# Is the presence of a first rib fracture in patients with polytrauma an indicator of severe trauma? A retrospective study on associated injuries and clinical outcomes

## TL;DR

This study examines if first rib fractures in polytrauma patients indicate severe trauma by comparing clinical outcomes with other rib fractures.

## Contribution

The study evaluates the reliability of first rib fractures as an indicator of trauma severity in polytrauma patients.

## Key findings

- First rib fractures are associated with vascular and neurological injuries in polytrauma patients.
- Patients with first rib fractures had a lower proportion of ISS >15 compared to those with other rib fractures.
- First rib fractures do not independently increase mortality but are linked to severe trauma indicators.

## Abstract

First rib fractures (FRFs) have traditionally been considered indicators of severe blunt trauma. This study aimed to evaluate whether FRFs reliably reflect the severity of such trauma.

The study was conducted at the Emergency Department (ED) of Tokat Gaziosmanpaşa University Medical School Hospital between August 1, 2020 and August 1, 2023. It included patients who presented to the ED with blunt trauma and had rib fractures either isolated or in association with injuries to other organs or skeletal structures. Patients were categorized into two groups. The Injury Severity Score (ISS) was calculated for both groups..

Of 313 patients, 53 had FRFs (Group-A) and 260 had other rib fractures (Group-B). Vehicle-related accidents were the leading cause in both groups. ISS >15 was found in 22 Group-A and 57 Group-B patients.

Although FRFs do not independently increase mortality, they may be associated with vascular and neurological injuries, and are considered reliable indicators of severe trauma in polytrauma patients.