of which is the femur, and multiple rib fractures. All included patients were divided into two groups: in Group I - 17 patients who underwent surgical stabilization of rib fractures, Group II - 24 included patients treated without rib osteosynthesis. Read More

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Radiological assessment after stereotactic body radiation of lung tumours.

Cancer Radiother 2020 Jun 10. Epub 2020 Jun 10.

Service de radiologie, hôpital Cochin, AP-HP, centre université de Paris, 27, rue du Faubourg-Saint-Jacques, 75014 Paris, France; Université de Paris, 12, rue de l'École-de-Médecine, 75006 Paris, France.

The increasing use of stereotactic body radiation therapy for lung tumours comes along with new post-therapeutic imaging findings that should be known by physicians involved in patient follow-up. Radiation-induced lung injury is much more frequent than after conventional radiation therapy, it can also be delayed and has a different radiological presentation. Radiation-induced lung injury after stereotactic body radiation therapy involves the lung parenchyma surrounding the target tumour and appears as a dynamic process continuing for years after completion of the treatment. Read More

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http://dx.doi.org/10.1016/j.canrad.2020.04.009DOI Listing

Lethal recreational activities involving horses - A Forensic study.

Authors:
Roger W Byard

Leg Med (Tokyo) 2020 Jun 6;46:101728. Epub 2020 Jun 6.

School of Medicine, The University of Adelaide, Frome Road, Adelaide, South Australia, 5005, Australia. Electronic address:

A search was undertaken of the Forensic Science South Australia, Australia, autopsy database over a 25-year period from 1995 to 2019 with the aim of understanding more about the role that recreational horse use not involving racing may have in mortality. Eight cases were found with an age range of 8-73 years (mean 47 years) and a male:female ratio of 5:3. The major category was a fall while riding (N = 7) with the remaining case (N = 1) sustaining a lethal kicking. Read More

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http://dx.doi.org/10.1016/j.legalmed.2020.101728DOI Listing

Exploring of the Mechanism of Rib Fracture Caused by Landing on Different Parts of the Trunk after Falls from Height Using Finite Element Method.

Fa Yi Xue Za Zhi 2020 Apr;36(2):181-186

School of Forensic Medicine, Southern Medical University, Guangzhou 510515, China.

Abstract: Objective To study the mechanism of rib fracture caused by landing on different parts of the trunk using finite element method, and to provide some new techniques and new ideas for the reconstruction of the whole process of falls from height. Methods The finite element method was used to study the rib fracture of human security model THUMS4.0 caused by landing on different parts of the trunk. Read More

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http://dx.doi.org/10.12116/j.issn.1004-5619.2020.02.007DOI Listing

Clinical experience of whole-body computed tomography as the initial evaluation tool after extracorporeal cardiopulmonary resuscitation in patients of out-of-hospital cardiac arrest.

Scand J Trauma Resusc Emerg Med 2020 Jun 11;28(1):54. Epub 2020 Jun 11.

Department of Surgery, National Taiwan University Hospital, College of Medicine, National Taiwan University, No. 7, Chung-Shan South Road, Taipei, 100, Taiwan.

Background: The routine application of whole-body CT after extracorporeal cardiopulmonary resuscitation (ECPR) in out-of-hospital cardiac arrest (OHCA) has not been extensively investigated. We aimed to evaluate the benefit of CT in this context.

Methods: We retrospectively analyzed all OHCA patients who had received ECPR between January 2006 to May 2019. Read More

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http://dx.doi.org/10.1186/s13049-020-00746-5DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7291474PMC

Assessment of a Deep Learning Algorithm for the Detection of Rib Fractures on Whole-Body Trauma Computed Tomography.

Korean J Radiol 2020 Jul;21(7):891-899

Clinic of Radiology and Nuclear Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.

Objective: To assess the diagnostic performance of a deep learning-based algorithm for automated detection of acute and chronic rib fractures on whole-body trauma CT.

