The clinical utility of rib detail films in the evaluation of trauma

The objective of this study was to assess the clinical utility of rib detail films (RDFs) when used in addition to chest radiographs in the evaluation of thoracic trauma. A retrospective review of medical records of all patients who obtained RDFs over a 4-year period was carried out. The study participants included 480 adult trauma patients who received RDFs and chest radiographs. Patients were assessed for the presence or absence of rib fracture(s) on radiographs, clinical management, follow-up, and complications resulting from rib fractures. Fractures were identified in 97 (20%) patients by RDFs. There were 26 (27%) complications due to rib injury, all of which were visualized on chest radiographs but not RDFs. Follow-up demonstrated no delayed complications. Treatment was directed only at complications. Visualization of rib fracture alone does not result in any significant change in treatment or outcome for the patient. Therefore, RDFs for blunt chest trauma have a limited clinical utility.