Costal cartilage fractures in blunt polytrauma patients - a prospective clinical and radiological follow-up study.

Autor: Nummela MT; Department of Radiology, Töölö Hospital, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, PL 266, 00029 HUS, Helsinki, Finland. mari.nummela@helsinki.fi., Pyhältö TT; Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Bensch FV; Department of Radiology, Töölö Hospital, HUS Diagnostic Center, Helsinki University Hospital and University of Helsinki, PL 266, 00029 HUS, Helsinki, Finland., Heinänen MT; Department of Orthopaedics and Traumatology, Töölö Hospital, Helsinki University Hospital and University of Helsinki, Helsinki, Finland., Koskinen SK; Department of Clinical Science, Intervention, and Technology, Division for Radiology, Karolinska Institute, Stockholm, Sweden.; Center for Medical Image Science and Visualization (CMIV), Linköping University, Linköping, Sweden.
Jazyk: angličtina
Zdroj: Emergency radiology [Emerg Radiol] 2022 Oct; Vol. 29 (5), pp. 845-854. Date of Electronic Publication: 2022 Jun 04.
DOI: 10.1007/s10140-022-02066-w
Abstrakt: Purpose: To assess the healing of costal cartilage fractures (CCFX) in patients with blunt polytrauma with follow-up imaging and clinical examination. Effect on physical performance and quality of life (QoL) was also evaluated.
Methods: The study group comprised twenty-one patients with diagnosed CCFX in trauma CT. All the patients underwent MRI, ultrasound, ultra-low-dose CT examinations, and clinical status control. The patients completed QoL questionnaires. Two radiologists evaluated the images regarding fracture union, dislocation, calcifications, and persistent edema at fracture site. An attending trauma surgeon clinically examined the patients, with emphasis on focal tenderness and ribcage mobility. Trauma registry data were accessed to evaluate injury severity and outcome.
Results: The patients were imaged at an average of 34.1 months (median 36, range 15.8-57.7) after the initial trauma. In 15 patients (71.4%), CCFX were considered stable on imaging. Cartilage calcifications were seen on healed fracture sites in all the patients. The fracture dislocation had increased in 5 patients (23.8%), and 1 patient (4.8%) showed signs of a non-stable union. Four patients (19.0%) reported persistent symptoms from CCFX.
Conclusion: Non-union in CCFX is uncommon but may lead to decreased stability and discomfort. Both clinical and radiological examinations play an important part in the post-traumatic evaluation of CCFX. CT and MRI visualize the healing process, while dynamic ultrasound may reveal instability. No significant difference in QoL was detected between patients with radiologically healed and non-healed CCFX. Post-traumatic disability was mostly due to other non-thoracic injuries.
(© 2022. The Author(s).)
Databáze: MEDLINE
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