Occult radiographic fractures of the chest wall identified by nuclear scan imaging: report of seven cases.
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.
LaBan
M M
MM
Department of Physical Medicine and Rehabilitation, William Beaumont Hospital, Royal Oak, MI 48073.
Siegel
C B
CB
Schutz
L K
LK
Taylor
R S
RS
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