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DIFFERENCES OF RIB FRACTURES IN BLUNT TRAUMA PATIENTS ACCORDING TO AGE AND GENDER: A COMPUTED TOMOGRAPHY STUDY

Year 2023, Volume: 30 Issue: 2, 179 - 184, 22.06.2023
https://doi.org/10.17343/sdutfd.1216776

Abstract

Objective
To investigate the difference between rib fractures
according to age and sex in blunt trauma patients.
Material and Method
The patients were classified into 3 age groups:
Group-1:18-44 years, Group-2:45-69 years, and
Group-3:70 years or more. Rib fractures were
classified into 3 groups based on their level on the
coronal plane (upper (1st-4th ribs), medium (5th-
8th ribs) and lower (9th-12th ribs)) and axial plane
(anterior, lateral and posterior).
Results
Rib fractures were found to be more common in male
(69%) to female (53%) (p=0.002). The incidence of
fractures was seen to increase with age (p=0.001;
r=615). Rib fractures were most commonly found in
the middle ribs (5th-8th ribs) in all-age-groups. The
incidence of fractures in the upper ribs was significantly
lower in the advanced age than the other age groups
(p=0.002). Fractures were least commonly found in the
anterior part of the rib in all age groups. Rib fractures
were observed at a higher rate in the lateral part in
young adults unlike the other age groups (p=0.001).
A significant difference was found between the age
groups in favor of young adults (group 1) in terms of
the presence of parenchymal contusion without rib
fracture (p=0.014).
Conclusion
Rib fracture was seen at a higher rate in male than
female in blunt thoracic trauma patients. Fractures
possibility of in the upper rib structures is lower in the
advanced age group. Unlike other groups, in young
people, a higher rate of fractures was detected in
the lateral part of the costa. One should be aware of
the possibility of parenchymal contusion without a rib
fracture in the young age group.

References

  • 1. Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: An overview. Chin J Traumatol. 2020;23:125-138.
  • 2. Sirmali M, Turut H, Topcu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24:133-138
  • 3. Ozerdemoglu AR, Aydınlı U. Çocuklarda Torakolomber Vertebra Kırıkları. SDU Tıp Fakültesi Dergisi. 1995; 2:19-22
  • 4. Holcombe SA, Wang SC, Grotberg JB. Age-related changes in thoracic skeletal geometry of elderly females. Traffic Inj Prev. 2017;29;122-128.
  • 5. Kent R, Lee SH, Darvish K, Wang S, Poster CS, Lange AW, Brede C, Lange D, Matsuoka F. Structural and material changes in the aging thorax and their role in crash protection for older occupants. Stapp Car Crash J. 2005;49:231-49.
  • 6. Kindig MW, Kent RW. Characterization of the centroidal geometry of human ribs. J Biomech Eng. 2013;135:111007.
  • 7. Gayzik FS, Yu MM, Danelson KA, Slice DE, Stitzel JD. Quantification of age-related shape change of the human rib cage through geometric morphometrics. J Biomech. 2008;41:1545-54.
  • 8. Campbell EJ, Lefrak SS. How aging affects the structure and function of the respiratory system. Geriatrics. 1978;33:68-74.
  • 9. Esme H, Solak O, Yurumez Y, Yavuz Y, Terzi Y, Sezer M, Kucuker H. The prognostic importance of trauma scoring systems for blunt thoracic trauma. Thorac Cardiovasc Surg. 2007;55:190-5.
  • 10. Weaver AA, Schoell SL, Stitzel JD. Morphometric analysis of variation in the ribs with age and sex. J Anat. 2014;225:246-61.
  • 11. Diaz JJ, Azar FK. Minimally invasive chest wall stabilization: a novel surgical approach to video-assisted rib plating (VARP). Trauma Surg Acute Care Open. 2019;18;PMCID: PMC6924860.
  • 12. Torun E., Yavuz Y. Acute Traumatic Pathologies (Especially Rib Fractures) Based on Age and Gender in Patients with Blunt Thoracic Trauma: a CT Study. Research Square DOI: 10.21203/rs.3.rs-1529053/v1
  • 13. Beshay M, Mertzlufft F, Kottkamp HW, Reymond M, Schmid RA, Branscheid D, Vordemvenne T. Analysis of risk factors in thoracic trauma patients with a comparison of a modern trauma centre: a mono-centre study. World J Emerg Surg. 2020;15:45
  • 14. Simon JB, Wickham AJ. Blunt chest wall trauma: an overview. Br J Hosp Med (Lond). 2019;80:711-715.
  • 15. Yazkan R. Pulmonary contusion in adult isolated chest injuries: Analysis of 73 cases. Bidder Tıp Bilimleri Dergisi. 2011;3:9-15.
  • 16. Altınok T. Akciğer Yaralanmaları. TTD Toraks Cerrahisi Bülteni 2010;1:55-9.