Materials And Methods: We retrospectively identified all whole-body trauma CT scans referred from the emergency department of our hospital from January to December 2018 (n = 511). Scans were categorized as positive (n = 159) or negative (n = 352) for rib fractures according to the clinically approved written CT reports, which served as the index test. Read More

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http://dx.doi.org/10.3348/kjr.2019.0653DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289702PMC

Automatic Detection and Classification of Rib Fractures on Thoracic CT Using Convolutional Neural Network: Accuracy and Feasibility.

Korean J Radiol 2020 Jul;21(7):869-879

Department of Radiology, The Affiliated Jiangning Hospital of Nanjing Medical University, Nanjing, China.

Objective: To evaluate the performance of a convolutional neural network (CNN) model that can automatically detect and classify rib fractures, and output structured reports from computed tomography (CT) images.

Materials And Methods: This study included 1079 patients (median age, 55 years; men, 718) from three hospitals, between January 2011 and January 2019, who were divided into a monocentric training set (n = 876; median age, 55 years; men, 582), five multicenter/multiparameter validation sets (n = 173; median age, 59 years; men, 118) with different slice thicknesses and image pixels, and a normal control set (n = 30; median age, 53 years; men, 18). Three classifications (fresh, healing, and old fracture) combined with fracture location (corresponding CT layers) were detected automatically and delivered in a structured report. Read More

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http://dx.doi.org/10.3348/kjr.2019.0651DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7289688PMC

Evaluation of Sensory Mapping of Erector Spinae Plane Block.

Pain Physician 2020 Jun;23(3):E289-E296

Pain Medicine Unit Hospital Universitario San Vicente Fundación, Medellín, Colombia; Department of Anesthesia-Pain Medicine Fellowship Program, University of Antioquia, Medellín, Colombia.

Background: Erector spinae plane (ESP) block is an effective regional analgesic technique for thoracic and abdominal pain. The volume of local anesthetic (LA) needed to produce sensory block in the spinal segment is unknown.

Objectives: The aim of the present study was to examine the extent of dermatomal spread following ultrasound-guided administration of ESP block, with a fixed-volume dose of a LA at the midthoracic area for analgesia in acute thoracic pain patients. Read More

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Concealment of trauma and occupational accidents among Fukushima nuclear disaster decontamination workers: A case report.

J Occup Health 2020 Jan;62(1):e12123

Department of Public Health, Fukushima Medical University School of Medicine, Fukushima, Japan.

Objectives: Limited information exists concerning occupational risks in decontamination work after the Fukushima Daiichi Nuclear Power Plant (FDNPP) accident. Workers involved tend to be migrant workers, face various health risks, and are usually from a low socioeconomic background and generally have difficulty in finding employment. We report a specific case to illustrate the way these workers tend to get injured during working hours and draw attention to the problems arising. Read More

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http://dx.doi.org/10.1002/1348-9585.12123DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7199476PMC
January 2020

Does chest wall Organ Injury Scale (OIS) or Abbreviated Injury Scale (AIS) predict outcomes? An analysis of 16,000 consecutive rib fractures.

Surgery 2020 Jul 13;168(1):198-204. Epub 2020 May 13.

Divisions of UCMC and WCH Trauma, Section of General Surgery, Department of Surgery, University of Cincinnati, OH. Electronic address:

Background: Chest wall injuries have serious clinical consequences. It is presumed a higher severity of injury correlates with worse outcomes. The 2 most common chest wall injury severity scores, the Organ Injury Scale and the Abbreviated Injury Scale, are based on expert opinion with unknown clinical endpoints. Read More

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http://dx.doi.org/10.1016/j.surg.2020.04.032DOI Listing

Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands.

Eur J Trauma Emerg Surg 2020 Jun 6. Epub 2020 Jun 6.

Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.

Purpose: Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups.

