Materiały źródłowe

• #1 Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224105

  Rib fractures represent the most common bone fracture, occurring in 10-20% of all blunt trauma patients and leading to concomitant injuries of the inner organs in severe cases. […] Rib fractures are common injuries after blunt chest trauma, occurring in 60-80% of all cases. […] In general, rib fractures represent the most frequent type of bone fractures, being observed in about 10-20% of all trauma patients. […] In about 50% of all rib fracture cases, three or more consecutive ribs are broken, also referred to as serial rib fractures. […] Serial rib fractures showed distinct fracture patterns depending on the cause of accident. […] The findings of the present study indicate that serial rib fractures generally show specific fracture patterns. […] The specific fracture patterns of the single groups can be mainly explained by the boundary conditions relating to the causes of accidents.

• #2 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  The incidence of rib fractures is dramatically underreported. More than 2 million blunt mechanisms of injury occur annually just as motor vehicle collisions, with reported incidence of chest injury between 67 and 70% of those. The prevalence of rib fractures is linked to the prevalence of the underlying cause of the trauma. Rib fractures are more common in countries with higher incidence of MVAs. […] Older persons are more prone to rib fractures than younger adults and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. […] Rib fractures are not usually dangerous in and of themselves. Patients may develop pneumonia from splinting. Morbidity correlates with the degree of injury to underlying structures.

• #3 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #4 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #5

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #6 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #7 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #8 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  The incidence of rib fractures is dramatically underreported. More than 2 million blunt mechanisms of injury occur annually just as motor vehicle collisions, with reported incidence of chest injury between 67 and 70% of those. The prevalence of rib fractures is linked to the prevalence of the underlying cause of the trauma. Rib fractures are more common in countries with higher incidence of MVAs. […] Older persons are more prone to rib fractures than younger adults and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. […] Rib fractures are not usually dangerous in and of themselves. Patients may develop pneumonia from splinting. Morbidity correlates with the degree of injury to underlying structures.

• #9 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Learn about the epidemiology, pathophysiology, and management of multiple rib fractures associated with blunt trauma, including their impact on respiration and risk factors. […] Frequency Dramatically underreported 2 million blunt mechanisms of injury occur annually as MVC Chest injury 67-70% of those. […] International Prevalence is linked to underlying cause of trauma More common in countries with higher incidence of MVC Mortality/Morbidity Rib f(x) not usually dangerous alone Pneumonia / atelectasis largest risk Morbidity correlates with degree of injury to underlying structures. […] Mortality rates of 12% in one study of rib f(x) 94% had associated injuries / 32% had a HTX/PTX Ziegler, W. J Trauma, Dec 2004. 50% required operative or ICU care Average blood loss was 150-200ml per rib f(x).

• #10 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #11 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=18639933&AN=155125257&h=RRLHKSv0uTXk8oj8IckEVpaP4%2Ft72Lvj%2BEHyz9KJDL%2FsWF%2FlroMUKxlyx7Q89TEniCW%2B1nh47RjlkF3ELkYsaw%3D%3D&crl=f

  Results: A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3–11) and 37.3% were admitted to the intensive care unit (ICU). […] Conclusions: Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #12 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,00 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #13

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #14 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,00 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #15

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #16 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,00 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #17

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #18 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,00 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #19

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #20 Traumatic Rib Fractures: Epidemiology, Treatment and Outcome

  https://dspace.library.uu.nl/handle/1874/406963

  Rib fractures are still a relevant and frequently occurring injury associated with a significant morbidity and mortality. Six percent of all hospitalized trauma patients appeared to sustain one or more fractured ribs and the absolute incidence rate of rib fractures requiring hospital admission among the Dutch population was 29 per 100,000 person-years. […] Furthermore, we found that the incidence rate of rib fractures in the elderly was even higher with 72 per 100,000 person-years, which illustrates the high clinical impact of rib fractures on the elderly population. Hence, given the considerable morbidity and mortality of rib fractures in these patients, it could be argued that rib fractures may impose the largest burden of disease after hip fractures in the elderly trauma patient. […] Furthermore, with the increasing aging population, it is to be expected that the incidence of elderly patients with fractured ribs requiring clinical care will increase.

• #21 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. […] Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. […] Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. […] A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. […] Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.

• #22 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5 per 1000 person years. Independent risk factors for an incident rib fracture (which represented 24% of all incident non-spine fractures) were age 80 or over, low bone mineral density, difficulty with instrumental activities of daily living, and a baseline history of rib or chest fracture. […] A history of rib or chest fracture carried at least a twofold increased risk of an incident rib fracture, hip fracture, or wrist fracture. […] Rib fracture should be considered to be an osteoporotic fracture when older men are evaluated for treatment to prevent future fracture.

• #23 Urgent Care Considerations for the Patient with Suspected Rib Fracture – Journal of Urgent Care Medicine

  https://www.jucm.com/urgent-care-considerations-for-the-patient-with-suspected-rib-fracture/

  Rib fractures are frequently encountered among patients after sustaining blunt thoracic trauma presenting to the emergency department (ED) or UC, with falls and motor vehicle collisions (MVC) accounting for the largest proportion of cases. […] Based on aggregate data from the National Trauma Data Bank, rib fractures have been found to occur more frequently in Caucasian and male patients with a median age of 51 years at the time of diagnosis. […] Importantly, to date, there have been no studies published describing the prevalence of rib fractures and associated injuries in patients presenting to UC centers after thoracic trauma. […] A systematic review of 73 studies on patients with chest injury revealed the most significant risk factors for mortality associated with blunt chest wall trauma: Age 65 years, Presence of 3 or more rib fractures, Presence of comorbid cardiopulmonary disease.

• #24 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  The incidence of rib fractures is dramatically underreported. More than 2 million blunt mechanisms of injury occur annually just as motor vehicle collisions, with reported incidence of chest injury between 67 and 70% of those. The prevalence of rib fractures is linked to the prevalence of the underlying cause of the trauma. Rib fractures are more common in countries with higher incidence of MVAs. […] Older persons are more prone to rib fractures than younger adults and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. […] Rib fractures are not usually dangerous in and of themselves. Patients may develop pneumonia from splinting. Morbidity correlates with the degree of injury to underlying structures.

• #25

  https://www.orthobullets.com/trauma/1061/flail-chest

  Flail chest is a traumatic chest injury defined as segmental fractures of 3 or more consecutive ribs and is often associated with pulmonary injuries such as hemothorax and pneumothorax. […] Incidence approximately 300,000 cases per year, 7% require hospitalization for medical and/or surgical treatment. […] Greater number of fractured ribs correlates with increased morbidity and mortality. […] Bimodal distribution younger patients involved in trauma older patients with osteopenia. […] Ribs 7-10 are most commonly fractured.

• #26 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #27 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  The incidence of rib fractures is dramatically underreported. More than 2 million blunt mechanisms of injury occur annually just as motor vehicle collisions, with reported incidence of chest injury between 67 and 70% of those. The prevalence of rib fractures is linked to the prevalence of the underlying cause of the trauma. Rib fractures are more common in countries with higher incidence of MVAs. […] Older persons are more prone to rib fractures than younger adults and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. […] Rib fractures are not usually dangerous in and of themselves. Patients may develop pneumonia from splinting. Morbidity correlates with the degree of injury to underlying structures.

• #28 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Each additional rib fracture increases mortality by 19% Increases incidence of pneumonia by 27%. […] Should raise high suspicion for severe injury Mortality rates 36% reported w/associated 1st rib fracture. […] Elderly more prone than young Pulmonary sequelae including atelectasis, pneumonia and respiratory arrest more likely in elderly Cardiopulmonary disease increases morbity/mortality in patients 65 y/o.

• #29 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  The incidence of rib fractures is dramatically underreported. More than 2 million blunt mechanisms of injury occur annually just as motor vehicle collisions, with reported incidence of chest injury between 67 and 70% of those. The prevalence of rib fractures is linked to the prevalence of the underlying cause of the trauma. Rib fractures are more common in countries with higher incidence of MVAs. […] Older persons are more prone to rib fractures than younger adults and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. […] Rib fractures are not usually dangerous in and of themselves. Patients may develop pneumonia from splinting. Morbidity correlates with the degree of injury to underlying structures.

• #30

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #31 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  The majority of rib fractures occur in older adults: patients who are 65 years of age or older. According to the United States (US) Census, there are 56 million adults over the age of 65 years, 16.8% of the total population. Hospitals in the US are now experiencing a higher volume of geriatrics patients and are faced with managing the health-related challenges this demographic brings. Older adults tend to be at heightened risk for respiratory complications following rib fractures such as pneumonia, acute respiratory distress syndrome, pulmonary embolism, pneumothorax, emphysema, and aspiration pneumonia. The mortality rate for rib fractures is substantial, approximately 10% for all ages. Although likely confounded by other concurrent traumatic injuries, such as head trauma, a retrospective study showed an increased mortality risk in patients older than 65. Each additional rib fracture in older adults compared to younger patients increases mortality by 19% and the risk of pneumonia by 27%. Data support a direct correlation between increasing numbers of rib fractures and increased pulmonary morbidity and mortality, with patients presenting with six or more rib fractures being at a higher risk for death from causes unrelated to the rib fracture.

