Rib fracture is the most common type of chest trauma, accounting for about 16% of the total number of recorded fractures. Rib fracture, symptoms of which we will discuss below, is not only its damage, but also damage internal organs, concentrated in the chest area. It is noteworthy that in some cases, this fracture can cause death, because to be injured, you seriously.
A broken rib – what it is and how to determine
Not complicated type fractures, in which damage to exposed 1-2 ribs, fused well enough, not knowing the victim for any threat. The main danger posed by this injury usually becomes breathing problems and damage to internal organs, which are developing related complications. These fractures, when there are no complications, observed in practice, about 40%, but 60% of the remaining inevitably associated with damage involving the pleura and lungs and the organs of the cardiovascular system, which in any case is a serious threat.
There are also situations in which the formation of multiple fractures of the ribs. It defines a serious injury, which in itself can be dangerous because of the probability of so-called pleuropulmonary shock and can also lead to complications, life-threatening.
Rib fracture: causes and types of fracture
To provoke a fracture of any impact, as such, can serve a direct blow aimed at the area of the ribs, or the fall, in addition to this a possible cause may be excessive compression of the chest. The most common fracture is the fracture within the areas of greatest bend, i.e., along the lateral surfaces of the thorax.
In the event of fracture of one rib rarely is offset from the fragments of ribs. Multiple fractures also frequently occur in complex with displacement of such bone fragments, due to the impact of sharp ends which can be, in turn, damaged the lungs and pleura and intercostal vessels.
When damage to the pleura, and with it the lungs, often develop complications – as such acts as hemothorax and pneumothorax.
Hemothorax is the accumulation of blood between the inner and outer pleural layers, the pneumothorax leads to accumulation of air in the chest. In the end, squeezed light, then it decreases in volume, there will be decay of the alveoli, and then terminated their participation in the process of respiration.
Broken ribs, which damaged lung, may also be accompanied by and entry of air to the subcutaneous tissue that determines the state of subcutaneous emphysema. If there is injury of intercostal blood vessels, this, in turn, can lead to profuse bleeding into soft tissue or into the pleural cavity.
Symptoms of rib fracture
The victim when the rib fracture is pain in the affected area. Increased pain occurs during breathing and making movements and when coughing. Reduced pain at rest, and in the adoption of a sitting position. Breathing characterized by superficiality, in its process it is lagging of the chest on the side where there was her defeat.
Palpation (probing) of a broken rib identifies the site of increased pain, in some cases, marked bony crepitus, which is manifested in the form of a sort of crunching sound produced by bone fragments.
Lateral and anterior fractures of the ribs are tolerated especially difficult, accompanied with marked disturbance of respiration. Damage to the ribs in any of the posterior is mainly manifested not so much.
Multiple rib fractures result in a deterioration of the General condition of the patient, his breath is also characterized by superficiality, noted and increase in heart rate. The skin in such cases becomes pale, and often becomes cyanotic. The patient seeks to engage a stationary position, avoiding, thus, unnecessary movements.
A survey of the field of fractures also detects the presence of bruising and swelling, which are soft tissue. Palpation reveals a sharp diffuse tenderness, and bony crepitus. During follow-up of fracture emphysema, palpation reveals crepitus of air, she, unlike crepitate bone, similar to a gentle creaking.
On the occurrence of pneumothorax in a patient show symptoms of broken ribs as a deterioration of his General condition with increase in shortness of breath. The affected area does not determine the breathing of her. While lung injury may appear the symptom such as hemoptysis.
These complications, such as hemothorax and pneumothorax appear, mainly, in the near future from the moment of receipt of trauma patients this field. A few days after the fracture, there is often another, not less dangerous complication is post-traumatic pneumonia, which is most likely older patients and patients of senile age category. In these cases, the pneumonia was characterized by a special severity of its duration.
On the development of fractured ribs post-traumatic pneumonia show symptoms such as intoxication and difficulty breathing, the temperature rises. It is important to note that weakened older patients and patients with severe combined trauma, do not always face the symptom in the form of higher temperature – often a characteristic feature of the state is its degradation.
Post-traumatic pneumonia due to reduced lung ventilation observed from the fracture. Broken ribs accompanied by painful breathing, for this reason, the patient to breathe superficially tries.
The aggravation of the symptoms quite often occurs on the background of medication. Most people assume that properly healing of the edges is ensured through the restriction of their mobility, which is achieved when perebintovany chest. In the end, this leads to even greater restriction of breathing, resulting in marked lung subsequently congestive phenomena of nature, and as a result determined the appropriate diagnosis – congestive pneumonia.
With regard to the actual situation, for most rib fractures do not need fixation of the affected area. The exception may be except that multiple or complicated fractures of the ribs, and in this case it is necessary to secure extremely specialized care in a hospital environment – any medication must be excluded!
If time does not produce treatment, complications of fractured rib/ribs can be a danger to the life of the victim. To prevent the development of complications or to eliminate the consequences caused by them, and upon the slightest suspicion of the relevance of the fractured rib should consult a doctor.
Diagnosis of the condition of the patient produced by x-rays if there is suspicion of hemothorax or pneumothorax, we also carried out x-ray examination, thoracentesis and ultrasound.
Video: Treatment of Rib fracture
Rib fracture treatment
Fracture one or more ribs requires complete exclusion of self-treatment, because this condition can be life-threatening.
If it is not a complicated fracture (1-2 ribs), the treatment is usually performed on an outpatient basis. At the break three or more ribs becomes compulsory hospitalization.
Of treatment of complicated fracture of the rib is performed under local anesthesia at the doctor and is in the blockade and fixing a broken section of rib. Further prescribed analgesics in combination with expectorant drugs, physiotherapy and therapeutic exercises that is designed to improve lung ventilation.
In some cases the hemothorax and the pneumothorax is not apparent at admission to the trauma of the victim, and later. In case of suspicion on the relevance of this type of complications, you should do repeated x-rays.
If the space between the pleural layers accumulates a small amount of blood, the resorption it occurs independently, in the case of pronounced puncture hemothorax is required, which implies the introduction of a doctor under anesthesia by a special needle for subsequent removal from the pleural cavity accumulated blood. In some situations, possible re-development of hemothorax, which requires repeated puncture.
In the case of a pneumothorax is often enough just to do a lumbar puncture, focused on the removal of air. In the case of a tension pneumothorax is required urgently to ensure the drainage of the pleural cavity.
As for the treatment of complications such as post-traumatic pneumonia, along with the above activities in the form of physiotherapy treatments and antibiotics, physiotherapy is used to normalize ventilation.
On average, treatment is not complicated by fracture of the ribs is of the order of months, while treatment of multiple rib fractures and complications provoked by them, determined in each case individually, based on the General condition of the patient.
If you suspect a rib fracture and relevance specific to the type of lesion symptoms, you should contact the surgeon.