Faculty of Medicine, Department of Orthopedic and Trauma Surgery, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Faculty of Medicine, Department of Anesthesiology, Friedrich-Alexander-Universität Erlangen-Nürnberg, Erlangen, Germany.
Eur J Trauma Emerg Surg. 2024 Oct;50(5):2295-2304. doi: 10.1007/s00068-024-02631-7. Epub 2024 Aug 27.
Aim of this work was the evaluation and validation of the AO/OTA classification of the anterior chest wall, here especially for the rib cartilage.
Study design was a retrospective analysis of patients who were hospitalized with fractures of the thoracic wall in the years 2010-2016. This resulted in a collective of n = 124 patients. All fractures of the anterior chest wall were classified according to their location, dislocation and fracture type according to the AO classification. An analysis of possible subtypes was carried out.
29.0% (36) of the patients had fractures of the rib cartilage. 23 of the 36 (64%) patients had multiple fractures, the total number of single fractures amounted to 94. 53.2% (50) of these fractures were in the right hemithorax, 46.8% (44) in the left hemithorax. 95.7% (90) of the fractures were A-fractures, 4.3% (4) were C-fractures. There were no B fractures. The C fractures also consisted exclusively of A fractures (AA fractures). 59.6% (56) of the fractures showed a dislocation. 30.9% (29) were avulsion fractures of either the osteochondral (22.3% (21)) or the sternocostal junction (8.5% (8)).
The costal cartilage obviously does not show typical B fractures as we know them from shaft fractures of long bones. We have compiled a structured analysis in the attached manuscript and validated the classification proposal. In conclusion, we propose an adaptation of the classification proposal based on our data with redefining type B fractures as fractures of the osteochondral joints.
本研究旨在评估和验证 AO/OTA 前胸壁分类法，特别是针对肋软骨。
本研究为回顾性分析，纳入 2010 年至 2016 年期间因胸壁骨折住院的患者，共纳入 124 例患者。所有前胸壁骨折均根据 AO 分类法的位置、错位和骨折类型进行分类。并对可能的亚型进行分析。
29.0%（36 例）患者存在肋软骨骨折。36 例中的 23 例（64%）为多发性骨折，单发骨折总数为 94 例。50.0%（50 例）骨折位于右侧胸腔，46.8%（44 例）位于左侧胸腔。95.7%（90 例）的骨折为 A 型骨折，4.3%（4 例）为 C 型骨折。无 B 型骨折。C 型骨折也完全由 A 型骨折组成（AA 骨折）。59.6%（56 例）的骨折存在错位。30.9%（29 例）为软骨-骨连接处的撕脱性骨折（22.3%（21 例））或胸骨肋连接处的撕脱性骨折（8.5%（8 例））。
肋软骨显然不显示我们从长骨骨干骨折中了解的典型 B 型骨折。我们在附加的手稿中编制了结构化分析，并验证了分类建议。结论是，我们根据数据提出了分类建议的改编，将 B 型骨折重新定义为软骨-骨连接处骨折。
