Damage to the chest

The skeleton of the chest with the blunt trauma items damaged quite often, especially in cases of traffic injuries, falls from height and others In a greater degree are damaged ribs (often IV-VII, as less secure). Rib fractures may occur at the site of impact damage of the subject (local fractures)and at a distance because of their excessive curl or extension (structural fractures). A separate fractures of the ribs without displacement of bone fragments and without damage to the parietal pleura (as cuts) when non-fatal injury quite often remain undiagnosed, especially in cases of injuries of the chest".
Multiple rib fractures can occur when multiple external influence (usually strikes)and single (usually in case of compression). In the latter case, rib fractures seem to be for one or more anatomical lines. The peculiarities of rib fractures possible to differentiate the conditions under which they emerged (table. 7, Fig. 30).

Table 7. Morphological signs of fractures of the ribs with the deformation of the bend
Sign The characteristic of
on the compression side side stretching
Outline the edges of the broken As abruptly broken line, oriented cooperate to the longitudinal axis of the edge. The comparison of the fragments of incomplete, defective substances CDs up to the formation of fragments Finely toothed in the form of direct cross or oblique lines; in the back parts (on the inside) often arched. The comparison of the fragments full
Cracks Rarely longitudinal Depart from fractures at an acute angle in the direction to the edge ribs
Fragments Diamond (in profile triangle) No
The surface of fracture Krupeshina Fine-grained or finely dentate
The plane of fracture Slash but towards the surface of the ribs Perpendicular to the surface of the ribs
a) single fractures (or multiple different anatomical lines) typical local damage;
b) multiple fractures on one (or several) anatomical lines typical for structural damage
rib fractures
Fig. 30. Rib fractures. a - local; - construction; 1,3 - damage from outer plate; 2, 4 - damage from internal records.

Fragments of the ribs with his sharp ends can damage not only the parietal pleura, but also to cause serious injuries to internal organs (lungs, blood vessels, heart).
When blunt solid object with a relatively small damaging the surface of the ribs broken in the place of application of force. In cases of pressing on the subject with a wide surface localization of the fracture is unevenly among different actors and depends on the shape of the chest (Fig. 31). The steady against external influence, under equal conditions in the chest of a various configuration varies: for flat, conical shape of the chest it is 1700-2000 N, for cylindrical - 3000-3500 N.

Fig. 31. Localization of rib fractures (shaded) with compression in the sagittal direction depending on the shape of the chest and flat; b - cylindrical; in - conic.

Compression of the chest between two solid blunt objects in expert practice, most often during collapses and transport injury. Damage to the skeleton, the thorax when compressing have a number of special features that allow to judge about the mechanisms of injury, and in some cases about the direction of external influence. Typical compression of the chest is multiple rib fractures, often for several lines at once. If the external exposure exceeds the resistance of the chest, there rib fractures in points with the greatest curvature and lower strength. Damaged bone skeleton of the chest confronts much weaker subsequent traumatic stress.
Broken sternum and shoulder blades occur, usually as a result of direct traumatic impact.
There is a certain relationship between the damage of shoulder blades and ribs. From strong shot in the shoulder area in the upright position of the body along with fractures of the shoulder blades occur multiple unilateral rib fractures on the shoulder line and even simultaneously on the shoulder, and mid-axillary (or anterior axillary) lines.
Damage to the edges when "moving" compression of the chest is observed in cases of moving wheel vehicles in the transverse direction through the body of the victim. G ore cell experiences with asymmetric compression.
Rib on the side of hitting usually destroyed more significant than on the side affected by deformation at the end of the roll. This contributes to the primary kick wheel of the car in the beginning of hitting and kind dismount wheel at the end of the move.