Juvenile First Rib Fracture Caused by Morning Stretching

Bilateral first rib fractures with multi-organ complications: A case report and literature review

“…However, it was interesting that the bilateral first rib fractures in our case could not be explained by the previously reported mechanism [ 5 , 10 , [12] , [13] , [14] , [15] , [16] , [17] , [18] , [19] , [20] , [21] , [22] , [23] , [24] , [25] , [26] , [27] , [28] , [29] ] ( Table 1 ), it had a different mechanism of occurrence. The right neck root collided with a bulge on the ground when the patient fell off the motorcycle.…”

Nontraumatic First Rib Fractures Secondary to Opposing Muscle Contractions

“…Instances of non-traumatic first rib fractures have been reported in athletes participating in swimming [1,2], baseball [3,4], football [5,6], soccer [3], tennis [6], powerlifting [7], rowing [8], lacrosse [9], martial arts [10,11], basketball [10], and surfing [12]. Many of these athletes participated in weight training for their respective sport [1,2,7].…”

“…One study on elite-level rowers found that rowers who had non-traumatic first rib fractures were more likely than their elite-level peers to have low bone mineral density, although their bone mineral density averages were equal to that of the general population [8]. Nontraumatic first rib fractures, resulting from either chronic stress over time [3,5,6,11] or from a sudden, forceful contraction of opposing muscles [1,4,6,9,11] are exceedingly rare. They tend to occur in adolescent or teenage athletes, perhaps due to bony maturation lagging behind muscle development [16].…”

“…While this can be a repetitive stress injury with insidious onset, it can also present as sudden, acuteon-chronic symptoms as the stress fracture becomes Rarely, in prolonged, complicated cases, surgical first rib resection can be done for symptomatic relief [5,6,11].…”

“…Without trauma, there is an extremely low incidence of associated neurological, vascular, or visceral complications. There was one report of thoracic outlet symptom secondary to excessive callus formation at the fracture site [5], one case of sternoclavicular subluxation [6], and one case of torticollis in a child [10]. Horner's syndrome as a consequence of first rib fracture has been described, but never in a non-traumatic fracture case [13].…”