Abstract

Isolated fracture of the first rib has been so infrequently reported that Breslin1 (1937), who added 5 cases of his own, was able to collect only 27 other instances of this injury from the world literature. Since then Out-land and Hanlon2 (1938) have reported a case, and the foreign literature refers to several others. Rebhorn's3 (1933) report of a case complicated by a Homer's syndrome is of particular interest, since the uniqueness of these injuries depends entirely upon the vulnerability of adjacent structures. The surgical significance of this situation was, therefore, suspected by anatomists long before it was clinically established.Our case is of particular interest because the fracture was bilateral and attended by a left Homer's syndrome. The exact relationship of the latter to the osseous injury is not clear-cut on account of the associated intra-ocular and intracranial complications also present.