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Rib Fracture

(Broken Rib; Fracture, Rib)

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
broken ribs resized
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Causes

Rib fractures are caused by:

Risk Factors

Rib fractures are common in people 65 years and older. Other factors that may increase your chance of a rib fracture include:

Symptoms

Rib fracture may cause:

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:

RESOURCES

Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

Trauma http://www.trauma.org

CANADIAN RESOURCES

Canadian Orthopaedic Association http://www.coa-aco.org

Canadian Orthopaedic Foundation http://www.canorth.org

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.

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