How to recuperate from a rib fracture

Written by Li Jin
Orthopedics
Updated on September 07, 2024
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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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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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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 Jie
Orthopedics
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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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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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Orthopedics
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How to treat rib fractures?

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)