Methods: A nationwide retrospective cohort study was performed with the use of the Dutch Trauma Registry which covers 99% of the acutely admitted Dutch trauma population. Read More

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http://dx.doi.org/10.1007/s00068-020-01412-2DOI Listing

Comparison of intravenous lidocaine versus epidural anesthesia for traumatic rib fracture pain: a retrospective cohort study.

Reg Anesth Pain Med 2020 Jun 4. Epub 2020 Jun 4.

Department of Anesthesiology, Perioperative and Pain Medicine, Stanford University, Stanford, California, USA

Background: Effective analgesia is essential in managing traumatic rib fractures. Intravenous lidocaine (IVL) is effective in treating perioperative pain, acute pain in the emergency department, cancer pain in hospice, and outpatient chronic neuropathic pain. Our study examined the associations between IVL versus epidural analgesia (EA) and pain for the treatment of acute rib fracture in the inpatient setting. Read More

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http://dx.doi.org/10.1136/rapm-2019-101120DOI Listing

Transphyseal Humeral Separations: What Can We Learn? A Retrospective, Multicenter Review of Surgically Treated Patients Over a 25-Year Period.

J Pediatr Orthop 2020 Jul;40(6):e424-e429

Department of Orthopaedics, University of Maryland Medical Center.

Purpose: Transphyseal humeral separations (TPHS) are rare injuries with only case reports and small series reported in the literature. This multicenter study aimed to assess the various patient characteristics, injury patterns, treatments, outcomes, and complications in a large series of these injuries.

Methods: A retrospective review was conducted at 5 pediatric institutions to identify TPHS that were treated surgically in patients 0 to 3 years of age over a 25-year period. Read More

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http://dx.doi.org/10.1097/BPO.0000000000001455DOI Listing

Chest wall stabilization with intercostal -suture and mesh for rib fractures.

Trauma Case Rep 2020 Aug 22;28:100311. Epub 2020 May 22.

Second Department of Surgery, School of Medicine, University of Occupational and Environmental Health, Japan.

Choosing an optimal procedure to stabilize the chest wall for multiple rib fractures can be challenging for surgeons. Stabilization with rib plates or intramedullary devices requires exposure of fractured bones, whereas chest stabilization with intercostal -suture and mesh does not, yet it offers the chest wall a sufficient level of stability. Here, we report a case of a flail chest due to multiple rib fractures for which a simple chest wall fixation using intercostal -suture and mesh was efficient. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100311DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256319PMC

Chylothorax caused by blunt trauma: Case review and management proposal.

Trauma Case Rep 2020 Aug 21;28:100308. Epub 2020 May 21.

Department of Surgery, St. Luke's Hospital of Kansas City, MO, United States of America.

Chylothorax is a potentially devastating complication of lymphatic trauma of the thorax. To date, no recommendations have provided decision making support for prompt definitive treatment. We present a 53 year old male involved in a motor vehicle collision sustaining 9 left rib fractures with flail segments. Read More

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http://dx.doi.org/10.1016/j.tcr.2020.100308DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7256325PMC

Clinical significance of rib fractures' anatomical patterns.

Injury 2020 May 23. Epub 2020 May 23.

Department of Surgery, Kaplan Medical Center, Rehovot and The Hebrew University Medical School, Jerusalem, Israel. Electronic address:

Objectives: Rib fractures are common and carry significant morbidity. Chest CT provides an accurate mapping of the fractures. The aim of this study is to propose an anatomical classification of rib fractures, and assess their relation to complication development. Read More

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http://dx.doi.org/10.1016/j.injury.2020.05.023DOI Listing

Major liver trauma post-mechanical cardiopulmonary resuscitation-the first reported case of survival with normal cardiovascular and neurological outcome.

Oxf Med Case Reports 2020 Apr 23;2020(4):omz144. Epub 2020 May 23.

Royal Brompton and Harefield NHS Foundation Trust, Harefield Hospital, Hill End Road, Harefield UB9 6JH, UK.

