The first rib is the broadest and shortest of all ribs, with a flat superior surface crossed by the subclavian artery groove and scalene muscle attachments. It articulates only with T1 and has no neck or angle.
The first rib is the broadest, flattest, and most curved rib and is rarely fractured due to its protected position beneath the clavicle. When fractured by high-energy trauma, the injury implies significant force that typically causes associated injuries to the brachial plexus, subclavian vessels, and cervical spine. Cervical rib (accessory rib from C7) is a common cause of thoracic outlet syndrome when it compresses the brachial plexus in the scalene triangle.
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