Common sites of rib fractures

Written by Luo Peng
Thoracic Surgery
Updated on September 09, 2024
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The most common sites for rib fractures are the fourth to tenth ribs, as they are more prone to fractures. The first to third ribs are relatively short and are protected by the scapula and clavicle. Additionally, the 11th and 12th ribs are quite mobile, making them less likely to fracture when subjected to external forces. Among the fourth to tenth ribs, the fourth to seventh ribs are the most susceptible to fractures, because their internal cartilage is relatively short, making these ribs the most likely to break when impacted.

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Written by Na Hong Wei
Orthopedics
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Is a rib fracture serious?

Whether a rib fracture is serious depends mainly on the extent of the fracture and the damage to the surrounding tissues. Generally, a single rib fracture or a non-displaced rib fracture is not serious and requires conservative treatment. However, if there are multiple rib fractures occurring at once, breaking several ribs, including possibly the sixth rib, the consequences can be very serious because it may result in a flail chest. Secondly, a rib fracture can potentially damage surrounding structures such as the pleura, lung tissue, and blood vessels, resulting in conditions such as pneumothorax, pleural effusion, and even active hemothorax, which must be promptly treated to avoid life-threatening situations. Thirdly, if a rib fracture heals in a deformed manner and is not treated, it can compress blood vessels and nerves, causing a persistent type of intercostal neuralgia even after healing. Apart from the local deformity, this situation often stimulates the intercostal nerves and may require surgical intervention. Therefore, the severity of a rib fracture depends mainly on the degree of the fracture and its aftermath, and typically requires assessment by a professional doctor.

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Written by Zhang Zhi Gong
Cardiothoracic Surgery
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Complications of rib fractures

Rib fracture complications. Structurally, each rib is located above the intercostal arteries, veins, and nerves. Therefore, the most critical issue with rib fractures is that they can cause severe pain for the patient. Thus, the main complication of a rib fracture is pain. This pain persists 24 hours a day, especially when the patient takes deep breaths, coughs, or turns over while sleeping during the night, which can awaken them due to the severe pain. Additionally, because of this pain, the patient is unable to cough effectively. Therefore, a large amount of phlegm, especially in smokers, accumulates in the lungs, leading to complications such as lung infections and pneumonia. Besides pain, another complication of rib fractures is the potential puncture of intercostal arteries or veins, which can cause hemothorax. This condition can result in a significant accumulation of blood in the pleural cavity, and a severe hemothorax can be life-threatening, especially a progressing hemothorax. Therefore, for patients with fractures of three or more ribs, it is recommended, according to the 2017 US guidelines for the treatment of internal fractures and the 2018 consensus from Chinese experts on internal fracture treatment, to actively proceed with surgical interventions. Studies have found that active surgical intervention for fractures of more than three ribs can significantly reduce the patient's pain, shorten hospital stays, and improve quality of life. In summary, the main complications of rib fractures include pneumothorax, hemothorax, pain, and resultant lung infections and pneumonia. These complications are crucial in the treatment of rib fractures and need to be actively addressed.

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Written by Li Jin
Orthopedics
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How to recuperate from a rib fracture

After a rib fracture, it is suggested to pay attention to the following aspects in terms of care: Firstly, after a rib fracture, it is advisable to use a chest binder for protection, which generally needs to be fixed for about four to six weeks. Secondly, in terms of diet, it is important to enhance nutrition. Foods rich in high-quality protein, calcium, and vitamins should be consumed more frequently. These foods help provide nutrients for the recovery of the fracture and promote healing. At the same time, symptomatic medication treatment can be used. For example, anti-inflammatory and analgesic drugs, and traditional Chinese medicines that promote blood circulation and remove blood stasis can facilitate recovery. During the recovery period of the fracture, it is recommended to start rehabilitative exercises as soon as possible and encourage activities like coughing and expectorating to avoid complications such as obstructive pneumonia and lung collapse.

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Written by Nie Lei Sheng
Orthopedics
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What should I do if I have a rib fracture?

Firstly, a clear diagnosis should be made for rib fractures to determine whether the fractures have caused damage to internal organs, leading to complications such as pneumothorax or hemopneumothorax, which are more serious conditions. Active treatment for internal organ damage and management of pneumothorax or hemopneumothorax should be pursued, along with treatment for the rib fractures. If the rib fracture is merely a simple, non-displaced fracture and the number of fractured ribs is less than three, wearing a chest brace for protection can be sufficient. Supportive symptomatic treatment and bed rest should be adopted. Generally, the fracture can begin to heal within four to six weeks. In cases of multiple rib fractures where the chest wall is unstable, with symptoms like abnormal breathing, surgery may be necessary to stabilize the chest wall and ensure respiratory and circulatory function. Therefore, treatment for rib fractures should be tailored based on the condition of the patient.

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Written by Lv Yao
Orthopedics
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Do rib fractures require surgery?

If there is a fracture of a single rib or a single spot with minor displacement, conservative treatment can be chosen without the need for surgery. However, if multiple ribs are fractured in multiple sections, it affects breathing, clinically known as flail chest. This condition can cause severe pain and breathing difficulties, and possibly fluid accumulation in the chest cavity. In such cases, surgery is required to reposition and stabilize the fractures, facilitating recovery. Therefore, whether surgery is needed should be based on the analysis of the injury.