A rib fracture is a fracture of one or more ribs, most often due to external force. Rib fractures usually progress well and heal without complications.
What is a broken rib?
A broken rib is a fracture of one of the twelve ribs in the human skeleton. Ribs have a bony and a cartilaginous area, whereby a fracture of the cartilaginous part is also referred to as a rib fracture. For diffuse esophageal spasm guide, please visit deluxesurveillance.com.
If, on the other hand, more than two adjacent ribs are broken, this is referred to as a serial rib fracture. If a single rib has two fractures, so that part of the rib has broken out of the rib composite, it is referred to as a rib fracture. In addition, a distinction is made between displaced and non-displaced rib fractures. A fractured rib is manifested by local pain in the chest area, which is aggravated by breathing movements, especially deep inhalation, and coughing.
Depending on the type of rib fracture, various forms of respiratory impairment can occur. There is also an increased risk of damage to nearby organs such as the heart, spleen, or aorta (main artery) with a fractured rib.
Causes
In most cases, a fractured rib is caused by external force resulting from a fall on the chest area or an accident. Extreme violence, such as traffic, riding or bicycle accidents, often leads to serial fractures and/or rib fractures.
If the surrounding organs, particularly the aorta, are injured as a result of the fractured rib, this can lead to very heavy bleeding into the lungs (hemothorax) or the collapse of a wing of the lung (pneumothorax). Depending on the shape and extent of the rib fracture, breathing can be severely impaired due to the pain.
For example, a serial fracture of a rib can cause respiratory arrest or reverse breathing, in which, unlike normal breathing, the chest pulls inward on inhalation and expands outward on exhalation. If you have osteoporosis (bone loss), a broken rib can also be caused by a strong cough.
Symptoms, Ailments & Signs
This injury to the ribs causes pain in the affected area. Breathing and mobility are often restricted with a rib fracture. However, simple rib fractures are uncomplicated and do not require special treatment. Rib fractures are the most common chest injury and result from direct or indirect trauma.
Usually it is the fourth to ninth rib. Ribs can break on the front, side, or back. If several ribs are affected, there is a serial rib fracture. The pain increases with movements, breathing, laughing, sneezing or coughing. The affected rib is sensitive to pressure.
When pressure is applied, a crunch can often be heard. Air accumulated in the skin can also be felt. The broken rib itself can often be palpated externally. Especially with serial fractures of ribs, further impairments can occur. It can lead to lung contusions, which is accompanied by increased breathing problems.
If there is severe pain and circulatory problems, the broken rib needs to be treated in any case. Sternum fractures can damage the thoracic spine or cause cardiac arrest. If the lower ribs are affected, the kidneys or liver may be affected.
Diagnosis & History
A fractured rib is diagnosed during an X-ray examination, in which the thorax is recorded in two planes. If there are concrete indications regarding the localization of the rib fracture, an X-ray target image can be taken. Due to the existing risk of pneumothorax, an X-ray should be taken in inspiration (inhalation) and expiration (exhalation).
If there is a suspicion of a non-displaced rib fracture, a control recording is indicated if the symptoms do not subside. A sonography (ultrasound examination) can be used to detect injuries to the surrounding organs. In addition, an EKG provides information about possible involvement of the heart.
If there is a serial fracture of a rib, a CT (computed tomography) can provide a comprehensive overview of the extent and localization. Rib fractures (including serial and rib fractures) usually progress well and heal without complications.
Complications
Rib fractures usually heal well. Sometimes, as a result of a rib fracture, air gets into the lungs (pneumothorax) or bleeding occurs there or in the chest. Accompanying this, skin emphysema can occur. Injury to the spleen cannot be ruled out either. Severe fractures may lead to an independent rupture of the spleen.
An unstable chest with paradoxical breathing can also occur – shortness of breath and other complications are the result. If the ventilation of the lungs is reduced as a result of the reduced breathing movement, this can result in pneumonia. Adverse events can also occur during the surgical treatment of a broken rib. Swelling in the area of the operation occurs relatively often, caused by bruising or accumulation of fluid.
Nerve pain or sensory disturbances can also occur and sometimes persist for a long time. Rarely does the fracture recur. Hardening and wound healing disorders are also rare, but cannot be ruled out. In addition, the prescribed painkillers and anti-inflammatory drugs can be associated with side effects and interactions. In the case of existing pre-existing conditions or allergies, further complications may arise.
When should you go to the doctor?
