Rib Fracture

(Broken Rib; Fracture, Rib)
  • Definition

    A rib fracture is a break in a rib bone. Bruised muscles and ligaments often happen with a rib fracture. With a rib fracture, the lungs and other organs can be injured. More than one rib fracture after a trauma can indicate serious internal injury.
    Multiple Rib Fractures with Damage to Lung
    broken ribs resized
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  • Causes

    Rib fractures are caused by:
    • A direct blow to the rib
    • Crushing of the chest, such as in contact sports or a car accident
    • Severe coughing incidents that can occur with lung problems or at high altitude
    • Rib fractures in young children are often a sign of abuse
  • Risk Factors

    Rib fractures are common in people 65 years and older. Other factors that may increase your chance of a rib fracture include:
    • Difficulty doing activities of daily living—generally with eldery people
    • Playing contact sports
    • Weak bones
    • Chronic cough
    • Extreme repetitive upper body activity, such as in:
      • Throwing
      • Basketball
      • Golf
      • Rowing
      • Weight lifting
    • Occupations involving a lot of overhead lifting
    • History of rib or chest fracture
  • Symptoms

    Rib fracture may cause:
    • Pain in the ribs or upper chest area
    • Pain when breathing or coughing
    • Swelling and bruising in the fracture area
    • Severe local tenderness in the fracture area
    • Internal bleeding
  • Diagnosis

    The doctor will ask about your symptoms and how the injury occurred. Your chest, lungs, and back will be examined.
    Imaging tests can evaluate your chest and surrounding structures. These may include:
  • Treatment

    Treatment may include:
    Rest
    Rest, without physical activity until the pain has gone away.
    Protection
    Your doctor may suggest wearing a chest binder around your ribs to protect them. The binder will also help you breathe properly. It is important to take deep breaths so that the lungs remain clear. Pneumonia can develop after rib fractures if you are not breathing deeply enough. If you play contact sports, you may need to wear a rib cage protector for 6-8 weeks when you return to playing.
    Medication
    Your doctor may recommend that you take over-the-counter medication to help reduce inflammation and pain, such as ibuprofen.
    Physical Therapy
    As your ribs heal, a physical therapist can teach you breathing exercises. The therapist can also help you maintain range of motion in arm and shoulder joints.
    Intercostal Nerve Blocks
    Special injections with local anesthetic can temporarily relieve pain.
    Epidural Anesthesia
    Sometimes, a temporary epidural catheter is used to place anesthetic near the spinal cord and nerves. This can help severe cases where the injury requires hospitalization.
    Hospitalization
    Hospitalization is usually only needed if there are complications such as damage to organs in the chest.
  • Prevention

    Sometimes rib fractures cannot be prevented. To help reduce your chance of a rib fracture:
    • Wear protective equipment, such as rib pads, when playing contact sports.
    • Avoid over-training.
    • Learn the proper technique for exercise and sporting activities.
    • Maintain strong bones by:
  • RESOURCES

    Ortho Info—American Academy of Orthopaedic Surgeons http://www.orthoinfo.org

    Trauma http://www.trauma.org

    CANADIAN RESOURCES

    Canadian Orthopaedic Association http://www.coa-aco.org

    Canadian Orthopaedic Foundation http://www.canorth.org

    References

    Boden BP, Osbahr DC, et al. Low-risk stress fractures. Am J Sports Med. 2001;29:100-111.

    Fractures (broken bones). American Academy of Orthopaedic Surgeons Ortho Info website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed August 26, 2013.

    Gregoretti C, et al. Regional anesthesia in trauma patients. Anesthesiol Clin. 2007;25(1):99-116.

    O'Kane J. Delayed complication of a rib fracture. Phys Sportsmed. 1998;26:69.

    1/4/2011 DynaMed's Systematic Literature Surveillance http://www.ebscohost.com/dynamed: Barrett-Connor E, Nielson CM, Orwoll E, Bauer DC, Cauley JA; Osteoporotic Fractures in Men Study Group. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study. BMJ. 2010;340:c1069.

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