Blunt thoracic injuries

Abstract

Blunt thoracic injuries This is a review of blunt thoracic trauma. Blunt thoracic trauma is responsible for approximately 10 % of all traumatic injuries in Norway and 25 % of all traumatic deaths. To study this subject a systematic literature search was preformed. The different types of injuries vary greatly in the different reports. Traffic-related injuries account for 10-98 % of blunt thoracic trauma, fall accidents 8-41 %. Other causes are work accidents, sport accidents, and violence. The most common injuries are rib fractures (13-78 %), heart contusion (1-55 %), lung contusion (4-40 %), pneumothorax (10-30 %) and haemothorax (4-26 %). The most lethal injuries are blunt aortic injury, blunt cardiac rupture, and commotio cordis; with lethality ratings that vary between 50 and 90 %. Most patients can be handled conservatively (59 %), while 36 % are in need of a tube thoracostomy. Only about 5 % needs open surgery. Luckily the most lethal injuries are quite rare, and the most common injuries have a low mortality. Much of the variation in incidence can be related to different levels of health care, different diagnostic criteria, and geographical and socio-economic differences in different countries. Blunt thoracic injury is a severe health problem in Norway. However, the number of serious traffic accidents in Norway seems to be decreasing during the last years.