Mintz A C, Albano A, Reisdorff E J, Choe K A, Lillegard W
College of Human Medicine, Michigan State University, Lansing.
Ann Emerg Med. 1990 Apr;19(4):411-4. doi: 10.1016/s0196-0644(05)82349-2.
Fracture of the first rib usually results from high-impact, direct trauma. Stress fractures are less common and are associated with minimal morbidity. The case of a patient with a stress fracture resulting from the use of an exercise machine is reported. Previous reports have attributed stress and fatigue fractures of the first rib to the forces exerted by the scalene muscles. A new pathophysiologic mechanism involving the serratus anterior muscle is introduced and is supported by T2 relaxation times from magnetic resonance imaging. Stress and fatigue fractures of the first rib have minimal complications. An aggressive diagnostic evaluation of first rib fractures occurring by this mechanism is not warranted.
第一肋骨骨折通常由高冲击力的直接创伤引起。应力性骨折较为少见，且发病率较低。本文报告了一例因使用健身器械导致应力性骨折的患者病例。既往报道将第一肋骨的应力性骨折和疲劳性骨折归因于斜角肌施加的力量。本文介绍了一种涉及前锯肌的新病理生理机制，并得到了磁共振成像T2弛豫时间的支持。第一肋骨的应力性骨折和疲劳性骨折并发症较少。对于由这种机制引起的第一肋骨骨折，无需进行积极的诊断评估。
