How does the prevalence of rib fractures vary by age?

Updated: Jun 13, 2017
  • Author: Sarah L Melendez, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Because children have more elastic ribs, they are less likely than adults to sustain fractures following blunt chest trauma. Elderly individuals are more likely to have associated injuries and complications. Children present more frequently with trauma to the underlying chest and abdominal organs without the associated rib fractures commonly seen in adults. Classically, this made rib fractures in children an ominous sign of potential high-force injury. Bruising near the fracture site is uncommon with pediatric rib fractures, seen in only 9.1% of pediatric rib fractures in one study. [15] Consider child abuse in children who lack a significant mechanism for multiple rib fractures or have fractures in different stages of healing. Children younger than 2 years with rib fractures have a prevalence of child abuse as high as 83%.

According to a report by the American College of Radiology, rib fractures may be the only abnormality in up to 30% of abused children. [17]

Older persons are more prone to rib fractures than younger adults [11] and, therefore, the pulmonary sequelae such as atelectasis, pneumonia, and respiratory arrest. The presence of cardiopulmonary disease also significantly increases morbidity and mortality rates in patients older than 65 years. The clinical benefits of a rib scoring system has been tested at one site for hospitalized older adults. [18]


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