Chest injuries are not uncommon, have varying degrees of severity, and if not properly treated can cause significant complications. Complications especially often arise as a result of injury such as rib fractures. Different chest injuries require different treatment methods. If uncomplicated bruises are treated on an outpatient basis, then a complex rib fracture requires the patient to be in a hospital. It is important to make a correct diagnosis and prescribe appropriate treatment as soon as possible after the injury occurs.
Many people wonder how to determine whether a rib is bruised or fractured. Accurate diagnosis is only possible in medical institution. It is not possible to make a correct diagnosis at home. Even the most experienced doctor cannot always visually distinguish between these injuries, since they have similar signs; hardware diagnostics of the injuries is often required.
A rib injury is considered severe and quite painful. The main causes of injury are:
A rib fracture or bruise has similar symptoms, so during the initial examination it is difficult to immediately recognize the type of injury and make the correct diagnosis. Common signs of such damage are:
In order to prescribe treatment, it is necessary to understand exactly what kind of injury we are dealing with - a bruise or a broken rib. The most accurate picture of damage is provided by an x-ray in two projections. If the patient has a fracture, then the fracture line and bone fragments will be visible in the picture, otherwise it will occur.
The approach to the treatment of uncomplicated bruises and fractures has similar features:
Do not forget about possible complications, the risk of which is higher, the more severe the damage. Complex bruises and fractures should be treated in inpatient conditions. More information about that.
A fracture of a rib (ribs) is an injury that results in a violation of the integrity of the bones of the chest and concomitant damage to nearby soft tissues, skin And internal organs.
The concept of “fracture” distinguishes between: complete and subperiosteal fractures. The above are general symptoms, characteristic of all chest injuries, however, there are also those that can be used to determine whether a fracture or just a bruise of the ribs occurs in a particular case.
During the initial examination of the fracture, asymmetry of parts of the chest can be identified; the affected part may “sink” inward when inhaling. When moving the victim, you can hear the crunching (crepitation) of broken bones and see fragments protruding from under the skin. In cases where a rib is broken, the pain is more pronounced. This may be a consequence of concomitant damage to muscle and lung tissue, pleura and nerve fibers. These injuries can immediately cause complications in the form of pneumothorax (accumulation of air in the pleura), hemothorax (bleeding into the chest cavity) and subcutaneous emphysema (accumulation of air in the pleura). subcutaneous tissue). Medical assistance in such cases must be provided urgently due to the need for immediate puncture to remove fluid or air. Due to congestion in the lungs over time, the victim of a fracture or severe bruise ribs may develop pneumonia.
It should be noted that the symptoms of an injury that involves only cracked ribs are very similar to those of a bruise.
In cases with a violation of the bone integrity of the rib, treatment involves connecting bone fragments and their reliable fixation for proper fusion. This can be achieved through conservative therapy; if this does not happen, then surgery is prescribed.
The following medications are used to treat fractures:
A bruise is mechanical damage soft tissues without integrity violations bone tissue and skin.
The distinctive signs of a bruised or cracked rib are as follows:
To choose the right treatment tactics for a patient, it is first necessary to diagnose a bruise and rule out rib fractures.
The goal of treating a bruise is to:
Non-steroidal anti-inflammatory drugs in the form of injections or tablets are usually used to relieve pain from a bruise. After reducing the pain, pain-relieving ointments and gels are used. To reduce swelling and resolve bruises, treatment at home includes the use of traditional medicine in the form of compresses, lotions and ointments. From medical supplies for these purposes you can use “Lioton”, “Bruise OFF” and others.
A rib fracture is a fairly common injury that can be caused by a blow, a fall, a traffic accident, or playing sports, but how do you know if a rib is broken?
Pain syndrome.
Usually, at the site of the fracture, the rib makes itself felt with a sharp, local pain. The victim can usually pinpoint not only the specific rib at the site of the fracture, but also its individual section, since he feels severe pain exactly there. The fact of injury is confirmed upon examination by bruises, scratches, hematomas and abrasions. Noteworthy is the fact that normal mobility of the chest is limited on the side where the injury occurred. The victim's breathing becomes rapid, causing pain, especially when performing deep breathing movements. A person with a rib fracture notes that the pain intensifies when changing body position, especially from a lying position to a sitting position.