Cardiopulmonary resuscitation (CPR) is often conducted with mechanical devices, such as Lund University Cardiac Arrest System in the setting of cardiac arrest during coronary catheterization, to enable effective chest compressions for a prolonged period. Certain injuries from such devices are common such as skin lesions, sternal and rib fractures. Others are rarer, such as visceral injury to the heart, major vessels, lung, liver, spleen and stomach. Read More

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http://dx.doi.org/10.1093/omcr/omz144DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7243720PMC

Lessons learned from cases of rib fractures after manual therapy: a case series to increase patient safety.

J Can Chiropr Assoc 2020 Apr;64(1):7-15

Canadian Memorial Chiropractic College.

Objective: To identify commonalities among cases of rib fractures after spinal manipulative therapy (SMT); discuss chiropractors' case management perspectives; and propose strategies for prevention and/or management of future cases.

Methods: Semi-structured interviews were conducted with chiropractors who identified cases of rib fractures after SMT at a chiropractic institution's teaching clinics. Patient characteristics, incident characteristics, and chiropractors' perspectives were collected and analysed. Read More

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7250508PMC

Spirometry Not Pain Level Predicts Outcomes in Geriatric Patients with Isolated Rib Fractures.

J Trauma Acute Care Surg 2020 May 26. Epub 2020 May 26.

Department of Surgery, Yale School of Medicine.

Background: Geriatric patients with rib fractures are at risk for developing complications and are often admitted to a higher level of care (intensive care units, ICU) based on existing guidelines. Forced vital capacity has been shown to correlate with outcomes in patients with rib fractures. Complete spirometry may quantify pulmonary capacity, predict outcome and potentially assist with admission triage decisions. Read More

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http://dx.doi.org/10.1097/TA.0000000000002795DOI Listing

Comparing FE human body model rib geometry to population data.

Biomech Model Mechanobiol 2020 May 22. Epub 2020 May 22.

International Center for Automotive Medicine, University of Michigan, Ann Arbor, MI, USA.

Finite element human body models (HBMs) are used to assess injury risk in a variety of impact scenarios. The ribs are a key structural component within the chest, so their accuracy within HBMs is vitally important for modeling human biomechanics. We assessed the geometric correspondence between the ribs defined within five widely used HBMs and measures drawn from population-wide studies of rib geometry, focusing on (1) rib global shape, (2) rib cross-sectional size and shape, and (3) rib cortical bone thickness. Read More

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http://dx.doi.org/10.1007/s10237-020-01335-2DOI Listing

The Clinical Characteristics of Fractures in Pediatric Patients Exposed to Proton Pump Inhibitors.

J Pediatr Gastroenterol Nutr 2020 Jun;70(6):815-819

Children's Mercy Hospital, Kansas City, MI.

Objectives: There are increasing concerns regarding proton pump inhibitor (PPI) use and the risk of fractures in adults. Few studies have evaluated this risk among pediatric patients. This study examined fractures and fracture location among pediatric patients exposed to PPI compared with those without documented exposure. Read More

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http://dx.doi.org/10.1097/MPG.0000000000002690DOI Listing

Opioid prescription practices for patients discharged from the emergency department with acute musculoskeletal fractures.

CJEM 2020 May 21:1-8. Epub 2020 May 21.

Ottawa Hospital Research Institute, Ottawa, ON.

Background: Opioid related mortality rate has increased 200% over the past decade. Studies show variable emergency department (ED) opioid prescription practices and a correlation with increased long-term use. ED physicians may be contributing to this problem. Read More

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http://dx.doi.org/10.1017/cem.2020.50DOI Listing

May the initial CT scan predict the occurrence of delayed hemothorax in blunt chest trauma patients?

Eur J Trauma Emerg Surg 2020 May 21. Epub 2020 May 21.

Surgical and Trauma Intensive Care Unit, Anesthesiology and Critical Care Department, Hôpital Pellegrin, CHU Bordeaux, Place Amélie Raba Léon, 33076, Bordeaux Cedex, France.

