Assessment of thoracic volume changes after the collapse of lateral rib fractures based on chest computed tomography data: computer simulation and a multiple variable linear regression analysis

Abstract

Background Chest blunt trauma (CBT) and the resultant rib fractures often lead to thoracic collapse. The purpose of this study was to explore the effect of displacement of the rib fracture and thoracic collapse on the thoracic volume by using normal chest CT data. Methods In this retrospective study, seven consecutive normal participants were selected from our hospital between June and July 2018. Normal thoracic models were reconstructed, followed by simulation of lateral fractures through the 4th to 9th ribs under three collapse modes with 1–5 cm of collapse. The thoracic collapse models ( n = 630) were reconstructed using 3Dmax 2014. We calculated the thoracic volume and reduction percentage for each thoracic collapse model. Linear regression-based comparisons of thoracic volume reductions were performed. Results In all three collapse modes, the degree of the collapse was linearly correlated with the mean thoracic volume reduction. The reduction percentage in the posterior collapse mode was higher than that in the anterior collapse mode ( P < 0.001). The largest volume reductions in the anterior, posterior, and simultaneous collapse models were in the 6th rib fracture model ( P < 0.001), 8th rib fracture model ( P < 0.001), and 7th rib fracture model ( P < 0.001), respectively. Conclusions The influences of rib fracture displacement and collapse on the thoracic volume in the 6th through 8th ribs are critical in lateral rib fractures. For patients with 6th to 8th rib fractures and posterior rib collapse, surgical intervention to restore thoracic volume may be more essential.

Respiratory Function Tolerance of Rats with Vaying Degrees of Thoracic Volume Reduction

“…These ribs are slender, and when the chest is subjected to direct or indirect violence, the middle section of the ribcage becomes the central point of the stress, so the lateral ribs are prone to fracture 12 . The thoracic volume reduced after rib fractures, and the degree of reduction is affected by fracture displacement and collapse, as well as the number of ribs affected and the location of the fracture 13 . At present, the optimal treatment of multiple rib fractures is controversial therapy and many of the current theories are not supported by high‐level clinical evidence.…”

“…12 The thoracic volume reduced after rib fractures, and the degree of reduction is affected by fracture displacement and collapse, as well as the number of ribs affected and the location of the fracture. 13 At present, the optimal treatment of multiple rib fractures is controversial therapy and many of the current theories are not supported by high-level clinical evidence. As a result, the treatment of multiple rib fractures is frequently guided by expert consensus or clinical experience.…”