A rib fracture can have serious consequences. The ribs are the part of the chest that protects the heart and lungs, and broken ribs can damage these organs. How do I know if my ribs are broken? What to do when a rib is broken? What is the treatment?

Rib fractureis now the most common consequence of blunt trauma to the chest. The direct force applied to the rib deforms it, forcing it inwards, until it breaks. Another mechanism is the sudden compressive compression of the chest causing the rib to flex excessively (greater than its adaptive capacity) according to its natural outward curvature.

A rib fracturecan have serious consequences. Ribs are part of the chest that protects the central organs of the circulatory system (heart, major blood vessels) and respiratory system (lungs), and when broken, they can be damaged, as well as other organs - the diaphragm, liver and spleen.

Rib fracture - causes

The most common cause ofrib fractureis a direct injury to the chest, resulting from an impact, a fall from a height, crushing, crushing, or a shot to the chest. The area with the highest fracture frequency is the posterior axillary line and the posterior parts of the ribs. The upper three ribs rarely break as they are protected by the collarbone (from the front), the shoulder blade from the back, and the shoulders and muscles (from the side).

A fracture of the ribcan also occur during first aid, and more precisely, when compressing the victim's chest by inexperienced people.

Rib fracturecan also occur indirectly, through a strong contraction of the respiratory muscles attached to the ribs. Even a sneeze or cough can contribute to such a fracture.

Less commonfractures of ribsas a result of the mechanism of sudden contracture of the neck muscles or as a result of repeated stresses on the muscles. Load fractures can occur in volleyball players due to repeated muscle strains occurring during serving.

Rib fracture - symptoms

  • pain on inhalation
  • restriction of mobility of the part of the chest (in placefractures)
  • spontaneous or compression soreness at the site of the injury
  • pathological mobility of the rib
  • sharp bone fragments can be felt under the skin

A direct compression injury to the chest may lead to the development of Perthes 'syndrome (not to be confused with Perthes' disease). Characteristic of this syndrome, bloody ecchymoses on mucous membranes, skin, intraocular haemorrhages occur as a result of a sudden return of blood to the venous system of the upper vein from the lungs and mediastinal vessels. and indicates the possibility of severe blunt organ injuries inside the chest.

Rib fracture - first aid

First place the injured person in a half-sitting position. Then, the fracture area should be immobilized by putting a pressure band or an elastic bandage on the chest - the patient has to exhale and then we put the band around the chest at the fracture level so that it does not obstruct breathing. The hand on the side of the damaged rib should be immobilized.

Rib fracture - diagnosis

In the case ofrib fracture , a chest X-ray is performed. However,fractures of the ribsafter trauma are in some cases overlooked in the first radiological examination. Computed tomography (without the possibility of reconstruction in the so-called 3D projection) is also not effective in this case. For this reason, a thorough physical examination is very important and it should determine the diagnosis of a post-traumaticrib fracture . In case of doubt, it is good to repeat the radiological examination 3-4 days after the injury.

Rib fracture - treatment

The treatment should not use bandages that immobilize the chest. They are only used to temporarily immobilize the injured person for the period of transport to the hospital. Treatment of simplerib fractures(without displacement of bone fragments) consists of:

  • administering painkillers and anti-inflammatory drugs
  • intensive pulmonary rehabilitation to prevent atelectasis (breathing exercises and inhalations)
  • in selected cases - using antibiotics (elderly patients or patients with chronic respiratory failure)

In the case of severe pain that cannot be alleviated with drugs, or in the case of a few fractures, additionally paraspinal intercostal nerve block or nerve block at the fracture site, subpleural anesthesia, intrapulmonary anesthesia,cryoanalgesia or transcutaneous electrical stimulation (TENS). In multi-fragmented rib fractures, epidural anesthesia may be necessary.

Surgically, the ribs fuse extremely rarely. This applies only to selected cases of patients.

Rib fracture - how long does a broken rib heal

A broken ribusually heals without any problem. A broken rib takes 6 to 8 weeks to heal. During this period, a diet rich in products containing protein, calcium and phosphates is important. If the patient has a cough, it is worth using antitussive drugs.

Read also:

  • Spine fracture - causes, symptoms, treatment, first aid
  • Fractured Femur - Causes, Symptoms & Treatment

Bibliography:

  1. Jabłonka A., Sawicki M., Rybojad P., Chest injuries, Selected issues in thoracic surgery Script for students of the Faculty of Medicine, Lublin 2014, on-line access

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