Do rib fractures require surgery?

Written by Lv Yao

Orthopedics

Updated on September 01, 2024

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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 Jie

Orthopedics

1min 13sec

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How to treat rib fractures well?

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 Nie Lei Sheng

Orthopedics

1min 5sec

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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 Guan Jing Tao

Orthopedics

56sec

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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 Luo Peng

Thoracic Surgery

32sec

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Common sites of rib fractures

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

1min 12sec

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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.