How to identify a fracture of the ribs with a bias - the technique of the traumatologist

The root cause of rib fractures is a directional blow, a fall from a height, or chest tightness. In many cases, rib fracture occurs in the lateral part of the sternum. This is due to the fact that the sides of the body of a human rib have the greatest bend. If there is a fracture of one rib, then the displacement of the fragments is rarely observed. But the numerous fracture is often characterized by a dangerous displacement of fragments, the sharp ends of which can injure the lungs, intercostal vessels and pleura.

Symptoms of rib fracture with displacement

The main symptom of such an injury is a rather sharp pain in the chest. It becomes stronger when moving, talking, breathing, coughing, and weakens when sitting in peace. At the same time, the breathing of a person is shallow, in the affected area of ​​the sternum there is a lag during breathing. During palpation, a broken rib responds with a sharp pain, and sometimes with a crunch of bone fragments.

Side and front fractures of the ribs with displacement, at which breathing is significantly impaired, are especially hard tolerated. Damaged posterior ribs do not interfere with pulmonary ventilation as much as the front and side ones. Numerous rib fractures with displacement significantly worsen the patient's well-being. He has shallow breathing, rapid pulse, blanching of the skin with blue, general weakness. Bruises and noticeable swelling of soft tissues are found in the injury zone. Injury to the lungs causes hemoptysis.

Dangerous effects of rib fractures with displacement

In the shortest possible time after injury, complications such as hemothorax and pneumothorax are formed. A few days later, a possible complication of post-traumatic pneumonia. Such a serious disease mainly affects elderly patients. A sign of the beginning of pneumothorax is a change in the patient's state of health for the worse, an increase in shortness of breath. Breathing in the area of ​​the fracture is not heard.

The symptoms of incipient pneumonia are intoxication, difficulty breathing, increased body temperature, and regression of the general well-being of the patient. It must be remembered that elderly patients and severe patients do not always have a fever. There are cases 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. The breath is painful, superficial. Self-medication only complicates the condition of the victim.

Diagnosis and treatment of displaced rib fractures

The diagnosis of a “fracture” and the complications following it are clarified after a mandatory X-ray examination. If hemothorax and pneumothorax are suspected, then pleural puncture, fluoroscopy and ultrasound are also performed.

It is believed that the ribs are well fused, you need to bandage the chest, thereby limiting its mobility. But it is fraught with stagnation 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 fractures with displacement. And care should be provided only in the hospital. If you do not help in time, such injuries are a direct danger to the life of the victim. To avoid this, one should send a person to a hospital at the slightest suspicion of a broken rib.

Fractures without complications of one or two ribs are treated on an outpatient basis. Victims with fractures of more than three ribs are sent to a traumatology for hospitalization. On admission of a patient with an uncomplicated rib fracture, a traumatologist makes local anesthesia of the fracture site, after which he prescribes expectorant drugs, analgesics, physiotherapy, and therapeutic breathing exercises to improve the ventilation of the lungs.

Elimination of complications

It happens that hemothorax and pneumothorax begin to progress after some time after admission of the patient. In order to accurately identify the presence or absence of these conditions, perform additional fluoroscopy. In case of complicated fractures of the ribs with displacement in parallel with the types of procedures listed above, additional medical measures are carried out.

A small amount of blood in the pleural cavity resolves itself. With the identified hemothorax, a puncture of the pleural cavity is done (a specialist under local anesthesia with a special needle eliminates the accumulation of blood). Sometimes it is required to make a series of punctures with the re-development of hemothorax.

When pneumothorax is sometimes enough to perform a puncture once to remove air. For this, the incision area is anesthetized and a drainage tube is inserted. Through it air comes out, and lungs are straightened. After this procedure, control fluoroscopy is performed and drainage is pulled out.

Rehabilitation after rib fracture with displacement

Special therapeutic exercises are especially important for the restoration of natural ventilation after such injuries. On average, the treatment of fractures of the ribs with an offset is carried out within one month. The duration of adhesion in case of multiple and complicated fractures depends on the severity of the complications and on the general health of the victim.

Education: Diploma in "General Medicine" received in 2009 at the Medical Academy. I.M. Sechenov. In 2012, completed a postgraduate course in the specialty "Traumatology and Orthopedics" in the City Clinical Hospital. Botkin at the Department of Traumatology, Orthopedics and Disaster Surgery.

