Rib Fracture
En Español (Spanish Version)

Definition
A rib fracture is a break in a rib bone. Bruised muscles and ligaments often happen with a rib fracture. With a rib fracture, the lungs and other organs can be injured. More than one rib fracture after a trauma can indicate serious internal injury.

Multiple Rib Fractures with Damage to Lung

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Causes
Rib fractures are caused by:

  • A direct blow to the rib
  • Crushing of the chest, such as in contact sports or a car accident
  • Severe coughing incidents that can occur with lung problems or at high altitude
  • Rib fractures in young children are often a sign of abuse
Risk Factors
Rib fractures are common in people 65 years and older. Other factors that may increase your chance of a rib fracture include:

  • Difficulty doing activities of daily living—generally with eldery people
  • Playing contact sports
  • Weak bones
  • Chronic cough
  • Extreme repetitive upper body activity, such as in:
    • Throwing
    • Basketball
    • Golf
    • Rowing
    • Weight lifting
  • Occupations involving a lot of overhead lifting
  • History of rib or chest fracture
Symptoms
Rib fracture may cause:

  • Pain in the ribs or upper chest area
  • Pain when breathing or coughing
  • Swelling and bruising in the fracture area
  • Severe local tenderness in the fracture area
  • Internal bleeding
Diagnosis
The doctor will ask about your symptoms and how the injury occurred. Your chest, lungs, and back will be examined.

Imaging tests can evaluate your chest and surrounding structures. These may include:

Treatment
Treatment may include:

Rest
Rest, without physical activity until the pain has gone away.

Protection
Your doctor may suggest wearing a chest binder around your ribs to protect them. The binder will also help you breathe properly. It is important to take deep breaths so that the lungs remain clear. Pneumonia can develop after rib fractures if you are not breathing deeply enough. If you play contact sports, you may need to wear a rib cage protector for 6-8 weeks when you return to playing.

Medication
Your doctor may recommend that you take over-the-counter medication to help reduce inflammation and pain, such as ibuprofen.

Physical Therapy
As your ribs heal, a physical therapist can teach you breathing exercises. The therapist can also help you maintain range of motion in arm and shoulder joints.

Intercostal Nerve Blocks
Special injections with local anesthetic can temporarily relieve pain.

Epidural Anesthesia
Sometimes, a temporary epidural catheter is used to place anesthetic near the spinal cord and nerves. This can help severe cases where the injury requires hospitalization.

Hospitalization
Hospitalization is usually only needed if there are complications such as damage to organs in the chest.

Prevention
Sometimes rib fractures cannot be prevented. To help reduce your chance of a rib fracture:

  • Wear protective equipment, such as rib pads, when playing contact sports.
  • Avoid over-training.
  • Learn the proper technique for exercise and sporting activities.
  • Maintain strong bones by:



RESOURCES:
Ortho Info—American Academy of Orthopaedic Surgeons


CANADIAN RESOURCES:
Canadian Orthopaedic Association

Canadian Orthopaedic Foundation

References:
Boden BP, Osbahr DC, et al. Low-risk stress fractures. Am J Sports Med. 2001;29:100-111.

Fractures (broken bones). American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed August 26, 2013.

Gregoretti C, et al. Regional anesthesia in trauma patients. Anesthesiol Clin. 2007;25(1):99-116.

O'Kane J. Delayed complication of a rib fracture. Phys Sportsmed. 1998;26:69.

1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Barrett-Connor E, Nielson CM, Orwoll E, Bauer DC, Cauley JA; Osteoporotic Fractures in Men Study Group. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study. BMJ. 2010;340:c1069.

Last Reviewed August 2014



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