Breaking waves and cartilage: Surgical management of costal cartilage injuries in surfing-related trauma

Blunt thoracic trauma, often leading to rib fractures and costal cartilage injuries, is a significant cause of morbidity and mortality in trauma patients. Rib fractures, occurring in up to 40 % of cases, frequently accompany other injuries and are commonly diagnosed. Conversely, costal cartilage fractures are challenging to diagnose, often necessitating advanced imaging techniques, exist on a spectrum from a simple fracture to complete costal margin disruption, and are likely underreported. The mainstay of therapy for costal cartilage injuries is pain management, although for more displaced or symptomatic fractures open reduction and internal fixation may offer benefit. Our paper presents a case series of two patients with costal cartilage injuries resulting from surfing-related trauma. These cases describe a unique injury pattern in surfing and successful surgical intervention for mal-union and ossification of fractured costal cartilage. Our observations contribute to a growing body of literature describing this injury pattern and treatment of these costal cartilage injuries.