Fisher R G, Ward R E, Ben-Menachem Y, Mattox K L, Flynn T C
AJR Am J Roentgenol. 1982 Jun;138(6):1059-62. doi: 10.2214/ajr.138.6.1059.
The prevailing opinion that inlet (first and second) rib fractures carry a high rate of aortic-brachiocephalic injuries was tested in a retrospective analysis of radiographic, angiographic, and surgical records of 214 patients. Two patient populations were defined, identical in all traumatologic and radiologic aspects, except for the presence of inlet rib fractures in one group. Aortic/brachiocephalic trauma occurred at the same frequency in both populations. Because the contemporaneous occurrence of aortic-brachiocephalic wounding and inlet rib fractures is entirely a matter of coincidence, the presence of an inlet rib fracture alone should not constitute an indication for angiography. Vascular studies must be prompted by the presence of clinical signs or by radiographic findings suggesting a hematoma.
通过对214例患者的放射学、血管造影和手术记录进行回顾性分析，对“第一和第二肋骨（入口处）骨折导致主动脉-头臂血管损伤的发生率较高”这一普遍观点进行了验证。定义了两个患者群体，除了一组存在入口处肋骨骨折外，在所有创伤学和放射学方面均相同。主动脉/头臂血管创伤在这两个群体中的发生率相同。由于主动脉-头臂血管损伤与入口处肋骨骨折同时发生完全是巧合，因此仅存在入口处肋骨骨折不应构成血管造影的指征。血管研究必须由临床体征或提示血肿的放射学表现来推动。
