Isolated Bilateral First-Rib Fractures

Abstract

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.