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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