How to treat rib fractures?

Written by Li Jin
Orthopedics
Updated on September 06, 2024
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For the treatment of rib fractures, if it is a single or multiple closed fractures, and if there are no internal organ injuries, and the fracture alignment is good, non-surgical treatment can generally achieve good results. For example, using a chest bandage to secure and protect the area, generally immobilizing it for about 4 to 6 weeks, can effectively aid recovery. For multiple rib fractures, especially those accompanied by abnormal breathing, open fractures, or concurrent internal organ injuries, surgical treatment is primarily adopted. During the recovery period from the fracture, rest is important. If there is pain, some non-steroidal anti-inflammatory pain relief medications can be used to alleviate the pain. Additionally, during the recovery period, coughing should be encouraged to prevent complications such as lung infections or atelectasis. (Please use medication under the guidance of a doctor)

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Written by Na Hong Wei
Orthopedics
1min 12sec home-news-image

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 Li Jie
Orthopedics
46sec home-news-image

Will rib fractures swell?

Generally, swelling after a localized fracture is due to damage to the blood vessels in the area of the fracture. The bleeding that follows accumulates under the skin at the fracture site, causing obvious swelling. However, rib fractures are somewhat unique because after a rib fracture, the bleeding generally occurs internally, meaning the blood enters the chest cavity, leading to accumulation of blood and fluids within the chest. Generally, the blood does not accumulate under the skin. Therefore, rib fractures typically do not exhibit obvious swelling. There might be some local swelling, but it is usually not prominent. If not examined closely, it is generally not noticeable that there is significant swelling at the site of a rib fracture.

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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 Jie
Orthopedics
33sec home-news-image

Can you move with a rib fracture?

After a rib fracture, the patient's limbs can still move, and movement of the limbs should generally not pose major problems. However, excessive movement can sometimes cause pain, as well as movement and displacement at the fracture ends. Therefore, it is generally advised that after a rib fracture, the patient should primarily rest and minimize movement, especially within the first two weeks of the acute phase, where bed rest is strongly recommended. Avoid strenuous activities, although some gentle exercise can be appropriate, but vigorous physical labor is not advised.

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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.