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Emerg Med J 2007;24:675 doi:10.1136/emj.2006.041236
  • Images in emergency medicine

Bilateral fractured clavicles with multiple rib fractures

  1. Gururaj Puranik,
  2. Nick Gillham
  1. Oxford Radcliffe Hospitals, Oxford, UK
  1. Correspondence to:
 Dr Gururaj Puranik
 5 Hollies Court, Britannia Road, Banbury, OX16 5DR, UK; gururajpuranik{at}rediffmail.com
  • Accepted 19 August 2006

A 45-year-old previously fit and healthy, female physiotherapist was walking her dog in fields. Cows in the field were frightened by her dog, resulting in her being trampled and crushed. She presented with severe pain in the chest along with pain in both shoulders. On examination she was severely short of breath. The only injury outside the chest was a minor scalp laceration. Radiographs of her chest revealed fractures of all 24 of her ribs and clavicles (fig 1) along with bilateral haemopneumothorax.

Figure 1

 Radiographs showing fractures of all 24 ribs and the clavicles, along with bilateral haemopneumothorax.

The patient was intubated …

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