Causes and types of offsets

Factors affecting complications may be objective and subjective. Sometimes the displacement occurs due to a large mechanical force at the time of injury. In addition to primary displacements, secondary ones arise, under the influence of muscle contractions after a fracture.

Wrong actions on first aid, transportation of the patient can become more dangerous than the main factor of influence.

Typical errors leading to complications after a fracture:

  • active movements after injury,
  • excessive pressure dressing on the rib cage,
  • careless probing in the area of ​​damage,
  • attempts to return fragments to their original position.

Before the arrival of the medical assistance brigade, it is strictly forbidden to carry out independent manipulations in the area of ​​damage, in order not to start the process of life-threatening complications.

Examination of the injury area by a qualified doctor, data from a computer tomography, X-ray images allow you to make a reliable diagnosis and prescribe a course of therapy.

A number of features help to identify the problem in advance:

  • coughing up blood (hemoptysis),
  • retraction of the side, change in the shape of the chest,
  • bone crevice,
  • visible bulging of bones,
  • very severe pain.

In the presence of symptoms of complications and general deterioration of the victim, urgent hospitalization is required.

Consequences and complications

The displacement of fragments of ribs with sharp edges is the cause of damage to other organs, soft tissues, nerves and blood vessels.

The most frequent complications are:

  • Subcutaneous emphysema - the accumulation of air in the subcutaneous tissue. The affected area is inflated like a ball,
  • pneumothorax - the accumulation of air in the pleura, which blocks the work of the lungs,
  • hemothorax - filling the pleural membranes with blood clots. Hematoma squeezes the lung, interferes with breathing, provokes inflammation,
  • pneumonia - restriction of ventilation of the lungs due to the difficulties of the respiratory process leads to inflammation,
  • damage to the membranes of organs, muscle breaks - severe forms of pathologies require surgical intervention.

The restoration of the natural position of the ribs after the shear of fragments is carried out surgically using special clamps.

Fractures with displacement are almost always accompanied by complications of varying severity.

In a medical institution, long-term treatment is aimed at stabilizing the condition of the victim, anesthetization and normalization of vital signs.

Rib fracture

1. Try to move lessThe first complications of a rib fracture that can occur immediately after an injury are internal bleeding, damage to the lungs, heart, liver and spleen, and sometimes even to the stomach. That is why we need an immediate diagnosis carried out by specialists.

Then the chest is wrapped in a tight bandage from a bandage or improvised means (clothing, a wide piece of cloth, etc.).

Radiography - the most common and accurate diagnostic method.

Hematoma at the fracture site is relevant for a traumatic fracture resulting from direct mechanical action.

The air that accumulates in the pleural cavity comes out through the tube, the lung straightens. Pleural drainage is usually maintained for several days until the air ceases to flow through the drainage tube. Then do a control fluoroscopy and remove the drainage.

Injury mechanism

In the area of ​​fractures there is swelling of soft tissues, bruises. On palpation is determined spilled sharp pain, bone crepitus. If a rib fracture is accompanied by subcutaneous emphysema, palpation of the subcutaneous tissue reveals air crepitus, which, unlike bone cremation, resembles a soft creaking.

Oh, I also have a broken rib

Symptoms of rib fracture

2 Apply a circular bandage on the chest.

Reasons for immediate hospitalization are a strong lowering of blood pressure, increased heart rate, and traumatic shock. All this testifies that the body is in a state of severe stress, and its systems may fail.

As soon as the doctors arrive at the scene, they usually give the patient an analgesic (1 ml of 2% promedol). After that, he is taken to the medical center to accurately understand the degree of danger of injury and prescribe the appropriate treatment. If the fracture is not very serious, you can undergo a rehabilitation course at home.

With a direct injury, that is, a bone hit,

In general, you should not engage in any self-treatment, you should not apply ointments, herbs, compresses, all this can only worsen the situation. If a person is in serious condition, he has an open fracture, shortness of breath, weakness, then an ambulance should be called. You can help him to take a half-sitting position, if it will be so easier for him. If you suspect a closed rib fracture, you can take a painkiller, apply ice, apply a tight bandage on the chest and contact the emergency room.

