Common types of chest injury
Traumatic injuries of the thorax are classified in severity and extent of damage in the underlying tissues. Injuries are classified as superficial, deep, open, closed, with or without fracture. With light injuries the prognosis is usually positive and the time in which the contusion is completely cured is relatively short. Depending on the circumstances of the accident, the damage can vary. This could be bruising, burns, torn wounds, bruises, broken bones (fractures) and others.
Types of chest and thorax trauma include:
• Fractures of the ribs
• Injuries to the mammary gland
• Injuries to the chest wall
• Other injuries
Flail Chest
When a segment of the thoracic cage is separated from the chest wall, a flail chest occurs. A flail chest segment becomes unable to support lung expansion. This usually happens when there are at least two fractures per rib, which are producing a free floating segment. Bigger flail segments usually involve a greater proportion of the chest wall. They may extend bilaterally and/or involve the sternum. The disruption of normal pulmonary mechanics could be large enough to require supported (mechanical) ventilation. The major significance in case of a flail chest is that the condition could indicate the presence of an underlying pulmonary injury. The management of flail chest includes standard management of rib fractures as well as the underlying pulmonary contusions.
Minor chest contusion
Usually a blow to the chest can be the cause of either a minor or serious injury. After a chest injury it is important to determine whether the pain is caused by a heart problem. The patient could experience chest wall pain after an injury to the chest. Pain can occur when the arm or shoulder are moved, as well as pain and swelling in the rib cage. Even a minor injury can cause outbursts of chest pain for a few days after the accident. Deep breathing, coughing and sneezing tend to increase the pain, as well as pressing down on or lying on the area. In case of minor chest injuries home treatment can usually relieve the pain and discomfort. Even in such cases it’s strongly advised to visit a doctor.
Serious chest injuries
If the injured person feels significant pain or has continuous difficulty breathing, that could be a sign of internal damage to the organs. In case of an accident immediately call a doctor. Use the emergency number – 112 within the EU. A thorough examination of the chest, lungs, heart, blood vessels should be performed in a hospital. Other symptoms usually develop rapidly: there could be shortness of breath, pain, shock, difficulty of movement and so on. A blunt trauma or a forceful blow to the chest can cause trauma of the internal organs in the chest and upper abdomen. A blow of the frontal chest and sternum can cause heart injury or large blood vessels and esophagus contusion, lungs or trachea injury. A blow to the back of the chest can cause a kidney injury. A side blow or a blow in the lower part of the chest could injure the liver or the spleen.
Fracture of the ribs
An injury to the chest may cause breaking or crack of one or more ribs, and could also cause injury of the rib cage cartilage. Ribs are most affected by trauma of the rib cage. Rib fractures are more common in adults, but under certain conditions (e.g. traffic accidents) can also be found in young patients.
Symptoms of a bruised or broken rib include:
• Severe, sharp pain in the damaged area
• Pain gets worse when breathing or coughing
• Pain gets worse when the injured area is pressed on
• Pain gets worse when the injured person lies on the damaged area
Rib fractures are usually very painful but in most cases can be treated at home after first aid medical attention.
Surface chest injuries
Surface injuries can be caused by direct or indirect impact to the chest or pressure from external force. They may occur with or without the presence of damaged skin (e.g. an open wound).
Open chest injuries (open wounds in chest area)
An open injury means there is a visible open wound and tear of the skin in the chest area. This could be caused by a serious fracture, where a fragment of the broken bone punctures the skin of the chest wall.
Traumatic injury to the blood vessels in the chest area
Damage to blood vessels often occurs when chest injury is present. This condition can be fatal to the patient because of the increased blood flow coming from the aorta (which is the largest artery in the body), located in the chest area.
Traumatic injury to the heart
One of the most important organs in the human body - the heart - is located in the chest area.
The injuries of the heart are classified as closed (around 90% of total cases) and open (nearly 10%). It is important to know that indoor injuries usually occur in cases of traffic accidents, as well as fall from heights. Open injuries (with wounds) are common in penetrating injuries to the chest.
Other and unspecified injuries of the chest and organs in the chest cavity
A serious damage to the muscles and ligaments of the chest may occur in an accident. In severe cases a multiple impairment or organ failure is present. Some of the more common conditions are haemothorax (collecting blood) and air/gas (pneumothorax) in the pleural cavity.
Traumatic amputation, crushing of the chest
Closed thoracic injuries usually occur as a result of road traffic accidents (RTA), as well as a fall from heights, domestic (household) and employment (industrial) accidents. According to their location, they can be unilateral or bilateral.