Methods for studying rib fractures.
Undoubtedly, the most important confirmation of a broken rib is an x-ray examination, which similar cases is carried out in several projections, which makes it possible to determine the fact of a fracture, as well as the location of the fracture line, the presence of damage to the pulmonary pleura from rib fragments, and the possibility of displacement of the fracture.
In case of rib injuries, their fragments can damage not only the layers of the pulmonary pleura, but also the lung itself, which can significantly worsen the well-being and condition of the victim. At the same time, the pain is joined respiratory failure and shortness of breath. All this is quite easy to determine by listening. On the affected side, breathing and lung sounds may not be heard at all. If you don’t have a special device at hand - a phonendoscope, then you can listen to the lung by simply pressing your ear to the area of injury and comparing it with listening on the symmetrical side of the chest. If there is any doubt about injury to the ribs and lungs, you should urgently call an ambulance. There are cases where rib fractures caused disturbances in the functioning of the heart.
How to tell if a rib is broken by symptoms.
The patient complains of severe chest pain, which intensifies with movements, breathing, coughing, talking and decreases in sitting positions and at rest.
Breathing is shallow, on the affected side the chest lags behind when breathing.
When pressing on the site of the lesion, you can hear the crunching of bone fragments.
Lateral and anterior rib fractures are usually accompanied by breathing problems. When the posterior parts of the ribs are damaged, the impairment of pulmonary ventilation is less pronounced.
If there are multiple rib fractures, the victim's condition can deteriorate sharply. The pulse is rapid, breathing is shallow, the skin is bluish or pale. The patient tries to sit as still as possible and avoid the slightest movements.
Bruising and swelling of the soft tissue may be observed at the site of the rib fracture.
Hemoptysis may occur if lung damage.
In elderly and elderly people, after a rib fracture, a complication in the form of post-traumatic pneumonia may appear. The development of this disease may be indicated by an increase in temperature, deterioration of condition, difficulty breathing and symptoms of intoxication. The occurrence of post-traumatic pneumonia is due to sharp decline ventilation of the lungs on the injured side.
It is important to remember that health problems can be significantly worsened by self-medication. Many people believe that in order to fuse the ribs, it is necessary to bandage the chest, thereby limiting their mobility. In fact, this can cause congestion in the lungs and cause pneumonia. In order to prevent the development of possible complications in a timely manner, it is necessary to contact a qualified medical assistance, as soon as possible.
Rib fractures most often accompany closed chest injuries (up to 60%), that is, traumatic lesions of the thoracic part of the body without damage to the outer skin. In case of penetrating chest injuries fractures ribs occur in only 5-7% of cases.Statistics show that rib fractures are not very uncommon. According to various sources, they make up from 5 to 15% of all bone fractures.
However, the statistics of rib fractures in the structure of closed chest injuries strongly depends on the age of the victims. In childhood and adolescence, the chest has a high degree of elasticity, so that even very strong compression does not cause fractures.
In adulthood, the elasticity of the chest decreases, so at 35-40 years old, rib fractures are no longer uncommon. However, at this age, to disrupt the integrity of the chest, a traumatic factor of sufficiently strong force is necessary (a fall from a height, the collapse of heavy objects, a direct blow of extreme force, a transport accident, etc.).
In older people and old people due to age-related changes bones become fragile, and rib fractures can occur even with minor impacts (unsuccessful fall from your own height onto a hard, uneven surface, etc.).
Among the causes of rib fractures, the first place is taken by domestic injuries, the second place is occupied by injuries received as a result of road accidents, and the third place is taken by injuries at work.
With closed chest injuries, bone injuries occur in approximately two-thirds of cases, and the ribs are most often affected. The most common fractures are multiple bones. It should be noted that the number of broken ribs, as a rule, indicates the strength of the traumatic factor, and indicates the possibility of damage to internal organs.