• #32 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. […] Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. […] Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. […] A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. […] Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.

• #33 Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States

  https://www.jtraumainj.org/journal/view.php?doi=10.20408/jti.2023.0065

  Different mechanisms of injury result in distinct rib fracture patterns. […] The mechanism of injury (MOI) is an important predictor of the extent of injury in trauma patients. […] The major finding of this investigation is that there is a significant association between the MOI and rib fracture pattern. […] Unique rib fracture patterns are generated by different mechanisms of injury. […] Research focusing on the association between MOI and rib fracture patterns, and the implications of morbidity and mortality, is ongoing.

• #34

  https://www.aast.org/resources-detail/rib-fractures

  Rib fractures that are single and non-displaced are classified as hairline fractures or simple fractures. […] The most common mechanism causing rib fractures is blunt trauma (i.e. automobile accidents, falls from height, assault, or even severe coughing). […] Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. […] Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures. […] Rib fractures are typically diagnosed on chest x-ray and the severity of the fracture is easily seen. […] The most common symptom of rib fractures is pain. […] A flail chest is invariably accompanied by pulmonary contusion, a bruise of the lung tissue that can result in a clinical entity called acute lung injury.

• #35 Inpatient management of traumatic rib fractures and flail chest in adults – UpToDate

  https://www.uptodate.com/contents/inpatient-management-of-traumatic-rib-fractures-and-flail-chest-in-adults

  Traumatic rib fractures are the consequence of significant forces impacting the chest wall and are most commonly due to blunt injuries (eg, motor vehicle crash, falls, assault), but penetrating injuries (eg, gunshot) can also fracture ribs. Rib fractures are a marker of more severe injuries and are present in 10 percent of all trauma patients and approximately 30 percent of patients with significant chest trauma. […] The number of fractured ribs also directly correlates with the presence of intrathoracic injury. […] Multiply fractured ribs or flail chest can significantly compromise respiratory function. Pneumonia is often the common pathway to acute respiratory failure resulting from rib fractures, and prevention offers the best means to avoid potentially preventable deaths. […] The main goal of treatment is to prevent pneumonia and other complications of rib fractures (eg, nonunion). Conservative treatment includes pain control and aggressive supportive pulmonary care to avoid the need for intubation. […] For patients in whom these conservative measures are not adequate, rib fracture stabilization may be beneficial. […] This topic review will discuss inpatient management of multiple traumatic rib fractures.

• #36 Inpatient management of traumatic rib fractures and flail chest in adults – UpToDate

  https://www.uptodate.com/contents/inpatient-management-of-traumatic-rib-fractures-and-flail-chest-in-adults

  Traumatic rib fractures are the consequence of significant forces impacting the chest wall and are most commonly due to blunt injuries (eg, motor vehicle crash, falls, assault), but penetrating injuries (eg, gunshot) can also fracture ribs. Rib fractures are a marker of more severe injuries and are present in 10 percent of all trauma patients and approximately 30 percent of patients with significant chest trauma. […] The number of fractured ribs also directly correlates with the presence of intrathoracic injury. […] Multiply fractured ribs or flail chest can significantly compromise respiratory function. Pneumonia is often the common pathway to acute respiratory failure resulting from rib fractures, and prevention offers the best means to avoid potentially preventable deaths. […] The main goal of treatment is to prevent pneumonia and other complications of rib fractures (eg, nonunion). Conservative treatment includes pain control and aggressive supportive pulmonary care to avoid the need for intubation. […] For patients in whom these conservative measures are not adequate, rib fracture stabilization may be beneficial. […] This topic review will discuss inpatient management of multiple traumatic rib fractures.

• #37

  https://www.aast.org/resources-detail/rib-fractures

  Rib fractures that are single and non-displaced are classified as hairline fractures or simple fractures. […] The most common mechanism causing rib fractures is blunt trauma (i.e. automobile accidents, falls from height, assault, or even severe coughing). […] Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. […] Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures. […] Rib fractures are typically diagnosed on chest x-ray and the severity of the fracture is easily seen. […] The most common symptom of rib fractures is pain. […] A flail chest is invariably accompanied by pulmonary contusion, a bruise of the lung tissue that can result in a clinical entity called acute lung injury.

• #38 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Rib fractures are common injuries that occur most often following blunt thoracic trauma but can also result from severe coughing, athletic activities (eg, rowing, swinging golf clubs, throwing, which can cause rib stress fractures), and nonaccidental trauma (ie, child abuse). Concomitant injuries and complications range from mild discomfort to life-threatening conditions such as pneumothorax, splenic laceration, and pneumonia. […] Rib fractures in victims of blunt trauma are generally identified clinically or by chest radiograph (CXR). A definitive diagnosis of rib fractures is not always necessary. The presence of isolated rib fractures does not have to be radiologically confirmed in all patients once associated injury has been adequately excluded, typically with a CXR, which is obtained primarily to identify pneumothorax, hemothorax, and other signs of intrathoracic injury.

• #39 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Rib fractures are common injuries that occur most often following blunt thoracic trauma but can also result from severe coughing, athletic activities (eg, rowing, swinging golf clubs, throwing, which can cause rib stress fractures), and nonaccidental trauma (ie, child abuse). Concomitant injuries and complications range from mild discomfort to life-threatening conditions such as pneumothorax, splenic laceration, and pneumonia. […] Rib fractures in victims of blunt trauma are generally identified clinically or by chest radiograph (CXR). A definitive diagnosis of rib fractures is not always necessary. The presence of isolated rib fractures does not have to be radiologically confirmed in all patients once associated injury has been adequately excluded, typically with a CXR, which is obtained primarily to identify pneumothorax, hemothorax, and other signs of intrathoracic injury.

• #40 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Upper extremity bone stress injuries are less common, but have been reported in many different athletes, including rowers, weightlifters, gymnasts, swimmers, golfers, and pitchers. […] Bone stress injuries in throwing athletes generally occur around the shoulder girdle and trunk, and have been reported in the clavicle, ribcage (primarily 1st rib), humerus, olecranon, and ulna. […] Case reports of rib stress injuries in pitchers indicate that the first rib may be the most common site in the ribcage, with injuries at the lower ribs less commonly reported. […] Compared to intercostal and abdominal oblique muscle strains, major league baseball pitchers who sustain rib stress fractures have a prolonged recovery, generally requiring 8-10 weeks before returning to play, versus an average of 5 weeks for muscle strains.

• #41 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Rib fractures are common injuries that occur most often following blunt thoracic trauma but can also result from severe coughing, athletic activities (eg, rowing, swinging golf clubs, throwing, which can cause rib stress fractures), and nonaccidental trauma (ie, child abuse). Concomitant injuries and complications range from mild discomfort to life-threatening conditions such as pneumothorax, splenic laceration, and pneumonia. […] Rib fractures in victims of blunt trauma are generally identified clinically or by chest radiograph (CXR). A definitive diagnosis of rib fractures is not always necessary. The presence of isolated rib fractures does not have to be radiologically confirmed in all patients once associated injury has been adequately excluded, typically with a CXR, which is obtained primarily to identify pneumothorax, hemothorax, and other signs of intrathoracic injury.

• #42 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Pitching is a complex kinetic chain activity requiring the transfer of energy from the lower body, through the core and trunk, and finally through the arm to generate explosive acceleration of the baseball. […] The repetitive cumulative load and high pitch velocities put professional pitchers at risk of rib stress fracture. […] Given the potential for a prolonged recovery course and high rate of recurrence, early recognition of rib bone stress injury is critical to optimize care. […] In this review, we discuss risk factors, mechanism of injury, typical clinical presentation, diagnostic imaging findings, and propose treatment and prevention strategies for rib stress fractures in overhand pitchers. […] Bone stress injury (BSI), including stress fracture, is common in sports medicine with reports of incidence between 1.4% and 4.4% of athletes.

• #43

  https://www.aast.org/resources-detail/rib-fractures

  Rib fractures that are single and non-displaced are classified as hairline fractures or simple fractures. […] The most common mechanism causing rib fractures is blunt trauma (i.e. automobile accidents, falls from height, assault, or even severe coughing). […] Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. […] Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures. […] Rib fractures are typically diagnosed on chest x-ray and the severity of the fracture is easily seen. […] The most common symptom of rib fractures is pain. […] A flail chest is invariably accompanied by pulmonary contusion, a bruise of the lung tissue that can result in a clinical entity called acute lung injury.

• #44 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. […] Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. […] Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. […] A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. […] Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.

• #45 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures. […] Independent risk factors for an incident rib fracture were age 80 or above, low bone density, difficulty with instrumental activities of daily living, and a baseline history of rib/chest fracture. […] Rib fracture, the most common incident clinical fracture in men, was associated with classic risk markers for osteoporosis, including old age, low hip bone mineral density, and history of fracture. […] A history of rib fracture predicted a more than twofold increased risk of future fracture of the rib, hip, or wrist, independent of bone density and other covariates. […] Rib fractures should be considered to be osteoporotic fractures in the evaluation of older men for treatment to prevent future fracture.

