Complications of rib fractures

Written by Zhang Zhi Gong
Cardiothoracic Surgery
Updated on September 12, 2024
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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 Wang Cheng Lin
Orthopedics
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Hazards of Rib Fractures

The most severe case of rib fracture is what we call the occurrence of pneumothorax. Pneumothorax is caused by the puncture of the pleural cavity due to the fractured end, resulting in pneumothorax or hemothorax compressing the lung tissue, causing severe systemic respiratory and circulatory disorders. Severe pneumothorax can directly endanger life; this is the most serious harm of rib fractures. However, generally speaking, it is rare for a rib fracture to result in severe pneumothorax; most cases involve only a small amount of effusion or a small amount of air accumulation. Thus, generally, the harm from rib fractures is not very significant; the most severe harm is causing severe pneumothorax, affecting the overall respiratory and circulatory functions, and endangering life.

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Written by Li Jin
Orthopedics
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Can someone with a rib fracture move?

Patients with rib fractures should rest during the acute injury phase. Premature activity can cause pain at the fracture site and is detrimental to the recovery of the fracture. After the condition stabilizes and symptoms such as pain have alleviated, patients can appropriately start mobilizing. Proper exercise can help prevent complications such as dependent pneumonia and bedsores. Rib fractures are generally treated non-surgically. A chest brace can be used for protection in conjunction with anti-inflammatory and analgesic medications, as well as Chinese medicines that promote blood circulation and remove blood stasis, which aid in the healing of the fracture. Recovery from a rib fracture generally takes about four to six weeks.

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Written by Cheng Bin
Orthopedics
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Symptoms of rib fracture and pneumothorax

Patients who have suffered a rib fracture typically experience localized pain which affects their ability to turn, bend, or perform normal movements such as breathing and coughing. If the rib fracture is accompanied by a pneumothorax, symptoms like chest tightness and breathlessness often occur. Diagnosing a rib fracture with pneumothorax requires an assessment of the patient's clinical symptoms along with various supportive examinations. For example, a chest CT scan can confirm the presence of a pneumothorax and determine the severity of the condition. In cases where the pneumothorax is severe and the lung compression exceeds one-third, it is necessary to actively pursue thoracic closed drainage surgery as treatment.

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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.

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Written by Guan Jing Tao
Orthopedics
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How to sleep with a rib fracture

For rib fractures requiring bed rest, wearing a chest brace for protection is advisable. During the initial 2 to 4 weeks, sleeping positions should be such that they do not cause pain. In cases of multiple rib fractures, pain might occur irrespective of whether the patient is lying on their back or side. Therefore, there are no special requirements for sleeping positions; it should be whatever position causes the least pain locally. A chest brace can also be used to help minimize the pain caused by friction between the fractured ends of the bones. In addition, it is recommended to consume foods rich in calcium and take oral bone-healing calcium supplements to promote fracture healing, as this is the fundamental way to alleviate pain.