Symptoms of rib fracture and pneumothorax

Written by Cheng Bin
Orthopedics
Updated on September 05, 2024
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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 Luo Peng
Thoracic Surgery
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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
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What are the symptoms of a rib fracture?

Symptoms of rib fractures include, firstly, there is usually a clear history of trauma, either from direct impact or from falling and the ribs making contact with the ground, etc. Secondly, the main symptoms of a rib fracture include three points: The first is local deformity. If it is a single rib fracture, this deformity is generally not easy to detect. However, after multiple rib fractures, this deformity becomes readily apparent, and you can see that the chest cage is abnormal, with a caved-in appearance. Moreover, in cases like flail chest, breathing is also abnormal. Normally, when inhaling, the ribs should expand outward, but if flail chest occurs, the chest cage appears to expand inward during inhalation; therefore, such a condition often requires surgical treatment, otherwise the consequences are very serious. The second symptom is friction sound and bone rubbing sensation. Some people, after fracturing a rib, during deep breathing or activity, hear cracking sounds from within. This occurs because the continuity and integrity are disrupted by the fracture, and then during breathing or during movement, there is friction between the bones. The third point is abnormal movement, which occurs at locations without joints, resembling joint movements. Normally, a person has 12 ribs on each side. If the continuity and integrity of the ribs are not damaged, there should be no abnormal movement; that is, pressing on the ribs should not cause sensations similar to joint movements at places where there are no joints. Therefore, the symptoms of a rib fracture include three points: the first point being local deformity; the second, bone friction sounds and sensations; and the third, abnormal movement. If any of these three symptoms are present, it is generally indicative of a rib fracture.

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Written by Li Jie
Orthopedics
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How long does a rib fracture hurt?

Rib fractures are indeed quite painful because there are abundant intercostal nerves around the rib cage. Once a fracture occurs, if it is not effectively immobilized and treated promptly, the pain is very noticeable. If treated effectively, such as applying external fixation with a rib belt or chest band, and addressing any pneumothorax or hemothorax with targeted treatments, along with using medications that activate blood circulation, reduce swelling, and relieve pain, proactive treatment can usually significantly alleviate the pain of rib fractures within about a week. Typically, by around two weeks, the pain can essentially disappear. However, if not treated actively, the duration of pain may significantly increase.

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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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Can you move with a rib fracture?

The rib has suffered a fracture. Depending on the displacement of the fracture, whether it's a single rib or multiple ribs in multiple locations, and whether breathing is affected or there is a presence of blood or fluid in the chest cavity, a comprehensive analysis is required. If the fracture is a single rib or multiple ribs with hairline fractures, it is possible to move around, but rest is also important to avoid turning a stable fracture into one with significant displacement. If there are fractures in multiple ribs at multiple locations and a large amount of blood or fluid in the chest cavity, along with flail chest that significantly impacts breathing, it is not recommended to continue activities. Rest should be prioritized, and, if necessary, joint cavity puncture drainage may be performed to relieve symptoms.