title: Occult radiographic fractures of the chest wall identified by nuclear scan imaging: report of seven cases.
abstract: Between 1985 and 1990 the enactment of state mandatory seat belt laws has reduced the risk of death from auto accident by at least 40% and the risk of moderate to severe injury by 45%. Although head and facial trauma has also been significantly reduced, there has not been a decrease in injuries to other parts of the body. We evaluated seven restrained drivers who complained of persistent anterior and/or lateral chest wall pain after being in motor vehicle accidents. All had normal x-rays of the osseous thorax. Nuclear scan imaging subsequently revealed that all seven had a healing fracture of either the sternum or ribs. In each instance, direct trauma to the sternum and ribs anteriorly by the chest strap itself and/or laterally displaced bending forces transmitted to the postero lateral rib margins was sufficient to produce x-ray occult fractures.
authors.affiliation: Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, MI 48073.
authors.forename: M M
authors.initials: MM
authors.lastname: LaBan
authors.forename: C B
authors.initials: CB
authors.lastname: Siegel
authors.forename: L K
authors.initials: LK
authors.lastname: Schutz
authors.forename: R S
authors.initials: RS
authors.lastname: Taylor
mesh_terms: D000063:Accidents, Traffic; D000328:Adult; D001696:Biomechanical Phenomena; D005260:Female; D050723:Fractures, Bone / Q000000981:diagnostic imaging* / Q000209:etiology; D006801:Humans; D008875:Middle Aged; D011859:Radiography; D011877:Radionuclide Imaging; D012253:Rib Fractures / Q000000981:diagnostic imaging* / Q000209:etiology; D012622:Seat Belts / Q000009:adverse effects* / Q000331:legislation & jurisprudence; D013249:Sternum / Q000293:injuries*; D014481:United States