Chest trauma: rib fracture and flail chest (R2)

Question 1

What injuries can come about with chest trauma?

Answer 1

Question 2

Rib fractures
- Traumatic causes?
- Non traumatic/medical causes?

Answer 2

Traumatic causes
- Physical assault (including child abuse)
- Falls
-MVAs and industrial accidents
- CPR

Non traumatic causes
- Cancer metastasis to ribs
- Osteoporosis
- Stress fractures (severe coughing, sports)

Question 3

Rib fractures
- Which ribs are most commonly affected?
- What part of the rib is most commonly affected?

Answer 3

The middle ribs
Just anterior to the angle

Question 4

Complications of rib fractures?

Answer 4

Lacerations to
- Lungs: pulmonary contusion
- Pleura: pneumothorax, hemothorax
- Abdominal organs - diaphragm, liver, speen, kidneys

Pneumonia

Question 5

What is flail chest?

Answer 5

Question 6

History?

Answer 6

Pain
SOB

Question 7

Exam:
- Vital signs?
- Chest?

Answer 7

Vital signs: decreased PO2
Chest
- Rib tenderness
- Asymmetrical expansion of chest wall if flail chest

Question 8

Diagnosis?

Answer 8

Imaging - CXR, CT, ultrasound

Question 9

Management?

Answer 9