Thus, fractures of one or two ribs are rarely combined with damage to the internal organs of the chest cavity (only in 10% of cases). These types of fractures are considered minor injury, since they do not cause serious disruptions to life important functions body and do not require hospital treatment.
Fractures of three to five ribs are much worse tolerated, and in about a third of cases they are complicated by complications from internal organs. When six to ten ribs are damaged, the frequency of internal injuries increases to 80%, and when ten or more ribs are fractured, it reaches 100%.
Multiple fractures, especially symmetrical bilateral ones, themselves lead to severe respiratory failure requiring emergency medical attention.
It should be remembered that in approximately 20% of cases, injuries to internal organs occur without compromising the integrity of the chest. Therefore, for any serious chest injury, it is necessary additional examination to identify or exclude damage to internal organs. Particular attention is required in cases of childhood and youth traumatism.
The rib cage is an elastic osteochondral formation consisting of twelve thoracic vertebrae, twelve pairs of ribs and the sternum. The chest is protected from above by the scapula and collarbone, so fractures of the first ribs are quite rare.
The ribs are fairly strong curved plates. The longer bony part is attached to the spine, and the wider cartilaginous part is attached to the sternum.
The bony part of each rib consists of a head, on which there is articular surface for connection with the bodies of the thoracic vertebrae, neck and curved body, passing into the cartilaginous end.
On the inner surface of the body of each rib in the lower part there is a special groove in which the intercostal nerve, the artery of the same name and two veins pass. Therefore, even with isolated rib fractures, severe bleeding is possible, requiring surgical intervention.
The upper seven pairs of ribs are called true because their cartilaginous ends are attached directly to the sternum. VIII – X pairs of ribs are called false. They are connected to the sternum using a common cartilaginous arch. The last two pairs of ribs are called swinging ribs because their bodies are not connected to the sternum. Thanks to this structure, the XI – XII ribs, as a rule, do not break even with extremely strong impacts and compressions.
The ribs are connected to each other using the external and internal intercostal muscles, as well as the subcostal and transverse thoracic muscles. From the inside, the costal part of the chest is covered with dense, especially strong in the anterolateral sections, intrathoracic fascia. So, with rib fractures, as a rule, divergence of the fragments does not occur, since they are located in the muscular-fascial sheaths.
The chest is strengthened by powerful layers of chest and back muscles. Good development muscles additionally protects the chest and its internal organs from damage.
Inside the chest is the thoracic cavity, which contains vital important organs: lungs with bronchi and trachea, heart with great vessels, esophagus, The lymph nodes, blood vessels and nerves. The lungs are most often affected by rib fractures, but other organs can also be damaged.
Attached to the costal arch is the diaphragm, a muscle-tendon formation that separates the thoracic cavity from the abdominal cavity. The diaphragm is actively involved in the act of breathing. With complete paralysis of the diaphragm in both humans and animals, death occurs from respiratory failure, while paralysis of the intercostal muscles does not lead to such consequences. Therefore, in case of multiple rib fractures during creation certain conditions victims can survive by diaphragmatic breathing.
The boundaries of the chest cavity do not coincide with the boundaries of the chest, since the right dome of the diaphragm is raised by the liver to the level of the fourth rib, and the left, under which the stomach, pancreas and spleen are located, reaches the level of the fifth rib. Thus, with rib fractures, damage to not only the thoracic organs, but also abdominal cavity.
There are direct and indirect mechanisms of rib fracture.
With a direct mechanism of injury, one or more ribs at the site of the traumatic factor bend into the chest cavity and break, and damage to the pleura and lung is possible. The number of broken ribs depends on both the force of the impact and the area of the traumatic surface.
With a strong blow from a traumatic surface of a large area, double fractures of the ribs are formed. Such fractures are called fenestrated because a “window” is formed - a segment of the chest separated from the general frame.
With an indirect mechanism, the chest is strongly compressed, and rib fractures occur on either side of the applied force. This type of lesion is typical for being pinched between two planes (the torso being pinched between the steering wheel and the seat during car accidents; the chest being pinched between the body of a car and the wall; compression of the chest by a car wheel; a heavy load, etc.). When compressed with great force, as a rule, multiple bilateral fractures are formed, complicated by damage to internal organs - the so-called “crushed chest” or “crushed chest”.
