• Preventive Nutrition and Food Science
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• v.8 no.1
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• pp.46-53
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• 2003

The current study investigated the effect of Korean safflower (Carthamus tinctorius L.) seed powder and its water and ethanol extracts on bone metabolism during recovery from rib-fracture induced by surgical operation in rats. 10-week-old male Sprague-Dawley rats weighing about 320 g were divided into 9 groups after arrival: 10d control (AIN 76 semi-purified diet), 10d safflower seed powder (10d SS-powder), 10d safflower seed ethanol extract (10d SS-EtOH), 10d safflower seed water extract (10d SS-$H_2O$), 20d control (AIN-76 semi-purified diet), 20d safflower heed powder (20d SS-powder), 20d safflower seed ethanol extract (20d SS-EtOH), 20d safflower seed water extract (20d SS-$H_2O$), and 20d sham-operation (20d sham), The dietary level for all the supplements was 5% based on the raw material weight. The rats were fed the experimental diets for 10 days before the rib fracture operation and for a further 10 or 20 days after the operation. A number 9 rib was fractured surgically and a sham-operation also performed. The rats were then sacrificed on the l0th or 20th day after the operation. The body weight initially decreased after the operation in all the rib-fractured groups, then gradually recovered. The concentrations of plasma osteocalcin were higher in the control group than in all the safflower-supplemented groups 10 and 20 days after the rib-fracture (p < 0.05). The bone-specific ALP (alkaline phosphatase) activity was significantly higher in the SS-EtOH group than in the other groups 20 days after the rib-fracture (p < 0.05). The level of urinary DPD (deoxypridinoline) was significantly higher in the SS-EtOH and SS-$H_2O$ groups than in the other groups 10 days after the rib-fracture. When comparing the PTH (parathyroid hormone) and calcitonin levels, the SS-$H_2O$ group exhibited the highest PTH level among the groups 10 and 20 days after the rib-fracture. Thus, it was concluded that the bone turnover during the fracture-healing period was more rapid in the rats supplemented with safflower seed powder or its fractions than in the control rats. Furthermore, the SS-$H_2O$ fraction was identified as the most effective in stimulating bone remodeling, as bone resorption and bone formation were both significantly increased during fracture healing when compared to the control group.

• Journal of Trauma and Injury
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• v.30 no.4
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• pp.179-185
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• 2017

Purpose: Rib fracture is the most common complication of blunt thoracic trauma. We investigated the effect of rib fracture on pulmonary function in the conservatively treated patients. Methods: From January 2000 to February 2017, we reviewed the records of 72 patients with rib fracture and pulmonary function tests were performed. According to the number of rib fractures, patients were classified into two groups: less than six fractured ribs (group A) and more than six fractured ribs (group B). The groups were compared concerning demographics, underlying diseases, associated thoracic injuries, surgery, mechanical ventilator times, days spent in the intensive care unit and pulmonary function test. Results: There were no statistically significant differences in the demographic data between the two groups. Mean hospitalization was 13.5 days in group A and 27.0 days in group B (p<0.001). There was no statistically significant difference between the two groups in the pulmonary function test. Conclusions: We conclude that pulmonary function is restored by conservative treatment in patients with rib fractures even if the number of rib fractures increases. In patients with multiple rib fractures, studies comparing open rib fixation and conservative treatment of long term pulmonary function are required.

• The Journal of Korean Medicine
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• v.41 no.3
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• pp.151-161
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• 2020

Objectives: The purpose of this study is to report the improvement of multiple rib fracture after korean medical treatment; adhesive treatment and herb-medicine treatment. Methods: A patient with multiple rib fracture was treated with Daewhangchija-paste(大黃梔子膏) adhesive and herb-medicine treatment. Verbal numeric rating scale, medical examination by interview and rib series x-ray were used to assess progress of treatment. And we took pictures of left flank after attaching Daewhangchija-paste to observe the changes of the skin colors. Results: Rib series x-ray taken after 2 months of treatment revealed hard callus which added stability against external force on rib cage. After taking off Daewhangchija-paste, left plank skin turned into blue, green and yellow. And the pain level(VNRS) of left plank decreased from 10 to 0.5 for 4 months. Conclusions: Pain reduction on trauma site and improvement of general health condition were observed during combination treatment of Daewhangchija-paste adhesive and herb-medicine.