• #46 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5 per 1000 person years. Independent risk factors for an incident rib fracture (which represented 24% of all incident non-spine fractures) were age 80 or over, low bone mineral density, difficulty with instrumental activities of daily living, and a baseline history of rib or chest fracture. […] A history of rib or chest fracture carried at least a twofold increased risk of an incident rib fracture, hip fracture, or wrist fracture. […] Rib fracture should be considered to be an osteoporotic fracture when older men are evaluated for treatment to prevent future fracture.

• #47 Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study | The BMJ

  https://www.bmj.com/content/340/bmj.c1069

  The incidence of rib fracture was 3.5 per 1000 person years. Independent risk factors for an incident rib fracture (which represented 24% of all incident non-spine fractures) were age 80 or over, low bone mineral density, difficulty with instrumental activities of daily living, and a baseline history of rib or chest fracture. […] A history of rib or chest fracture carried at least a twofold increased risk of an incident rib fracture, hip fracture, or wrist fracture. […] Rib fracture should be considered to be an osteoporotic fracture when older men are evaluated for treatment to prevent future fracture.

• #48 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #49

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #50 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=18639933&AN=155125257&h=RRLHKSv0uTXk8oj8IckEVpaP4%2Ft72Lvj%2BEHyz9KJDL%2FsWF%2FlroMUKxlyx7Q89TEniCW%2B1nh47RjlkF3ELkYsaw%3D%3D&crl=f

  Results: A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3–11) and 37.3% were admitted to the intensive care unit (ICU). […] Conclusions: Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #51 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #52 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Learn about the epidemiology, pathophysiology, and management of multiple rib fractures associated with blunt trauma, including their impact on respiration and risk factors. […] Frequency Dramatically underreported 2 million blunt mechanisms of injury occur annually as MVC Chest injury 67-70% of those. […] International Prevalence is linked to underlying cause of trauma More common in countries with higher incidence of MVC Mortality/Morbidity Rib f(x) not usually dangerous alone Pneumonia / atelectasis largest risk Morbidity correlates with degree of injury to underlying structures. […] Mortality rates of 12% in one study of rib f(x) 94% had associated injuries / 32% had a HTX/PTX Ziegler, W. J Trauma, Dec 2004. 50% required operative or ICU care Average blood loss was 150-200ml per rib f(x).

• #53 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #54 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Each additional rib fracture increases mortality by 19% Increases incidence of pneumonia by 27%. […] Should raise high suspicion for severe injury Mortality rates 36% reported w/associated 1st rib fracture. […] Elderly more prone than young Pulmonary sequelae including atelectasis, pneumonia and respiratory arrest more likely in elderly Cardiopulmonary disease increases morbity/mortality in patients 65 y/o.

• #55 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. […] The substantial heterogeneity among rib fracture patients with considerable differences in epidemiology perhaps prevents a one-size-fits-all solution to rib fracture management. […] The importance to detect rib fractures is underlined by the fact that the pulmonary morbidity and mortality directly increases with each additional rib fracture, approaching a mortality of 40% if more than six ribs are fractured. […] Over the last two to three decades, surgical stabilization of rib fractures (SSRF) has gained popularity compared to conservative treatment options, especially for flail chest.

• #56 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  An increasing number of rib fractures correlates with serious intrathoracic and intra-abdominal injuries. Displaced fractures increase the risk of internal injury and delayed bleeding. […] The rate of significant complications associated with rib fractures increases with the number and severity (eg, displacement) of fractures, patient age or frailty, and compromised respiratory function, either acute or chronic due to underlying disease. Among older adults, morbidity and mortality are twice that in younger populations, and some increased morbidity is apparent in patients over 45 years old. […] Pneumonia is one of the most common complications of rib fractures, typically due to splinting and atelectasis. Risk with isolated minor rib fractures is low but increases with the number of fractured ribs and patient’s age.

• #57

  https://perioperative.org.ua/index.php/prtmdc/article/view/119

  Trauma is a leading cause of death in people younger than 40 years, and on the third place after cardiovascular and oncological disease overall. Chest trauma is a finding in up to 60% of patients with multiple trauma and has a mortality rate as high as 2025%. Rib fractures are the most common findings in patients with thoracic trauma with mortality rates among hospitalised patients between 10 and 22%. The mortality rate is higher in elderly patients and patients with flail chest. […] The incidence of pneumonia in the elderly population with three to four and more than six rib fractures is 31% and 51%, respectively. […] The purpose of this review is to analyse the modern literature regarding pain management for a patient with rib fractures and extract the best evidence-based practice. […] Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands.

• #58 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. […] The overall incidence of VTE in hospitalized patients with traumatic rib fractures was 8.1%. […] Patients with isolated traumatic rib fractures had a significantly lower incidence of VTE (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). […] Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. […] Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower VTE incidence compared to conservative treatment. […] Patients with rib fractures have a higher incidence of VTE, positively correlated with the number of rib fractures.

• #59 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  However, the occurrence of thrombosis is relatively low in isolated rib fractures. […] Targeted thromboprophylaxis strategies should be implemented for these patients, and surgical stabilization of rib fractures may be beneficial in reducing the risk of VTE. […] Reported incidence rates of trauma-related VTE range from 1 to 58%, depending on patient populations and demographic characteristics, leading to increased mortality and complications. […] However, there is currently limited reported data on the actual incidence of VTE and related risk factors specifically in patients with acute chest trauma, particularly rib fractures. […] Investigating the incidence of VTE and associated risk factors in patients with traumatic rib fractures can effectively aid in the early clinical diagnosis and improve diagnostic efficiency for this condition.

• #60 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Rib fractures are the most common injury after thoracic (chest) trauma, accounting for approximately two-thirds of cases. […] Rib fractures are quite common after blunt trauma to the trunk, with motor vehicle crashes and falls being the leading causes. […] In the majority of cases, rib fractures are uncomplicated. However, because of the associated pain, patients with such injuries often need to be admitted to hospital for pain control. […] A common dogma among doctors is that pain after rib fractures that have been treated just with pain relief lasts up to six weeks. Unfortunately, this isn’t really the case. There are recent studies describing persistent pain and disability, with up to 76% of patients with uncomplicated rib fractures reporting pain at two months after the injury, and up to 56% of them still complaining of pain six months after the injury. Approximately 13% of patients report that their quality of life is being affected by chronic pain one year after simple rib fractures.

• #61 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Additionally, in another study, 30% of patients with rib fractures that had been managed conservatively with standard pain relief were not able to return to pre-injury employment even two years after their injury. […] This significant long-term pain and disability has a huge socio-economic impact and is putting increasing pressure on doctors to find and try alternative treatments for uncomplicated rib fracture injuries. […] The PAROS study, a multicentre randomised clinical trial, aims to compare the pain-control effect of rib-fixation surgery to that achieved with just standard medical analgesia in patients with uncomplicated rib fractures. […] Since there is no previous study that provides enough evidence to recommend rib fixation as a treatment for uncomplicated rib fractures, the aim of the PAROS study is to investigate the benefits of surgery and the possibility of it becoming an approved treatment option in the future.

• #62 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands. | EBSCOhost

  https://search.ebscohost.com/login.aspx?direct=true&profile=ehost&scope=site&authtype=crawler&jrnl=18639933&AN=155125257&h=RRLHKSv0uTXk8oj8IckEVpaP4%2Ft72Lvj%2BEHyz9KJDL%2FsWF%2FlroMUKxlyx7Q89TEniCW%2B1nh47RjlkF3ELkYsaw%3D%3D&crl=f

  Results: A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. Of these, 573 (3.9%) patients had a flail chest, 4438 (29.9%) were polytrauma patients, 9273 (63.4%) were patients with primary thoracic trauma, and 6663 (44.9%) were elderly patients. The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n = 1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). The median hospital length of stay was 6 days (IQR, 3–11) and 37.3% were admitted to the intensive care unit (ICU). […] Conclusions: Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #63 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #64 Urgent Care Considerations for the Patient with Suspected Rib Fracture – Journal of Urgent Care Medicine

  https://www.jucm.com/urgent-care-considerations-for-the-patient-with-suspected-rib-fracture/

  Rib fractures are frequently encountered among patients after sustaining blunt thoracic trauma presenting to the emergency department (ED) or UC, with falls and motor vehicle collisions (MVC) accounting for the largest proportion of cases. […] Based on aggregate data from the National Trauma Data Bank, rib fractures have been found to occur more frequently in Caucasian and male patients with a median age of 51 years at the time of diagnosis. […] Importantly, to date, there have been no studies published describing the prevalence of rib fractures and associated injuries in patients presenting to UC centers after thoracic trauma. […] A systematic review of 73 studies on patients with chest injury revealed the most significant risk factors for mortality associated with blunt chest wall trauma: Age 65 years, Presence of 3 or more rib fractures, Presence of comorbid cardiopulmonary disease.

