Como a maioria das fraturas de costela está associada a impactos de alta energia, sua incidência está diretamente relacionada à incidência geral de trauma torácico contuso. Cerca de 10% a 40% dos pacientes com traumatismo contuso apresentam fratura de costela, com um aumento da incidência em decorrência do avanço da idade.[16]Sharma OP, Oswanski MF, Jolly S, et al. Perils of rib fractures. Am Surg. 2008 Apr;74(4):310-4.
http://www.ncbi.nlm.nih.gov/pubmed/18453294?tool=bestpractice.com
[17]Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003 Jul;24(1):133-8.
https://academic.oup.com/ejcts/article/24/1/133/375481
http://www.ncbi.nlm.nih.gov/pubmed/12853057?tool=bestpractice.com
[18]Ekestubbe L, Forssten MP, Cao Y, et al. Morbidity prediction in conservatively managed rib fracture patients. Eur J Trauma Emerg Surg. 2025 Apr 29;51(1):184.
https://pmc.ncbi.nlm.nih.gov/articles/PMC12041140
http://www.ncbi.nlm.nih.gov/pubmed/40299043?tool=bestpractice.com
Em crianças pequenas, estudos demonstraram que fraturas nas costelas são resultado de abuso infantil em 65% a 100% dos casos.[2]Burkow J, Holste G, Otjen J, et al. High sensitivity methods for automated rib fracture detection in pediatric radiographs. Sci Rep. 2024 Apr 10;14(1):8372.
https://pmc.ncbi.nlm.nih.gov/articles/PMC11006902
http://www.ncbi.nlm.nih.gov/pubmed/38600311?tool=bestpractice.com
[3]Darling SE, Done SL, Friedman SD, et al. Frequency of intrathoracic injuries in children younger than 3 years with rib fractures. Pediatr Radiol. 2014 Oct;44(10):1230-6.
http://www.ncbi.nlm.nih.gov/pubmed/24771095?tool=bestpractice.com
[4]Barsness KA, Cha ES, Bensard DD, et al. The positive predictive value of rib fractures as an indicator of nonaccidental trauma in children. J Trauma. 2003 Jun;54(6):1107-10.
http://www.ncbi.nlm.nih.gov/pubmed/12813330?tool=bestpractice.com
[5]Cadzow SP, Armstrong KL. Rib fractures in infants: red alert! The clinical features, investigations and child protection outcomes. J Paediatr Child Health. 2000 Aug;36(4):322-6.
http://www.ncbi.nlm.nih.gov/pubmed/10940163?tool=bestpractice.com
[6]Paine CW, Fakeye O, Christian CW, et al. Prevalence of abuse among young children with rib fractures: a systematic review. Pediatr Emerg Care. 2019 Feb;35(2):96-103.
https://pmc.ncbi.nlm.nih.gov/articles/PMC5378682
http://www.ncbi.nlm.nih.gov/pubmed/27749806?tool=bestpractice.com
[7]Brennan B, Henry MK, Altaffer A, et al. Prevalence of abuse and additional injury in young children with rib fractures as their presenting injury. Pediatr Emerg Care. 2021 Dec 1;37(12):e1451-6.
http://www.ncbi.nlm.nih.gov/pubmed/32205804?tool=bestpractice.com
Com o avanço da idade, o risco absoluto de ocorrência de fratura por fragilidade é inversamente proporcional à densidade mineral óssea do paciente, com cerca de 27% dessas fraturas ocorrendo nas costelas.[19]Siris ES, Brenneman SK, Barrett-Connor E, et al. The effect of age and bone mineral density on the absolute, excess, and relative risk of fracture in postmenopausal women aged 50-99: results from the National Osteoporosis Risk Assessment (NORA). Osteoporos Int. 2006;17(4):565-74.
http://www.ncbi.nlm.nih.gov/pubmed/16392027?tool=bestpractice.com
Adicionalmente, espera-se um aumento do número de idosos com fraturas de costelas associadas a quedas, com o aumento contínuo da idade média da população.[20]Palvanen M, Kannus P, Niemi S, et al. Epidemiology of minimal trauma rib fractures in the elderly. Calcif Tissue Int. 1998 Mar;62(3):274-7.
http://www.ncbi.nlm.nih.gov/pubmed/9501963?tool=bestpractice.com
Pacientes com mais de 65 anos apresentam aumento do risco de morbidade e mortalidade em caso de fraturas de múltiplas costelas, em comparação com indivíduos mais jovens.[21]Holcomb JB, McMullin NR, Kozar RA, et al. Morbidity from rib fractures increases after age 45. J Am Coll Surg. 2003 Apr;196(4):549-55.
http://www.ncbi.nlm.nih.gov/pubmed/12691929?tool=bestpractice.com
[22]Marini CP, Petrone P, Soto-Sánchez A, et al. Predictors of mortality in patients with rib fractures. Eur J Trauma Emerg Surg. 2021 Oct;47(5):1527-34.
http://www.ncbi.nlm.nih.gov/pubmed/31324938?tool=bestpractice.com
Pneumotórax ocorre em cerca de 14% a 37% dos pacientes com fraturas de costela, hemopneumotórax em 20% a 27%, contusões pulmonares em 17% e tórax instável em até 6%.[17]Sirmali M, Türüt H, Topçu S, et al. A comprehensive analysis of traumatic rib fractures: morbidity, mortality and management. Eur J Cardiothorac Surg. 2003 Jul;24(1):133-8.
https://academic.oup.com/ejcts/article/24/1/133/375481
http://www.ncbi.nlm.nih.gov/pubmed/12853057?tool=bestpractice.com
[23]Keel M, Meier C. Chest injuries - what is new? Curr Opin Crit Care. 2007 Dec;13(6):674-9.
http://www.ncbi.nlm.nih.gov/pubmed/17975389?tool=bestpractice.com
[24]Liman ST, Kuzucu A, Tastepe AI, et al. Chest injury due to blunt trauma. Eur J Cardiothorac Surg. 2003 Mar;23(3):374-8.
https://academic.oup.com/ejcts/article/23/3/374/521809
http://www.ncbi.nlm.nih.gov/pubmed/12614809?tool=bestpractice.com
[Figure caption and citation for the preceding image starts]: Tomografia computadorizada (TC) mostrando grande pneumotórax do lado esquerdoDo acervo do Dr. Paul Novakovich; usado com permissão [Citation ends].
[Figure caption and citation for the preceding image starts]: Radiografia torácica retratando o mesmo pneumotórax mostrado na tomografia computadorizada (TC)Do acervo do Dr. Paul Novakovich; usado com permissão [Citation ends].