First Rib Fracture Nonunion Treated With Bone Marrow Aspirate Concentrate in a Division 1 Collegiate Baseball Player

S Kanjiya,Cn Moon,Ra Gambardella

doi:10.23937/2469-5718/1510187

Abstract

Fractures of the first rib have historically been described in major trauma with a high prevalence for cardiothoracic and musculoskeletal fractures. However, there have been several case reports describing first rib fractures in athletes. The vast majority of these patients return to play with conservative management. Unfortunately, some patients may develop fracture nonunion. Patients that develop a nonunion may remain asymptomatic. In the rare case that a patient is symptomatic or develops thoracic outlet from a fracture nonunion then a first rib resection may be indicated. With the use of biologic agents such as bone marrow aspirate concentrate, physicians may have the option to treat first rib fracture nonunion without invasive procedures.

Highlights

Fractures of the first rib have historically been described in major trauma with a high prevalence for cardiothoracic and musculoskeletal fractures
At 12 weeks post BMAC injection, the patient was allowed to return to Citation: Kanjiya S, Gambardella RA, Moon CN (2021) First Rib Fracture Nonunion Treated With Bone Marrow Aspirate Concentrate in a Division 1 Collegiate Baseball Player
To avoid a first rib resection, we proposed the use of bone marrow aspirate concentrate via Computerized Tomography (CT) guided injection into the fracture site

Summary

Introduction

Fractures of the first rib have historically been described in major trauma with a high prevalence for cardiothoracic and musculoskeletal fractures. The pain began after colliding with the outfield wall will attempting to catch a ball After this event he continued to play with mild posterior shoulder discomfort that was treated with physical therapy and symptomatic control. 2 weeks prior to presentation the patient complained of increased sharp pain after hitting a ball while batting in a game On physical examination, he was found to have full range of motion and normal strength of the right upper extremity. At 12 weeks post BMAC injection, the patient was allowed to return to Citation: Kanjiya S, Gambardella RA, Moon CN (2021) First Rib Fracture Nonunion Treated With Bone Marrow Aspirate Concentrate in a Division 1 Collegiate Baseball Player. The patient remained asymptomatic and successfully completed the remainder of the baseball season

Findings

Discussion

Conclusion