• Journal of Korean Medicine Rehabilitation
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• v.29 no.3
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• pp.157-163
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• 2019

This study is to report the usefulness of ultrasound in diagnosing rib fracture and the effectiveness of ultrasound-guided essential bee venom pharmacopuncture as a treatment of it. A 46-year-old unable to find a fracture by chest radiography was diagnosed it on ultrasound. The patient was applied integrative Korean medical treatments and ultrasound-guided essential bee venom pharmacopuncture at the fracture site for 4 weeks, 18 times total. Numeral rating scale (NRS) was used to evaluate the amount of pain. The chest pain when turning over the body was reduced from NRS 8 to 2 for 4 weeks. The remarkable aspect is that the pain was immediately relieved after phamacopuncture and its effect lasted for 3 hours. This report suggests ultrasound can be useful for diagnosing rib fracture and also helpful for safety and accuracy of pharmacopuncture. Additionally, essential bee venom can be considered one of the methods of treating rib fracture.

• Journal of Chest Surgery
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• v.43 no.1
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• pp.53-57
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• 2010

Background: The purpose of this study is to evaluate intercostal neuropathy after rib fracture and to determine the severity of intercostal neuropathy with using a numerical rating scale and according to the duration of pain and the body mass index. Material and Method: We measured the positive sharp wave and fibrillation on the intercostal and paraspinal muscles in the thoracic region by performing needle electromyography in 47 patients who had intercostal neuralgia after rib fracture and who had needed daily analgesic for more than three months. Result: We diagnosed 11 cases as intercostal neuropathy among the 47 cases. Of the total 11 cases, 8 were male and 3 were female and they were most often of an active generation in the community. The common location of intercostal neuropathy was the intercostal space below the rib fracture and from the 7th to the 12th intercostal rib area. The incidence of intercostal neuropathy was significantly related with multiple rib fracture rather than single rib fracture. The symptoms observed were chest pain (90.9%), sensory change (81.8%), paresthesia and numbness (63.6%), back pain (27.2%) and muscle atrophy (18.2%). The numerical rating scale, the duration of pain and the body mass index showed no significant correlation with the severity of intercostal neuropathy. Conclusion: We concluded that the electrodiagnostic approach with considering the affecting factors and the clinical findings will be helpful for diagnosing and treating persistent intercostal neuralgic pain (more than 3 months) after rib fracture.

• Journal of Chest Surgery
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• v.25 no.10
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• pp.1013-1019
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• 1992

A clinical evaluation was performed on 1, 110 cases of chest trauma treated at the Department of Chest Surgery, Chonnam University Hospital, during the past 23 years from January 1968 to June 1990. The ratio of male to female was 5.5: 1. The most common causes of chest trauma was stab wounds in penetrating trauma and traffic accidents in nonpenetrating trauma. The most common injuries in chest trauma were hemothorax in penetrating trauma and rib fracture in nonpenetrating trauma. Hemothorax or pneumothorax was observed in 592 cases [53.3%] of the total cases and rib fracture was observed in 527 cases[47.5%] of the total cases. Rib fracture was prevalent from the 3th to 8th rib, and 1st and 2nd rib fractures were associated with major thoracic injuries and other organ injuries. Open thoracotomy was performed in 163 cases[14.7%] and conservative nonoperative treatment in the others. Overall mortality rate was 8.5%[94 cases], and common causes of the death were shock and respiratory insufficiency.

• Journal of Chest Surgery
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• v.49 no.1
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• pp.1-8
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• 2016

More than a century ago, the first scientific report was published about fracture fixation with plates. During the 1950's, open reduction and plate fixation for fractures were standardized by the founders of Arbeitsgemeinschaft $f{\ddot{u}}r$ osteosynthesefragen/Association for the Study of Internal Fixation. Since the introduction of plate fixation for fractures, several plates and screws have been developed, all with their own characteristics. To accomplice more fracture stability, it was thought the bigger the plate, the better. The counter side was a compromised blood supply of the bone, often resulting in bone necrosis and ultimately delayed or non-union. With the search and development of new materials and techniques for fracture fixation, less invasive procedures have become increasingly popular. This resulted in the minimally invasive plate osteosynthesis (MIPO) technique for fracture fixation. With the MIPO technique, procedures could be performed with smaller incisions and thus with less soft tissue damage and a better preserved blood supply. The last 5 years rib fixation has become increasingly popular, rising evidence has becomeavailable suggesting that surgical rib fixation improves outcome of patients with a flail chest or isolated rib fractures. Many surgical approaches for rib fixation have been described in the old literature, however, most of these techniques are obscure nowadays. Currently mostly large incisions with considerable surgical insult are used to stabilize rib fractures. We think that MIPO deserves a place in the surgical treatment of rib fractures. We present the aspects of diagnosis, preoperative planning and operative techniques in regard to MIPO rib fixation.

