l The age of 65 years. 3,4,9 11-15 This is likely associated with increased comorbidities and loss of physical reserve seen in the elderly.7
The presence of injury to the thoracic cage often coexists with underlying lung tissue. Lung injury such lung contusions andhaemathoraces are seen in 50% of patients with rib fractions. 3,5 Patients with multiple rib fractures or a flail segment have been shown to have a higher incidence of underlying lung injury. 3,16 The combination of chest wall and lung injury significantly reduces pulmonary function, resulting in a higher incidence of patients requiring mechanical ventilation and length of stay in ICU17 as demonstrated in the case study. Further, blunt chest injury affects 70% of long term lung capacity which has detrimental results specifically on pulmonary quality of life. 18 The cause of the this is unclear, however, it is thought this is may be due to a mechanical cause such as muscle weakness and rib cage deformity or as a result or obstruction and increased residual lung volumes.18