Particularly dangerous are the so-called floating rib fractures, leading to severe respiratory failure. Due to multiple double or bilateral fractures, a segment separated from the chest is formed, which disrupts the normal breathing process. Clinically, this is expressed in the so-called flotation of the chest - when inhaling, the separated segment sinks, and when exhaling, it bulges.
With fenestrated fractures, so-called paradoxical breathing is observed. At the moment of inhalation, when the fenestrae is retracted lung segment on the sore side it collapses, and the air from it rushes into healthy lung. As you exhale, the segment bulges, the lung on the affected side expands and fills with waste air from the healthy lung.
If the “window” is large enough, not only a violation of the respiratory function occurs, but also pendulum-like movements (flotation) of the heart and great vessels when breathing, which leads to cardiac dysfunction.
The most dangerous are anterior bilateral and left-sided anterolateral fenestrated fractures. Mortality from this type of injury, even in modern medical institutions, can reach 40%.
For posterior fractures, the prognosis is more favorable due to the fixing role of the back muscles and the position of the victim primarily on the back.
When a rib is fractured, victims complain of sharp pain at the site of injury, aggravated by breathing, coughing, straining, sudden movements. A characteristic symptom is “broken inhalation” - when trying to slowly inhale air, the patient stops inhaling due to pain. This sign rib fracture is important diagnostic value, since it is not observed with bruises. Sometimes, when you inhale slowly, you can hear a click, indicating a fracture.
At general examination The shallow breathing and forced position of the victim are noteworthy (the patient tries to spare the damaged part of the chest). The affected half of the chest may lag behind when breathing.
With fractures in the posterior parts of the chest, all of the above symptoms of a rib fracture are less pronounced due to the lesser mobility of the fragments during breathing. Besides, in in this case in the supine position, the affected area is partially immobilized (immobilized), and the pain subsides.
An important sign of a rib fracture, the severity of which does not depend on the location of the fracture, is the symptom of axial load. This symptom is determined by alternating anterior-posterior and lateral compression of the chest - in the case of a rib fracture, the pain at the site of injury will intensify.
When examining the site of injury, you can sometimes detect a painful swelling. To confirm the diagnosis, palpation examination (feeling) is performed. In this case, the rib is carefully palpated in the direction from the sternum to the spine. A reliable sign A rib fracture is a deformity determined by palpation in the form of a step in the area of maximum pain.
The diagnosis of a rib fracture is usually verified (scientifically confirmed) using x-ray examination. However, the main goal of additional research methods is not to confirm the diagnosis, but to exclude damage to internal organs.
However, even with a fracture of just one rib, such serious complications as internal bleeding, damage to the internal organs of the chest and abdominal cavity (lungs, heart, liver, spleen) or retroperitoneal space (kidney).
When providing first aid to a victim with a rib fracture, it should be remembered that even single fractures are often complicated by bleeding and/or traumatic shock. Therefore, you should count your heart rate and measure your blood pressure. In case of shock and massive blood loss, blood pressure drops ( systolic pressure below 100 mmHg), and the heart rate increases (above 100 beats per minute). Suspicion of the development of complications is an indication for emergency hospitalization.
In addition to shock and blood loss, the most common complications of rib fractures in the acute period are hemothorax (accumulation of blood in the chest cavity), pneumothorax (accumulation of air in the chest cavity) and lung injury.
Hemothorax can be caused either by a rupture of an intercostal vessel or by damage to the lung. It should be noted that bleeding from lung injuries often stops on its own, and the damaged vessel often requires surgical intervention. With increasing hemothorax, a clinical picture of acute blood loss and respiratory failure develops due to compression of the lung by accumulating blood. In such cases general state The patient is seriously ill, shortness of breath is pronounced, the skin is pale, the pulse is frequent and weakly filled (“thread-like pulse”). A patient with hemothorax needs emergency medical care.
