A prospective randomized trial on trauma thoracic cage with rib fracture especially first rib fracture and associated complications

Abstract

Background: Thoracic cage is an osseocartilaginous cavity which not only protects and supports vital organs but also has dynamic role in mechanism of respiration. The aim was to study the mechanism of first rib fracture, incidence and complications of first rib and other ribs’ fracture and their sequelae.

Methods: A prospective randomized trial was conducted on 300 patients of trauma thoracic cage having rib fracture with or without associated injuries at NIMS Medical College and Hospital, Jaipur, Rajasthan, India from April 2013 to March 2016. All patients were examined on a fixed protocol (age, sex, mode of injury, vital status, number and site of rib fracture) with associated injury and complications.

Results:Maximum patients (including males and females both) with first and other rib fractures were in the age group of 11-30 years. The most common mode of trauma was roads traffic accident (RTA). First rib fractured at shaft by indirect trauma mostly. Commonly reported chest, abdomen and associated injury complications were haemothorax, haemoperitoneum and head injury respectively. Most of the patients were treated conservatively except 1% patients who required thoracotomy.

Conclusions:Most common cause of chest trauma with rib fracture was RTA and first rib fracture was indirect trauma. The most common cause of mortality was an associated head injury.