• Ivan Felizardo Contrera Toro
  • Ricardo Kalaf MussiEmail author


Traumatic injuries related to athletic activities in general are closed traumas and usually affect the bony parts, ribs, clavicles, and less frequently the sternum, spine, and scapula, and consequently are of less seriousness for the athlete. These individuals may have isolated or simultaneously other major risk factors such as pneumothorax, hemothorax, and pulmonary or myocardial contusion or situations involving life-threatening conditions, including tension pneumothorax, massive hemothorax, cardiac tamponade, or commotio cordis. Therefore, a careful and systematic initial evaluation by the professional at the event site is necessary for stratification of the potential severities and initial measures to stabilize the airway, ventilation, circulatory, and hemodynamic status. After adequate initial stabilization, the athlete should be referred as soon as possible to a trauma referral hospital for further detailed evaluation and definitive therapeutic procedures. This chapter aims to present an overview of the individualized main diagnoses in chest trauma and to allow the reader to acquire the most relevant information for the initial care and definitive treatment of these patients.


Thoracic trauma Athletes Sports Life-threatening Sports Sports medicine Athletic injuries 


  1. 1.
    Al-Koudmani I, Darwish B, Al-Kateb K, Taifour Y. Chest trauma experience over eleven-year period at al-mouassat university teaching hospital-Damascus: a retrospective review of 888 cases. J Cardiothorac Surg. 2012;7:35.CrossRefGoogle Scholar
  2. 2.
    Asensio JA, Petrone P, Toro IFC. Trauma cardiaco penetrante, Trauma edit Atheneu. p. 305–26. ISBN 978-85-388-0082-8.Google Scholar
  3. 3.
    de Moya M, Nirula R, Biffl W. Rib fixation: who, what, when? Trauma Surg Acute Care Open. 2017;2(1):e000059.CrossRefGoogle Scholar
  4. 4.
    Doerer JJ, Haas TS, Estes NA, Link MS, Maron BJ. Evaluation of chest barriers for protection against sudden death due to commotio cordis. Am J Cardiol. 2007;99(6):857–9.CrossRefGoogle Scholar
  5. 5.
    Fabian RL. Sports injury to the larynx and trachea. Phys Sportsmed. 1989;17(2):111–8.CrossRefGoogle Scholar
  6. 6.
    Fanter NJ, Kenny RM, Baker CL. Surgical treatment of clavicle fractures in the adolescent athlete. Sports Health. 2015;7(2):137–41.CrossRefGoogle Scholar
  7. 7.
    Feden JP. Closed lung trauma. Clin Sports Med. 2013;32(2):255–65.CrossRefGoogle Scholar
  8. 8.
    Harris JH, et al. To reduce routine computed tomographic angiography for thoracic aortic injury assessment in level II blunt trauma patients using three mediastinal signs on the initial chest radiograph: a preliminary report. Emerg Radiol. 2018;25:387–91.CrossRefGoogle Scholar
  9. 9.
    Huis In ‘t Veld MA, Craft CA, Hood RE. Blunt cardiac trauma review. Cardiol Clin. 2018;36(1):183–91.CrossRefGoogle Scholar
  10. 10.
    Keenan RJ, Van Deusen MA, Alegre RA, Normando Jr GR. Trauma Torácico, Trauma edit Atheneu. p. 245–56. ISBN 978-85-388-0082-8.Google Scholar
  11. 11.
    Kizer KW, MacQuarrie MB. Pulmonary air leaks resulting from outdoor sports. A clinical series and literature review. Am J Sports Med. 1999;27(4):517–20.CrossRefGoogle Scholar
  12. 12.
    Link MS. Pathophysiology, prevention, and treatment of commotio cordis. Curr Cardiol Rep. 2014;16(6):495.CrossRefGoogle Scholar
  13. 13.
    Menezes RG, Fatima H, Hussain SA, Ahmed S, Singh PK, Kharoshah MA, et al. Commotio cordis: a review. Med Sci Law. 2017;57(3):146–51.CrossRefGoogle Scholar
  14. 14.
    Naidoo K, Hanbali L, Bates P. The natural history of flail chest injuries. Chin J Traumatol. 2017;20(5):293–6.CrossRefGoogle Scholar
  15. 15.
    Noh D, Lee CK, Hwang JJ, Cho HM. Concomitant avulsion injury of the subclavian vessels and the main bronchus caused by blunt trauma. Korean J Thorac Cardiovasc Surg. 2018;51(2):153–5.CrossRefGoogle Scholar
  16. 16.
    Patel N, Mansouri M, Shankar S, Singh A. Imaging of acute thoracic trauma. In: Emergency radiology: imaging of acute pathologies. 2nd ed. Springer International Publishing; 2017. p. 403–18. Scholar
  17. 17.
    Prokakis C, Koletsis EN, Dedeilias P, Fligou F, Filos K, Dougenis D. Airway trauma: a review on epidemiology, mechanisms of injury, diagnosis and treatment. J Cardiothorac Surg. 2014;9:117.CrossRefGoogle Scholar
  18. 18.
    Robertson GA, Wood AM, Oliver CW. Displaced middle-third clavicle fracture management in sport: still a challenge in 2018. Should you call the surgeon to speed return to play? Br J Sports Med. 2018;52(6):348–9.PubMedGoogle Scholar
  19. 19.
    Singhal P, Kejriwal N. Ascending aortic tear with severe aortic regurgitation following rugby injury. Heart Lung Circ. 2009;18(2):150–1.CrossRefGoogle Scholar
  20. 20.
    Shorr RM, Crittenden M, Indeck M, Hartunian SL, Rodriguez A. Blunt thoracic trauma. Analysis of 515 patients. Ann Surg. 1987;206(2):200–5.CrossRefGoogle Scholar
  21. 21.
    Symbas PN, Justicz AG, Ricketts RR. Rupture of the airways from blunt trauma: treatment of complex injuries. Ann Thorac Surg. 1992;54(1):177–83.CrossRefGoogle Scholar
  22. 22.
    Wilkerson RG, Stone MB. Sensitivity of bedside ultrasound and supine anteroposterior chest radiographs for the identification of pneumothorax after blunt trauma. Acad Emerg Med. 2010;17(1):11–7.CrossRefGoogle Scholar

Copyright information

© ISAKOS 2019

Authors and Affiliations

  • Ivan Felizardo Contrera Toro
    • 1
  • Ricardo Kalaf Mussi
    • 1
    Email author
  1. 1.Thoracic Surgery DivisionState University of Campinas—UNICAMPCampinasBrazil

Personalised recommendations