다발성 늑골골절의 외상성 혈기흉 발생에 대한 영향

• Published in: Daehan oe'sang haghoeji Vol. 21; no. 2; pp. 91 - 99
• Main Authors: 양승준, Seung Joon Yang, 이제원, Je Won Lee, 진상찬, Sang Chan Jin, 주명돈, Myeong Don Joo, 최우익, Woo Ik Choi
• Format: Journal Article
• Language: Korean
• Published: 대한외상학회 30.12.2008
• Subjects: Hemothorax; Pneumothorax; Rib fracture; 의학일반; Pneumothorax; Hemothorax; Rib fracture
• ISSN: 1738-8767; 2799-4317; 2287-1683

Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was 3.7±2.1, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered. (J Korean Soc Traumatol 2008;21:91-99)