Bilateral first rib fractures associated with driver's air bag inflation: case report and implications for surgery

Eur J Emerg Med. 1995 Mar;2(1):60-2. doi: 10.1097/00063110-199503000-00013.


A case of bilateral fractures of the first rib occurring in an otherwise fit road traffic accident victim is described. The only other injuries sustained were of the peripheral limbs. The driver's air bag was inflated during the crash, leading to speculation as to whether this may have contributed to the mechanism of injury. The patient was well oxygenated and cardiovascularly stable with no evidence of neurovascular damage to the thoracic aorta or its branches. Aortic arch aortography was not performed before internal fixation of the peripheral fractures was undertaken under general anaesthesia. A review of the indications for angiography in such patients follows. The policy that patients with fractures of the upper first ribs do not require angiography unless there is other evidence of neurovascular damage is supported.

Publication types

  • Case Reports

MeSH terms

  • Accidents, Traffic
  • Adult
  • Air Bags / adverse effects*
  • Angiography
  • Craniocerebral Trauma / diagnostic imaging
  • Craniocerebral Trauma / etiology
  • Disease-Free Survival
  • Fractures, Bone / diagnostic imaging
  • Fractures, Bone / etiology
  • Hand Injuries / diagnostic imaging
  • Hand Injuries / etiology
  • Humans
  • Leg Injuries / diagnostic imaging
  • Leg Injuries / etiology
  • Male
  • Multiple Trauma / diagnostic imaging
  • Multiple Trauma / etiology
  • Multiple Trauma / surgery
  • Rib Fractures / diagnostic imaging
  • Rib Fractures / etiology*
  • Rib Fractures / surgery