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Rib Fracture

(Broken Rib; Fracture, Rib)
  • Definition

    A rib fracture is a break in a rib bone. Bruised muscles and damaged 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
    Copyright © Nucleus Medical Media, Inc.
  • Causes

    Rib fractures are caused by:
    • A direct blow to the rib
    • Crushing of the chest, such as in contact sports, a car accident, or having CPR
    • 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
    • Shortness of breath
    • 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, without physical activity until the pain has gone away.
    Your doctor may suggest wearing a chest binder around your ribs to protect them. The binder may 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.
    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 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 seat belts with shoulder strap.
    • 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:

    Ortho Info—American Academy of Orthopaedic Surgeons

    Trauma—Care of the Injured


    Canadian Orthopaedic Association

    Canadian Orthopaedic Foundation


    Boden BP, Osbahr DC, Jiminez C. Low-risk stress fractures. Am J Sports Med. 2001;29(1):100-111.

    Broken or bruised ribs. NHS Choices website. Available at: Updated April 29, 2015. Accessed August 4, 2015.

    Fractures (broken bones). American Academy of Orthopaedic Surgeons Ortho Info website. Available at: Updated October 2012. Accessed August 4, 2015.

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

    Rib fracture. Merck Manual Professional Version website. Available at: Updated August 2014. Accessed August 4, 2015.

    Rib fracture—emergency management. EBSCO DynaMed website. Available at: Accessed August 4, 2015.

    1/4/2011 DynaMed's Systematic Literature Surveillance Barrett-Connor E, Nielson CM, Orwoll E, et al. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study. BMJ. 2010;340:c1069.

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