Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry?
<b>Objective:</b> We evaluated the necessity of follow-up chest X-rays (CXRs) to exclude a pneumothorax after 1 week of initial hospital presentation in patients with no signs of respiratory distress and fewer than three rib fractures. <b>Materials and Methods:</b> Adult pati...
| Main Authors: | , , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2022-12-01
|
| Series: | Healthcare |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2227-9032/10/12/2471 |
| _version_ | 1797457527259004928 |
|---|---|
| author | Amelie Deluca Susanne Deininger Florian Wichlas Valeska Hofmann Berndt Amelunxen Julian Diepold Thomas Freude Christian Deininger |
| author_facet | Amelie Deluca Susanne Deininger Florian Wichlas Valeska Hofmann Berndt Amelunxen Julian Diepold Thomas Freude Christian Deininger |
| author_sort | Amelie Deluca |
| collection | DOAJ |
| description | <b>Objective:</b> We evaluated the necessity of follow-up chest X-rays (CXRs) to exclude a pneumothorax after 1 week of initial hospital presentation in patients with no signs of respiratory distress and fewer than three rib fractures. <b>Materials and Methods:</b> Adult patients with fewer than three fractured ribs who presented at our Level I trauma center between 2015 and 2017 were evaluated retrospectively. Patients with sternal fractures, who had suffered a polytrauma, or were primarily treated with a chest tube were excluded. The patients’ and fractures’ characteristics, trauma mechanism, median follow-up time, and the number of required secondary interventions were recorded. <b>Results</b>: This study included 249 patients, 137 (55.0%) of whom were male, with a median age of 64.34 years. In 150 patients (60.2%) one rib was affected, in 99 patients (39.8%) two ribs were affected, with the fractured ribs being true ribs (1–7) in 72 cases (28.9%), false ribs (8–12) in 151 cases (60.6%), and both in 26 cases (10.4%). The affected thorax half was the left side in 124 cases (49.8%) and both thorax halves in 4 cases (1.6%). The median follow-up time was 9 ± 4 days. In the follow-up CXRs, six patients (1.6%) required delayed intervention (tube thoracostomy): one case of hemopneumothorax and five cases of pneumothorax. All of the patients fully recovered. <b>Conclusions</b>: Planned CXR follow-ups revealed only a small number of complications that needed intervention and therefore seem not to be necessary. Symptom-triggered reappearance seems to be more sufficient and economical compared to habitual reimaging. |
| first_indexed | 2024-03-09T16:23:19Z |
| format | Article |
| id | doaj.art-1e566b433a2c49e791e39d06c11e62ae |
| institution | Directory Open Access Journal |
| issn | 2227-9032 |
| language | English |
| last_indexed | 2024-03-09T16:23:19Z |
| publishDate | 2022-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Healthcare |
| spelling | doaj.art-1e566b433a2c49e791e39d06c11e62ae2023-11-24T15:10:37ZengMDPI AGHealthcare2227-90322022-12-011012247110.3390/healthcare10122471Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry?Amelie Deluca0Susanne Deininger1Florian Wichlas2Valeska Hofmann3Berndt Amelunxen4Julian Diepold5Thomas Freude6Christian Deininger7Institute of Tendon and Bone Regeneration, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, AustriaDepartment of Urology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Trauma and Reconstructive Surgery, University of Tübingen, 72076 Tübingen, GermanyDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaDepartment of Orthopedics and Traumatology, Salzburg University Hospital, Paracelsus Medical University, 5020 Salzburg, AustriaInstitute of Tendon and Bone Regeneration, Spinal Cord Injury & Tissue Regeneration Center Salzburg, 5020 Salzburg, Austria<b>Objective:</b> We evaluated the necessity of follow-up chest X-rays (CXRs) to exclude a pneumothorax after 1 week of initial hospital presentation in patients with no signs of respiratory distress and fewer than three rib fractures. <b>Materials and Methods:</b> Adult patients with fewer than three fractured ribs who presented at our Level I trauma center between 2015 and 2017 were evaluated retrospectively. Patients with sternal fractures, who had suffered a polytrauma, or were primarily treated with a chest tube were excluded. The patients’ and fractures’ characteristics, trauma mechanism, median follow-up time, and the number of required secondary interventions were recorded. <b>Results</b>: This study included 249 patients, 137 (55.0%) of whom were male, with a median age of 64.34 years. In 150 patients (60.2%) one rib was affected, in 99 patients (39.8%) two ribs were affected, with the fractured ribs being true ribs (1–7) in 72 cases (28.9%), false ribs (8–12) in 151 cases (60.6%), and both in 26 cases (10.4%). The affected thorax half was the left side in 124 cases (49.8%) and both thorax halves in 4 cases (1.6%). The median follow-up time was 9 ± 4 days. In the follow-up CXRs, six patients (1.6%) required delayed intervention (tube thoracostomy): one case of hemopneumothorax and five cases of pneumothorax. All of the patients fully recovered. <b>Conclusions</b>: Planned CXR follow-ups revealed only a small number of complications that needed intervention and therefore seem not to be necessary. Symptom-triggered reappearance seems to be more sufficient and economical compared to habitual reimaging.https://www.mdpi.com/2227-9032/10/12/2471rib fractureX-rayfollow-upcontrolchest traumathorax trauma |
| spellingShingle | Amelie Deluca Susanne Deininger Florian Wichlas Valeska Hofmann Berndt Amelunxen Julian Diepold Thomas Freude Christian Deininger Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? Healthcare rib fracture X-ray follow-up control chest trauma thorax trauma |
| title | Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? |
| title_full | Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? |
| title_fullStr | Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? |
| title_full_unstemmed | Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? |
| title_short | Follow-Up Chest X-rays in Minor Chest Trauma with Fewer Than Three Rib Fractures: A Justifiable, Habitual Re-Imaging Industry? |
| title_sort | follow up chest x rays in minor chest trauma with fewer than three rib fractures a justifiable habitual re imaging industry |
| topic | rib fracture X-ray follow-up control chest trauma thorax trauma |
| url | https://www.mdpi.com/2227-9032/10/12/2471 |
| work_keys_str_mv | AT ameliedeluca followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT susannedeininger followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT florianwichlas followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT valeskahofmann followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT berndtamelunxen followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT juliandiepold followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT thomasfreude followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry AT christiandeininger followupchestxraysinminorchesttraumawithfewerthanthreeribfracturesajustifiablehabitualreimagingindustry |