• #65 Urgent Care Considerations for the Patient with Suspected Rib Fracture – Journal of Urgent Care Medicine

  https://www.jucm.com/urgent-care-considerations-for-the-patient-with-suspected-rib-fracture/

  Rib fractures are frequently encountered among patients after sustaining blunt thoracic trauma presenting to the emergency department (ED) or UC, with falls and motor vehicle collisions (MVC) accounting for the largest proportion of cases. […] Based on aggregate data from the National Trauma Data Bank, rib fractures have been found to occur more frequently in Caucasian and male patients with a median age of 51 years at the time of diagnosis. […] Importantly, to date, there have been no studies published describing the prevalence of rib fractures and associated injuries in patients presenting to UC centers after thoracic trauma. […] A systematic review of 73 studies on patients with chest injury revealed the most significant risk factors for mortality associated with blunt chest wall trauma: Age 65 years, Presence of 3 or more rib fractures, Presence of comorbid cardiopulmonary disease.

• #66 Urgent Care Considerations for the Patient with Suspected Rib Fracture – Journal of Urgent Care Medicine

  https://www.jucm.com/urgent-care-considerations-for-the-patient-with-suspected-rib-fracture/

  Rib fractures are frequently encountered among patients after sustaining blunt thoracic trauma presenting to the emergency department (ED) or UC, with falls and motor vehicle collisions (MVC) accounting for the largest proportion of cases. […] Based on aggregate data from the National Trauma Data Bank, rib fractures have been found to occur more frequently in Caucasian and male patients with a median age of 51 years at the time of diagnosis. […] Importantly, to date, there have been no studies published describing the prevalence of rib fractures and associated injuries in patients presenting to UC centers after thoracic trauma. […] A systematic review of 73 studies on patients with chest injury revealed the most significant risk factors for mortality associated with blunt chest wall trauma: Age 65 years, Presence of 3 or more rib fractures, Presence of comorbid cardiopulmonary disease.

• #67 Rib fractures | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/rib-fractures?lang=us/1000

  Rib fractures are a common consequence of trauma and can cause life-threatening complications. […] Rib fractures are often associated with other injuries and the greater the number of rib fractures the more likely are associated injuries. […] The 4th-10th ribs are the most commonly fractured. […] Fractures of the 1st-3rd ribs are associated with high-energy trauma. […] Rib fractures themselves are treated symptomatically and have a good prognostic outcome. […] Aside from immediate traumatic complications outlined above atelectasis and pneumonia may develop, mainly due to poor respiratory effort secondary to pain, and this increases the morbidity and mortality due to rib fractures. […] The number of displaced rib fractures is more predictive for complications in chest trauma patients. […] Epidemiology of Rib Fractures in Older Men: Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study.

• #68 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  An increasing number of rib fractures correlates with serious intrathoracic and intra-abdominal injuries. Displaced fractures increase the risk of internal injury and delayed bleeding. […] The rate of significant complications associated with rib fractures increases with the number and severity (eg, displacement) of fractures, patient age or frailty, and compromised respiratory function, either acute or chronic due to underlying disease. Among older adults, morbidity and mortality are twice that in younger populations, and some increased morbidity is apparent in patients over 45 years old. […] Pneumonia is one of the most common complications of rib fractures, typically due to splinting and atelectasis. Risk with isolated minor rib fractures is low but increases with the number of fractured ribs and patient’s age.

• #69

  https://www.orthobullets.com/trauma/1061/flail-chest

  Flail chest is a traumatic chest injury defined as segmental fractures of 3 or more consecutive ribs and is often associated with pulmonary injuries such as hemothorax and pneumothorax. […] Incidence approximately 300,000 cases per year, 7% require hospitalization for medical and/or surgical treatment. […] Greater number of fractured ribs correlates with increased morbidity and mortality. […] Bimodal distribution younger patients involved in trauma older patients with osteopenia. […] Ribs 7-10 are most commonly fractured.

• #70

  https://www.orthobullets.com/trauma/1061/flail-chest

  Flail chest is a traumatic chest injury defined as segmental fractures of 3 or more consecutive ribs and is often associated with pulmonary injuries such as hemothorax and pneumothorax. […] Incidence approximately 300,000 cases per year, 7% require hospitalization for medical and/or surgical treatment. […] Greater number of fractured ribs correlates with increased morbidity and mortality. […] Bimodal distribution younger patients involved in trauma older patients with osteopenia. […] Ribs 7-10 are most commonly fractured.

• #71 Epidemiology and outcome of rib fractures: a nationwide study in the Netherlands

  https://pmc.ncbi.nlm.nih.gov/articles/PMC8825616/

  The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,00 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #72

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  The incidence rate of rib fractures requiring hospital admission for the entire cohort was 29 per 100,000 person-years. […] The incidence rate of patients with flail chest was 1 per 100,000 person-years. […] The incidence rate of polytrauma patients with rib fractures was 9 per 100,000 person-years. […] The incidence rate of primary thoracic trauma patients with rib fractures was 18 per 100,000 person-years. […] The incidence rate of elderly patients with rib fractures was 72 per 100,000 person-years. […] This epidemiological study reports on the population-based incidence rates of rib fractures and demonstrates that rib fractures still remain a frequently occurring injury associated with a significant morbidity.

• #73

  https://www.aast.org/resources-detail/rib-fractures

  Rib fractures that are single and non-displaced are classified as hairline fractures or simple fractures. […] The most common mechanism causing rib fractures is blunt trauma (i.e. automobile accidents, falls from height, assault, or even severe coughing). […] Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. […] Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures. […] Rib fractures are typically diagnosed on chest x-ray and the severity of the fracture is easily seen. […] The most common symptom of rib fractures is pain. […] A flail chest is invariably accompanied by pulmonary contusion, a bruise of the lung tissue that can result in a clinical entity called acute lung injury.

• #74

  https://link.springer.com/article/10.1007/s00068-020-01412-2

  Rib fractures following thoracic trauma are frequently encountered injuries and associated with a significant morbidity and mortality. The aim of this study was to provide current data on the epidemiology, in-hospital outcomes and 30-day mortality of rib fractures, and to evaluate these results for different subgroups. […] A total of 14,850 patients were admitted between 2015 and 2017 with one or more rib fractures, which was 6.0% of all trauma patients. […] The incidence rate of patients with rib fractures for the entire cohort was 29 per 100.000 person-years. The overall 30-day mortality was 6.9% (n=1208) with higher rates observed in flail chest (11.9%), polytrauma (14.8%), and elderly patients (11.7%). […] Rib fractures are a relevant and frequently occurring problem among the trauma population. Subgroup analyses showed that there is a substantial heterogeneity among patients with rib fractures with considerable differences regarding the epidemiology, in-hospital outcomes, and 30-day mortality.

• #75 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #76 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #77 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Each additional rib fracture increases mortality by 19% Increases incidence of pneumonia by 27%. […] Should raise high suspicion for severe injury Mortality rates 36% reported w/associated 1st rib fracture. […] Elderly more prone than young Pulmonary sequelae including atelectasis, pneumonia and respiratory arrest more likely in elderly Cardiopulmonary disease increases morbity/mortality in patients 65 y/o.

• #78 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #79 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Given the prolonged healing time and high risk of recurrence, it is important to consider the diagnosis of rib stress injury in order to accurately diagnose these athletes as early as possible, determine prognosis, and optimize treatment. […] Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. […] In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. […] The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury. […] Of note, 20% of these injuries occurred on the side of the nonthrowing arm.

• #80 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Given the prolonged healing time and high risk of recurrence, it is important to consider the diagnosis of rib stress injury in order to accurately diagnose these athletes as early as possible, determine prognosis, and optimize treatment. […] Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. […] In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. […] The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury. […] Of note, 20% of these injuries occurred on the side of the nonthrowing arm.

• #81 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Given the prolonged healing time and high risk of recurrence, it is important to consider the diagnosis of rib stress injury in order to accurately diagnose these athletes as early as possible, determine prognosis, and optimize treatment. […] Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. […] In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. […] The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury. […] Of note, 20% of these injuries occurred on the side of the nonthrowing arm.

• #82 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Given the prolonged healing time and high risk of recurrence, it is important to consider the diagnosis of rib stress injury in order to accurately diagnose these athletes as early as possible, determine prognosis, and optimize treatment. […] Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. […] In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. […] The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury. […] Of note, 20% of these injuries occurred on the side of the nonthrowing arm.

• #83 Rib Fractures in Professional Baseball Pitchers | OAJSM

  https://www.dovepress.com/rib-fractures-in-professional-baseball-pitchers-mechanics-epidemiology-peer-reviewed-fulltext-article-OAJSM

  Given the prolonged healing time and high risk of recurrence, it is important to consider the diagnosis of rib stress injury in order to accurately diagnose these athletes as early as possible, determine prognosis, and optimize treatment. […] Stress injuries of the first rib have been the most commonly reported rib stress injury in pitchers. […] In a study of 24 first rib stress fractures in overhead throwing athletes, three types of rib fractures were discovered. […] The majority of the fractures (75%) occurred at the attachment of the middle scalene muscle (intrascalene type), while 12.5% were located at the subclavian artery groove (groove type) and 12.5% occurred posteriorly near the costovertebral articulation (posterior type), suggesting differing mechanisms of injury. […] Of note, 20% of these injuries occurred on the side of the nonthrowing arm.