The sound of rubbing bones or crunching during injury is important for fractures with a large number of fragments, or for multiple fractures of one rib without displacement of individual parts of the damaged bone

Terminal fracture - rib damage in two or more locations on one side of the chest

In the course of treatment of post-traumatic pneumonia, along with general therapeutic measures (antibiotics, physiotherapy), it is very important to conduct therapeutic exercises to restore normal ventilation of the lungs.

On the occurrence of pneumothorax shows a deterioration in the general condition of the patient, increasing shortness of breath. Breathing on the affected side is not bugged. Damage to the lung may be accompanied by hemoptysis.

- The most common damage to the chest. Fractures of the ribs make up about 16% of the total number of fractures. In older people, rib fractures are more common, due to the age-related decrease in the elasticity of the bony structures of the chest. Fractures of the ribs are accompanied by chest pain and limit the mobility of the chest, for this reason, breathing becomes more superficial, which can cause impaired pulmonary ventilation. Multiple rib fractures can be accompanied by damage to the chest organs and represent a danger to the patient's life. The diagnosis of rib fracture is set on the basis of X-ray data, and, if necessary, an ultrasound of the pleural cavity and its puncture are performed.

I put an elastic bandage and I go

3 With single simple fractures of the ribs heading to the emergency room.

Rib fracture treatment

The patient can not only suffer from blood loss, but also its accumulations in the chest cavity (hemothorax). At the same time, the patient has shortness of breath, pale skin, weak pulse. Another problem is pneumothorax (air accumulates in the chest cavity), which occurs due to damage to the lung tissue. Valvular pneumothorax is especially dangerous, as it develops, air with breaths enters the pleural cavity, and when exhaling it does not come out of it due to the closure of the valve of damaged tissues. It threatens to compress the lung, pleuropulmonary shock and death.

As a rule, the patient is prescribed an alcohol-procaine blockade. 10 ml of 2% procaine is injected into the damaged area, and then, without pulling the needles, the doctor refills 1 ml of 70% alcohol. It helps to stop the pain and ease breathing.

With a strong squeezing of the chest.

The main treatment methods for uncomplicated rib fractures are anesthesia and immobilization.

In case of multiple and complicated fractures, there may be the following signs:

Bilateral fracture - damage to the ribs on the right and left side. Often complicated by impaired ventilation

Fixation of rib fractures is required very rarely and is performed, as a rule, with massive chest injuries, accompanied by multiple unstable rib fractures.

Pneumothorax and hemothorax are complications that tend to develop soon after an injury. A few days after the fracture, another dangerous complication can develop - post-traumatic pneumonia. Patients of advanced and old age are more prone to the development of this complication, in which pneumonia is particularly difficult.

4 In case of multiple rib fractures with damage to the chest organs, call the doctors to your place.

Anatomy of the chest and ribs

It is quite difficult to say exactly which of these reasons is more common. In children and young people, injury is caused by fights and falls from a height. In adults, various occupational injuries are not excluded.

In the hospital, the patient spend alcoholprokainovuyu blockade.

Subcutaneous emphysema - if the lung is damaged, air can gradually get under the skin.

Etiology of the disease

By the number of fractures:

The average duration of treatment for uncomplicated fractures of the ribs is about 1 month. The duration of treatment of multiple and complicated rib fractures is determined by the severity of the complications and the general condition of the patient.

