A Method for Documenting Locations of Rib Fractures for Occupants in Real-World Crashes Using Medical Computed Tomography (CT) Scans

A method has been developed to identify and document the locations of rib fractures from two-dimensional CT images obtained from occupants of crashes investigated in the Crash Injury Research Engineering Network (CIREN). The location of each rib fracture includes the vertical location by rib number (1 through 12), the lateral location by side of the thorax (inboard and outboard), and the circumferential location by five 36-degree segments relative to the sternum and spine. The latter include anterior, anterior-lateral, lateral, posterior-lateral, and posterior regions. 3D reconstructed images of the whole ribcage created from the 2D CT images using Voxar software are used to help identify fractures and their rib number. A geometric method for consistently locating each fracture circumferentially is described. Patterns of rib fractures resulting from different crash types and restraint conditions based on these methods can be compared to patterns of rib fractures resulting from biomechanical testing using unembalmed cadavers under different loading scenarios, and thereby validate the experimental test methods and provide a possible means to extrapolate skeletal injury data from biomechanical testing to more general thoracic injury criteria.