Classification of stress fractures of the first rib in adolescent athletes

被引:9
作者
Kawashima, Kenji [1 ]
Terabayashi, Nobuo [1 ]
Asano, Hiromi [1 ]
Akiyama, Haruhiko [1 ]
机构
[1] Gifu Univ, Dept Orthopaed Surg, Grad Sch Med, 1-1 Yanagido, Gifu, Gifu 5011194, Japan
来源
JOURNAL OF PEDIATRIC ORTHOPAEDICS-PART B | 2020年 / 29卷 / 04期
关键词
adolescent athlete; classification; first rib; stress fracture; three-dimensional computed tomography;
D O I
10.1097/BPB.0000000000000720
中图分类号
R826.8 [整形外科学]; R782.2 [口腔颌面部整形外科学]; R726.2 [小儿整形外科学]; R62 [整形外科学(修复外科学)];
学科分类号
摘要
Stress fractures of the first rib occur infrequently in adolescent athletes; therefore, there have been few case reports. Initial radiographs do not always lead to the diagnosis of first rib stress fractures. This study proposed a classification system and a possible mechanism for stress fractures of the first rib using three-dimensional computed tomography (3D-CT). The data of 10 stress fractures of the first rib in adolescent athletes obtained using 3D-CT between 2007 and 2018 were reviewed. Fractures of the first rib were classified according to the location and type of the fracture line. Stress fractures of the first rib were classified into three types: type 1, center-transverse fracture; type 2, center to posterior-oblique fracture; and type 3, posterior-transverse fracture. There were three type 1 fractures, five type 2 fractures, and two type 3 fractures. The fracture lines of types 1 and 2 were on the deep groove of the subclavian artery between the anterior and middle scalene muscle attachments, which is the thinnest and weakest portion of the first rib. However, the fracture line of type 3 was across the posterior part of the first rib and located slightly away from the deep groove of the subclavian artery. A 3D-CT classification of stress fractures of the first rib in adolescent athletes was proposed. Our results suggested that there are three types of the fracture and different mechanisms that cause this type of injury. This classification system helped to implement adequate conservative therapeutic plans based on the proposed mechanism.
引用
收藏
页码:409 / 411
页数:3
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