Chest wall trauma

Sufficient trauma to the chest can result in injury to the bony thorax and soft tissues of the chest wall, increasing patient morbidity and mortality. Fractured ribs can lacerate the pleura, lung, or abdominal organs. Fractur es to upper ribs, clavicle, and upper sternum can signal brachial plexus or vascular injury. paradoxical movement of a flail chest can impair respirat ory mechanics, promote atelectasis, and impair pulmonary drainage. Most pat ients with thoracic spine fracture-dislocations have complete neurologic de ficits. Scapular fractures, associated with other injuries in almost all pa tients, are frequently overlooked on supine chest radiographs, Sternal frac tures, associated with clinically silent myocardial contusion, are best vis ualized on chest computed tomography (CT). Severe trauma to the chest: wall can be associated with large chest wall hematomas or collections of air wi thin the crest wall that can communicate with the intrathoracic space. CT s canning can easily distinguish chest wall from parenchymal or mediastinal i njury, whereas this differentiation my not be possible with chest radiograp hy.