Buckle rib fractures are incomplete fractures involving only the inner cortex. They typically occur due to an anterior compressive force to the chest, most commonly during external cardiac massage, but can be seen following any such traumatic injury.
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Pathology
Buckle rib fractures occur in all ages, even very elderly patients. Thus ribs are not the same as most adult long bones that tend to break like pencils on the tensile side when exposed to extreme force.
Buckle fractures are usually seen in the middle ribs (anterior one-third) and in a line. The anterior force responsible for the rib injury may also cause a similar sternal fracture.
Radiographic features
Buckle rib fractures are similar in appearance to buckle fractures elsewhere but have important implications in forensic radiology.
They cannot be detected on routine chest X-rays.
On CT, they appear as a focal deformity of the inner cortex of a rib.
History and etymology
Buckle is an engineering term describing cortical disruption to the compressive (inner) side of a structure (i.e. the rib) and maintenance of the tensile (outer) side cortex.
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