• #84 Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224105

  Rib fractures represent the most common bone fracture, occurring in 10-20% of all blunt trauma patients and leading to concomitant injuries of the inner organs in severe cases. […] Rib fractures are common injuries after blunt chest trauma, occurring in 60-80% of all cases. […] In general, rib fractures represent the most frequent type of bone fractures, being observed in about 10-20% of all trauma patients. […] In about 50% of all rib fracture cases, three or more consecutive ribs are broken, also referred to as serial rib fractures. […] Serial rib fractures showed distinct fracture patterns depending on the cause of accident. […] The findings of the present study indicate that serial rib fractures generally show specific fracture patterns. […] The specific fracture patterns of the single groups can be mainly explained by the boundary conditions relating to the causes of accidents.

• #85 Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224105

  Rib fractures represent the most common bone fracture, occurring in 10-20% of all blunt trauma patients and leading to concomitant injuries of the inner organs in severe cases. […] Rib fractures are common injuries after blunt chest trauma, occurring in 60-80% of all cases. […] In general, rib fractures represent the most frequent type of bone fractures, being observed in about 10-20% of all trauma patients. […] In about 50% of all rib fracture cases, three or more consecutive ribs are broken, also referred to as serial rib fractures. […] Serial rib fractures showed distinct fracture patterns depending on the cause of accident. […] The findings of the present study indicate that serial rib fractures generally show specific fracture patterns. […] The specific fracture patterns of the single groups can be mainly explained by the boundary conditions relating to the causes of accidents.

• #86 Patterns of serial rib fractures after blunt chest trauma: An analysis of 380 cases | PLOS One

  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0224105

  The average number of rib fractures per patient within the present study (9.7) was considerably higher than in previous studies investigating epidemiological aspects of rib fractures, where the average number was between two and six rib fractures per patient. […] The present study entails some limitations, which especially result from its retrospective study design. […] In conclusion, the results of the present study show that there are specific rib fracture patterns after blunt chest trauma.

• #87 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2015.30.2.194

  Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). […] The authors sought to document the frequency of rib fractures in OVCF patients and to identify factors that affect their occurrence by conducting bone scans. […] In a previous study, the authors found that rib fractures are one of main causes of persistent chest or flank pain. […] In fact, rib fractures are one of the most common osteoporotic non-vertebral fractures in the elderly. […] It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. […] The authors recommend that bone scans should be performed for the diagnosis of rib fracture accompanying OVCF. […] And bone scans have outstanding screening ability for patients with concurrent non-adjacent multiple fractures of the thoracic and lumbar spines or fractures not definitively detected by plain radiography.

• #88 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2015.30.2.194

  Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). […] The authors sought to document the frequency of rib fractures in OVCF patients and to identify factors that affect their occurrence by conducting bone scans. […] In a previous study, the authors found that rib fractures are one of main causes of persistent chest or flank pain. […] In fact, rib fractures are one of the most common osteoporotic non-vertebral fractures in the elderly. […] It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. […] The authors recommend that bone scans should be performed for the diagnosis of rib fracture accompanying OVCF. […] And bone scans have outstanding screening ability for patients with concurrent non-adjacent multiple fractures of the thoracic and lumbar spines or fractures not definitively detected by plain radiography.

• #89 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2015.30.2.194

  Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). […] The authors sought to document the frequency of rib fractures in OVCF patients and to identify factors that affect their occurrence by conducting bone scans. […] In a previous study, the authors found that rib fractures are one of main causes of persistent chest or flank pain. […] In fact, rib fractures are one of the most common osteoporotic non-vertebral fractures in the elderly. […] It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. […] The authors recommend that bone scans should be performed for the diagnosis of rib fracture accompanying OVCF. […] And bone scans have outstanding screening ability for patients with concurrent non-adjacent multiple fractures of the thoracic and lumbar spines or fractures not definitively detected by plain radiography.

• #90 :: JKMS :: Journal of Korean Medical Science

  https://jkms.org/DOIx.php?id=10.3346/jkms.2015.30.2.194

  Rib fractures are one of main causes of chest or flank pain when related to an osteoporotic vertebral compression fracture (OVCF). […] The authors sought to document the frequency of rib fractures in OVCF patients and to identify factors that affect their occurrence by conducting bone scans. […] In a previous study, the authors found that rib fractures are one of main causes of persistent chest or flank pain. […] In fact, rib fractures are one of the most common osteoporotic non-vertebral fractures in the elderly. […] It is concluded that a bone scan has outstanding ability for the screening of rib fractures associated with OVCF. […] The authors recommend that bone scans should be performed for the diagnosis of rib fracture accompanying OVCF. […] And bone scans have outstanding screening ability for patients with concurrent non-adjacent multiple fractures of the thoracic and lumbar spines or fractures not definitively detected by plain radiography.

• #91 Traumatic rib fractures: a marker of severe injury. A nationwide study using the National Trauma Data Bank | Trauma Surgery & Acute Care Open

  https://tsaco.bmj.com/content/5/1/e000441

  Traumatic rib fractures are a marker of severe injury as approximately half of patients were patients with polytrauma. […] The primary aim of this nationwide database study was to determine the epidemiology, injury characteristics and in-hospital outcomes of patients with traumatic rib fractures. […] Traumatic rib fractures must be considered as a surrogate marker of severe injury, as about half of our cohort consisted of patients with polytrauma. […] This study primarily shows that patients with rib fractures are a very heterogeneous group with a considerable difference in epidemiology, injury characteristics and in-hospital outcomes. […] Future studies should recognize these differences and treatment should be evaluated accordingly.

• #92 Inpatient management of traumatic rib fractures and flail chest in adults – UpToDate

  https://www.uptodate.com/contents/inpatient-management-of-traumatic-rib-fractures-and-flail-chest-in-adults

  Traumatic rib fractures are the consequence of significant forces impacting the chest wall and are most commonly due to blunt injuries (eg, motor vehicle crash, falls, assault), but penetrating injuries (eg, gunshot) can also fracture ribs. Rib fractures are a marker of more severe injuries and are present in 10 percent of all trauma patients and approximately 30 percent of patients with significant chest trauma. […] The number of fractured ribs also directly correlates with the presence of intrathoracic injury. […] Multiply fractured ribs or flail chest can significantly compromise respiratory function. Pneumonia is often the common pathway to acute respiratory failure resulting from rib fractures, and prevention offers the best means to avoid potentially preventable deaths. […] The main goal of treatment is to prevent pneumonia and other complications of rib fractures (eg, nonunion). Conservative treatment includes pain control and aggressive supportive pulmonary care to avoid the need for intubation. […] For patients in whom these conservative measures are not adequate, rib fracture stabilization may be beneficial. […] This topic review will discuss inpatient management of multiple traumatic rib fractures.

• #93 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  An increasing number of rib fractures correlates with serious intrathoracic and intra-abdominal injuries. Displaced fractures increase the risk of internal injury and delayed bleeding. […] The rate of significant complications associated with rib fractures increases with the number and severity (eg, displacement) of fractures, patient age or frailty, and compromised respiratory function, either acute or chronic due to underlying disease. Among older adults, morbidity and mortality are twice that in younger populations, and some increased morbidity is apparent in patients over 45 years old. […] Pneumonia is one of the most common complications of rib fractures, typically due to splinting and atelectasis. Risk with isolated minor rib fractures is low but increases with the number of fractured ribs and patient’s age.

• #94 Rib Fracture: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/825981-overview

  In one study of patients with rib fractures, the mortality rate reached 12%; of these, 94% had associated injuries and 32% had a hemothorax or a pneumothorax. More than half of all patients required either operative or ICU management. Average blood loss per fractured rib is reportedly 100-150 mL. […] Rib fractures are the most common injury in elderly blunt chest trauma patients, and each additional rib fracture increases the odds of dying by 19% and of developing pneumonia by 27%. […] First-rib fractures have often been described as having a high association with serious or lethal spinal or vascular injuries. They are the rarest of all rib fractures and were once thought to be a harbinger of severe trauma, since the first rib is very well protected by the shoulder, lower neck musculature, and clavicle. […] While first-rib fractures have a high association with spinal fractures and are associated with multisystem injuries, the occurrence of first-rib fractures is not always associated with increased morbidity and mortality.

