Offset rib fracture
The root cause of rib fractures is a directional impact, a fall from a height, or tightness of the chest. In many cases, rib fractures occur in the lateral part of the sternum. This is due to the fact that the ribs on the sides of the human body have the greatest bend. If a fracture of one rib occurs, then the displacement of the fragments is rarely observed. But a multiple fracture is often characterized by a dangerous displacement of fragments, the sharp ends of which can injure the lungs, intercostal vessels and pleura.
Content:
- Symptoms of a displaced rib fracture
- Dangerous consequences of displaced rib fractures
- Diagnosis and treatment of displaced rib fractures
Symptoms of a displaced rib fracture
The main symptom of such an injury is a rather sharp pain in the chest. It becomes stronger when moving, talking, breathing, coughing, and weakening when sitting still. At the same time, a person's breathing is shallow, in the affected area of the sternum there is a lag during breathing. During palpation, a broken rib responds with sharp soreness, and sometimes with a crunch of bone fragments.
Lateral and anterior fractures of the ribs with displacement, in which breathing is significantly impaired, are especially difficult. Damaged posterior ribs do not impede pulmonary ventilation as much as the anterior and lateral ones. Numerous fractures of the ribs with displacement significantly worsen the patient's well-being. He has shallow breathing, rapid pulse, pale skin with blue, general weakness. In the area of injury, bruises and noticeable swelling of soft tissues are found. Lung injury causes hemoptysis.
Dangerous consequences of displaced rib fractures
In the shortest possible time after the injury, complications such as hemothorax and pneumothorax are formed. After a few days, a complication of the condition with post-traumatic pneumonia is possible. Such a serious disease affects mainly elderly patients. A sign of a beginning pneumothorax is a change in the patient's well-being for the worse, an increase in shortness of breath. Breath cannot be heard in the area of the fracture.
Symptoms of incipient pneumonia are intoxication, shortness of breath, fever, regression of the patient's general well-being. It must be remembered that elderly patients and seriously ill patients do not always have a fever. There are times when only the general condition worsens. Post-traumatic pneumonia is manifested by a decrease in the level of ventilation of the lungs in the area of the fracture. Breathing is painful, shallow. Self-medication only complicates the condition of the victim.
Diagnosis and treatment of displaced rib fractures
The diagnosis of a "fracture" and the complications that follow it are clarified after a mandatory X-ray examination. If there is a suspicion of hemothorax and pneumothorax, then in addition, pleural puncture, fluoroscopy and ultrasound are performed.
It is believed that for the ribs to heal well, you need to bandage the chest, thereby limiting its mobility. But this is fraught with congestion in the lungs, as a result of which post-traumatic pneumonia develops. In the majority of cases of rib fractures, fixation is not necessary; it is necessary only when there are numerous complicated displaced fractures. And help should be provided only in a hospital. If you do not provide assistance in time, such injuries pose a direct danger to the victim's life. To avoid this, at the slightest suspicion of a fractured ribs, send a person to the hospital.
Fractures without complications of one or two ribs are treated on an outpatient basis. Victims with fractures of more than three ribs are referred to traumatology for hospitalization. When a patient is admitted with an uncomplicated rib fracture, the traumatologist performs local anesthesia at the fracture site, after which he prescribes expectorant drugs, analgesics, physiotherapy procedures, as well as therapeutic breathing exercises to improve lung ventilation.
Elimination of complications
It happens that hemothorax and pneumothorax begin to progress some time after the patient is admitted. In order to accurately identify the presence or absence of these conditions, an additional fluoroscopy is performed. For complicated fractures of the ribs with displacement, in parallel with the types of procedures listed above, additional medical measures are carried out.
A small volume of blood in the pleural cavity is absorbed by itself. If hemothorax is detected, a puncture of the pleural cavity is done (a specialist under local anesthesia with a special needle eliminates the accumulation of blood). Sometimes a series of punctures are required when hemothorax develops again.
With pneumothorax, it is sometimes enough to perform a puncture once to remove air. To do this, anesthetize the incision area and insert a drainage tube. Air comes out through it, and the lungs expand. After this procedure, a control fluoroscopy is performed and the drainage is pulled out.
Rehabilitation after displaced rib fracture
Special therapeutic exercises are especially important for the resumption of natural ventilation after such injuries. On average, displaced rib fractures are treated within one month. The duration of fusion with multiple and complicated fractures depends on the severity of the complications and the general health of the victim.
Author of the article: Kaplan Alexander Sergeevich | Orthopedist
Education: diploma in the specialty "General Medicine" received in 2009 at the Medical Academy. I. M. Sechenov. In 2012 completed postgraduate studies in Traumatology and Orthopedics at the City Clinical Hospital named after Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.