• Journal of Trauma and Injury
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• v.21 no.2
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• pp.91-99
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• 2008

Purpose: Multiple rib fracture (MRF) and a hemopneumothorax accompany with most blunt chest traumas. We aimed to analyze the factors increasing the probability of a hemopneumothorax. In addition, other injuries accompanying MRF were analyzed. Methods: We retrospectively reviewed the medical records of 154 mutiple rib fracture patients who visited our hospital between January 2005 and December 2007. The medical records were reviewed for sex, age, mechanism of injury, location, number of fractures, distance of dislocated rib fragments, and presence of complications. We measured the distance of bony dislocations by using the PACS (Picture Archiving and Communication System). Results: The average number of rib fractures was $3.7{\pm}2.1$, and the number of rib fractures significantly influenced the incidence of a hemothorax (p<0.001). The risk of a hemothorax was increased in a bilateral MRF compared to a unilateral MRF (p=0.027). The distance of dislocated rib fragments influenced the probability of a hemothorax significantly (p=0.018), and subcutaneous emphysema and lung contusion were significantly associated with a pneumothorax (p=0.021, p=0.036). Conclusion: The number of MRFs did not influence the risk for a pneumothorax, but did influence the risk for a hemothorax. The laterality, distance of dislocation, also had an influence on the risk for a hemothorax. Also, subcutaneous emphysema and lung contusion were increased in cases with a pneumothorax. We must consider the possibility of a hemothorax even when the initial chest X-ray shows no evidence of a hemothorax. If a lung contusion is present, then an occult pneumothorax must be considered.

• Journal of Chest Surgery
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• v.42 no.5
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• pp.674-676
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• 2009

Isolated stress fracture of the first rib is rare, and repeated muscular pulling and fatigue of bone is thought to be responsible for this fracture. The diagnosis can be made by taking a thorough history and performing chest roentgenography, computed tomography or magnetic resonance imaging. Conservative treatment generally cures this condition. We report here on a case of exercise-induced isolated stress fracture of the first rib in a non-athlete college student and we review the related articles.

• Journal of Korean Medicine Rehabilitation
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• v.30 no.3
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• pp.23-44
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• 2020

Objectives The purpose of this study is to evaluate the healing effect of Hyeolbuchugeo-tang (HC) in rats with rib fracture. Methods Rats were randomly divided into 5 groups (naive, control, positive control, HC-L and HC-H). All groups except naive group were subjected to bone fracture of rib. Naive group received no treatment at all. Control group was fed with phosphate buffered saline. Positive control group was orally medicated with tramadol. Experimental group was orally medicated with HC extract (50 mg/kg for low concentration [HC-L], 100 mg/kg for high concentration [HC-H]). X-ray and micro-computed tomography (micro-CT) were conducted to assess the effect of HC. We analysed the level of 2) transforming growth factor-β1 (TGF-β1), Ki67, alkaline phosphatase (ALP), receptor activator of nuclear factor kappa-β, runt-related transcription factor 2 (Runx2) and tartrate resistant acid phosphatase (TRAP) on 7 and 14 days after fracture. ALP, alanine aminotransferase, aspartate aminotransferase, blood urea nitrogen, creatinine was measured for safety assessment. Results X-ray and micro-CT, showed HC enhance bone repair process. Callus formation was increased in experimental group at 7 days after fracture, but decreased at 14 days after fracture. 7 days after fracture, the level of TGF-β1 in experimental group was decreased. The level of Ki67, Runx2 in HC-H, TRAP in HC-L was increased. 14 days after fracture, the level of Ki67 in HC-L and HC-H was decreased. The level of ALP, Runx2, BUN in HC-L, TRAP in HC-L and HC-H was increased. Conclusions Taken together the results, HC promoted healing of bone fracture. In conclusion, HC has a potential to promote healing of bone fracture.