• #95 PPT – Multiple Rib Fractures: Epidemiology and Management Overview PowerPoint Presentation – ID:9347667

  https://www.slideserve.com/steelee/blunt-trauma-multiple-rib-fractures-powerpoint-ppt-presentation

  Learn about the epidemiology, pathophysiology, and management of multiple rib fractures associated with blunt trauma, including their impact on respiration and risk factors. […] Frequency Dramatically underreported 2 million blunt mechanisms of injury occur annually as MVC Chest injury 67-70% of those. […] International Prevalence is linked to underlying cause of trauma More common in countries with higher incidence of MVC Mortality/Morbidity Rib f(x) not usually dangerous alone Pneumonia / atelectasis largest risk Morbidity correlates with degree of injury to underlying structures. […] Mortality rates of 12% in one study of rib f(x) 94% had associated injuries / 32% had a HTX/PTX Ziegler, W. J Trauma, Dec 2004. 50% required operative or ICU care Average blood loss was 150-200ml per rib f(x).

• #96

  https://link.springer.com/article/10.1007/s00068-021-01701-4

  The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. […] Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 5660.6% versus 29% in patients without clavicle fractures. […] Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. […] Future research should further investigate indications and benefits of operative treatment of this injury. […] In patients who suffered a blunt chest trauma, 18.6% had combined clavicle fractures and rib fractures. […] Among polytrauma patients with clavicle fractures, there were approximately twice as much patients with rib fractures (5660.6%) as compared to patients without clavicle fractures (29%).

• #97

  https://link.springer.com/article/10.1007/s00068-021-01701-4

  The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. […] Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 5660.6% versus 29% in patients without clavicle fractures. […] Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. […] Future research should further investigate indications and benefits of operative treatment of this injury. […] In patients who suffered a blunt chest trauma, 18.6% had combined clavicle fractures and rib fractures. […] Among polytrauma patients with clavicle fractures, there were approximately twice as much patients with rib fractures (5660.6%) as compared to patients without clavicle fractures (29%).

• #98

  https://link.springer.com/article/10.1007/s00068-021-01701-4

  The aim of this systematic review was to provide an overview of the incidence of combined clavicle and rib fractures and the association between these two injuries. […] Among blunt chest trauma patients, 18.6% had concomitant clavicle and rib fractures. The incidence of rib fractures in polytrauma patients with clavicle fractures was 5660.6% versus 29% in patients without clavicle fractures. […] Clavicle fractures and rib fractures are closely related in polytrauma patients and almost a fifth of all blunt chest trauma patients sustain both injuries. […] Future research should further investigate indications and benefits of operative treatment of this injury. […] In patients who suffered a blunt chest trauma, 18.6% had combined clavicle fractures and rib fractures. […] Among polytrauma patients with clavicle fractures, there were approximately twice as much patients with rib fractures (5660.6%) as compared to patients without clavicle fractures (29%).

• #99 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #100 Rib fractures | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/rib-fractures?lang=us/1000

  Rib fractures are a common consequence of trauma and can cause life-threatening complications. […] Rib fractures are often associated with other injuries and the greater the number of rib fractures the more likely are associated injuries. […] The 4th-10th ribs are the most commonly fractured. […] Fractures of the 1st-3rd ribs are associated with high-energy trauma. […] Rib fractures themselves are treated symptomatically and have a good prognostic outcome. […] Aside from immediate traumatic complications outlined above atelectasis and pneumonia may develop, mainly due to poor respiratory effort secondary to pain, and this increases the morbidity and mortality due to rib fractures. […] The number of displaced rib fractures is more predictive for complications in chest trauma patients. […] Epidemiology of Rib Fractures in Older Men: Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study.

• #101 Rib fractures | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/rib-fractures?lang=us/1000

  Rib fractures are a common consequence of trauma and can cause life-threatening complications. […] Rib fractures are often associated with other injuries and the greater the number of rib fractures the more likely are associated injuries. […] The 4th-10th ribs are the most commonly fractured. […] Fractures of the 1st-3rd ribs are associated with high-energy trauma. […] Rib fractures themselves are treated symptomatically and have a good prognostic outcome. […] Aside from immediate traumatic complications outlined above atelectasis and pneumonia may develop, mainly due to poor respiratory effort secondary to pain, and this increases the morbidity and mortality due to rib fractures. […] The number of displaced rib fractures is more predictive for complications in chest trauma patients. […] Epidemiology of Rib Fractures in Older Men: Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study.

• #102 Rib fractures | Radiology Reference Article | Radiopaedia.org

  https://radiopaedia.org/articles/rib-fractures?lang=us/1000

  Rib fractures are a common consequence of trauma and can cause life-threatening complications. […] Rib fractures are often associated with other injuries and the greater the number of rib fractures the more likely are associated injuries. […] The 4th-10th ribs are the most commonly fractured. […] Fractures of the 1st-3rd ribs are associated with high-energy trauma. […] Rib fractures themselves are treated symptomatically and have a good prognostic outcome. […] Aside from immediate traumatic complications outlined above atelectasis and pneumonia may develop, mainly due to poor respiratory effort secondary to pain, and this increases the morbidity and mortality due to rib fractures. […] The number of displaced rib fractures is more predictive for complications in chest trauma patients. […] Epidemiology of Rib Fractures in Older Men: Osteoporotic Fractures in Men (MrOS) Prospective Cohort Study.

• #103 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Trauma centers, nationally, have shown better outcomes when rib fracture protocols were geared towards geriatric age groups. These protocols not only help to triage high-risk patients but also incorporate timely involvement of a multidisciplinary team. It is important to note that protocols can vary by center and can lead to different paths of management for similar cases. A study from North Carolina noted lower ICU admissions, fewer pulmonary complications, and shorter hospital lengths of stay (LOS) in a center with a rib fracture protocol. A level 1 trauma center in Rhode Island established a geriatric rib fracture protocol that resulted in decreased ICU LOS, mortality, and reduced need for mechanical ventilation. Multidisciplinary rib fracture protocol in a level 1 trauma center in Washington State incorporated early initiation of multimodal pain therapy, and frequent function-based scoring driven by nursing staff and the patient.

• #104 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Trauma centers, nationally, have shown better outcomes when rib fracture protocols were geared towards geriatric age groups. These protocols not only help to triage high-risk patients but also incorporate timely involvement of a multidisciplinary team. It is important to note that protocols can vary by center and can lead to different paths of management for similar cases. A study from North Carolina noted lower ICU admissions, fewer pulmonary complications, and shorter hospital lengths of stay (LOS) in a center with a rib fracture protocol. A level 1 trauma center in Rhode Island established a geriatric rib fracture protocol that resulted in decreased ICU LOS, mortality, and reduced need for mechanical ventilation. Multidisciplinary rib fracture protocol in a level 1 trauma center in Washington State incorporated early initiation of multimodal pain therapy, and frequent function-based scoring driven by nursing staff and the patient.

• #105 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Trauma centers, nationally, have shown better outcomes when rib fracture protocols were geared towards geriatric age groups. These protocols not only help to triage high-risk patients but also incorporate timely involvement of a multidisciplinary team. It is important to note that protocols can vary by center and can lead to different paths of management for similar cases. A study from North Carolina noted lower ICU admissions, fewer pulmonary complications, and shorter hospital lengths of stay (LOS) in a center with a rib fracture protocol. A level 1 trauma center in Rhode Island established a geriatric rib fracture protocol that resulted in decreased ICU LOS, mortality, and reduced need for mechanical ventilation. Multidisciplinary rib fracture protocol in a level 1 trauma center in Washington State incorporated early initiation of multimodal pain therapy, and frequent function-based scoring driven by nursing staff and the patient.

• #106 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Trauma centers, nationally, have shown better outcomes when rib fracture protocols were geared towards geriatric age groups. These protocols not only help to triage high-risk patients but also incorporate timely involvement of a multidisciplinary team. It is important to note that protocols can vary by center and can lead to different paths of management for similar cases. A study from North Carolina noted lower ICU admissions, fewer pulmonary complications, and shorter hospital lengths of stay (LOS) in a center with a rib fracture protocol. A level 1 trauma center in Rhode Island established a geriatric rib fracture protocol that resulted in decreased ICU LOS, mortality, and reduced need for mechanical ventilation. Multidisciplinary rib fracture protocol in a level 1 trauma center in Washington State incorporated early initiation of multimodal pain therapy, and frequent function-based scoring driven by nursing staff and the patient.

• #107 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Trauma centers, nationally, have shown better outcomes when rib fracture protocols were geared towards geriatric age groups. These protocols not only help to triage high-risk patients but also incorporate timely involvement of a multidisciplinary team. It is important to note that protocols can vary by center and can lead to different paths of management for similar cases. A study from North Carolina noted lower ICU admissions, fewer pulmonary complications, and shorter hospital lengths of stay (LOS) in a center with a rib fracture protocol. A level 1 trauma center in Rhode Island established a geriatric rib fracture protocol that resulted in decreased ICU LOS, mortality, and reduced need for mechanical ventilation. Multidisciplinary rib fracture protocol in a level 1 trauma center in Washington State incorporated early initiation of multimodal pain therapy, and frequent function-based scoring driven by nursing staff and the patient.

• #108 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. […] The substantial heterogeneity among rib fracture patients with considerable differences in epidemiology perhaps prevents a one-size-fits-all solution to rib fracture management. […] The importance to detect rib fractures is underlined by the fact that the pulmonary morbidity and mortality directly increases with each additional rib fracture, approaching a mortality of 40% if more than six ribs are fractured. […] Over the last two to three decades, surgical stabilization of rib fractures (SSRF) has gained popularity compared to conservative treatment options, especially for flail chest.

