Break in a rib bone
Medical condition
A rib fracture is a break in a rib bone.[ 1] This typically results in chest pain that is worse with inspiration.[ 1] Bruising may occur at the site of the break.[ 3] When several ribs are broken in several places a flail chest results.[ 4] Potential complications include a pneumothorax , pulmonary contusion , and pneumonia .[ 2] [ 1]
Rib fractures usually occur from a direct blow to the chest such as during a motor vehicle collision or from a crush injury .[ 2] [ 1] Coughing or metastatic cancer may also result in a broken rib.[ 1] The middle ribs are most commonly fractured.[ 5] [ 1] Fractures of the first or second ribs are more likely to be associated with complications.[ 6] Diagnosis can be made based on symptoms and supported by medical imaging .[ 3]
Pain control is an important part of treatment.[ 7] This may include the use of paracetamol (acetaminophen), NSAIDs , or opioids .[ 2] A nerve block may be another option.[ 1] While fractured ribs can be wrapped, this may increase complications.[ 1] In those with a flail chest, surgery may improve outcomes.[ 8] [ 9] They are a common injury following trauma.[ 10]
^ a b c d e f g h i j Mosby's Medical Dictionary (E-Book) . Elsevier Health Sciences. 2013. p. 1567. ISBN 978-0323112581 . Archived from the original on 2017-10-13.
^ a b c d e f g May, L; Hillermann, C; Patil, S (January 2016). "Rib fracture management" . BJA Education . 16 (1): 26–32. doi :10.1093/bjaceaccp/mkv011 .
^ a b c d Adams, James G. (2012). Emergency Medicine E-Book: Clinical Essentials (Expert Consult – Online) . Elsevier Health Sciences. p. 682. ISBN 978-1455733941 . Archived from the original on 2017-10-13.
^ Wanek, Sandra; Mayberry, John C (2004). "Blunt thoracic trauma: flail chest, pulmonary contusion, and blast injury". Critical Care Clinics . 20 (1): 71–81. doi :10.1016/S0749-0704(03)00098-8 . PMID 14979330 .
^ Nanni, Christina (2012). PET-CT: Rare Findings and Diseases . Springer. p. 257. ISBN 978-3-642-24698-2 .
^ Murphy CE, 4th; Raja, AS; Baumann, BM; Medak, AJ; Langdorf, MI; Nishijima, DK; Hendey, GW; Mower, WR; Rodriguez, RM (27 May 2017). "Rib Fracture Diagnosis in the Panscan Era" (PDF) . Annals of Emergency Medicine . 70 (6): 904–909. doi :10.1016/j.annemergmed.2017.04.011 . PMID 28559032 . S2CID 23442272 . {{cite journal }}
: CS1 maint: numeric names: authors list (link )
^ Brown, SD; Walters, MR (2012). "Patients with rib fractures: use of incentive spirometry volumes to guide care". Journal of Trauma Nursing . 19 (2): 89–91, quiz 92–03. doi :10.1097/JTN.0b013e31825629ee . PMID 22673074 . S2CID 45547470 .
^ Schuurmans, J; Goslings, JC; Schepers, T (April 2017). "Operative management versus non-operative management of rib fractures in flail chest injuries: a systematic review" . European Journal of Trauma and Emergency Surgery . 43 (2): 163–68. doi :10.1007/s00068-016-0721-2 . PMC 5378742 . PMID 27572897 .
^ Coughlin, TA; Ng, JW; Rollins, KE; Forward, DP; Ollivere, BJ (August 2016). "Management of rib fractures in traumatic flail chest: a meta-analysis of randomised controlled trials". The Bone & Joint Journal . 98-B (8): 1119–25. doi :10.1302/0301-620X.98B8.37282 . PMID 27482027 .
^ Senekjian, L; Nirula, R (January 2017). "Rib Fracture Fixation: Indications and Outcomes". Critical Care Clinics . 33 (1): 153–65. doi :10.1016/j.ccc.2016.08.009 . PMID 27894495 .