Dolinak David
Cuyahoga County Coroner's Office, Cleveland, Ohio 44106, USA.
Am J Forensic Med Pathol. 2007 Jun;28(2):107-10. doi: 10.1097/01.paf.0000257392.36528.b8.
Although it is widely known that adults may sustain fractures of the anterior and/or lateral aspects of the ribs due to cardiopulmonary resuscitation (CPR) efforts, relatively little is written about the generation of CPR-related rib fractures in the infant age range. In a series of 70 consecutive autopsies in infants ranging in age from 2 weeks to 8 months, with no history or indications of injury, the parietal pleura of the thoracic cage was stripped and the ribs carefully examined for fracture. Subtle fractures of the anterolateral aspects of the ribs were discovered in 8 (11%) of the 70 cases. In 7 of the 8 cases, multiple ribs were fractured (ranging up to 10 rib fractures), and in 5 of these cases, the rib fractures were bilateral. All of the rib fractures were subtle, had little if any associated blood extravasation, and would have been easily missed had the parietal pleura not been stripped. These anterolateral rib fractures in infants are the likely correlate of anterolateral rib fractures that are not uncommonly seen in the adult population, resulting from resuscitation efforts. The rib fractures are subtle and may not be identified unless the parietal pleura is stripped.
虽然众所周知，成人可能因心肺复苏（CPR）操作而导致肋骨前侧和/或外侧骨折，但关于婴儿年龄范围内与CPR相关的肋骨骨折的发生情况，相关文献相对较少。在一系列连续70例年龄从2周龄至8月龄的婴儿尸检中，这些婴儿均无受伤史或受伤迹象，剥离胸廓的壁层胸膜并仔细检查肋骨是否骨折。在70例中的8例（11%）发现肋骨前外侧有细微骨折。在这8例中的7例，有多根肋骨骨折（多达10根肋骨骨折），其中5例肋骨骨折为双侧性。所有肋骨骨折均很细微，几乎没有或没有相关的血液外渗，如果不剥离壁层胸膜，这些骨折很容易被漏诊。婴儿的这些前外侧肋骨骨折可能与成人中因复苏操作而常见的前外侧肋骨骨折相关。肋骨骨折很细微，除非剥离壁层胸膜，否则可能无法识别。
