Rib Fracture - Signs And Symptoms, First Aid For Rib Fracture. Classification And Treatment

2024 Author: Josephine Shorter | [email protected]. Last modified: 2023-12-16 21:43

Broken ribs

Signs, symptoms, classification and treatment of rib fracture

What is a fractured rib?

Broken ribs are the most common chest injury. Of the total number of fractures, about 16% are rib fractures. In people of a rather advanced age or with certain chronic diseases, rib injuries are much more common, since the elasticity of important bone structures of the chest decreases with age.

Uncomplicated fractures are usually fractures of one or two ribs. They do not pose a danger to human health and life and usually grow together quite well. The greatest danger associated with this injury is serious damage to internal organs and significant respiratory failure. Fractures without complications occur in about 40% of chest injuries. In the remaining 60%, internal organs are noticeably affected - the lungs, pleura, and organs of the cardiovascular system are damaged.

Multiple rib fractures are incredibly serious injuries that pose a great threat, as in this case, the likelihood of serious complications associated with life-threatening increases dramatically.

Signs and symptoms of rib fracture

When the ribs are broken, many victims complain of quite noticeable pain at the site of injury, they also have difficulty breathing, they cannot breathe freely. Even the slightest cough causes a sharp pain. The victims move very carefully, fearing to feel an increase in pain, slowly undress and dress. Also, due to the fear of experiencing severe pain, the victims' breathing becomes shallow. If a lung is injured due to a broken rib, coughing up blood appears.

After the injury has occurred, the victims almost immediately point to the classic signs of trauma: a sharp pain appears in the chest, which, when talking, coughing, breathing and moving, noticeably increases and, accordingly, decreases when the patient lies or is in a sitting position. In this case, breathing is rather shallow, and the entire human chest on the side of the fracture lags far behind during breathing.

Signs of fractured ribs on the side and in front are especially difficult for the victims, and breathing is impaired. If there is a posterior rib fracture, the signs of this damage are less pronounced, and significant disturbances in pulmonary ventilation, as a rule, do not occur.

If the patient has injured several ribs, his condition becomes much worse. Breathing becomes very shallow, the skin becomes pale, acquiring a bluish tint, while the pulse increases significantly. The patient tries not to move, preferring to sit still. The main signs of rib fracture are severe bruising, noticeable swelling of soft tissues. When listening, it is not always possible to detect breathing.

One of the dangerous complications of rib fracture that can develop is a dangerous post-traumatic pneumonia. Usually this complication makes itself felt a few days after the injury. The development of this complication directly depends on the state of health and age, as a rule, elderly and senile patients are susceptible to it.

If the victim's condition worsens, severe symptoms of intoxication are observed, the body temperature rises greatly, and breathing becomes heavy and difficult. In this case, we can talk about the development of dangerous pneumonia. However, do not forget that in weakened elderly patients, post-traumatic pneumonia does not always proceed with a noticeable increase in temperature, sometimes only a general deterioration and weakness are observed.

Post-traumatic pneumonia often occurs due to a significant decrease in the level of ventilation in the lungs on the side where there is damage to the ribs. The victim usually experiences severe pain during the fracture, so he tries to take shallow shallow breaths. There are times when a rather painful swelling forms in a certain area of the fracture

If the victim tries to take a deep breath, there is always severe pain, and therefore the attempt fails. This particular symptom is called "interrupted inspiration". This symptom is not observed when there is a chest contusion.

Another significant sign of rib fracture is the so-called axial load symptom. They are trying to determine it by alternately squeezing the entire chest. Since the chest is a bony ring, compression of some of its sections increases the load on other sections. When the injury occurs, the victim feels pain at the site of the fracture, and not in the place where the compression occurred.

With correct palpation, a sharp local pain is always detected. A specific deformity in the form of a step at that point of maximum pain also indicates a fractured rib. Then, to exclude possible complications, it is possible to perform palpation not only of the chest, but also of the entire abdominal cavity, determine the heart rate and blood pressure. A good assistant in diagnosing a fracture is X-ray.

True, there are reasons due to which it is not always possible to determine a rib fracture. Therefore, a specific clinical picture usually plays a dominant role in establishing a diagnosis. If all signs point to chest injuries, X-rays may not be taken in some cases. To reduce the risk of complications, urinalysis and complete blood counts are done to get a more complete picture of the damage.

First aid for fractured ribs

You should not engage in any self-medication for fractured ribs, but first aid is necessary:

• Give the person a pain reliever (such as ibuprofen);
• Make the necessary fixing bandage from a towel and bandage;
• The affected area should be kept cold (ice is best applied)

After that, come to the doctor's appointment as soon as possible. If the victim is being taken to the hospital, it is necessary to carry out transportation in the supine position or in a half-sitting position.

Rib fracture classification

Effects on human ribs are subdivided into indirect and direct. With an indirect impact, the chest is compressed, so the ribs break on both sides of the compression site. As a rule, several ribs break at once. In the case of direct impact, the fragments of the rib can damage various internal organs, the lung, when the ribs bend inward.

There are bilateral fractures, as a result of which the chest loses the necessary stability, as well as a dangerous violation of lung ventilation. So-called fenestrated fractures also occur, i.e. fractures in two places on one side. Rib fractures are most common in people over 40. This is due to the changes in bone tissue that occur in the human body due to age. Rib fractures are extremely rare in childhood because the baby's ribcage is very elastic.

There is also the following division of rib fractures: rib fracture, bone fracture (called subperiosteal fracture) and complete rib fracture. The latter most often occurs at the site of the bending of the ribs. All of these cases have the same fracture symptoms.

Rib fracture treatment

If there is a fracture of one or two ribs, treatment can be carried out at home or in a clinic under the supervision of a specialist, the patient must be put in a plaster cast. If there are complications or multiple rib fractures occur, the patient must be treated in a hospital.

As modern medicines, 10 ml of a 1-2% solution of procaine is used, which is injected into the fracture site. Further, without removing the needle, quickly add 1 ml of 70% alcohol. In the case of the correct administration of drugs, the pain syndrome practically disappears, and the patient is able to breathe deeply, and the cough does not cause such severe pain.

Also, when treating fractures of the rib, an expectorant mixture is prescribed, and ordinary mustard plasters must be placed on the chest. It is necessary to perform breathing exercises with caution, and UHF (ultra-high-frequency therapy) procedures are prescribed from the third day after injury. Further, at the site of the fracture, electrophoresis of procaine and obligatory calcium chloride is used as a treatment, and then special therapeutic exercises are prescribed.

In especially difficult cases, it is necessary to carry out surgical treatment of the fracture. For the release of accumulated blood, on the recommendation of the attending physician, if necessary, a puncture is performed. As a rule, for recovery in uncomplicated cases, the patient needs about four weeks, while strict bed rest and complete rest are required. With multiple fractures, the duration of treatment depends on the general condition of the patient himself.

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".