The development of pneumonia is evidenced by a deterioration in the patient’s general condition, symptoms of intoxication, difficulty in breathing and an increase in temperature. It should be borne in mind that in weakened elderly patients and patients with severe concomitant injury, post-traumatic pneumonia is not always accompanied by fever. In some cases, there is only a deterioration of the general condition.
  • - The most common damage to the chest.Fractures of the ribs make up about 16% of the total number of fractures. In older people, rib fractures are more common, due to the age-related decrease in the elasticity of the bony structures of the chest.
  • Rib fracture treatment
5 You need to know exactly what to do if you broke a rib, because initiative in this situation can be disastrous.
  • Vadim Sokolov
  • And if the bones do not grow together a month after the incident or more, then a special treatment for a rib fracture is prescribed, which consists in a superficial surgical intervention. For example, a tire made of plastic in shape is applied to a patient on a damaged section. In order to apply it, a plastic plate is heated in hot water, which is superimposed on the chest and follows the contour of the body. After that, the tire is fixed with sutures using a surgical needle. Such a construction is usually kept for 3 weeks, after which it is removed.
  • There are two mechanisms of rib fracture - direct and indirect.
  • Procaine and 1 ml of 70% ethyl alcohol are injected into the projection of the fracture.
  • Hemoptysis - when coughing, blood is released from the respiratory tract. This symptom indicates lung tissue damage.
Multiple fractures - multiple rib fracture
  • Among all injuries of the chest, a rib fracture is most common. The frequency of this injury is 10-15% among all fractures. An important aspect is that such a fracture can damage internal organs. Sometimes it can lead to death, so this question is much more important than it might seem.
The occurrence of post-traumatic pneumonia is due to a decrease in the level of ventilation of the lungs on the side of the fracture. Breathing at the fracture of the ribs is painful, so the patient tries to breathe as superficially as possible.
  • Uncomplicated fractures of one or two ribs grow well together and do not in themselves pose a threat to human life and health. The main danger of this injury is associated with respiratory failure, damage to internal organs and the development of related complications. Uncomplicated rib fractures occur in 40% of cases. The remaining 60% are accompanied by damage to the lungs, pleura and organs of the cardiovascular system.
  • Uncomplicated fractures of one (in some cases, two) ribs are treated on an outpatient basis. Fracture of three or more ribs is an indication for emergency hospitalization in the Department of Traumatology.

Full rib fracture

The first occurs when the chest has been damaged in one place by a traumatic factor. Usually, one or several ribs bend and break, and damage to internal organs and blood vessels is possible. The number of damaged bones depends on the strength and area of ​​the impact. Sometimes a final fracture is formed, i.e. separation of part of the rib from the common body of the chest. Such a terminal fracture is also called flotation. The segment that has separated from the chest prevents normal breathing, as a result of which it sinks during inhalation and is released during exhalation. It also threatens the flotation of the heart and impaired blood circulation. Such cases of fractures end in death of the victim in 40% of cases.

Clinical picture

Pneumothorax - air entering the pleural cavity. In the absence of timely treatment, it can turn into an intense pneumothorax, after which cardiac arrest may occur.

  • By the presence of displacement of bone fragments:
  • Fracture of the ribs - a violation of the integrity of the cartilage or bone of the rib or several ribs. If 1 or 2 edges are damaged, then, as a rule, it does not require hospitalization and immobilization. When more ribs are damaged, complications and damage to the chest organs are often observed. In this case, you must be treated in a hospital under the supervision of a physician.
  • The problem is exacerbated by self-treatment. Many believe that for a good fusion of the ribs it is necessary to limit their mobility by bandaging the rib cage. As a result, breathing is limited even more, congestion appears in the lungs, and congestive pneumonia develops.
  • Multiple rib fractures are a serious injury, which is dangerous both because of the possible development of pleuropulmonary shock, and because of the sharply increasing probability of life-threatening complications.
  • With an uncomplicated fracture of the ribs at the time of admission, the traumatologist produces a local anesthesia of the fracture or Vago-sympathetic blockade according to Vishnevsky. Then the patient is prescribed analgesics, expectorant drugs, physiotherapy and medical gymnastics to improve the ventilation of the lungs.

By themselves, fractures of the ribs are not dangerous and heal quickly enough, danger is concomitant damage to internal organs. With rib fractures, bone fragments can damage nerve endings, blood vessels, pleura, and lung tissue. In severe cases, the injury is accompanied by damage to the heart, liver. Most often fractures occur where the edges are bent the most - along the lateral surface of the chest. If one edge is broken, fragment displacement usually does not occur. With multiple rib fractures, debris can cause injury to tissues and organs located nearby and cause complications.

  • Key features:
  • But if there was a fenestrated fracture, and the dropped out part of the rib is not fixed at all, the doctors perform osteosynthesis with the help of a special apparatus. This helps to secure the damaged part of the bone and accelerate bone tissue splicing.