Pneumothorax always indicates damage to the lung tissue, and in itself poses a danger to the life of the victim, since it compresses the lung and causes acute respiratory failure. With rib fractures, pneumothorax develops in every third patient. Unlike hemothorax, with pneumothorax blood pressure is usually increased. The pulse is moderately rapid. The general condition is moderate.
The classic symptom of pneumothorax is emphysema. Air from pleural cavity exits through the damaged pleura into the subcutaneous tissue, causing it to swell. Largest accumulation air is observed not at the site of injury, but in the subcutaneous tissue of the neck and face, which gives the patient a characteristic appearance.
Of particular danger is the so-called tension or valve pneumothorax, when air enters the pleural cavity during inhalation, and during exhalation the valve formed from damaged tissue closes. Thus, the pressure in the pleural cavity constantly increases, compression of the lung and displacement of the mediastinum occurs, which can lead to pleuropulmonary shock and death of the patient.
Lung damage causes symptoms such as pneumothorax, emphysema, and hemoptysis. Bleeding through the upper respiratory tract is sometimes observed.
Injuries to other organs (heart, liver, spleen, kidneys) are much less common, but the possibility of their damage should always be taken into account in case of multiple fractures of the corresponding ribs.
Most common complication late period– hypostatic pneumonia, developing as a result of prolonged restriction of the respiratory movements of the lungs against the background of a general weakening of the body.
In case of complicated rib fractures, the first few days the victims should be in the intensive care unit under constant monitoring of respiratory and of cardio-vascular system. For fenestrated fractures, it is possible to switch to artificial respiration. Multiple bilateral and bicuspid fenestrated fractures require surgical intervention(osteosynthesis using special metal staples) or traction of a segment separated from the chest.
Emergency care for hemothorax and pneumothorax involves puncture of the chest and aspiration of blood or air. Such patients require specialized treatment in the appropriate department.
Isolated uncomplicated fractures of one or two ribs, as a rule, do not require hospitalization and are treated on an outpatient basis (at home).
Even a single isolated rib fracture is accompanied by severe pain, so first aid includes pain relief by novocaine blockade of the corresponding intercostal nerve.
If the pain syndrome returns, the blockade can be repeated two to three times. Adequate anesthesia helps to increase the excursion of the chest during breathing, straighten the lung on the affected side and expectorate secretions accumulated in the bronchi.
Thus, pain relief for a rib fracture not only improves the patient’s general condition, but is also a worthy prevention of post-traumatic hypostatic pneumonia.
As a rule, uncomplicated fractures of one or two ribs heal well and do not require any special manipulations. The victims are recommended to take a gentle regimen, breathing exercises, and expectorants to prevent hypostatic pneumonia.
Since in case of rib fractures the predominant diaphragmatic breathing, you should avoid increasing intra-abdominal pressure. Fractional nutritious meals are recommended; the diet should not contain foods that cause
A rib fracture is the most common chest injury that occurs as a result of an accident, a strong blow, compression, or a fall. There are single and multiple bone injuries. The main symptoms of a rib fracture: severe pain, worsened by coughing, difficulty breathing, pain in the area of injury, bone crepitus. We will tell you what to do if a rib is fractured in this article.
According to statistics, 16% of fractures occur due to damage to the ribs.
IMPORTANT! With a complex fracture, not only damage to bones is possible, but also to internal organs, which can lead to pleuropulmonary shock and serious life-threatening complications.
Children are quite often susceptible to various fractures, including rib fractures. If a rib is broken in children, it has the following symptoms:
If you notice such behavioral symptoms in a child, he probably has broken ribs. Examine his body carefully and carefully, you may find a hematoma in the bruised area. Provide complete rest to the child and be sure to go to the nearest hospital.
The victim is helped into a comfortable body position and a pressure bandage is applied to the bruised area. If there is no bandage, use a towel or any piece of cloth.
IMPORTANT! In some cases, chest bracing may lead to serious violations breathing, resulting in the formation of sputum stasis and pneumonia.
If a person open fracture, he is immobilized and an ambulance is called.
