Rib Fracture

Definition

A rib fracture is a break in a rib bone. Bruised muscles and damaged 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, a car accident, or having CPR
• 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 the 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
• Shortness of breath
• Internal bleeding

Diagnosis

You will be asked 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:

• Chest x-ray
• CT scan
• MRI scan

Treatment

Treatment may include:

Rest

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

Protection

A chest binder may need to be worn around the ribs to protect them. The binder may promote proper breathing. It is important to take deep breaths so that the lungs remain clear. Pneumonia can develop after rib fractures when breathing is not deep enough. A rib cage protector may need to be worn for 6-8 weeks when returning to contact sports.

Medication

Over-the-counter medication may be advised to help reduce inflammation and pain.

Physical Therapy

A physical therapist can teach breathing exercises. The therapist can also help maintain range of motion in the 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 seat belts with shoulder strap.
• 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:
  • Getting plenty of calcium in your diet
  • Doing weight-bearing exercise
  • Not smoking