Complications

  • An indirect damage mechanism is a fracture of the ribs under heavy pressure. As a rule, the sternum is pressed in front or behind, as a result of which the ribs crack and break in the places of the greatest bend, that is, on the sides. This injury is also called the “crushed chest”; it can occur when the body is clamped between the steering wheel and the seat during car accidents or, for example, between a wall and a car body.
  • When signs of respiratory failure are oxygen inhalation.
  • Hemothorax - blood entering the pleural cavity. As in the case of pneumothorax, there is a compression of the lung, the patient has difficulty breathing, shortness of breath. As the condition progresses, the following complication develops.
  • Fractured ribs with offset.
  • The thorax is represented by 12 thoracic vertebrae, with which 12 pairs of ribs are connected with the help of the joints. The front is the sternum, adjacent to it are the cartilaginous parts of the ribs.

Stages of healing of a rib fracture

  • In fact, in the fracture of the ribs in the absolute majority of cases, fixation is not required. The exception is some complicated and multiple fractures of the ribs, the help for which should be provided only in a hospital.
  • The chest is the upper part of the human body. The bone structure that protects the heart and lungs is called the rib cage. The chest is formed by 12 pairs of ribs. Between the ribs are intercostal muscles, blood vessels and nerves. Behind all the ribs are connected to the spine. In its front, ten pairs of upper ribs end in cartilage.
  • Sometimes pneumothorax and hemothorax do not develop at the time of admission, but somewhat later. If you suspect the development of these complications during treatment, an additional fluoroscopy is performed.

Diagnosis of the disease

  • To alleviate the condition of the victim, give him 1-2 tablets of dipyrone or baralgin, a towel or a sheet of loose wrap his chest and secure the fabric with pins. Then spend the victim in a medical facility, where, after an x-ray examination, the doctor will clarify the diagnosis and prescribe treatment.
  • 1. Usually with fractures of the ribs there is a sharp pain. It is especially clearly manifested when feeling the injured place, as well as taking a deep breath or coughing. It can be painful for a person to laugh, sometimes even to speak.
  • If the injury is not very serious, then complete healing and fusion takes about 4-6 weeks. But this rule is valid only if the patient has been provided with the correct treatment and peace! He is ready to go to work and more or less active physical activity after 6-8 weeks.
  • If a person fell unsuccessfully, or was hit in the chest, the appearance of pain is not a signal that a fracture occurred. This may be a simple injury, which will calmly heal in a few days, if the victim is given proper rest. But the symptoms of a rib fracture are much more pronounced and serious:
  • With pneumothorax and extensive hemothorax, a puncture of the pleural cavity is performed, thus withdrawing air or blood.

First aid to the victim

Respiratory failure. Appears very frequent shallow breathing, pallor and cyanosis of the skin, increased heart rate. When breathing, you can see a depression of the chest areas and its asymmetry.

  • No offset.
  • The ribs are divided into true (1-7 pair), false (8-10 pair) and oscillating (11-12 pair). True ribs are connected to the sternum by their own cartilaginous plates. False ribs do not have a direct connection with the sternum, their cartilaginous parts grow together with the cartilages above the lying ribs. And the cartilaginous part of oscillating ribs has no articulation with anything at all.
  • In the absence of timely treatment, complications of rib fractures represent an immediate danger to the life of the patient. In order to prevent the development of complications or eliminate their consequences, in case of suspected fracture of the ribs, it is necessary as soon as possible to seek qualified medical assistance.
  • Elastic rib cartilage provides chest mobility. The cartilages of the seven upper pairs of ribs are connected to the sternum. The cartilages of the VIII-X ribs are connected to each other, and the XI and XII ribs lie loosely, not joining in front of the other bone structures.
  • In the course of treatment of complicated rib fractures, along with standard procedures (fracture anesthesia, analgesics, physiotherapy and therapeutic gymnastics), additional therapeutic measures are carried out.
  • Usually the condition of a person who has received a similar injury is not heavy. But with prolonged squeezing of the chest, for example, during road accidents or collapses, multiple fractures of the ribs on both sides often occur. Their acute fragments can damage the internal organs of the chest and abdomen: lungs, liver, spleen, kidneys. In such cases, the upper half of the body of the victim acquires a bright red color with multiple small purple hemorrhages. Bleeding from the nose and ears may begin, the person temporarily stops hearing and seeing. The victim needs urgent medical care, and should be transported in the prone position on rigid stretchers.
  • 2 The victim spares the damaged part of the chest, breathing from this side is shallow.
  • But if there was a multiple and severe injury, then no one can say for sure how much a rib fracture coalesces in such a case. All individually. End fractures, for example, can grow together over several months.