KÜNT TRAVMALI HASTALARDA KOSTA KIRIKLARININ YAŞ VE CİNSİYETE GÖRE FARKLILIĞI: BİLGİSAYARLI TOMOGRAFİ ÇALIŞMASI

Year 2023, Volume: 30 Issue: 2, 179 - 184, 22.06.2023
https://doi.org/10.17343/sdutfd.1216776

Abstract

Amaç
Künt travmalı hastalarda kosta kırıklarının yaş ve cinsiyete
göre farklılığını araştırmak.
Gereç ve Yöntem
Toraks BT incelemede akut torasik travmatik patoloji
saptanan 18 yaş ve üzeri 411 erişkin hasta (214 erkek,
197 kadın) çalışma kapsamına dahil edildi ve geriye
dönük olarak incelendi. BT incelemede hastalarda kırık
(kosta, skapula, sternum, vertebra, klavikula), hemotoraks,
pnömotoraks, pnömomediastinum, akciğer
parankiminde posttravmatik patoloji (kontüzyon, laserasyon),
diyafragmatik ve vasküler hasar varlığı kaydedildi.
Hastalar yaş gruplarına göre 1. Grup: 18-44 yaş,
2. Grup: 45-69 yaş ve 3. Grup: 70 yaş ve üzeri olmak
üzere 3 grupta sınıflandırıldı. Kosta kırıkları seviyesine
göre 3 grupta (üst seviye: 1-4. kostalar, orta seviye:
5-8. kostalar ve alt seviye: 9-12. kostalar) sınıflandırıldı.
Kosta kırıkları aksiyel plandaki lokalizasyonuna
göre; ön, orta ve arka olmak üzere 3 gruba ayrıldı.
Bulgular
Kosta kırıkların erkeklerde (%69), kadınlara göre
(%53) daha sık olduğu bulundu (p=0.002). Yaş arttıkça
kırık sıklığının arttığı görüldü (p=0.001; r=615).
Tüm yaş gruplarında kosta kırıkları en sık orta kostalarda
(5.-8. kostalar) tespit edildi. İleri yaş grubunda
(Grup 3) üst kostalarda kırık varlığı diğer yaş gruplarına
göre belirgin düşüktü (p=0.002). Tüm yaş gruplarında
en düşük sıklıkla kostaların anterior kesiminde
kırık tespit edildi. Genç erişkinlerde (Grup 1) diğer yaş
gruplarının aksine kosta kırığı lateral kesimde daha
yüksek oranda izlendi (p=0.001). Kosta kırığı olmadan
parankimal kontüzyon varlığı açısından yaş grupları
arasında genç erişkinler (grup 1) lehine belirgin
farklılık bulundu (p=0.014).
Sonuç
Künt toraks travma hastalarında kosta kırığı erkeklerde
kadınlara göre daha yüksek oranda görülmüştür.
İleri yaş grubunda üst kostalarda kırık olasılığı diğer
yaş gruplarına göre daha azdı. Diğer gruplardan farklı
olarak, gençlerde, kostaların lateral kesiminde daha
yüksek oranda kırık saptanmıştır. Genç yaş grubunda
kosta kırığı olmadan parankimal kontüzyon olasılığı
açısından uyanık olunmalıdır.