It is worth paying more attention to the consideration of a fracture of the 6th-7th rib, since most often a person receives a fracture of the first six ribs and this is quite easy to identify. The difference is the fracture of the 7th rib, since the symptoms are expressed as follows: rapid breathing, pulse up to 90 beats per minute, painful sensations on palpation. A hematoma from a bruise may also appear, and upon examination it may show the formation of a crack or fracture. The patient usually complains of general weakness, malaise, and pain on the right or left side.
After providing first aid, you must immediately contact medical institution, get examined and begin treatment for broken ribs.
Watch the video on how to treat a rib fracture and speed up healing.
If you suspect a rib fracture, the victim should contact a medical center to identify the complexity of the disease and provide assistance. To make an accurate diagnosis, specialists take x-rays of the sore spot.
Important! If your ribs are broken, only a doctor can prescribe treatment! Don't self-medicate!
How is a rib fracture treated? A fracture of one or two ribs can be treated at home; multiple injuries are an indication for emergency hospitalization. You should also not ignore the fact if you have broken ribs and you feel severe pain. What to do in this case? Contact a traumatologist; hospitalization may be necessary.
After examination, the traumatologist performs an alcohol-procaine blockade to relieve pain and prescribes the following treatment:
IMPORTANT! Recovery period– at least 4 weeks.
Finding themselves in such a situation, many people do not know what to do and try to completely switch to bed rest. This is not entirely correct. To heal a rib faster, the patient needs to move a lot, walk on fresh air, study therapeutic exercises and stick to a certain diet.
The diet should be dominated by foods rich in protein and calcium: cottage cheese, jelly, aspic, kelp. The menu needs to be diversified fresh fruit, berries: currants, cauliflower, lemons, olives, persimmons. You should also drink vitamin teas from yarrow, lungwort, and nettle.
IMPORTANT! Before using medicinal herbal drinks, read the contraindications.
One of best recipes for the healing of ribs is considered boiled onion. The preparation of the medicine is very simple: boil the onion in a small amount of water and eat 2-3 pieces per day. You can eat it not only during the rehabilitation period, but also during for preventive purposes. Indian yogis have been using this remedy for hundreds of years to strengthen bones.
Therapeutic exercises and breathing exercises– mandatory components for complex treatment rib fracture. Physical education is carried out from the first day of injury, provided that the pain syndrome disappears. Breathing exercises will help avoid congestion in the lungs, and exercise will restore motor function upper section chest.
IMPORTANT! Therapeutic exercise is prohibited in case of persistent pain syndrome, large blood loss or danger of bleeding.
The complex can be supplemented or modified depending on the severity of the disease.
Non-traditional and folk remedies will help the body cope with the disease faster and have a significant impact on recovery. Infusions and decoctions are used internally, as well as externally in the form of compresses. To do this, the fabric is moistened in the prepared broth and placed on the chest, covered with a piece of polyethylene on top to create a greenhouse effect and secured with a rigid bandage.
A product of natural origin in the form of a solid mass with inclusions of animal, mineral and plant origin. Used in Ayurvedic practice and alternative medicine in the treatment of various diseases.
Dilute 0.1–0.2 g mumiyo in 50 ml warm water. Take one hour before meals. The course of treatment is 10 days, then take a break for 5 days and repeat taking the drug.
Dissolve 0.1 g mummy in 10 ml oil. Rub the resulting mixture into the damaged area.
Mix 15 g of copper sulfate, 2 tbsp. l. chopped onions, 50 ml vegetable oil and 20 g of resin (can be from any coniferous tree), heat the mass in a water bath and rub into the damaged area.
Fresh root is ground in a meat grinder and mixed 1:1 with fresh unsalted lard. Apply to the sore spot.
Grind the vegetable (twist through a meat grinder or grate) and apply to the bruise. The mass will help relieve pain temporarily.
It has a strong anti-inflammatory and wound-healing effect. Lubricate the sore spot with oil 2 times a day.
IMPORTANT! Fir oil may cause a burn or bronchial spasm. Before use, consult a doctor and familiarize yourself with contraindications.
IMPORTANT! It is prohibited to use magnetic therapy for hypotension, tumors, blood diseases, and heart attack.
A rib fracture is a serious injury that can lead to dangerous consequences. Therefore, it is necessary to approach treatment with full responsibility and strictly follow the recommendations of the attending physician.