Purpose: To assess the impact of delayed hemothorax on outcomes in blunt chest trauma patients without life-threatening condition at admission and characterize the predictive value of predefined anatomical factors for delayed hemothorax.

Methods: In a single-centre retrospective study, every spontaneous breathing patient admitted for a blunt chest trauma without significant pleural effusion at ICU admission was included. A multivariable regression model was used to determine the covariate-adjusted odd of secondary respiratory complications in patients with delayed hemothorax ≥ 500 ml. Read More

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http://dx.doi.org/10.1007/s00068-020-01391-4DOI Listing

Chest Trauma: Current Recommendations for Rib Fractures, Pneumothorax, and Other Injuries.

Curr Anesthesiol Rep 2020 15;10(1):61-68. Epub 2020 Jan 15.

2Consultant Anaesthetist, Intensive Care Physician & Director of Trauma Services, Wellington Hospital, Wellington, New Zealand.

Purpose Of Review: This article provides an overview of the common and important chest injuries that the anesthesiologist may encounter in patients following trauma including blunt injury, pneumothorax, hemothorax, blunt aortic injury, and blunt cardiac injury.

Recent Findings: Rib fractures are frequently associated with chest injury and are associated with significant pain and other complications. Regional anesthesia techniques combined with a multimodal analgesic strategy can improve patient outcomes and reduce complications. Read More

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http://dx.doi.org/10.1007/s40140-020-00374-wDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7223697PMC
January 2020

Analgesia of Patients with Multiple Rib Fractures in Critical Care: A Survey of Healthcare Professionals in the UK.

Indian J Crit Care Med 2020 Mar;24(3):184-189

Department of Anesthesia and Critical Care, Queen Elizabeth Hospital Birmingham, Birmingham, UK.

Introduction: Good analgesia has been shown to reduce the risk of pneumonia, chronic pain, and mortality in patients with multiple rib fractures (MRFs). This survey explores the current analgesic practice in the UK, protocol use, barriers to provision, and physician preferences.

Materials And Methods: A web-based survey was distributed nationally to an enriched cohort of clinicians working in UK trauma units with an interest in MRF management. Read More

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http://dx.doi.org/10.5005/jp-journals-10071-23375DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7225763PMC

Diagnostic Accuracy of Physical Examination and History Taking in Traumatic Rib Fracture; A Single Center Experience.

Bull Emerg Trauma 2020 Apr;8(2):111-114

Department of Emergency Medicine, Jahrom University of Medical Sciences, Jahrom, Iran.

Objective: To evaluate the diagnostic accuracy of history taking and physical examination in the patients with traumatic rib fractures.

Methods: In a cross-sectional study, all patients with multiple traumas who referred to the emergency department were evaluated for the mechanism of injury, chief complaints, vital signs and oxygen saturation. History taking and physical examination were performed according to Barbara Bates reference. Read More

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http://dx.doi.org/10.30476/BEAT.2020.46451DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7211385PMC

Blunt trauma related chest wall and pulmonary injuries: An overview.

Chin J Traumatol 2020 Jun 20;23(3):125-138. Epub 2020 Apr 20.

Gulhane Medical School, University of Health Sciences, Ankara, Turkey.

Physical traumas are tragic and multifaceted injuries that suddenly threaten life. Although it is the third most common cause of death in all age groups, one out of four trauma patients die due to thoracic injury or its complications. Blunt injuries constitute the majority of chest trauma. Read More

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http://dx.doi.org/10.1016/j.cjtee.2020.04.003DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7296362PMC

Successful surgical treatment of Cronkhite-Canada Syndrome with bilateral flail chest: a case report.

BMC Surg 2020 May 13;20(1):103. Epub 2020 May 13.

Department of Thoracic Surgery, First Hospital of Jilin University, No. 71, Xinmin Street, Changchun, Jilin, People's Republic of China.

