İzole Bilateral Birinci Kosta Kırığı

Yıl 2014, Cilt: 5 Sayı: 2, 47 - 49, 01.02.2014

Hüseyin Çebiçci , Murat Yücel Oğuzhan Bol Nurullah Günay

Öz

Giriş: Bilateral birinci kosta kırığı son derece nadirdir ve genellikle
birden fazla kosta kırığı veya ciddi travmatik yaralanmalarla
birliktedir. Birçok vakada birinci kosta kırığı intratorasik ciddi yaralanmalarla,
ciddi nörovasküler yaralanmaları içeren baş ve sevikal
vertebra travmalarıyla ilişkilidir. Biz yaklaşık 3 metre yüksekten
düşen ve izole olarak bilateral birinci kostası kırılan bir olgu sunuyoruz.

Olgu Sunumu: Elli iki yaşında kadın, acile gelmeden 2 saat önce
düşmüş, glasgow koma skoru 15’di. Hastanın vital bulguları stabildi.
Akciğer, kalp sesleri, bilateral üst ekstremite ve karotis arter
nabız muayenelerinde bir anormallik tespit edilmedi. Servikal vertebra
radyografik olarak intaktı, ancak direkt radyografi ve torakal
bilgisayarlı tomografide bilateral birinci kosta kırığı mevcuttu.
Hastada başka herhangi bir patolojik bulguya rastlanılmadı.
Sonuç: Birinci kosta derin yerleşimlidir, omuz kuşağı ve kaslar tarafından
korunur, kırılması tüm kosta kırıkları içerisinde nadirdir.
Biliyoruz ki birinci kosta kırığı hayatı tehdit eden yaralanmalarla
beraberdir, bu yüzden bilateral kosta kırığı olan vakalarda potansiyel
riskin yüksek olduğunu düşünüyoruz. Bizim hastamız şanslıydı.

Anahtar Kelimeler

Bilateral rib fractures, isolated fracture of the first rib

Isolated Bilateral First-Rib Fractures

Öz

Introduction: Bilateral fractures of the first rib are extremely rare and usually associated with either multiple rib fractures or serious traumatic injuries. In many cases, first rib fracture is related to serious trauma of the intrathoracic, head, and cervical spine, including neurovascular injuries. We present a case report of isolated bilateral first rib resulting from fracture following falling down from approximately 3 meters in height.Case Report: A 52-year-old woman, with Glasgow coma scale score 15, fell down 2 hours ago and was admitted to the emergency department. Patient’s vital signs were stable. Breath and heart sounds and pulse examinations in the bilateral carotid arteries and upper extremities were not determined to be aberrant. The cervical spine radiographic figures were obtained as intact; however, the bilateral first ribs were fractured by direct radiography and thoracal computerized tomography. There were no other pathological findings related to the patient. Conclusion: The first rib is deeply placed and protected by the shoulder girdle and muscles, the fracture of which remains the rarest of all rib fractures. We know that potential life-threatening injuries occur with only first-rib fracture; so, we think that the potential risk of that trauma is too high in the case of bilateral firstrib fractures. Our patient was fortunate

Anahtar Kelimeler

Bilateral rib fractures, isolated fracture of the first rib

Kaynakça

• Qureshi T, Mander BJ, Wishart GC. Isolated bilateral first rib fractures-an unusual sequel of whiplash injury. Injury 1998 Jun; 29: 397-8. [CrossRef]
• Dwivedi SC, Varma AN. Bilateral fracture of the first ribs. J Trauma. 1983; 23: 538. [CrossRef]
• Villa I, Pessina R, Bonacina P, Gaetani G. Traumatic simultaneous bilateral fracture of the first rib. Chir Ital. 1985; 37: 194-7.
• Lee SJ, Chu SJ, Tsai SH. Isolated bılateral fırst-rib fractures. J Emerg Med 2010; 39: 204-5. [CrossRef]
• Ozel SK, Kazez A. Horner syndrome due to first rib fracture after major thoracic trauma. J Pediatr Surg 2005; 40: e17-9. [CrossRef]
• Colosimo AJ, Byrne E, Heidt RS, Jr, Carlonas RL, Wyatt H. Acute traumatic first-rib fracture in the contact athlete: a case report. Am J Sports Med 2004; 32: 1310-2. [CrossRef]
• Stoneham MD. Bilateral first rib fractures associated with driver’s air bag inflation: case report and implications for surgery. Eur J Emerg Med 1995; 2: 60-2. [CrossRef]
• Hassen AN, Ballester J, Slater N. Bilateral first rib fractures associated with Horner’s syndrome. Injury 2000; 31: 273-4. [CrossRef]
• Ozel SK, Kazez A. Horner’s syndrome secondary to tube thoracostomy. Turk J Pediatr 2004; 46: 189-90.