Chest Injury : Rib Fracture
The 12 ribs comprise the bony skeleton of the thorax (chest). They serve to protect the underlying organs. A direct blow to the ribs can result in a break in the bone known as a fracture. Simple, uncomplicated rib fractures (those without damage to underlying organs) heal well with only pain relieving medications. Multiple rib fractures can be more serious and interrupt normal respiratory function.
Common symptoms of rib fractures include tenderness at the fracture site, with sharp pain upon movement, coughing, or deep breathing.
Evaluation will include chest x-rays to determine the number of ribs fractured, and to disclose any possible damage to the lung. It is important to realize that rib fractures may be associated with hemothorax, pneumothorax, or pulmonary contusion. Fractures of lower ribs, 8-12, can result in associated injuries to the liver, spleen, or kidneys.
Recovery from a rib fracture is slow, with total bone healing at 6 weeks. Smoking should be avoided. Pneumonia is a common secondary complication of rib fracture, particularly in the elderly. Smoking and wrapping the chest are not recommended and have been shown to increase the possibility of complications, such as pneumonia. Hospitalization is necessary in cases of multiple rib fractures, chronic illness, advanced age, or associated injuries. Stronger pain medications are necessary in most cases. Ibuprofen can be helpful when the patient wishes to avoid the sedation seen with the narcotic pain medications.
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