Abstract
<jats:p>Background. Combined clavicle and rib fractures account for 18.6–29.1 % of cases among patients with polytrauma. Blunt chest trauma is one of the main causes of mortality. Clavicle and rib fractures are considered markers of injury severity and independently increase the risk of mortality. These lesions are characterized by multifaceted clinical manifestations and polysymptomatic presentation. Objective of the study: to improve the level of diagnosis for combined fractures of the clavicle and ribs by determining the informativeness of instrumental examination methods and creating a clinical and instrumental diagnostic algorithm. Materials and methods. Literature sources from PubMed, Embase databases were analyzed using keywords: polytrauma, fractures of the clavicle and ribs, injuries of the chest organs, clinical and instrumental diagnosis. Results. In terms of mechanism of injury, road accidents prevail (57.1–80 % of cases). Among clavicle fractures, fractures of the middle third prevail — 72.2 %. Fracture of two ribs was diagnosed in 40.7 % of cases, three — in 16.7 %, more than three — in 42.6 %, lung damage: lung contusion — in 33.3 %, pneumothorax — in 22.2 %, hemothorax — in 44.5 %. The nature of the clinical and instrumental examination depends on the general condition of the patient. In those with severe or extremely severe condition, the priority is to conduct chest ultrasound, which is characterized by sufficiently high sensitivity of 92.45 %, specificity of 99.07 % and diagnostic accuracy of 96.88 %. Conclusions. Combined fractures of the clavicle and ribs are characterized by polymorphism of the lesion and multifaceted symptoms, which requires a multidisciplinary differential approach to diagnosis. The proposed clinical and instrumental diagnostic algorithm for combined injuries of the clavicle and chest provides a rational approach to diagnosis and helps reduce the number of diagnostic errors.</jats:p>