Clinical case

Severe sharp pain manifests itself when trying to inhale. As a result, the breathing of a person becomes intermittent and shallow,

  • With a small volume of blood in hemothorax puncture is not required, resorption occurs without intervention.
  • Pleuropulmonary shock - occurs when pneumothorax and a wide area of ​​the wound, when a large amount of air enters the pleural cavity, especially fast shock occurs if the air is cold. Manifested by symptoms of respiratory failure, painful cough and cold extremities.

Fracture mechanisms

Inside the chest is lined with a connective tissue sheath (intrathoracic fascia) just below the fascia is the pleura, consisting of two smooth sheets. Between the sheets there is a thin layer of lubricant, which allows the inner leaflet of the pleura to slide freely relative to the outside during breathing.

  • A small amount of blood in the cavity between the leaves of the pleura resolves independently. In patients with severe hemothorax, a puncture of the pleural cavity is performed. A doctor under local anesthesia inserts a special needle into the pleural cavity and removes the accumulated blood. Sometimes the hemothorax develops again, therefore during the treatment it is necessary to perform several punctures.
  • At home, during rehabilitation, you should not make sharp bends, lift weights and sleep as much as possible on a high pillow. It is necessary to learn more about his injury, to know what to do if he broke a rib, so that the treatment would pass without complications.
  • 3 If not only a fracture occurs, but also damage to the lungs, then air “leaks” into the subcutaneous tissue. Outwardly, this manifests itself in the form of edema of the chest, and the subcutaneous tissue cracks when palpating.

If you are a victim of a fracture, then follow the rules below to accelerate the healing of bone tissue of the ribs:

The pain also becomes stronger when coughing, talking, laughing,

  • The duration of treatment for rib fracture varies from 3 to 4 weeks on average.
  • Pneumonia. With low motor activity, the inability to perform normal respiratory movements and damage to the lung tissue, often there is inflammation of the lung.

How to distinguish a broken rib?

Fractures in the back of the costal arch have a blurred clinical picture. This is due to the lower mobility of bone fragments in this area during breathing. Fractures in the lateral and anterior part of the costal arch are most severely tolerated and their symptoms are very pronounced. Consider the 3 most common types of fracture depending on the mechanism of injury.

  • The cause of the fracture of the ribs, as a rule, is falling on a protruding solid object by the chest, a blow to the chest or its compression. Also found pathological fractures, they are formed as a result of the course of other diseases, for example, tumor process, osteoporosis, osteomyelitis.
  • Uncomplicated fractures of one (in some cases, two) ribs are treated on an outpatient basis. Fracture of three or more ribs is an indication for emergency hospitalization in the Department of Traumatology.
  • The lung tissue is formed by the smallest hollow vesicles - alveoli, in which, in fact, gas exchange takes place.
  • With pneumothorax in some cases, it is enough to puncture to remove air. A strained pneumothorax is an indication for urgent drainage of the pleural cavity.
  • Additionally, see the link:
  • Fractures of the ribs make up to 5% of all fractures. They are especially common in older people, as bone strength decreases with age.

Ensure sufficient rest

First aid

A person tries to move as little as possible - it causes discomfort,

  1. Patient M. was admitted to the emergency room with complaints of weakness, pain in the right side of the chest and difficulty breathing. From the anamnesis: In a state of intoxication fell on the asphalt, hitting his chest against a large stone.
  2. Stage 1 - connective tissue. Blood accumulates at the injury site, where cells that produce connective tissue (fibroblasts) migrate to the blood stream.

Occurs when injured with a small, heavy, angular object. Damage occurs in the same place where there was a traumatic effect.Fracture occurs inside. The inner part of the rib is damaged first, then the outer one.

Medication Treatment

The classification of rib fractures.

With an uncomplicated fracture of the ribs at the time of admission, the traumatologist produces a local anesthesia of the fracture or Vago-sympathetic blockade according to Vishnevsky. Then the patient is prescribed analgesics, expectorant drugs, physiotherapy and medical gymnastics to improve the ventilation of the lungs.

