Introduction
Rib fractures in patients over 70 years of age are a common presentation to emergency departments across Australia. Computed Tomography (CT) scans is an essential modality for assessing the extent of injury.
Aims
Identify the prevalence of osteoporosis in the elderly (>70 years) population with 3 or more acute rib fractures secondary to blunt trauma.
Examine the relationship between L1 vertebral body Hounsfield Unit (HU) value and hospital outcomes.
Methodology
Retrospective study over 5 years. The L1 vertebral body HU value was measured and recorded in three planes. Two-sample t-tests with equal variances were performed for statistical analysis.
Results:
Two hundred and thirty patients, mean age was 79.5 years, with of 61% male predominance and 95 (41%) having L1 vertebral body HU < 110.
The mechanism of trauma reveals a statistically significant difference with the high-energy trauma group with a mean HU of 133. The low-energy (LET) mechanism group mean HU of 112.6.
Twenty-six underwent surgical stabilization of rib fractures (SSRF), 10 had an L1 vertebral body HU <110. Average length of stay for these patients was 20.5 days. Eleven of 16 operated patients had a follow-up CT at 12 months. There was no non-union or hardware failure.
Average length of stay for patients with L1 vertebral body HU <110 who were managed non operatively was 9.3 days
Conclusions
The results indicate low bone mineral density, L1 vertebral body HU <110, should not be considered as contraindication to surgical stabilization of rib fractures in the elderly and referred for formal osteoporosis screening.