Nontraumatic First Rib Fractures Secondary to Opposing Muscle Contractions

Abstract

While first rib fractures typically occur from direct traumatic injuries and have high rates of serious complications, nontraumatic first rib fractures are less common and encountered in young athletes. The mechanism for these nontraumatic fractures is thought to be due to sudden contractions of opposing muscle forces on a developing bone. Because of the biomechanics of the first rib’s opposing muscle attachments, first rib fractures should be considered in patients who report pain deep to the medial clavicle, even without a history of direct severe trauma.