References

  • 1. Dogrul BN, Kiliccalan I, Asci ES, Peker SC. Blunt trauma related chest wall and pulmonary injuries: An overview. Chin J Traumatol. 2020;23:125-138.
  • 2. Sirmali M, Turut H, Topcu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003;24:133-138
  • 3. Ozerdemoglu AR, Aydınlı U. Çocuklarda Torakolomber Vertebra Kırıkları. SDU Tıp Fakültesi Dergisi. 1995; 2:19-22
  • 4. Holcombe SA, Wang SC, Grotberg JB. Age-related changes in thoracic skeletal geometry of elderly females. Traffic Inj Prev. 2017;29;122-128.
  • 5. Kent R, Lee SH, Darvish K, Wang S, Poster CS, Lange AW, Brede C, Lange D, Matsuoka F. Structural and material changes in the aging thorax and their role in crash protection for older occupants. Stapp Car Crash J. 2005;49:231-49.
  • 6. Kindig MW, Kent RW. Characterization of the centroidal geometry of human ribs. J Biomech Eng. 2013;135:111007.
  • 7. Gayzik FS, Yu MM, Danelson KA, Slice DE, Stitzel JD. Quantification of age-related shape change of the human rib cage through geometric morphometrics. J Biomech. 2008;41:1545-54.
  • 8. Campbell EJ, Lefrak SS. How aging affects the structure and function of the respiratory system. Geriatrics. 1978;33:68-74.
  • 9. Esme H, Solak O, Yurumez Y, Yavuz Y, Terzi Y, Sezer M, Kucuker H. The prognostic importance of trauma scoring systems for blunt thoracic trauma. Thorac Cardiovasc Surg. 2007;55:190-5.
  • 10. Weaver AA, Schoell SL, Stitzel JD. Morphometric analysis of variation in the ribs with age and sex. J Anat. 2014;225:246-61.
  • 11. Diaz JJ, Azar FK. Minimally invasive chest wall stabilization: a novel surgical approach to video-assisted rib plating (VARP). Trauma Surg Acute Care Open. 2019;18;PMCID: PMC6924860.
  • 12. Torun E., Yavuz Y. Acute Traumatic Pathologies (Especially Rib Fractures) Based on Age and Gender in Patients with Blunt Thoracic Trauma: a CT Study. Research Square DOI: 10.21203/rs.3.rs-1529053/v1
  • 13. Beshay M, Mertzlufft F, Kottkamp HW, Reymond M, Schmid RA, Branscheid D, Vordemvenne T. Analysis of risk factors in thoracic trauma patients with a comparison of a modern trauma centre: a mono-centre study. World J Emerg Surg. 2020;15:45
  • 14. Simon JB, Wickham AJ. Blunt chest wall trauma: an overview. Br J Hosp Med (Lond). 2019;80:711-715.
  • 15. Yazkan R. Pulmonary contusion in adult isolated chest injuries: Analysis of 73 cases. Bidder Tıp Bilimleri Dergisi. 2011;3:9-15.
  • 16. Altınok T. Akciğer Yaralanmaları. TTD Toraks Cerrahisi Bülteni 2010;1:55-9.
There are 16 citations in total.

Details

Primary Language English
Subjects Clinical Sciences
Journal Section Research Articles
Authors

Ebru Torun 0000-0003-0879-5285

Yavuz Yüksel 0000-0002-3805-4245

Publication Date June 22, 2023
Submission Date December 27, 2022
Acceptance Date April 10, 2023
Published in Issue Year 2023 Volume: 30 Issue: 2

Cite

Vancouver Torun E, Yüksel Y. DIFFERENCES OF RIB FRACTURES IN BLUNT TRAUMA PATIENTS ACCORDING TO AGE AND GENDER: A COMPUTED TOMOGRAPHY STUDY. Med J SDU. 2023;30(2):179-84.

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