• #109 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. […] The substantial heterogeneity among rib fracture patients with considerable differences in epidemiology perhaps prevents a one-size-fits-all solution to rib fracture management. […] The importance to detect rib fractures is underlined by the fact that the pulmonary morbidity and mortality directly increases with each additional rib fracture, approaching a mortality of 40% if more than six ribs are fractured. […] Over the last two to three decades, surgical stabilization of rib fractures (SSRF) has gained popularity compared to conservative treatment options, especially for flail chest.

• #110 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. […] The substantial heterogeneity among rib fracture patients with considerable differences in epidemiology perhaps prevents a one-size-fits-all solution to rib fracture management. […] The importance to detect rib fractures is underlined by the fact that the pulmonary morbidity and mortality directly increases with each additional rib fracture, approaching a mortality of 40% if more than six ribs are fractured. […] Over the last two to three decades, surgical stabilization of rib fractures (SSRF) has gained popularity compared to conservative treatment options, especially for flail chest.

• #111 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  The Chest Wall Injury Society (CWIS), represented by a variety of surgical and non-surgical specialists, seeks optimal outcomes for patients with both non-operative and operative management of rib fracture. […] CWIS set distinct recommendations on the indications to perform SSRF for both ventilated and non-ventilated patients. […] Risk factors for morbidity and mortality after SSRF, including age and number of fractured ribs, have however been reported inconsistently in the literature. […] While the short-term clinical patient outcomes after SSRF are clearly described in the literature, more studies are now investigating long-term benefits of SSRF. […] The current potential of peripheral nerve blocks is believed to surpass neuraxial techniques in the future. […] Numerous factors attribute to the success of SSRF, with an adequate reconstruction of the chest wall being key, allowing for proper expansion and retraction of the rib cage during breathing.

• #112 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  The Chest Wall Injury Society (CWIS), represented by a variety of surgical and non-surgical specialists, seeks optimal outcomes for patients with both non-operative and operative management of rib fracture. […] CWIS set distinct recommendations on the indications to perform SSRF for both ventilated and non-ventilated patients. […] Risk factors for morbidity and mortality after SSRF, including age and number of fractured ribs, have however been reported inconsistently in the literature. […] While the short-term clinical patient outcomes after SSRF are clearly described in the literature, more studies are now investigating long-term benefits of SSRF. […] The current potential of peripheral nerve blocks is believed to surpass neuraxial techniques in the future. […] Numerous factors attribute to the success of SSRF, with an adequate reconstruction of the chest wall being key, allowing for proper expansion and retraction of the rib cage during breathing.

• #113 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  The Chest Wall Injury Society (CWIS), represented by a variety of surgical and non-surgical specialists, seeks optimal outcomes for patients with both non-operative and operative management of rib fracture. […] CWIS set distinct recommendations on the indications to perform SSRF for both ventilated and non-ventilated patients. […] Risk factors for morbidity and mortality after SSRF, including age and number of fractured ribs, have however been reported inconsistently in the literature. […] While the short-term clinical patient outcomes after SSRF are clearly described in the literature, more studies are now investigating long-term benefits of SSRF. […] The current potential of peripheral nerve blocks is believed to surpass neuraxial techniques in the future. […] Numerous factors attribute to the success of SSRF, with an adequate reconstruction of the chest wall being key, allowing for proper expansion and retraction of the rib cage during breathing.

• #114 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. […] The overall incidence of VTE in hospitalized patients with traumatic rib fractures was 8.1%. […] Patients with isolated traumatic rib fractures had a significantly lower incidence of VTE (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). […] Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. […] Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower VTE incidence compared to conservative treatment. […] Patients with rib fractures have a higher incidence of VTE, positively correlated with the number of rib fractures.

• #115 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  However, the occurrence of thrombosis is relatively low in isolated rib fractures. […] Targeted thromboprophylaxis strategies should be implemented for these patients, and surgical stabilization of rib fractures may be beneficial in reducing the risk of VTE. […] Reported incidence rates of trauma-related VTE range from 1 to 58%, depending on patient populations and demographic characteristics, leading to increased mortality and complications. […] However, there is currently limited reported data on the actual incidence of VTE and related risk factors specifically in patients with acute chest trauma, particularly rib fractures. […] Investigating the incidence of VTE and associated risk factors in patients with traumatic rib fractures can effectively aid in the early clinical diagnosis and improve diagnostic efficiency for this condition.

• #116 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. […] The overall incidence of VTE in hospitalized patients with traumatic rib fractures was 8.1%. […] Patients with isolated traumatic rib fractures had a significantly lower incidence of VTE (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). […] Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. […] Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower VTE incidence compared to conservative treatment. […] Patients with rib fractures have a higher incidence of VTE, positively correlated with the number of rib fractures.

• #117 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. […] The overall incidence of VTE in hospitalized patients with traumatic rib fractures was 8.1%. […] Patients with isolated traumatic rib fractures had a significantly lower incidence of VTE (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). […] Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. […] Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower VTE incidence compared to conservative treatment. […] Patients with rib fractures have a higher incidence of VTE, positively correlated with the number of rib fractures.

• #118 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This study aimed to determine the incidence and influencing factors of venous thromboembolism (VTE) in patients with traumatic rib fractures. […] The overall incidence of VTE in hospitalized patients with traumatic rib fractures was 8.1%. […] Patients with isolated traumatic rib fractures had a significantly lower incidence of VTE (4.4%) compared to patients with rib fractures combined with other injuries (12.0%). […] Multivariate analysis identified the number of rib fractures as an independent risk factor for thrombosis. […] Surgical stabilization of isolated rib fractures involving three or more ribs was associated with a lower VTE incidence compared to conservative treatment. […] Patients with rib fractures have a higher incidence of VTE, positively correlated with the number of rib fractures.

• #119 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  However, the occurrence of thrombosis is relatively low in isolated rib fractures. […] Targeted thromboprophylaxis strategies should be implemented for these patients, and surgical stabilization of rib fractures may be beneficial in reducing the risk of VTE. […] Reported incidence rates of trauma-related VTE range from 1 to 58%, depending on patient populations and demographic characteristics, leading to increased mortality and complications. […] However, there is currently limited reported data on the actual incidence of VTE and related risk factors specifically in patients with acute chest trauma, particularly rib fractures. […] Investigating the incidence of VTE and associated risk factors in patients with traumatic rib fractures can effectively aid in the early clinical diagnosis and improve diagnostic efficiency for this condition.

• #120 Incidence and influence factors of venous thromboembolism in traumatic rib fracture patient: a multicenter study | Journal of Orthopaedic Surgery and Research | Full Text

  https://josr-online.biomedcentral.com/articles/10.1186/s13018-024-04622-1

  This positive impact of surgical stabilization on VTE prevention provides a basis for considering more proactive strategies for rib fracture fixation in the future. […] Our study findings indicate that prophylactic anticoagulation with medication is a risk factor for VTE in patients with rib fractures. […] Considering the relatively low incidence of VTE observed in this study involving isolated rib fractures, we recommend a cautious approach to the selection of prophylactic anticoagulation therapy, weighing the pros and cons, and taking into account other VTE risk factors that may be present in each individual patient. […] Overall, in clinical treatment, considering the characteristics of VTE occurrence in thoracic trauma, both the attention degree and the preventive and treatment strategies should be approached differently compared to traumatic orthopedics.

• #121 Traumatic Rib Fractures: Epidemiology, Treatment and Outcome

  https://dspace.library.uu.nl/handle/1874/406963

  Rib fractures are still a relevant and frequently occurring injury associated with a significant morbidity and mortality. Six percent of all hospitalized trauma patients appeared to sustain one or more fractured ribs and the absolute incidence rate of rib fractures requiring hospital admission among the Dutch population was 29 per 100,000 person-years. […] Furthermore, we found that the incidence rate of rib fractures in the elderly was even higher with 72 per 100,000 person-years, which illustrates the high clinical impact of rib fractures on the elderly population. Hence, given the considerable morbidity and mortality of rib fractures in these patients, it could be argued that rib fractures may impose the largest burden of disease after hip fractures in the elderly trauma patient. […] Furthermore, with the increasing aging population, it is to be expected that the incidence of elderly patients with fractured ribs requiring clinical care will increase.

• #122 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  The majority of rib fractures occur in older adults: patients who are 65 years of age or older. According to the United States (US) Census, there are 56 million adults over the age of 65 years, 16.8% of the total population. Hospitals in the US are now experiencing a higher volume of geriatrics patients and are faced with managing the health-related challenges this demographic brings. Older adults tend to be at heightened risk for respiratory complications following rib fractures such as pneumonia, acute respiratory distress syndrome, pulmonary embolism, pneumothorax, emphysema, and aspiration pneumonia. The mortality rate for rib fractures is substantial, approximately 10% for all ages. Although likely confounded by other concurrent traumatic injuries, such as head trauma, a retrospective study showed an increased mortality risk in patients older than 65. Each additional rib fracture in older adults compared to younger patients increases mortality by 19% and the risk of pneumonia by 27%. Data support a direct correlation between increasing numbers of rib fractures and increased pulmonary morbidity and mortality, with patients presenting with six or more rib fractures being at a higher risk for death from causes unrelated to the rib fracture.

