Nonpenetrating Thoracic Injuries

Wilson, Robert F.; Murray, Charles; Antonenko, David R.

doi:10.1016/s0039-6109(16)41131-x

Cited by 98 publications

(35 citation statements)

References 20 publications

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“…It is also the leading cause of death from physical trauma after head and spinal cord injury. 1 Thoracic injuries are found to be the primary or a contributing cause of about a quarter of all trauma related deaths. 1 The mortality rate due to chest trauma is about 10%.…”

Section: Introductionmentioning

confidence: 99%

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A prospective study of chest injuries and associated complications with special reference to surgical emphysema

2018

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Background: Chest trauma (or thoracic trauma) is a serious injury of the chest. Thoracic injuries may present extremely dramatic clinical problem that demand rapid diagnosis, decision making and aggressive management. Thoracic injuries can range from simple single rib fracture to major thoracic vessel injury and pulmonary contusion.Objective of this study was to describe the clinical characteristics and risk factors of thoracic trauma patients, and to evaluate their relationship in the development of complications with special emphasis to surgical emphysema.Methods: Descriptive, prospective and analytical study of a cohort of patients with thoracic trauma who were followed up for a period of 30 days. Excluded from the study were those patients with moderate to severe cranio-encephalic trauma, long bone fractures, abdominal trauma, and patients who required mechanical ventilation.Results: A total of 102 patients met the inclusion criteria out of which 90(88.23%)patients were male and 12(11.77%) female with male to female ratio of 7.5:1. Patients having surgical emphysema were all male 21(21.56%). Most common mode of the injury seen was road traffic accidents in 80 (80.95%) patients, followed by assault in 9(9.52%) patients, bull horn injury and fall from height in 4(4.76%) patients. Other chest injury which was most commonly associated with surgical emphysema was haemothorax in 11(52.38%) patients, followed by pneumothorax in 7(33.33%) patients, pulmonary contusion in 6(28.57%) patients and flail chest in 3(14.26%) patients. The risk of complications increases significantly in patients with more than 2 rib fractures, in older patients and in the presence of some comorbidities such as COPD and pathologies that require anticoagulation. The risk of re-admittance is greater in patients older than 60 years.Conclusions: Patients with thoracic trauma who present with co-morbidities, are older than 60 years and have more than 2 ribs fractures may present with more complications. These factors should be contemplated in the evaluation, management and follow-up of these subjects.

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Section: Introductionmentioning

confidence: 99%

“…1 Thoracic injuries are found to be the primary or a contributing cause of about a quarter of all trauma related deaths. 1 The mortality rate due to chest trauma is about 10%. 2 Thoracic injuries account for 20-25% of deaths due to trauma.…”

Section: Introductionmentioning

confidence: 99%

A prospective study of chest injuries and associated complications with special reference to surgical emphysema

2018

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“…7,8,[16][17][18] Incidence of isolated first rib fracture isolated first rib fracture with other ribs and with flail chest was 6.00%, 1.66% and 5.66% respectively. 8,[19][20][21] Middle ribs were most commonly fractured (76.33%), almost all patients of flail chest were found in this group. Majority of patients of lower ribs fracture (5.66%) were reported with abdominal organs injury.…”

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confidence: 75%

A prospective randomized trial on trauma thoracic cage with rib fracture especially first rib fracture and associated complications

Kochar

Singh

2016

Int Surg J

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Background: Thoracic cage is an osseocartilaginous cavity which not only protects and supports vital organs but also has dynamic role in mechanism of respiration. The aim was to study the mechanism of first rib fracture, incidence and complications of first rib and other ribs' fracture and their sequelae. Methods: A prospective randomized trial was conducted on 300 patients of trauma thoracic cage having rib fracture with or without associated injuries at NIMS Medical College and Hospital, Jaipur, Rajasthan, India from April 2013 to March 2016. All patients were examined on a fixed protocol (age, sex, mode of injury, vital status, number and site of rib fracture) with associated injury and complications. Results: Maximum patients (including males and females both) with first and other rib fractures were in the age group of 11-30 years. The most common mode of trauma was roads traffic accident (RTA). First rib fractured at shaft by indirect trauma mostly. Commonly reported chest, abdomen and associated injury complications were haemothorax, haemoperitoneum and head injury respectively. Most of the patients were treated conservatively except 1% patients who required thoracotomy. Conclusions: Most common cause of chest trauma with rib fracture was RTA and first rib fracture was indirect trauma. The most common cause of mortality was an associated head injury. Kochar MP et al. Int Surg J. 2016 Aug;3(3):1278-1282 International Surgery Journal | July-September 2016 | Vol 3 | Issue 3 Page 1279 contraction of scalene and sternocleidomastoid muscle, thus fracture of first rib. Most commonly fractured ribs are 4 th -9 th , generally at the weakest area (posterior angle). Flail/stove in chest lead to paradoxical respiratory movements. Lower ribs fracture is usually associated with injury to diaphragm and abdominal organs (fracture of left lower ribs-spleen, right lower ribs-liver, floating ribs-renal injuries). Chest injuries are usually life threatening, either on their own or in conjunction with other system injuries. Ribs fracture may compromise ventilation, pain can cause respiratory splinting and fragments of fractured ribs can act as penetrating objects. Threats to life are; Keywords ImmediatePneumothorax, haemothorax, flail/ stove in chest, airway injuries, pericardial tamponade. PotentialPulmonary contusion, oesophageal/ aortic/ tracheobronchial/ myocardial injuries, rupture of diaphragm.The aim was to study rib fractures' mechanism, incidence and complications especially the first rib and their sequelae. METHODSThe study was conducted on 300 patients at NIMS Medical College and Hospital, Jaipur, Rajasthan, India, during the period April 2013 to March 2016, admitted in various departments mainly department of orthopaedics and neurosurgery having rib fracture with or without associated injuries. All patients were examined on a fixed protocol (age, sex, mode of injury, vital status, number and site of rib fracture) with associated injury and their complications were recorded. All patients underwent routine...

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“…Chest trauma is responsible for one-fourth of all deaths in the United States. 1 It also contributes significantly to the lethal outcome although the relative contribution of chest injury to mortality after trauma victim have reached to the hospital ward is small. 2 With rapid industrialization of cities, urbanization, and tremendous increase in high speed traffic flow, trauma in general and chest trauma in particular are on increase, requiring augmented care, trained personnel and sophisticated equipment for saving the life of these patients.…”

Section: Discussionmentioning

confidence: 99%

“…The mortality rate in these cases is about 10%. 1 Thoracic injuries account for 20-25% of deaths due to trauma. Approximately, 16,000 deaths per year in India alone are a result of chest trauma.…”

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confidence: 99%

Analytic Study of Chest Injury

2015

IJSS j of Surgery

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Background: Trauma is one of the leading causes of morbidity and mortality worldwide. Chest trauma constitutes about 10-15% of all cases and is responsible for 25% of deaths as a result of trauma. It is a major problem for India, where there is a very high incidence of vehicular accidents (6% of global vehicular accidents), along with crime and riots. In spite of that very few studies have been documented that assess the prevalence and management of these events. Hence, this retrospective study was carried out to determine the magnitude and management of patients with chest trauma in rural setup.

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Nonpenetrating Thoracic Injuries

Cited by 98 publications

References 20 publications

A prospective study of chest injuries and associated complications with special reference to surgical emphysema

A prospective study of chest injuries and associated complications with special reference to surgical emphysema

A prospective randomized trial on trauma thoracic cage with rib fracture especially first rib fracture and associated complications

Analytic Study of Chest Injury

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