The cause of the fracture of the ribs may be a fall, a direct blow to the ribs or a chest squeeze. Most often the ribs break in the place of the greatest bend - along the lateral surfaces of the chest. At the fracture of one rib, fragments are displaced very rarely. Multiple rib fractures are often accompanied by displacement of fragments (fracture with displacement). In this case, fragments with their sharp ends can damage the pleura, lungs and intercostal vessels.

Under local anesthesia, the doctor makes a small incision in the second intercostal space along the midclavicular line. A drainage tube is inserted into the incision. The other end of the tube is immersed in a jar of liquid. It is important that this bank is always below the level of the patient’s chest.

Healing time

Rib fractures occur:

Avoid heavy physical activity.

In the place where the fracture occurred, the chest moves less while breathing,

  • On examination: In the area of ​​5-8 ribs to the right along the axillary line on the skin there is a bruise, slight swelling of soft tissues. Pallor of the skin. Palpation tenderness and crepitus in the region of 6-7 ribs. Dyspnea up to 20 respiratory movements per minute, breathing shallow, pulse - 88 beats per minute. The examination revealed a right-sided hemothorax and a fracture of the 6th and 7th rib on the right.
  • Stage 2 - osteoid callus. The deposition of inorganic substances, mineral salts in the connective corns and osteoid is formed.
  • Most often occurs when falling on the chest. This forms a fragment of the rib, it moves during respiratory movements. Damage to the pleura, lung and intercostal vessels and nerves is often observed.
  • By the presence of damage to the skin:
  • Sometimes pneumothorax and hemothorax do not develop at the time of admission, but somewhat later. If you suspect the development of these complications during treatment, an additional fluoroscopy is performed.
  • Damage to the pleura and lungs is often accompanied by the development of complications - hemothorax and pneumothorax. In hemothorax, blood accumulates between the outer and inner pleura. When pneumothorax in the chest air accumulates. The lung is compressed, decreases in volume, the alveoli collapse and stop taking part in breathing.

How to cure a broken rib

Treatment: relief of pain, immobilization of the chest, infusion therapy, oxygen inhalation, puncture of the pleural cavity with abduction of 80 ml of blood.

Stage 3 - hydroxyapatites are deposited in the osteoid, the strength of the corn increases. At first, this corn is still loose, it is larger in size than the diameter of the rib, then decreases to normal size.
When a high force is applied to a larger area of ​​the chest, an indentation of the rib fragment inside the chest is observed. At the same time the pleura, vessels, nerves, a lung are often injured. Such fractures are called fenestrated. If several ribs are damaged at once, then with such a mechanism of injury a large movable area is formed in the chest wall and it is called a costal valve.
Closed fracture - without damaging the skin
In the course of treatment of complicated rib fractures, along with standard procedures (fracture anesthesia, analgesics, physiotherapy and therapeutic gymnastics), additional therapeutic measures are carried out.
Fracture of the ribs with lung damage may be accompanied by air penetration into the subcutaneous tissue (subcutaneous emphysema). If the intercostal vessels are damaged, excessive bleeding can develop into the pleural cavity or soft tissues.
In the course of treatment of post-traumatic pneumonia, along with general therapeutic measures (antibiotics, physiotherapy), it is very important to conduct therapeutic exercises to restore normal ventilation of the lungs.
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- with a direct blow to the chest,
Use dairy products and vitamin-mineral complexes, in order not to have calcium deficiency in the body and to strengthen the immune system (during rehabilitation you are struggling not only with the fracture itself, but also with its consequences, which can be expressed by various diseases and disorders)
If the fracture occurred in several places, then the victim’s well-being may deteriorate greatly. The skin turns pale and turns blue in places, tachycardia is observed, there are signs of swelling and bruising.
The human chest, protecting the heart and lungs from external influence, consists of 12 vertebrae, 12 pairs of ribs and sternum. The first ten pairs of ribs form a ring around the chest area, and the bottom two pairs, that is, 11 and 12, do not connect to the sternum, and therefore break and damage in rare cases.
Inspection and collection history. Palpation in the area of ​​injury, you can feel the crepitus of bone fragments and detect the deformation in the form of steps.
Consider what are the symptoms at the turn of the ribs.
Open fracture - with skin damage
A small amount of blood in the cavity between the leaves of the pleura resolves independently. In patients with severe hemothorax, a puncture of the pleural cavity is performed. A doctor under local anesthesia inserts a special needle into the pleural cavity and removes the accumulated blood. Sometimes the hemothorax develops again, therefore during the treatment it is necessary to perform several punctures.
The patient complains of a sharp pain in the chest. The pain increases with breathing, movements, talking, coughing, decreases at rest in a sitting position. Breathing is shallow, the thorax on the affected side lags behind when breathing. On palpation of a broken rib, a region of sharp pain is revealed, sometimes - bone crepitus (a peculiar crunch of bone fragments).
Fixation of rib fractures is required very rarely and is performed, as a rule, with massive chest injuries, accompanied by multiple unstable rib fractures.
The doctor after X-rays will put a tight bandage.
- when squeezing the chest.
Avoid flatulence products.
If doctors cannot absolutely say whether an injury has occurred or not, then a photo of a rib fracture helps to determine this — an X-ray shows if there are cracks or chips on the bone.
The bones of the ribs are relatively fragile due to their small thickness, and therefore susceptible to bruises and fractures. Statistics show that all bone fractures account for approximately 15% of rib fractures.
Symptom of interrupted inhalation - the patient interrupts a deep breath because of the pain.

