Acute Torticollis After Isolated Stress Fracture of the First Rib in a Child: A Case Report

Juvenile First Rib Fracture Caused by Morning Stretching

“…Vigorous sports activity and respiratory distress require maximum increase in the capacity of the thoracic cavity with forced inspiration using accessory breathing muscles such as the serratus and scalenus. Children carrying heavy schoolbags using only one strap are at higher risk for this situation (5). In adults, on the other hand, pseudoarthrosis formation of the costomanubrial joint of the first rib results in limitation of ''bucket handle'' motion during respiration, and this is assumed to be associated with reduced ''buffer power'' during muscular impacts, and predisposes to stress fracture (6).…”

“…The timing of the patient's return to physical activities depends on symptoms. Late complications that require surgical decompression such as brachial plexus palsy, thoracic outlet syndrome, and Horner syndrome, are rare but possible due to extensive callus formation (4,5).…”

Bilateral First Rib Fracture in a Dive With Life Vest

“…However, attention is drawn to a case of spontaneous fracturing caused by coughing mechanisms in a patient with pertussis, another case of spontaneous fracture with a condition of acute torticollis in an eight-year-old boy with a history of carrying a heavy schoolbag by means of a strap across his shoulder, and a further report with the same history in an 17-yearold boy. Even though the reports presented have been anecdotal, they carry a relevant message: in cases of painful symptoms in the shoulder and scapular regions, it is important to investigate the first rib 9 , 12 , 18 , 20 , 32 , 33 . Such pain is sometimes nonspecific and even not correlated by patients with the type of trauma that generally triggers it.…”

“…Pain in the sternal, scapular and thoracic regions is generally of benign nature and may arise from muscle distension or intervertebral joint dysfunction, or it may be mentioned as a problem of the cervical spine. Such pain often leads to thinking of problems of the shoulder joints or even of the cervical spine, without thinking of the first rib exactly because of rarity of this occurrence 2 , 12 , 20 , 21 , 31 , 33 .…”