Thorax trauma

Blunt thorax injuries

The most frequent reason for thorax injuries are traffic accidents, followed by followed by work and home accidents. These patients often also show extrathoracic, intracranial and/or intraabdominal injuries:

I.   Thoracic wall injuries: rib fractures, sternum fractures, clavicle fracture,
      vertebral body fractures.
II.   Lung injuries: pulmonary contusion, lung rupture
III.  Bronchial rupture
IV.  Cardiac contusion
V.   Cardiac rupture
VI.  Aorta and great vessel rupture
VII.  Esophagus rupture

Open thorax injuries

Stab, shot or impalement traumas lead to open thorax injuries. Thereby the lung is often affected. At open thorax trauma the focus lies on hemothorax, pneumothorax or hemopneumothorax.
Hemothorax is defined blood collection in the thoracic cavity. It results from rib fractures (intercostal vessel injuries), lesions of the lung or intrathoracic large vessel injuries.

Symptoms
Chest pain tachycardia, and tachypnea.

Diagnosis
Reduction of breath sounds on the effected side. Radiologically opacity  of the affected thorax side can be recognized. For assuring the exactness of the diagnosis a needle puncture can be performed.

Therapy
Minimal hemothorax requires no therapy. All other forms of hemothorax are treated with a thoracic drainage. At sustained  bleeding a thoracotomy  as well as a  shock therapy are indicated.

Pneumothorax

Collection of air in the thoracic cavity is defined as  pneumothorax.

Symptoms
A complete lung collapse causes a significant respiratory distress and pain.

Diagnosis
Clinically a reduced breathing sounds is found and reduced mobility of the affected sides. Radiologically a collapsed lung is recognizable.