title: Traumatic vertebral fractures with concomitant fractures of the first rib.
abstract: OBJECTIVE
  To investigate the characteristics of patients with traumatic vertebral fractures and concomitant fractures of the first rib and their management.
  
  
  METHODS
  From January 2001 to December 2010, 17/3142 patients (0.5%) with traumatic vertebral fractures who presented to our hospitals had concomitant fractures of the first rib.
  
  
  RESULTS
  The study included 14 men (82.4%) and 3 women (17.6%) patients of age 32-57 years (mean, 46.6 years). The mechanisms of trauma were falls from heights in seven, motor vehicle accidents in five and direct collisions with blunt objects in five. Thirteen patients (76.5%) presented initially with pulmonary complications after sustaining trauma. Three patients sustained one rib fracture, two three rib fractures, three four rib fractures and 10 >  five rib fractures. The injuries were right-sided in three cases, left-sided in three and bilateral in eleven. Four patients (23.5%) presented with craniocerebral injuries. According to the American Spinal Injury Association (ASIA) classification, 10 patients (58.8% of the total study group) had motor and sensory deficits (ASIA A-D). There were no vascular injuries or deaths.
  
  
  CONCLUSIONS
  Traumatic vertebral fractures with concomitant fractures of the first rib are associated with multisystem injuries, but not always with morbidity and mortality. A multidisciplinary approach, early diagnosis, appropriate treatment and observation in the intensive care unit may prevent morbidity and/or mortality.
authors: Department of Orthopaedics, Xinqiao Hospital, Chongqing, China.
authors: Hong-wei
authors: HW
authors: Wang
authors: Qiang
authors: Q
authors: Xiang
authors: Chang-qing
authors: CQ
authors: Li
authors: Yue
authors: Y
authors: Zhou
mesh_terms: D000328:Adult; D002681:China / Q000453:epidemiology; D005260:Female; D006801:Humans; D055370:Lung Injury / Q000453:epidemiology / Q000209:etiology; D008297:Male; D008875:Middle Aged; D009104:Multiple Trauma / Q000000981:diagnostic imaging* / Q000453:epidemiology; D011030:Pneumothorax / Q000453:epidemiology / Q000209:etiology; D012189:Retrospective Studies; D012253:Rib Fractures / Q000150:complications / Q000000981:diagnostic imaging* / Q000453:epidemiology; D016103:Spinal Fractures / Q000000981:diagnostic imaging* / Q000453:epidemiology; D014057:Tomography, X-Ray Computed
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