Pain in the hip area as well as shortness of breath and discomfort indicate a broken rib. A medical examination is recommended for persistent symptoms that cannot be alleviated by rest and other general measures. Affected patients are best advised to consult their general practitioner or the hospital directly. If the symptoms appear in connection with a fall or accident involving the ribs, it is necessary to see a doctor immediately. The same applies if there is acute shortness of breath or bleeding. People who are constantly coughing due to a chronic respiratory disease or who notice the symptoms mentioned after a cardiac massage are particularly at risk.
A broken rib is treated by an orthopedist or surgeon. Most patients require physiotherapy after the procedure. After the treatment of the fractured rib, the patient only has to attend one or two follow-up checks. If the prescribed painkillers cause problems, you must inform the doctor so that the medication can be adjusted.
Treatment & Therapy
Non- displaced rib fractures are usually treated conservatively with pain-relieving drugs such as ibuprofen, novalgin or tramadol. If a dry cough is present at the same time, expectorant cough medicines such as Paracodin N drops are also used to reduce the cough.
If breathing is slow as a result of the rib fracture, the affected person should be checked regularly for infections in order to avoid pneumonia (pneumonia) or to be able to treat it in good time. In the case of a mantle pneumothorax (collapsed lungs of minor severity), X-ray control images should be taken at regular intervals to check the improvement in lung function. In the case of a pneumothorax, on the other hand, the collapsed lung must be brought to unfold again through a thoracic drainage.
For this purpose, a tube is placed in the pleural space (gap in the pleura) as part of a minimally invasive procedure, through which the air in the pleura is sucked out by the negative pressure, the affected lung is relieved so that it can unfold again. Respiratory therapy is often recommended for older people with a broken rib because of the risk of hypoventilation (restricted ventilation of the lungs) or atelectasis (collapsed sections of the lungs) as a result of breathing slowly due to the pain.
In addition, a broken rib can cause painful damage to nerves in the area between the ribs (intercostal neuralgia), which must be treated accordingly (e.g. with non-steroidal anti- inflammatory drugs).
Prevention
A preventative measure against a broken rib is, for example, wearing protective clothing in so-called contact sports such as football or martial arts to avoid injuries to the chest. Older people who have an increased risk of skeletal injuries due to osteoporosis should use walking aids (walkers) if they are unsteady in walking in order to avoid falls and thus broken ribs.
Aftercare
In the case of a broken rib, targeted physiotherapy makes sense to relieve pain, shorten the healing process and restore full mobility of the chest and thoracic spine. Pain after a broken rib is usually caused by the breathing movement of the chest. Therefore, respiratory therapy makes sense.
The patient learns important self-help techniques to prevent shortness of breath. The physiotherapist also shows the correct execution of everyday movements and the right breathing technique to keep the diaphragm and chest flexible. Aftercare for a broken rib also includes manual therapy, massages and heat applications. They relieve pain-related tension in the shoulders, arms and thoracic vertebrae.
Physiotherapists often use kinesio tapes. The self-adhesive, elastic cotton tapes lightly fix the bones and stabilize the corresponding parts of the body. In addition, they relieve pain and prevent the development of edema. The tapes are applied directly over the fracture site to ensure full mobility in the affected area.
Many therapists offer magnetic field therapy for broken ribs. Bone and tissue healing is stimulated and pain is reduced. Prior consultation with the doctor treating you is recommended. In order for a broken rib to heal smoothly, all strenuous physical activity should be avoided. For example, heavy carrying or lifting is also prohibited during the aftercare phase.
You can do that yourself
A simple broken rib usually heals on its own with a few weeks of rest. However, if there is severe pain, circulatory problems or breathing problems, the affected patient should seek medical treatment. The fracture may be complicated and/or injured adjacent organs. If multiple ribs are affected, the chest may become unstable, affecting breathing and lungs. Surgeons or orthopedists can treat this professionally.
If the rib fracture or rib serial fracture is medically treated or uncomplicated, the patient can relieve his pain by taking anti-inflammatory painkillers. Cooling, light pads also have a pain-relieving effect. Since a cough shakes the chest, it is also advisable to take cough suppressants if you have a cold at the same time. Bandages and tapes are no longer used to treat a broken rib because they impede breathing more than they stabilize the chest.
Although sport is taboo in the first four weeks after the fracture, moderate outdoor exercise is definitely advisable. Longer walks activate the immune system and ensure a better attitude towards life. Patients should also not withdraw or be overly restful. It may take up to eight weeks for a broken rib to heal, but the worst is over after three weeks.
