Jaiswal Atin, Tanwar Yashwant S, Habib Masood, Jain Vijay
Department of Orthopaedics, Bokaro General Hospital, Bokaro, India.
Chin J Traumatol. 2013;16(4):251-3.
According to medical literature, fracture of the first rib is quite rare and the bilateral condition is especially rare. This type of fracture is usually associated with severe intrathoracic trauma and other bony or neurovascular injuries, thus can be considered as a harbinger of major trauma. However here we present three cases of low velocity first rib fractures without any major trauma or multisystem injuries. All the three patients were treated conservatively and did well on simple analgesics and rest and had no early or late complications. It can be seen that not all the first rib fractures are associated with major trauma or multisystem injuries. There is a variant of first rib fracture with low velocity injuries which is not associated with any major complications in contrast to majority of first rib fractures associated with high velocity injuries. Causative factor of such injuries may be violent muscular contraction of scalenus anterior or serratus anterior, but not direct trauma.
根据医学文献，第一肋骨骨折相当罕见，双侧骨折尤为罕见。此类骨折通常与严重的胸内创伤及其他骨骼或神经血管损伤相关，因此可被视为重大创伤的先兆。然而，我们在此呈现三例低速第一肋骨骨折病例，这些病例并无任何重大创伤或多系统损伤。所有三名患者均接受保守治疗，仅使用简单止痛药物并休息，恢复良好，无早期或晚期并发症。可见，并非所有第一肋骨骨折都与重大创伤或多系统损伤相关。存在一种低速损伤导致的第一肋骨骨折变体，与大多数与高速损伤相关的第一肋骨骨折不同，这种骨折不伴有任何重大并发症。此类损伤的致病因素可能是前斜角肌或前锯肌的剧烈肌肉收缩，而非直接创伤。
