Department of Orthopaedics, Xinqiao Hospital, Chongqing, China.
Orthop Surg. 2013 May;5(2):100-4. doi: 10.1111/os.12039.
To investigate the characteristics of patients with traumatic vertebral fractures and concomitant fractures of the first rib and their management.
From January 2001 to December 2010, 17/3142 patients (0.5%) with traumatic vertebral fractures who presented to our hospitals had concomitant fractures of the first rib.
The study included 14 men (82.4%) and 3 women (17.6%) patients of age 32-57 years (mean, 46.6 years). The mechanisms of trauma were falls from heights in seven, motor vehicle accidents in five and direct collisions with blunt objects in five. Thirteen patients (76.5%) presented initially with pulmonary complications after sustaining trauma. Three patients sustained one rib fracture, two three rib fractures, three four rib fractures and 10 > five rib fractures. The injuries were right-sided in three cases, left-sided in three and bilateral in eleven. Four patients (23.5%) presented with craniocerebral injuries. According to the American Spinal Injury Association (ASIA) classification, 10 patients (58.8% of the total study group) had motor and sensory deficits (ASIA A-D). There were no vascular injuries or deaths.
Traumatic vertebral fractures with concomitant fractures of the first rib are associated with multisystem injuries, but not always with morbidity and mortality. A multidisciplinary approach, early diagnosis, appropriate treatment and observation in the intensive care unit may prevent morbidity and/or mortality.
探讨创伤性椎体骨折合并第一肋骨骨折患者的特点及其治疗方法。
自 2001 年 1 月至 2010 年 12 月，我院收治的 3142 例创伤性椎体骨折患者中，有 17 例（0.5%）合并第一肋骨骨折。
本研究纳入 14 例男性（82.4%）和 3 例女性（17.6%）患者，年龄 32-57 岁（平均 46.6 岁）。创伤机制为高处坠落 7 例，机动车事故 5 例，钝性物体直接撞击 5 例。13 例（76.5%）患者创伤后初始即出现肺部并发症。3 例患者单处肋骨骨折，2 例 3 处肋骨骨折，3 例 4 处肋骨骨折，10 例>5 处肋骨骨折。损伤部位右侧 3 例，左侧 3 例，双侧 11 例。4 例（23.5%）患者合并颅脑损伤。根据美国脊柱损伤协会（ASIA）分类，10 例（总研究组的 58.8%）患者存在运动和感觉功能障碍（ASIA A-D）。无血管损伤或死亡。
创伤性椎体骨折合并第一肋骨骨折常伴有多系统损伤，但不一定导致发病率和死亡率增加。多学科方法、早期诊断、适当的治疗和重症监护室观察可能预防发病率和/或死亡率。
