Rib Fracture: Causes, Symptoms, And Treatment

The chest cavity contains vital organs such as the heart and lungs, which are protected by the rib cage. A fracture in any part of the rib cage can be either a simple fracture or a hairline fracture. Rib fractures usually occur at the most vulnerable part of the rib or the point of significant impact. It is interesting to note that children have more elastic rods compared to adults, and therefore, are less prone to rib fractures and associated complications. Complications due to rib fractures include pneumonia and respiratory arrest.

How Is Rib Fracture Diagnosed?

Your doctor will give you an test. He’ll ask you what happened and will touch the rib area where you feel the pain. He will want to hear your lungs when you breathe and watch your rib cage as your chest goes up and down. If your doctor suspects a rib fracture, he will want to get images of your chest. If the broken rib is due to direct trauma or a severe accident, he might want to make sure there’s no other severe damage to internal organs. Your doctor might tell you to do the following tests:

• X-ray- These catch approximately 75% of all broken ribs. They can also show other problems, like a deflated lung.
• CT scan- CT scan shows fractures that don’t appear on X-rays. Your doctor will want you to get one if he thinks the X-ray missed something. CT scan can further show damage to soft tissue and organs, like your lungs, liver, or spleen.
• MRI- Like a CT scan, MRI images can show fractures that X-rays miss. They can pinpoint damage to soft tissue and organs.

Causes of Rib Fracture

There are various causes of rib fractures:

• Direct trauma from motor vehicle accidents (MVA)
• Motorcycle drivers have a higher chance for rib fractures compared to their passengers
• Severe Coughing spells
• Falls down the staircase, especially in the elderly
• Stress fractures to the first rib in athletes that do repetitive throwing
• Some cancers that metastasize to bones such as breast, prostate, and renal cancers
• Higher risk in patients with cardiopulmonary disease and those over 65 years of age
• Assault
• Elderly patients with osteoporosis

Symptoms of Rib Fracture

If in a car accident, the paramedics at the accident scene can provide vital information and clues about the likelihood of rib fractures to the emergency room doctors. The triggering of airbags, seat belts, and deformity of the steering wheels involves a high risk of rib fractures. The most typical symptoms of rib fractures are:

• Pain on inhalation
• Dyspnea
• Coughing spells with or without other significant trauma
• Tenderness on palpation
• Chest wall deformity
• Anxiety
• Agitation
• Bruising near the fracture site
• Abdominal tenderness in case of lower rib fracture
• Respiration inadequacy

Treatment

Treatment depends on the type of fracture and severity of the breach. Even though there is no one specific treatment that is indicated for rib fractures, patient-specific supportive actions are taken. Rib fractures are diagnosed based on a chest x-ray, and the severity can quickly be discovered. Originally, rib fractures heal by themselves. Doctors only give external support to keep the fractured parts in place, so that they improve in their correct position.

For simple fractures

A non-displaced fracture can be treated with pain management alone in most cases. This type of fracture occurs as cracks in the rib. People are recommended to use a spirometer to help improve lung function and control their pain with pain medication. If pain medication alone does not help, the person may be given other therapy, such as nerve blockage. Nerve blockage provides additional pain control without suppressing respiratory function. It is relatively easy to administer and provides dramatically more effective pain control compared to conventional medications.

For displaced fractures

This type of fracture appears to lack contour along the edge of the rib. Oxygen may be needed in this case in addition to spirometer and pain medications.

Floating ribs

Also known as a flail chest, it affects the process of breathing. It may demand ventilator support to improve blood oxygen concentration and possible fitting of metal plates to repair the fracture. CT scans are not usually required but may be needed if lung injury is suspected. CT scans may also be required to assess whether air has escaped the lung as in pneumothorax, requiring draining the air out of the chest using a chest tube. In conclusion, rib fractures can prove fatal if not treated at the right time. Complications include pneumonia, damage to vital organs, pneumothorax, and rarely, respiratory failure.