Clinical Rib Fractures: Are Follow-Up Chest X-Rays A Waste of Resources?

Bansidhar, Brian J.; Lagares-Garcia, Jorge A.; Miller, S.L.
May 2002
American Surgeon;May2002, Vol. 68 Issue 5, p449
Academic Journal
Rib fractures (RFs) are estimated to be present in 10 per cent of all traumatic injuries. However, up to 50 per cent of all fractures go undetected on the screening chest X-ray (CXR). The purpose of this study was to identify the incidence of clinical (CRFs) and objective rib fractures (ORFs) as well as to examine the utility of the routine follow-up CXR with regard to patient recovery and healthcare cost. We identified patients sustaining RF in addition to other traumatic injuries with an Injury Severity Score (ISS) ≤ 15 and RF as the primary pathology. Five hundred fifty-two patients sustained blunt thoracic trauma with resultant RF. Two hundred nine patients had RFs and an ISS ≤ 15. The average ISS was 8. Follow-up films illustrated that 93 per cent of CRFs had resolution of any pathology, 4 per cent had persistent X-ray findings, and 4 per cent were lost to follow-up. Ultimately 93 per cent of patients with CRF were able to resume daily activities without disability and 3 per cent incurred lifestyle changes at home or work, which was significantly better than those with ORFs (P < 0.05). Follow-up films produced no change in clinical management and cost approximately $2000/year. The prognosis for CRFs is excellent if treatment consists of appropriate pain management and pulmonary rehabilitation. We do not advocate routine follow-up CXRs in addition to physical examination for the evaluation of CRFs unless clinical deterioration is evident.


Related Articles

  • Characteristics of rib fractures among abused infants. Apgar, Barbara // American Family Physician;1/1/1997, Vol. 55 Issue 1, p294 

    Summarizes a study by P.K. Kleinman, et al, from the 1996, volume 200, issue of `Radiology,' that examined the morphologic alteration of rib fractures sustained by infants from physical abuse. Background on the study; Outline of results; Conclusions by the authors.

  • The chest radiograph: trauma and intervention. Snaith, Beverly; Hardy, Maryann // Synergy: Imaging & Therapy Practice;Mar2012, p13 

    The article focuses on the chest radiograph, the first imaging investigation in polytrauma or thoracic that influence initial treatment as a result of some appearances in emergency environment. It mentions that the evaluation of chest radiograph in mechanism of injury and trauma that include...

  • Fractures of the first rib as an indicator of child abuse.  // American Family Physician;5/1/1996, Vol. 53 Issue 6, p2193 

    Presents an evaluation of the incidence of rib fractures in children, which can be viewed as an indicator of child abuse. Evaluation conducted by P.J. Strouse; How the evaluation was carried out; Findings from the evaluation; Why rib fractures are rare in children; Possible mechanisms of...

  • Surgical Treatment of Heavy Fragmental Fractures of Osteal Framework of Thorax. Kolkin, K. G.; Khatsko, V. V.; Stypachenko, O. N.; Pershin, E. C.; Kolklna, V.Y.; Akhtar, N.; Stypachenko, D. O. // European Surgical Research;May/Jun2004 Supplement 1, Vol. 36, p141 

    This study, studies various methods of surgical stabilization of osteal framework of the thorax at heavy fragmental fractures of ribs and sternum. The present research is based on experience of supervision of 2043 victims treated in clinic for the period 1991-2003. From them in 397 were heavy...

  • Cough-Induced Rib Fractures. Hanak, Viktor; Hartman, Thomas E.; Ryu, Jay H. // Mayo Clinic Proceedings;Jul2005, Vol. 80 Issue 7, p879 

    OBJECTIVES: To define the demographic, clinical, and radiological features of patients with cough-induced rib fractures and to assess potential risk factors. PATIENTS AND METHODS: For this retrospective, single-center study, we identified all cases of cough-induced rib fractures diagnosed at the...

  • NEUROLOGICAL PICTURE: Bilateral first rib fractures due to tardive dystonia. Hacking, D.; Werring, D. J. // Journal of Neurology, Neurosurgery & Psychiatry;Jul2005, Vol. 76 Issue 7, p983 

    This article presents a case study related to the bilateral first rib fractures due to tardive dystonia. A 37 year old man with mild learning disability and a history of previous neuroleptic use was admitted for investigation of a 1 year history of dystonia. On admission he had severe axial and...

  • ANATOMY OF THE RIBS AND MANAGEMENT OF THEIR FRACTURES AS VIEWED BY AVICENNA (980-1037 AD). Paydar, Shahram; Akbarzadeh, Armin; Jahanabadi, Shahram // Acta Medico-Historica Adriatica;2019, Vol. 17 Issue 2, p305 

    Introduction: Avicenna stated interesting points on the symptoms of rib bone fractures, their physical examination, and also treatment and management of the complications in his master piece Canon in Tibb. Method: We reviewed Avicenna's Canon and his viewpoints on the anatomy of the rib bones...

  • Population based estimates of non-fatal injuries in the capital of Iran.  // BMC Public Health;2011, Vol. 11 Issue 1, p608 

    The article offers information on a study conducted by the authors on non-fatal injuries and related medical expenses in Tehran, Iran. It states that household survey of residents was performed using cluster random sampling approach in April 2008. It mentions that fractures were 19.3 percent,...

  • Relation between fractures and mortality: results from the Canadian Multicentre Osteoporosis Study. Ioannidis, George; Papaioannou, Alexandra; Hopman, Wilma M.; Akhtar-Danesh, Noori; Anastassiades, Tassos; Pickard, Laura; Kennedy, Courtney C.; Prior, Jerilynn C.; Olszynski, Wojciech P.; Davison, Kenneth S.; Goltzman, David; Thabane, Lehana; Gafni, Amiran; Papadimitropoulos, Emmanuel A.; Brown, Jacques P.; Josse, Robert G.; Hanley, David A.; Adachi, Jonathan D. // CMAJ: Canadian Medical Association Journal;9/1/2009, Vol. 181 Issue 5, p265 

    Background: Fractures have largely been assessed by their impact on quality of life or health care costs. We conducted this study to evaluate the relation between fractures and mortality. Methods: A total of 7753 randomly selected people (2187 men and 5566 women) aged 50 years and older from...

  • 多排螺旋 CT 对隐匿性肋骨骨折的诊断价值及最佳复查时间研究. 向成燕; 曹秀峰; 杨亚芳; 仲豆豆; 梁志鹏 // Progress in Modern Biomedicine;Nov2019, Vol. 19 Issue 22, p4261 

    Objective: To investigate the diagnostic value and optimal review time of multi-slice spiral CT for occult rib fracture.Methods: 95 patients with chest trauma who were treated in our hospital from July 2017 to July 2018 were enrolled. All patients underwent X-ray and multi-slice spiral CT...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics