Closed and open rib fracture
A fractured rib is a serious injury to the chest wall. Like any external effect on a living organism, it can be very dangerous for human health in the event of an untimely diagnosis and subsequent treatment. it is necessary to understand exactly what causes of fractures occur, what symptoms accompany them, and what exactly needs to be paid attention to when providing first aid.
The prerequisites for this type of damage should be considered first. Not the least role here is played by the age of the injured person, on which a certain level of elasticity of the chest depends. Most often, fractures occur in the elderly. Their bones become more fragile with age and even a small fall on hard tiles or slippery asphalt in winter can cause injury.
The risk of injury in a person 35 - 40 years old is also not uncommon, but during this period they happen a little less often and require more solid reasons for themselves. In young children, even with multiple rib fractures, things are more positive. A high degree of elasticity, even with strong compression of the chest, allows it to maintain its integrity.
If we consider the common causes of such a serious type of injury, then among them we can distinguish such as injuries at home, injuries at work, road traffic accidents, osteoporosis, as well as tumor and various infectious diseases.
Closed rib fracture
Closed fractures are of two types. Uncomplicated fractures and complex fractures of the ribs. If in the first case everything is quite clear, then in the second - an incredibly sad picture appears. Broken sections of the ribs penetrate into the internal organs of a person and damage them, or multiple fractures of the ribs lead to a dangerous deformation of the chest.
With an uncomplicated fracture, the pain of the injured person usually manifests itself sharply when coughing, inhaling and exhaling, as well as with the slightest movement. If the fracture is complex, breathing will be shallow and rapid, the patient will feel very severe pain, in some cases it may come to shock.
If a closed simple fracture is found in a person, a specific anesthetic is first administered. Then it is necessary to give the patient a half-sitting position, to tie the arm bent at the elbow to the body in order to create pressure on the broken rib. In case of a complex fracture, seat the injured person half-sitting and, tilting towards the injury, apply a good supporting bandage, fixing the arm near the body, so as to immobilize the ribs. In both cases, call an ambulance immediately.
Open rib fracture
Open rib fractures are extremely rare. Most often they are caused by a gunshot wound or a severe blow to the chest. In the event of such dangerous fractures, the bleeding of the wound increases. In this case, the blood comes out with foam. You may also hear sounds similar to squelching or champing.
First aid in this case will consist in the initial introduction of an accurate dose of promedol for quick pain relief, then after closing the wound with the palm of your hand, it is necessary to seat the injured person and tilt him towards the injury. Next, apply a special material for dressing, cover it with polyethylene or any other material that does not allow air to pass through, and only then carefully bandage it.
The hand on the side where the injury is located must be immobilized by fixing it with a kerchief and tied to the body, so that the ribs are immobilized.
With this type of injury, there is a rather sharp pain in the chest, which is greatly aggravated by breathing, talking and coughing. Because of what breathing is quickened and shallow. On the side where the lesion is found, the chest, as a rule, lags far behind in the act of breathing, and in the place of the fracture, in rare cases, edema can be found.
It is also possible to note in an injured person a certain symptom of "interrupted inhalation" - when pain prevents an attempt to take a deep breath to end - and Pyr's symptom (pain that occurs when bending to the uninjured side). Another important factor is the symptom of axial loads, when, when the chest is squeezed in the sagittal (front to back) and frontal (parallel to the plane of support) planes, pain occurs not in the place of compression, but in the area of the bone defect.
Anterior and lateral fractures are very difficult to tolerate. Often they are accompanied by serious disorders of pulmonary ventilation, as well as a violation of gas exchange in the human body. A fracture of the ribs from behind is much easier to carry, in such cases, there is no impairment of pulmonary ventilation, most often.
In the event of damage to the lung, additional symptoms may occur such as hemoptysis, subcutaneous emphysema (when air accumulates in the subcutaneous retina of the chest and further moves to other parts of the body), pneumothorax (when air or gases accumulate in the pleural cavity), hemothorax (also accumulation in the pleural cavity, but not air, but blood).
With a fracture of several ribs, the patient's affairs are much worse: the pulse quickens, the skin turns pale (it often acquires a bluish tint). In order not to inflict sharp pain on himself, the injured person tries to sit still, afraid of the slightest changes in body position. A rib fracture can only be diagnosed in a clinical setting. With the help of X-ray examination, as well as taking anamnesis and performing additional blood and urine tests.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".