• #123 Traumatic Rib Fractures: Epidemiology, Treatment and Outcome

  https://dspace.library.uu.nl/handle/1874/406963

  Rib fractures are still a relevant and frequently occurring injury associated with a significant morbidity and mortality. Six percent of all hospitalized trauma patients appeared to sustain one or more fractured ribs and the absolute incidence rate of rib fractures requiring hospital admission among the Dutch population was 29 per 100,000 person-years. […] Furthermore, we found that the incidence rate of rib fractures in the elderly was even higher with 72 per 100,000 person-years, which illustrates the high clinical impact of rib fractures on the elderly population. Hence, given the considerable morbidity and mortality of rib fractures in these patients, it could be argued that rib fractures may impose the largest burden of disease after hip fractures in the elderly trauma patient. […] Furthermore, with the increasing aging population, it is to be expected that the incidence of elderly patients with fractured ribs requiring clinical care will increase.

• #124 Rib Fracture Management in Older Adults: A Scoping Review | Published in Journal of Brown Hospital Medicine

  https://bhm.scholasticahq.com/article/82211-rib-fracture-management-in-older-adults-a-scoping-review

  Rib fractures result in 248,000 emergency department visits and 48,000 hospital admissions annually in the United States. A National Inpatient Sample study revealed 373,053 rib fracture hospitalizations between 2007 and 2016, with 85% of patients presenting with multiple rib fractures. This study also indicated a significant increase in the financial burden of rib fracture hospitalization, rising from an estimated $209 million per annum in 2007 to $469 million per annum in 2016. One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of rib fracture patients also have additional injuries with more than 50% requiring immediate surgery or admission to the Intensive Care Unit (ICU) level of care.

• #125 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Additionally, in another study, 30% of patients with rib fractures that had been managed conservatively with standard pain relief were not able to return to pre-injury employment even two years after their injury. […] This significant long-term pain and disability has a huge socio-economic impact and is putting increasing pressure on doctors to find and try alternative treatments for uncomplicated rib fracture injuries. […] The PAROS study, a multicentre randomised clinical trial, aims to compare the pain-control effect of rib-fixation surgery to that achieved with just standard medical analgesia in patients with uncomplicated rib fractures. […] Since there is no previous study that provides enough evidence to recommend rib fixation as a treatment for uncomplicated rib fractures, the aim of the PAROS study is to investigate the benefits of surgery and the possibility of it becoming an approved treatment option in the future.

• #126 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Additionally, in another study, 30% of patients with rib fractures that had been managed conservatively with standard pain relief were not able to return to pre-injury employment even two years after their injury. […] This significant long-term pain and disability has a huge socio-economic impact and is putting increasing pressure on doctors to find and try alternative treatments for uncomplicated rib fracture injuries. […] The PAROS study, a multicentre randomised clinical trial, aims to compare the pain-control effect of rib-fixation surgery to that achieved with just standard medical analgesia in patients with uncomplicated rib fractures. […] Since there is no previous study that provides enough evidence to recommend rib fixation as a treatment for uncomplicated rib fractures, the aim of the PAROS study is to investigate the benefits of surgery and the possibility of it becoming an approved treatment option in the future.

• #127 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Additionally, in another study, 30% of patients with rib fractures that had been managed conservatively with standard pain relief were not able to return to pre-injury employment even two years after their injury. […] This significant long-term pain and disability has a huge socio-economic impact and is putting increasing pressure on doctors to find and try alternative treatments for uncomplicated rib fracture injuries. […] The PAROS study, a multicentre randomised clinical trial, aims to compare the pain-control effect of rib-fixation surgery to that achieved with just standard medical analgesia in patients with uncomplicated rib fractures. […] Since there is no previous study that provides enough evidence to recommend rib fixation as a treatment for uncomplicated rib fractures, the aim of the PAROS study is to investigate the benefits of surgery and the possibility of it becoming an approved treatment option in the future.

• #128 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Rib fractures are a very common injury often associated with immense levels of persistent pain and disability, which have a large psycho-socio-economic impact on patients and our healthcare systems. […] New methods for treating rib-fracture patients that alleviate pain and reduce disability are urgently required and are expected to have a positive impact not only on individual patients but also on the wider community. […] It therefore doesn’t come as a surprise that the surgical treatment of rib fractures in the absence of a flail chest is drawing increased surgical attention lately.

• #129 Rib fracture pain and disability: Do we need a more aggressive approach?

  https://researchoutreach.org/articles/rib-fracture-pain-disability-aggressive-approach/

  Rib fractures are a very common injury often associated with immense levels of persistent pain and disability, which have a large psycho-socio-economic impact on patients and our healthcare systems. […] New methods for treating rib-fracture patients that alleviate pain and reduce disability are urgently required and are expected to have a positive impact not only on individual patients but also on the wider community. […] It therefore doesn’t come as a surprise that the surgical treatment of rib fractures in the absence of a flail chest is drawing increased surgical attention lately.

• #130 Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States

  https://www.jtraumainj.org/journal/view.php?doi=10.20408/jti.2023.0065

  Different mechanisms of injury result in distinct rib fracture patterns. […] The mechanism of injury (MOI) is an important predictor of the extent of injury in trauma patients. […] The major finding of this investigation is that there is a significant association between the MOI and rib fracture pattern. […] Unique rib fracture patterns are generated by different mechanisms of injury. […] Research focusing on the association between MOI and rib fracture patterns, and the implications of morbidity and mortality, is ongoing.

• #131 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  The Chest Wall Injury Society (CWIS), represented by a variety of surgical and non-surgical specialists, seeks optimal outcomes for patients with both non-operative and operative management of rib fracture. […] CWIS set distinct recommendations on the indications to perform SSRF for both ventilated and non-ventilated patients. […] Risk factors for morbidity and mortality after SSRF, including age and number of fractured ribs, have however been reported inconsistently in the literature. […] While the short-term clinical patient outcomes after SSRF are clearly described in the literature, more studies are now investigating long-term benefits of SSRF. […] The current potential of peripheral nerve blocks is believed to surpass neuraxial techniques in the future. […] Numerous factors attribute to the success of SSRF, with an adequate reconstruction of the chest wall being key, allowing for proper expansion and retraction of the rib cage during breathing.

• #132 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  The Chest Wall Injury Society (CWIS), represented by a variety of surgical and non-surgical specialists, seeks optimal outcomes for patients with both non-operative and operative management of rib fracture. […] CWIS set distinct recommendations on the indications to perform SSRF for both ventilated and non-ventilated patients. […] Risk factors for morbidity and mortality after SSRF, including age and number of fractured ribs, have however been reported inconsistently in the literature. […] While the short-term clinical patient outcomes after SSRF are clearly described in the literature, more studies are now investigating long-term benefits of SSRF. […] The current potential of peripheral nerve blocks is believed to surpass neuraxial techniques in the future. […] Numerous factors attribute to the success of SSRF, with an adequate reconstruction of the chest wall being key, allowing for proper expansion and retraction of the rib cage during breathing.

• #133 Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-024-00559-2

  The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research. […] SSRF should be considered in all flail chest (FC) patients. […] SSRF should be considered in non-FC patients with rib fractures, in the presence of multiple (3) ipsilateral severely displaced rib fractures. […] SSRF is optimal in dedicated centers with a multidisciplinary team, developing and optimizing protocols addressing NOM and SSRF for rib fractures patients. […] Despite the advantages of SSRF and its growing popularity, it remains not uniformly considered in trauma centers. […] The relationship between center-specific SSRF volume and patient-level outcomes has been debated due to contradictory evidence. […] An optimal cut point of 12.5 procedures annually was used to define high- and low-volume centers.

• #134 Surgical stabilization of rib fractures (SSRF): the WSES and CWIS position paper | World Journal of Emergency Surgery | Full Text

  https://wjes.biomedcentral.com/articles/10.1186/s13017-024-00559-2

  The expert recommendations clarify current evidences on SSRF indications, timing, operative planning, approaches and techniques, with the aim to guide clinicians in optimizing the management of rib fractures, to improve patient outcomes and direct future research. […] SSRF should be considered in all flail chest (FC) patients. […] SSRF should be considered in non-FC patients with rib fractures, in the presence of multiple (3) ipsilateral severely displaced rib fractures. […] SSRF is optimal in dedicated centers with a multidisciplinary team, developing and optimizing protocols addressing NOM and SSRF for rib fractures patients. […] Despite the advantages of SSRF and its growing popularity, it remains not uniformly considered in trauma centers. […] The relationship between center-specific SSRF volume and patient-level outcomes has been debated due to contradictory evidence. […] An optimal cut point of 12.5 procedures annually was used to define high- and low-volume centers.

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