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KMID : 0364020090420040502
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Korean Journal of Thoracic and Cardiovascular Surgery
2009 Volume.42 No. 4 p.502 ~ p.508
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Clinical Usefulness of Chest Wall Ultrasonography for Detecting Fractures of Costal Cartilage due to Minor Blunt Chest Trauma
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Lee Woo-Surng
Kim Yo-Han
Chee Hyun-Keun
Choi Young-Chil
Hwang Jae-Joon
Lee Song-Am
Jung Ho-Sung
Shin Hyun-Joon
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Abstract
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Background : Rib fractures are the most common injuries that are caused by blunt chest trauma. However, fractures of the costal cartilage generally go unnoticed on chest X-rays unless they involve a calcified cartilage. For this reason, the sensitivity of conventional radiography for detecting rib fractures is low, and especially those involving the cartilaginous part of the rib. Thus, we have evaluated the usefulness of ultrasonography for detecting fractures of the costal cartilage that were overlooked on the conventional radiographs of patients who suffered minor blunt chest traumas.
Materials and Methods : A total of 45 patients who suffered minor blunt chest trauma and who had no evidence of rib fractures or other major fractures on conventional radiographs were admitted for ultrasonography between April 2008 and March 2009. There were 24 women and 21 men, and the mean age of the patients was 50.4±15.91 years (range: 17∼76 years). They were examined for the detection of fractures of the costal cartilage by performing ultrasonography with a 7.5-MHz linear transducer.
Results :A total of 30 patients (67%) had fractures of the costal cartilage, whereas 15 patients (33%) had no evidence of chondral rib fractures. The mean number of fracture sites of the fractured costal cartilage was 1.6±0.81 (range: 1∼4 sites) in 30 patients. Periosteal hematoma was the most common finding associated with fractures of the costal cartilage (n=7, 17%), followed by sternum fracture (n=5, 12%). However, periosteal hematoma was noticed in 1 patient (2%) who was without fracture of the costal cartilage, and sternum fracture was noticed in 1 patient (2%) who was without fractures of the costal cartilage.
Conclusion :The results of this study suggest that ultrasonography may be a useful imaging modality for detecting fractures of the costal cartilage that are overlooked on the conventional radiographs of patients who suffer minor blunt chest trauma. (Korean J Thorac Cardiovasc Surg 2009;42:502-508)
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KEYWORD
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Ribe, Ultrasonoqraphy, Trauma
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