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Theses and Dissertations

Name:Cristina L. Kelbaugh
Professor:Erin Kimmerle

Rib Fracture Patterns in Fatal Motor Vehicle Accidents


Rib fractures are present in 25 percent of all trauma-related deaths, making the mechanism and pattern of rib fractures an important area of trauma research (Lien et al. 2009). Rib fractures are important to consider when researching trauma because they can cause serious complications contributing to an individual’s mortality.
This retrospective research study focuses on rib fracture patterns in fatal motor vehicle accidents (MVAs). The sample consists of 105 MVA victims—68 males and 37 females. Data was collected at the Hillsborough County Medical Examiner’s Office in Tampa, Florida. The study investigates motor-vehicle-related deaths from 2011 to 2013 to establish rib fracture patterns in association with several variables. Fractures of the manubrium and sternum are included in the analyses since the ribs articulate in several places with the manubrium and sternum and they are frequently injured in MVAs.
First, this research study investigates the rib fracture patterns that exist in correlation to soft tissue organ injury. Injuries to the heart, lungs, liver, diaphragm, and spleen were analyzed based on their direct contact with the ribcage. The results show that several significant relationships exist, including that lung injury is about 12 times more likely to occur when a fracture is present in the left middle ribs and 4 times more likely to occur when there is a fracture on the manubrium. Heart injury is found to be 9 times more likely to occur when the sternum is fractured and the liver is found to be 4 times more likely when the right middle ribs are fractured and 0.3 times more likely when the right high ribs are fractured.
Second, this study examines rib fracture patterns controlling for seatbelt use, airbag deployment, and cardiopulmonary resuscitation (CPR) administration. Each of these variables is tested to determine their influence in causing injury and the fracture patterns resulting from accidents. For drivers, specifically, it is also tested if fracture patterns can predict seatbelt use. The results show a significant relationship between fracture of the left low ribs and seatbelt use. In drivers, it is 5 times more likely that the individual was wearing a seatbelt if the left low ribs are fractured. Lastly, a significant relationship was found for fractures of the manubrium and CPR administration.
Finally, this research study aims to predict the number of ribs fractured by an individuals’ age. Progressive mineralization of the skeleton and other age-related changes increase the risk of fracture in elderly individuals. The results of this study indicate a significant, positive correlation between age and the total number of rib fractures sustained in MVAs, supporting the presumption that elderly are at a higher risk for rib fractures.