How to sleep with a rib fracture

Written by Li Jin
Orthopedics
Updated on October 23, 2024
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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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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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Orthopedics
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How to care for a rib fracture

After a rib fracture, it is recommended to adhere to the following aspects in terms of care. Firstly, after a rib fracture, a chest bandage can be used to protect and stabilize the area, which generally requires about four to six weeks. Secondly, in terms of diet, it is important to enhance nutrition. Consume foods rich in high-quality proteins, calcium, and vitamins. These foods aid in recovery by providing nutrients and energy, helping to promote the healing of fractures. Additionally, symptomatic medication treatment, such as non-steroidal anti-inflammatory painkillers and traditional Chinese medicine that invigorates blood circulation and removes blood stasis, can be used to facilitate recovery. During the recovery period of the fracture, it is advised to start rehabilitation exercises as soon as possible and encourage activities such as coughing and expectorating to prevent complications such as dependent pneumonia and atelectasis. (Please consult a professional physician for specific medication usage and avoid self-medication.)

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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 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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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.