Background: Development of multiple rib fractures leading to bilateral flail chest in Cronkhite-Canada Syndrome (CCS) has not been reported.

Case Presentation: A 59-year-old man presented with complaints of fatigue, chest pain, respiratory distress and orthopnea requiring ventilatory support to maintain oxygenation. CCS with bilateral anterior and posterior flail chest due to multiple rib fractures (2nd-10th on the right side and 2nd-11th on the left side). Read More

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http://dx.doi.org/10.1186/s12893-020-00766-zDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7222535PMC

Utility of erector spinae plane block in thoracic surgery.

J Cardiothorac Surg 2020 May 12;15(1):91. Epub 2020 May 12.

Department of General Surgery, Georgetown University School of Medicine, Medstar Washington Hospital Center, Washington DC, USA.

Background: Thoracic surgeons have been incorporating enhanced recovery after surgery (ERAS) protocols into their practices, not only to reduce narcotic usage but also to improve complication rates and decrease lengths of stay. Here, we describe the utility of a regional block technique that can be used for patients undergoing urgent or elective thoracic surgical procedures or suffering from rib fractures.

Methods: We report our initial one-year experience with these erector spinae plane (ESP) blocks. Read More

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http://dx.doi.org/10.1186/s13019-020-01118-xDOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7218639PMC

Stability of Surgical Rib Fixation Hardware after Repeat Chest Trauma.

J Emerg Trauma Shock 2020 Jan-Mar;13(1):84-87. Epub 2020 Mar 19.

Department of Surgery, Medical University of South Carolina, Charleston, South Carolina, USA.

Surgical management of rib fractures has long been a controversial topic, but improvements in rib plating technology have led to a recent increase in interest among surgeons. Unfortunately, follow-up data are limited in patients following rib fracture plating. We present a unique case of an adult male who had multiple ribs plated for symptomatic rib fracture nonunions and developed periprosthetic fractures following repeat trauma several months later. Read More

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http://dx.doi.org/10.4103/JETS.JETS_67_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7204963PMC

Indication-Specific Opioid Prescribing for US Patients With Medicaid or Private Insurance, 2017.

JAMA Netw Open 2020 May 1;3(5):e204514. Epub 2020 May 1.

National Center for Injury Prevention and Control, Centers for Disease Control and Prevention, Atlanta, Georgia.

Importance: Although opioids can be effective medications in certain situations, they are associated with harms, including opioid use disorder and overdose. Studies have revealed unexplained prescribing variation and prescribing mismatched with patient-reported pain for many indications.

Objective: To summarize opioid prescribing frequency, dosages, and durations, stratified across numerous painful medical indications. Read More

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http://dx.doi.org/10.1001/jamanetworkopen.2020.4514DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7215258PMC

Anatomy of the Ribs and Management of their Fractures as Viewed by Avicenna (980-1037 Ad).

Acta Med Hist Adriat 2019 12;17(2):305-312

Department of Orthopedic Surgery, Bone and Joint Disease Research Center, Chamran Hospital, Shiraz University of Medical Sciences, District 6, Chamran Blvd, 71948-15644 Shiraz, Iran. E‑mail:

Introduction: Avicenna statedinteresting points on the symptoms of rib bone fractures, their physical examination, and also treatment and management of the complications in his master piece Canon in Tibb.

Method: We reviewed Avicenna's Canon and his viewpoints on the anatomy of the rib bones and their fractures and compared it with conventional medicine.

Result: He described the ana omy of the ribs; he explained the effectiveness of their structure in the prote tion of vital organs. Read More

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http://dx.doi.org/10.31952/amha.17.2.8DOI Listing
December 2019

Neurofibromatosis type 1 associated with hypophosphatemic osteomalacia due to hypersecretion of fibroblast growth factor 23: a case report.

J Med Case Rep 2020 May 9;14(1):56. Epub 2020 May 9.

