Traumatic fracture of the first rib is often associated with serious intrathoracic, head, and cervical spine (C-spine) as well neurovascular injuries. We report a young, healthy motorbike rider who developed isolated bilateral first-rib fractures in the absence of associated injuries. Nevertheless, recognition of potentially life-threatening injuries associated with first-rib fractures is essential.A 23-year-old healthy motorbike rider suffered frontal collision with a vehicle at a speed of approximately 40 mph. Despite being ejected from the motorbike, the safety helmet he wore remained intact. On arrival in the Accident and Emergency Department, his Glasgow Coma Scale score was 15. His vital signs included blood pressure of 126/78 mm Hg, pulse rate 98 beats/min, respiratory rate 18 breaths/min, and oxygen saturation was 98% while breathing ambient air. Physical examination revealed mild tenderness over the lower cervical spine, the sternum, and central thoracic cage, with bruises over the chin and anterior aspect of neck.
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