The role of computed tomography in the evaluation of intrapulmonary complications in rib fractures according to their sites and types

Abstract

Abstract Objective: To evaluate the complication risks by different locations and types of rib fractures and to emphasize the role of computed tomography (CT). Material and Method: Patients’ findings undergoing thoracic CT due to blunt chest trauma in the emergency department of our hospital between 1st September 2021 and 31st December 2023 were retrospectively evaluated, and 560 patients with rib fractures were included in the study. Such factors as age, gender, axial (anterior, posterior, lateral, and multiple) and coronal plane (upper, middle, and lower) fracture status, and the incidence of intrapulmonary complications of all patients were evaluated through CT. It was investigated whether there were statistical differences between the study findings. Results: In the Mann-Whitney U test, the mean age of females was seen to be significantly higher than in males (p<0.001). It was also found that the frequency of displaced fractures was significantly higher in those with advanced age (p=0.22), and the frequency of intrapulmonary complications was significantly higher (p<0.001). Rib fractures were most frequently seen in the posterior plane in the axial plane, and most frequently in the midplane in the coronal plane. However, in the Kruskal-Wallis test, the development of complications was found to be significantly higher in these localizations, compared to other regions (p<0.001). Discussion: CT plays a critical role in those with rib fractures, both in determining the location of the fracture and in detecting fracture-related complications. Our study findings reveal that CT should be included in clinical decision-making processes in the management of rib fractures.

Keywords

• Computed tomography
• fracture
• intrapulmonary complication
• rib

Kot kırıklarının farklı yerleşim yerleri ve tiplerine göre komplikasyon risklerini değerlendirmek ve bilgisayarlı tomografinin rolünü vurgulamak.

Abstract

ÖZET Amaç: Kot kırıklarının farklı yerleşim yerleri ve tiplerine göre komplikasyon risklerini değerlendirmek ve bilgisayarlı tomografinin (BT) rolünü vurgulamak. Gereç ve Yöntem: 1 Eylül 2021 ile 31 Aralık 2023 tarihleri arasında hastanemiz acil servisinde künt toraks travması nedeniyle toraks BT’si yapılan hastaların verileri geriye dönük olarak değerlendirildi ve kot kırığı saptanan 560 hasta çalışmaya dahil edildi. Hastaların yaşı, cinsiyeti, aksiyel (anterior, posterior, lateral ve çoklu) ve koronal düzlemdeki (üst, orta ve alt) kırık durumları ile intrapulmoner komplikasyon görülme sıklıkları BT ile değerlendirildi. Elde edilen bulgular arasında istatistiksel fark olup olmadığı araştırıldı. Bulgular: Mann-Whitney U testi sonucunda kadınların yaş ortalamasının erkeklere göre anlamlı derecede yüksek olduğu görüldü (p<0.001). Ayrıca, ileri yaş grubunda deplase kırık sıklığı (p=0.22) ve intrapulmoner komplikasyon sıklığı (p<0.001) anlamlı derecede yüksek bulundu. Kot kırıkları aksiyel planda en sık posterior, koronal planda ise en sık orta düzeyde görüldü. Kruskal-Wallis testi ile bu lokalizasyonlarda komplikasyon gelişiminin diğer bölgelere kıyasla anlamlı derecede yüksek olduğu saptandı (p<0.001). Tartışma: BT, kot kırığı olan hastalarda hem kırık lokalizasyonunun belirlenmesinde hem de kırığa bağlı komplikasyonların saptanmasında kritik bir rol oynamaktadır. Çalışma bulgularımız, BT’nin kot kırığı yönetiminde klinik karar verme sürecine dahil edilmesi gerektiğini ortaya koymaktadır.

Keywords

• Bilgisayarlı tomografi
• kırık
• intrapulmoner komplikasyon
• kot

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