Purpose: We aimed to assess the pattern and impact of sternal injury with rib fracture in a Level 1 trauma center.
Patients And Methods: We conducted a retrospective review of trauma registry data to identify patients who presented with sternal fracture between 2010 and 2017. Data were analyzed and compared in patients with and without rib fracture.
Results: We identified 212 patients with traumatic sternal injury, of them 119 (56%) had associated rib fractures. In comparison to those who had no rib fracture, patients with rib fractures were older (40.1 ± 13.6 vs. 37.8 ± 14.5), were frequently involved in traffic accidents (75% vs. 71%), had higher chest abbreviated injury scale (AIS 2.8 ± 0.6 vs. 2.2 ± 0.5) and Injury Severity Score ( ISS 17.5 ± 8.6 vs. 13.3 ± 9.6), were more likely to be intubated (33% vs. 19%), required chest tube insertion (13.4% vs. 4.3%), and received blood transfusion (29% vs. 17%). Rates of spine fracture, head injury, and solid organ injury were comparable in the two groups. Manubrium, clavicular and scapular fractures, lung contusion, hemothorax, and pneumothorax were significantly more evident in those who had rib fractures. Hospital length of stay was prolonged in patients with rib fractures ( = 0.008). The overall mortality was higher but not statistically significant in patients with rib fractures (5.0% vs. 3.2%).
Conclusions: Sternal fractures are rare, and detection of associated injuries requires a high index of suspicion. Combined sternal and rib fractures are more evident in relatively older patients after chest trauma. This combination has certain clinical implications that necessitate further prospective studies.
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http://dx.doi.org/10.4103/IJCIIS.IJCIIS_67_18 | DOI Listing |
Infect Drug Resist
December 2024
Department of Laboratory Medicine, Shanghai East Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, People's Republic of China.
Objective: is usually found in urogenital tract infections and is associated with several extra-genitourinary infections, including septic arthritis, bacteremia, and meningitis. Here, we report a rare case of induced bloodstream infection with thoracic inflammation in a surgical patient.
Methods: A 56-year-old male who underwent surgery for multiple pelvic and rib fractures developed fever, pleural effusion, and wound exudation despite receiving prophylactic anti-infection treatment with cefotiam.
J Trauma Acute Care Surg
October 2024
From the Sheffield Teaching Hospitals NHS Foundation Trust (P.W., J.N.R., S.T., J.G.E.), Sheffield, England; Erasmus Medical Centre (M.M.E.W.), Rotterdam, The Netherlands; and University Hospital of Southampton NHS Foundation Trust (A.T.).
Introduction: Costal margin rupture (CMR) injuries in association with intercostal hernia (IH) are rare and symptomatic and provide a significant surgical challenge. Surgical failure rates up to 60% are reported, and optimal techniques are unclear. We have characterized these injuries and describe the evolution of our surgical management techniques.
View Article and Find Full Text PDFAm J Case Rep
December 2024
Department of General Medicine, Saga University Hospital, Saga, Japan.
BACKGROUND Appropriate management of patients who have fallen is crucial for reducing damage and mortality. We report the case of a patient who fell from a seated position, which caused traumatic liver injury, with gastrointestinal symptoms as the primary patient concern. CASE REPORT A woman in her 80s who was living independently fell from a seated position during the daytime.
View Article and Find Full Text PDFArch Orthop Trauma Surg
December 2024
Department of Surgery, University Medical Center Utrecht, PO Box 85500, 3508 GA, Utrecht, The Netherlands.
Background: Nosocomial pneumonia is common in trauma patients and associated with an adverse prognosis. We recently externally validated and recalibrated an existing formula to predict nosocomial pneumonia risk. Identifying more potential predictors could aid in a more accurate prediction of nosocomial pneumonia risk in level-1 trauma patients.
View Article and Find Full Text PDFAnesthesiology
December 2024
In Residence, Department of Anesthesiology, University of California San Diego, La Jolla, CA, USA.
Background: Traumatic rib fractures are associated with pain lasting weeks to months and a decreased ability to inspire deeply or cough to clear secretions. Ultrasound-guided percutaneous cryoneurolysis involves reversibly ablating peripheral nerve(s) using exceptionally low temperature with a transdermal probe, resulting in a prolonged nerve block with a duration measured in months. We hypothesized that cryoneurolysis would improve analgesia and inspired volume following rib fracture.
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