Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States
Purpose Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest...
Saved in:
| Main Authors: | , , , , , , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
Korean Society of Traumatology
2024-03-01
|
| Series: | Journal of Trauma and Injury |
| Subjects: | |
| Online Access: | http://jtraumainj.org/upload/pdf/jti-2023-0065.pdf |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1841527046022365184 |
|---|---|
| author | Jennifer M. Brewer Owen P. Karsmarski Jeremy Fridling T. Russell Hill Chasen J. Greig Sarah E. Posillico Carol McGuiness Erin McLaughlin Stephanie C. Montgomery Manuel Moutinho Ronald Gross Evert A. Eriksson Andrew R. Doben |
| author_facet | Jennifer M. Brewer Owen P. Karsmarski Jeremy Fridling T. Russell Hill Chasen J. Greig Sarah E. Posillico Carol McGuiness Erin McLaughlin Stephanie C. Montgomery Manuel Moutinho Ronald Gross Evert A. Eriksson Andrew R. Doben |
| author_sort | Jennifer M. Brewer |
| collection | DOAJ |
| description | Purpose Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0–3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management. |
| format | Article |
| id | doaj-art-a55e3904d58e465099000439bed1956f |
| institution | Kabale University |
| issn | 2799-4317 2287-1683 |
| language | English |
| publishDate | 2024-03-01 |
| publisher | Korean Society of Traumatology |
| record_format | Article |
| series | Journal of Trauma and Injury |
| spelling | doaj-art-a55e3904d58e465099000439bed1956f2025-01-16T06:10:09ZengKorean Society of TraumatologyJournal of Trauma and Injury2799-43172287-16832024-03-01371485910.20408/jti.2023.00651288Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United StatesJennifer M. Brewer0Owen P. Karsmarski1Jeremy Fridling2T. Russell Hill3Chasen J. Greig4Sarah E. Posillico5Carol McGuiness6Erin McLaughlin7Stephanie C. Montgomery8Manuel Moutinho9Ronald Gross10Evert A. Eriksson11Andrew R. Doben12 Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Department of General Surgery, University of Connecticut School of Medicine, Farmington, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USA Department of Surgery, Medial University of South Carolina, Charleston, SC, USA Department of Surgery, Saint Francis Hospital and Medical Center, Hartford, CT, USAPurpose Research on rib fracture management has exponentially increased. Predicting fracture patterns based on the mechanism of injury (MOI) and other possible correlations may improve resource allocation and injury prevention strategies. The Chest Injury International Database (CIID) is the largest prospective repository of the operative and nonoperative management of patients with severe chest wall trauma. The purpose of this study was to determine whether the MOI is associated with the resulting rib fracture patterns. We hypothesized that specific MOIs would be associated with distinct rib fracture patterns. Methods The CIID was queried to analyze fracture patterns based on the MOI. Patients were stratified by MOI: falls, motor vehicle collisions (MVCs), motorcycle collisions (MCCs), automobile-pedestrian collisions, and bicycle collisions. Fracture locations, associated injuries, and patient-specific variables were recorded. Heat maps were created to display the fracture incidence by rib location. Results The study cohort consisted of 1,121 patients with a median RibScore of 2 (range, 0–3) and 9,353 fractures. The average age was 57±20 years, and 64% of patients were male. By MOI, the number of patients and fractures were as follows: falls (474 patients, 3,360 fractures), MVCs (353 patients, 3,268 fractures), MCCs (165 patients, 1,505 fractures), automobile-pedestrian collisions (70 patients, 713 fractures), and bicycle collisions (59 patients, 507 fractures). The most commonly injured rib was the sixth rib, and the most common fracture location was lateral. Statistically significant differences in the location and patterns of fractures were identified comparing each MOI, except for MCCs versus bicycle collisions. Conclusions Different mechanisms of injury result in distinct rib fracture patterns. These different patterns should be considered in the workup and management of patients with thoracic injuries. Given these significant differences, future studies should account for both fracture location and the MOI to better define what populations benefit from surgical versus nonoperative management.http://jtraumainj.org/upload/pdf/jti-2023-0065.pdfchest traumarib fracturesmechanism of injury |
| spellingShingle | Jennifer M. Brewer Owen P. Karsmarski Jeremy Fridling T. Russell Hill Chasen J. Greig Sarah E. Posillico Carol McGuiness Erin McLaughlin Stephanie C. Montgomery Manuel Moutinho Ronald Gross Evert A. Eriksson Andrew R. Doben Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States Journal of Trauma and Injury chest trauma rib fractures mechanism of injury |
| title | Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States |
| title_full | Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States |
| title_fullStr | Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States |
| title_full_unstemmed | Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States |
| title_short | Chest wall injury fracture patterns are associated with different mechanisms of injury: a retrospective review study in the United States |
| title_sort | chest wall injury fracture patterns are associated with different mechanisms of injury a retrospective review study in the united states |
| topic | chest trauma rib fractures mechanism of injury |
| url | http://jtraumainj.org/upload/pdf/jti-2023-0065.pdf |
| work_keys_str_mv | AT jennifermbrewer chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT owenpkarsmarski chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT jeremyfridling chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT trussellhill chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT chasenjgreig chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT saraheposillico chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT carolmcguiness chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT erinmclaughlin chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT stephaniecmontgomery chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT manuelmoutinho chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT ronaldgross chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT evertaeriksson chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates AT andrewrdoben chestwallinjuryfracturepatternsareassociatedwithdifferentmechanismsofinjuryaretrospectivereviewstudyintheunitedstates |