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Journal of the Korean Society of Traumatology 2008;21(2):91-99.
Influence of Multiple Rib Fracture upon Traumatic Hemo-pneumothorax
Seung Joon Yang, Jewon Lee, Sang Chan Jin, Myeong Don Joo, Woo Ik Choi
Department of Emergency Medicine, School of Medicine, Keimyung University, Korea. emtaegu@dsmc.or.kr
다발성 늑골골절의 외상성 혈기흉 발생에 대한 영향
양승준·이제원·진상찬·주명돈·최우익
계명대학교 의과대학 응급의학교실
Abstract
PURPOSE
Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed.
METHODS
We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System).
RESULTS
The average number of rib fractures was 3.7+/-2.1, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a phemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036).
CONCLUSION
The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.
Key Words: Rib fracture; Hemothorax; Pneumothorax


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