From the Guidelines
The proper terminology for a rib dislocated from its juncture with the sternum is a chondro-sternal junction dislocation or costochondral junction dislocation. This condition occurs when the cartilage connecting a rib to the sternum (breastbone) becomes separated or dislocated from its normal position 1. According to the study by the World Journal of Emergency Surgery, the term "costochondral" should not be used in isolation, as it remains unclear, and instead, precise reporting language should specify if a cartilage fracture involves the short segment of cartilage associated with a single rib versus the shared cartilage segments of the 8th through 10th ribs 1.
Key Points to Consider
- The chondro-sternal junction refers to the transition between the cartilage and sternum, making it the most accurate term for a rib dislocated from its juncture with the sternum 1.
- Costal cartilage fractures are a special type of fractures that can be challenging to diagnose and treat, and the exact point of fracture should be described as “Costal cartilage” if it refers to the cartilage itself, “Costochondral junction” if it refers to the transition between the rib and the cartilage, or “Chondro-sternal junction” which refers to the transition between the cartilage and sternum 1.
- Treatment for chondro-sternal junction dislocations may involve pain management with NSAIDs, rest, and occasionally immobilization, and severe cases may require surgical intervention 1.
Important Considerations for Diagnosis and Treatment
- Ultrasound or MRI may be able to detect costal cartilage fractures more effectively than a traditional CT scan 1.
- Current fixation systems are neither designed nor ideally suited for placement into cartilage, but several anecdotal reports of successful fixation of cartilage using plates, wires, and suture are available 1.
- Medial fixation to the sternum has also been performed with plates spanning across to the sternum and additional screws placed into the cartilage to reduce the fracture 1.
From the Research
Definition and Terminology
- The proper terminology for a rib dislocated from its juncture with the sternum is costochondral separation 2.
- This condition occurs when there is a disruption of the costochondral junction, which is the area where the rib meets the sternum.
- Costochondral separation is a rare consequence of blunt thoracic trauma and can lead to life-threatening complications such as a flail chest 2.
Related Conditions
- Costochondritis is a related condition that refers to inflammation of the costochondral junctions of ribs or chondrosternal joints of the anterior chest wall 3.
- Atypical costochondritis is a type of costochondritis that does not self-resolve and is associated with high medical expenses and psychological burden on the patient 4.
- These conditions can cause chest pain and tenderness, and it is important to distinguish them from other, more serious causes of chest pain 3.
Note on Relevance of Studies
- Study 5 is not relevant to the topic of rib dislocation or costochondral separation, as it discusses interspecies interactions of arboviruses.
- The other studies 2, 4, 3 provide information on costochondral separation, costochondritis, and atypical costochondritis, which are related to the topic of rib dislocation from the sternum.