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Abstract
A rib fracture secondary to blunt thoracic trauma is an important indicator of the
severity of the trauma. In the present study we explored the morbidity and mortality
rates and the management following rib fractures.
Between May 1999 and May 2001, 1417 cases who presented to our clinic for thoracic
trauma were reviewed retrospectively. Five hundred and forty-eight (38.7%) of the
cases had rib fracture. There were 331 males and 217 females, with an overall mean
age of 43 years (range: 5-78 years). These patients were allocated into groups according
to their ages, the number of fractured ribs and status, i.e. whether they were stable
or unstable (flail chest).
The etiology of the trauma included road traffic accidents in 330 cases, falls in
122, assault in 54, and industrial accidents in 42 cases. Pulmonary complications
such as pneumothorax (37.2%), hemothorax (26.8%), hemo-pneumothorax (15.3%), pulmonary
contusion (17.2%), flail chest (5.8%) and isolated subcutaneous emphysema (2.2%) were
noted. 40.1% of the cases with rib fracture were treated in intensive care units.
The mean duration of their stay in the intensive care unit was 11.8+/-6.2 days. 42.8%
of the cases were treated in the wards whereby their mean duration of hospital stay
was 4.5+/-3.4 days, while 17.1% of the cases were followed up in the outpatient clinic.
Twenty-seven patients required surgery. Mortality rate was calculated as 5.7% (n=31).
Rib fractures can be interpreted as signs of significant trauma. The greater the number
of fractured ribs, the higher the mortality and morbidity rates. Patients with isolated
rib fractures should be hospitalized if the number of fractured ribs is three or more.
We also advocate that elderly patients with six or more fractured ribs should be treated
in intensive care units due to high morbidity and mortality.