Rehabilitation Following an Acute Traumatic First Rib Fracture in a Collegiate Football Player: A Case Report.

Authors: Sclafani MP, Amin NH, Delehanty E, Figler R, Williams J.

Isolated fractures involving the first rib are rare and often difficult to diagnose. There is a paucity of literature regarding isolated first rib fractures and even fewer reported cases involving those due to contact. The purpose of this case report is to describe the mechanism of injury, differential diagnosis, and rehabilitation, and return to sport decision making for an isolated first rib fracture secondary to acute trauma in a collegiate football player. An 18 year-old right-hand dominant male collegiate football player was involved in a facemask-to-facemask collision during a football game while playing defensive back. His chief complaint during the sideline evaluation was left-sided neck and shoulder pain with concomitant clicking reported with active movement of his left shoulder.  A musculoskeletal ultrasound performed in the training room suggested a possible scapular spine fracture. However, a magnetic resonance image revealed an acute isolated anterolateral fracture of the first rib. The athlete was treated conservatively with extensive rehabilitation and was able to return to full participation for summer training camp as well as the fall football season.

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