The chest is a kind of protective frame, inside which vital internal organs are located. She is mobile, able to endure heavy loads. Damage occurs from forces that exceed bone density. A rib fracture is one of the most common reasons for visiting a doctor. Single injuries without displacement in most cases heal on their own and are not life-threatening. If the fragments are displaced or it is a comminuted fracture, the risk of damage to the lungs and heart is very high. Timely first aid in this case will help prevent serious complications and save a person’s life.
Knowledge of the anatomy of the chest is necessary to determine the most vulnerable areas, possible complications and methods of treating them.
The chest consists of ribs, of which there are 12 pairs. These are flat, long bones located under a certain curvature. In childhood, their structure is dominated by cartilage tissue, which makes them more mobile and elastic. Therefore, chest injuries in children are rare. With age, cartilage tissue is replaced by bone tissue, which does not have the same elasticity as in childhood.
At the back, the ribs are attached with cartilage and ligaments to the spinal column, and at the front, with the cartilaginous part, to the sternum. There are some structural features, as a result of which the following types of ribs are distinguished:
This structure allows you to maximally strengthen the upper part of the chest, protect the heart, lungs and ensure the movement of the lower part, which is necessary for a full breath.
Between the ribs there are muscles that hold them together. The muscles are called intercostal muscles and are external and internal. Therefore, uncomplicated single fractures heal well. The 4th-7th ribs are most susceptible to injury, since the muscle layer is less pronounced in this place.
The inside of the chest is lined with pleura, it is well supplied with blood and innervated (supplied nerve endings), its outer leaf is located on the surface of the ribs, and the inner layer covers the lungs. Between the sheets there is a small amount of liquid, which prevents friction during breathing. When the pleura is damaged by shrapnel, serious complications arise: hemothorax (collection of blood) and pneumothorax (accumulation of air between the sheets of the pleura). After some time, post-traumatic pleurisy may develop, in which fluid accumulates between the leaves. These conditions are life-threatening and require emergency care And long-term treatment.
There are several mechanisms of rib injury. All of them are associated with the action of great force. But at the same time, pathological fractures are distinguished, which occur due to excessive fragility of bones. A similar condition occurs when a tumor metastasizes and a section of bone tissue is destroyed. For such a fracture, a small force is enough, often a simple deep breath. Such injuries in most cases are associated with a violation of mineral metabolism, endocrine system.
About 80% of all rib fractures are traumatic in nature. The following damage mechanisms are distinguished:
In pathological fractures, there may not be a traumatic factor. It is enough to touch a person with a shoulder, push a little, and a violation of the integrity of the bones is already observed. The reasons may be problems with thyroid gland, insufficient calcium intake, tumor lesions of the ribs, osteoporosis, congenital defect - absence or underdevelopment of the sternum.
Classification of injuries is necessary to assess the severity of the patient and select the optimal treatment method. Depending on the integrity of the skin, open and closed injuries are distinguished. In the first case, the risk of complications infectious nature much higher. As a rule, there is bleeding, subcutaneous emphysema, and there is a risk of lung damage.
Depending on the number of bone fragments and their location, the following types of fractures are distinguished:
Note! There is a so-called fenestrated fracture. The line of damage runs in two places, resulting in the formation of a mobile bone fragment.
Displacement is a prognostically unfavorable sign. Injuries without displacement heal faster, the risk of damage to internal organs is much lower.
Rib fractures can be of the following types:
Symptoms of rib fractures vary significantly among different types of injuries. Single damage without displacement of fragments occurs more easily. Serious complications occur with injuries to the lungs, pleura, and heart. In such cases, first aid must be provided immediately, and the patient is transported to intensive care.
The clinical picture of chest injuries is quite indicative, but to confirm the diagnosis it is necessary to X-ray examination. Some manifestations occur at the time of injury, others - after some time. The following symptoms are typical for a rib fracture:
IN severe cases rib fractures are accompanied by damage to internal organs. Symptoms depend on which organ is injured and how much it affects vital functions.
