Nontraumatic First Rib Fractures Secondary to Opposing Muscle Contractions

Abstract

While first rib fractures typically occur from direct traumatic injuries and have high rates of serious complications, nontraumatic first rib fractures are less common and encountered in young athletes. The mechanism for these nontraumatic fractures is thought to be due to sudden contractions of opposing muscle forces on a developing bone. Because of the biomechanics of the first rib’s opposing muscle attachments, first rib fractures should be considered in patients who report pain deep to the medial clavicle, even without a history of direct severe trauma.

Fragility fracture of the fourth rib in a patient with a cardiac pacemaker: an uncommon case

“…Our patient had no history of trauma either. In addition, non-traumatic first rib fractures have been reported in young athletes who generally participate in sports with heading or overhead arm movements; stress fractures likely to result from the opposite force of muscle contractions on the bones with ongoing maturation [5]. There are case series of non-traumatic rib fractures after coughing not only in elderly but also in young patients, all of whom demonstrated a T-score below − 2.5 [3].…”