Department of Diabetes and Endocrine Medicine, Kagoshima University Graduate School of Medicine and Dental Sciences, Kagoshima University, 8-35-1 Sakuragaoka, Kagoshima, 890-8520, Japan.

Background: Neurofibromatosis type 1 is characterized by multiple café au lait spots and cutaneous and plexiform neurofibromas, and is one of the most common autosomal dominant hereditary disorders caused by mutations of the neurofibromatosis type 1 tumor suppressor gene. Osteomalacia in neurofibromatosis type 1 is very rare and is characterized by later onset in adulthood. In humans, fibroblast growth factor 23, which is a causative factor of tumor-induced osteomalacia, is not only a paracrine and autocrine factor, but is also a physiological regulator of phosphate balance in normal serum. Read More

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http://dx.doi.org/10.1186/s13256-020-02381-1DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7210688PMC

Unilateral Bilevel Erector Spinae Plane Catheters for Flail Chest: A Case Report.

A A Pract 2020 May;14(7):e01211

From the Department of Anesthesiology and Perioperative Medicine, University of Louisville, Louisville, Kentucky.

Providing effective analgesia for acute rib fractures is crucial in avoiding pulmonary complications. Erector spinae plane (ESP) block is an alternative treatment option to neuraxial techniques. ESP blocks have demonstrated pain relief in patients with rib fractures. Read More

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http://dx.doi.org/10.1213/XAA.0000000000001211DOI Listing

Pediatric Rib Fractures Identified by Chest Radiograph: A Comparison Between Accidental and Nonaccidental Trauma.

Pediatr Emerg Care 2020 May 4. Epub 2020 May 4.

Department of Pediatrics, The Warren Alpert Medical School of Brown University.

Objective: The objective of this study was to determine the prevalence of rib fractures (RFs) identified by chest x-ray (CXR) among children younger than 2 years who sustained accidental versus nonaccidental injuries. It is hypothesized that RFs are uncommon among all accidental pediatric trauma mechanisms (eg, falls, motor vehicle crashes) as compared with the prevalence of RFs in the setting of nonaccidental trauma (NAT).

Methods: A retrospective chart review of sequential CXRs of children younger than 2 years evaluated at a pediatric level 1 trauma center for accidental trauma and possible NAT was conducted from January 1, 2011, to October 31, 2016. Read More

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http://dx.doi.org/10.1097/PEC.0000000000002061DOI Listing

Combining the use of Nuss procedure and rib fixation for severe flail chest: a case report.

BMC Surg 2020 May 5;20(1):87. Epub 2020 May 5.

Department of Thoracic Surgery, Shenzhen Hospital, Southern Medical University, No.1333, Xinhu Road, Bao'an District, Shenzhen, 518101, Guangdong, China.

Background: Severe flail chest is a life-threatening situation. The Nuss procedure is a new effective treatment for severe flail chest patients who cannot be weaned from prolonged mechanical ventilation in the last few years. However, the procedure is not suitable when there are multiple fractures in both the anterior and lateral chest walls. Read More

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http://dx.doi.org/10.1186/s12893-020-00747-2DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7201783PMC

Clinical Decision Support Intervention for Rib Fracture Treatment.

J Am Coll Surg 2020 Apr 30. Epub 2020 Apr 30.

Trauma Services, North Memorial Health Hospital, Robbinsdale, University of Minnesota, Minneapolis, MN; Department of Surgery, University of Minnesota, Minneapolis, MN; Institute for Health Informatics, University of Minnesota, Minneapolis, MN. Electronic address:

Background: Rib fractures are associated with significant morbidity and mortality. Despite the publication of management guidelines and national outcomes benchmarking, there is significant variation in evidence-based (EB) adherence and outcomes. Systems for clinical decision support intervention (CDSI) allow rapid ordering of bundled disease-specific EB treatments. Read More

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http://dx.doi.org/10.1016/j.jamcollsurg.2020.04.023DOI Listing