The presence of a first rib fracture (FRF) in a trauma patient is associated with significant trauma.

Patient selection: first rib fracture


CT imaging is more sensitive than chest X-ray and has increased its recognition. Recognition of FRF on CT but not chest X-ray indicates less severe injury.


Conditions associated with first rib fracture:

(1) older age

(2) severe trauma to the head and neck

(3) severe chest trauma

(4) need for intubation

(5) pelvic fracture

(6) Glasgow coma score 9 to 14

(7) flail chest

(8) hemothorax

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