Introduction to Chest Trauma (Injury): Causes, Types and Medical Interventions

Dec 21 , 2023 | 2 min read

A trauma-related death is reported every 1.9 minutes in India. Trauma is the third most common cause of death in all age groups after cardiovascular diseases and cancer, and one out of four trauma patients die due to chest injury or its complications. This emphasizes the importance of chest trauma among all traumas.

The chest, although fortified by the rib cage for protecting vital organs like the heart and lungs, is still susceptible to injuries. Chest trauma can be a result of penetrating or blunt trauma. Penetrating injuries disrupt tissue integrity. Blunt injuries can cause damage to organs and structures under the tissue without disrupting the integrity of the tissue.

The incidence of chest injuries has increased due to high-speed vehicular travel. Road traffic accidents remain the most common cause of chest trauma in non-war zones of the world. Chest trauma can also be the result of falls, stabbings, gunshot injuries, industrial accidents, contact sports, etc.

Trauma to the chest can vary in severity, ranging from rib fractures and lung contusions to life-threatening injuries such as pneumothorax, massive haemothorax, cardiac trauma, airway injuries and injury to larger vessels.

Rib fractures are a common outcome of chest trauma, and most simple rib fractures heal with conservative management, including good pain relief and chest physiotherapy. Severe cases like multiple rib fractures with displaced fractured ends, a flail chest or fractures with damage to nearby organs or blood vessels may require surgery.

Lung contusion is a bruise in or on the lungs caused by blunt force to the chest. It requires supportive therapy until the contusion heals. Because contusions can gradually evolve over the first 24-48 hours after trauma, close monitoring is required. The goal of therapy is to prevent respiratory insufficiency, failure, and complications.

Pneumothorax is the accumulation of air in the pleural space and poses a significant threat to respiratory function as the underlying lung collapses. Timely intervention, often involving chest tube insertion to drain the air, is crucial to reinstate normal lung expansion and prevent further complications.

Haemothorax is defined as blood outside the lungs that may result from injury to small arteries running under the ribs, laceration of the lung, or rupture of large vessels. A chest tube insertion is done urgently to drain the blood and to help the lung expand. It also helps to estimate the amount of blood loss to guide blood transfusions and the need for emergency surgery to control the bleeding.

Airway injury is an injury to the trachea, bronchi and tracheobronchial tree. Although it is rare, it is the most severe form of chest trauma. The main logic of treatment in tracheobronchial injury is to maintain airway continuity and to repair the injury surgically.

The journey of a patient with chest trauma doesn't end with immediate medical attention or surgery. Postoperative care and rehabilitation play pivotal roles in ensuring a full

recovery. This phase involves monitoring for complications, appropriate pain management, and tailored rehabilitation programs.

Modern medical advancements enable thoracic surgeons to manage chest trauma efficiently. Thoracic injuries can be repaired to restore optimal organ function, emphasizing the importance of a well-equipped healthcare system in managing such critical cases.