With multiple fractures, painful shock may occur. Frequent shallow breathing is combined with tachycardia and pale skin. The patient is thrown into cold sweat, loss of consciousness is possible.
In most cases, the person’s condition is serious. Depending on which organ is damaged, clinical picture could be as follows:
Pneumothorax and normal contours lung
It is not the rib fracture itself that is dangerous, but its consequences. They can occur either immediately after injury or during long term. The following types of complications are distinguished:
Many people are interested in the question of what to do if a rib is fractured. An X-ray examination of the chest cavity is mandatory. The doctor may also prescribe an ultrasound of the heart and abdominal organs. For differential diagnosis MRI or CT is indicated. If complications occur, you may need additional methods examinations. Consultation required thoracic surgeon.
In most cases, rib fractures are treated conservatively. Surgery is necessary for open injuries or damage to internal organs.
In the hospital, at the first stage, the condition of vital functions is assessed. If necessary, correction of cardiac activity and respiratory support are performed.
The next point is pain relief. The patient is given a novocaine blockade. The anesthetic is injected into the fracture site using a syringe. Before the procedure, it is necessary to conduct an allergy test for novocaine.
Conservative treatment Non-displaced fractures include the use of medications and physiotherapy. Non-steroidal anti-inflammatory drugs are indicated for pain relief; calcium supplements will allow the fracture to heal faster. In some cases, B vitamins are used to quickly restore the function of the intercostal nerves.
IN in some cases the doctor decides on immobilization with plaster. To date this method is almost never used, since patients find it difficult to tolerate prolonged stay in a cast. Any immobilization for rib fractures is strictly contraindicated, since there is a risk of developing post-traumatic pneumonia, pleurisy and other complications.
If the fractures are comminuted or fenestrated, osteosynthesis is performed. The ribs are aligned and fixed using plates and screws.
Surgical treatment is indicated in following cases:
Remember! The puncture is carried out along the upper edge of the rib. A neurovascular bundle passes near the lower edge.
The duration of recovery depends on the patient’s age, type of fracture, and number of broken ribs. On average, the rehabilitation period can range from a month to six months if complications arise. For rapid fusion fracture, it is recommended to pay attention to nutrition. The diet should contain proteins and foods containing calcium. At home, you need to follow the regime for the first two weeks. The position in bed should be semi-sitting. The question may arise, how to sleep with a broken rib? It is necessary to place several pillows; lying on the damaged side is prohibited. This can lead to re-displacement of the fragments.
Additionally, breathing exercises are used, and walks in the fresh air are useful. It is very useful to inflate balloons during treatment and recovery. Additionally, the doctor may prescribe inhalations with medicines. Physiotherapy is indicated to reduce pain and speed up recovery. Some of them are aimed at liquefying and removing mucus. Exercises aimed at strengthening the chest muscles are shown.
If a rib injury is suspected, an x-ray should be taken. If left untreated, a fracture may cause the bones to not heal properly. chronic pain at the site of injury.
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At the edge of a large, very large meadow, on a long emerald blade of grass lived a tiny Ladybug. Little Ladybug...
Nowadays, it is quite common for people to turn to the stars. With the help of a horoscope a person can learn a lot about...
Business or friendly. If you were pursuing a stranger, it means your level of trust in the female sex...
according to Freud's dream book If you dreamed about how you were fishing, it means that in real life you can hardly switch off...
The New Year's whirlwind will spin us around so quickly and rapidly that it's time to thoroughly think through the New Year's...
The article offers you some of the most delicious recipes for making vinaigrette. Vinaigrette is a delicious salad...
July 4th, 2015 , 08:33 pm Lately our Nastena has been completely giving up sweets (and thank God), but...
Fragrant, very tasty chocolate cake, it’s impossible to stop eating! The Negro’s Kiss cake is very easy to prepare,...
Dream interpretation is an ancient art that allows you to at least assess the psychological status...
As soon as the first mirrors were born, people immediately endowed them with all sorts of mystical abilities....
The head of a small business can easily manage the budget independently. CHECKED! If you manage...
The creation of new projects involves a preliminary economic justification for their feasibility, subsequent...