How to treat rib fractures well?

Written by Li Jie
Orthopedics
Updated on September 10, 2024
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Rib fractures are very common. We consider fractures of three or fewer ribs to be stable fractures, which generally only require local external fixation using a rib belt or chest wrap to stabilize the fracture and alleviate pain. Additionally, treatments can include drugs that activate blood circulation and reduce stasis, anti-swelling and pain relief drugs, or non-steroidal anti-inflammatory drugs. Then, the fractures can heal on their own. However, if more than three ribs are fractured, we consider it an unstable fracture, which may need to be fixed. Such cases might require surgery to reposition and stabilize the fractured bones. Rib fractures themselves are not very concerning; what is concerning are the complications, such as hemothorax or pneumothorax. If conditions like pleural effusion or pneumothorax occur, it is advised to perform closed chest drainage by inserting a drainage tube to release the accumulated blood and air to avoid severe complications. Rib fractures do not require special treatment; with effective stabilization and treatment, most can fully recover.

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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 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.

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Written by Li Jin
Orthopedics
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How long does the pain from a rib fracture last?

Pain generally persists for about three days after a rib fracture, as the first three days post-fracture are the acute phase of the condition, during which pain is relatively severe. This pain will gradually subside as the condition improves, typically fading substantially within one to two weeks. If pain occurs after a rib fracture, it can be alleviated with non-steroidal anti-inflammatory analgesic drugs, which can be taken short-term after meals. Additionally, it is important to rest after a rib fracture and avoid irritating the fracture site to effectively reduce pain. During the recovery period, some traditional Chinese medicines that invigorate blood circulation and dissipate blood stasis can also be used to promote healing. These measures are generally helpful in the recovery from a rib fracture.

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Written by Guan Jing Tao
Orthopedics
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What should I do if I have a rib fracture?

If it is a single, isolated rib fracture, and a chest CT scan shows no significant pleural effusion or obvious damage to the lungs and other thoracic organs, bed rest and wearing a chest brace for protection are recommended. A follow-up X-ray should be taken one and a half months later. If significant callus formation is observed at that time, attempts can be made to sit up and engage in weight-bearing activities. In this case, the recovery period should be at least three months. After three months, another X-ray should be taken; if further growth of the callus is observed, the chest brace can be removed, and normal daily activities can resume, but it is important to avoid heavy lifting to prevent exacerbating local pain. If multiple, severe rib fractures are present, accompanied by significant displacement and damage to the thoracic organs and tissues, hospitalization and possibly surgery are required.

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Written by Li Jin
Orthopedics
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How to sleep with a rib fracture

Patients with rib fractures need to choose their resting positions based on their specific situations. If the fracture is on one side, the patient can rest in a lateral decubitus position on the healthy side to avoid stimulating and compressing the fractured area. The fractured side should not be used for side-lying as it can easily compress the fracture site, leading to displacement of the fracture ends, causing pain, and potentially affecting the healing and recovery of the fracture. In cases of fractures on both sides, it is recommended to adopt a supine position for sleeping, as side-lying can negatively impact the fractures and is not conducive to their recovery.