Pain - it occurs in the area of ​​the fracture, increases with movement, inhaling and exhaling, coughing. Reduction of pain is possible at rest and in a sitting position.

By damage rate:

With pneumothorax in some cases, it is enough to puncture to remove air. A strained pneumothorax is an indication for urgent drainage of the pleural cavity.

Anterior and lateral rib fractures are severely tolerated by patients, accompanied by respiratory failure. In case of damage to the posterior ribs, impaired pulmonary ventilation is usually less pronounced.

The average duration of treatment for uncomplicated fractures of the ribs is about 1 month. The duration of treatment of multiple and complicated rib fractures is determined by the severity of the complications and the general condition of the patient.

Of course, the blow or pressure should be very strong. As a result, a fracture may appear, a subperiosteal fracture occurs (bone tissue breaks down, and the periosteum remains intact), a complete fracture of the rib.

Go through physiotherapy, treat the sore spot with an ointment for bruises and bruises (of course, if it is a closed fracture).
It is desirable for each person to know what to do when the ribs are broken. The injury can happen unexpectedly, but for now the victim and the people around will wait for the ambulance, it will take 5-30 minutes, or even more. The algorithm for rendering first aid is the following:

By itself, such an injury has different degrees of danger. A simple fracture of the bone is quickly treated with proper treatment and compliance with the regimen. But a rib fracture with displacement is dangerous due to damage and tearing of tissues and internal organs, which can be fatal if you do nothing or illiterate handling of the patient. There is also a closed fracture, when only the bones and internal organs are damaged, and an open one, which is characterized by the break of the skin by the sharp edges of the broken bone.

Symptom of axial loads - when squeezing the chest in different planes, the pain will be in the place of the fracture, and not in places of pressure.
Shallow breathing and lag in breathing of the half of the chest where there is an injury.
A complete fracture - the rib is damaged throughout the thickness. The most common type of fracture
Under local anesthesia, the doctor makes a small incision in the second intercostal space along the midclavicular line. A drainage tube is inserted into the incision. The other end of the tube is immersed in a jar of liquid. It is important that this bank is always below the level of the patient’s chest.
With multiple rib fractures, the patient's condition worsens. Breathing is shallow. Pulse is speeded up. The skin is pale, often bluish. The patient tries to sit still, avoids the slightest movements.
Serg bloody
It is necessary to make a tight bandage on the ribs (so that the rib does not stick in the lungs, like - look in the internet) and contact the emergency room
How to help:
Never let a recovery take its course! In case of a rib fracture, it is imperative that you see a doctor, since it is impossible to accurately determine the severity of such an injury only by eye and by sensation. The problem is that the fracture is accompanied by unpleasant infectious diseases, respiratory disorders and cardiac activity, if it is not cured in time.
It is necessary to place the victim in a lying or semi-sitting position, ensuring him peace,
Rib injury can be caused by several reasons:
Symptom Payra - pain in the area of ​​the fracture when bending in a healthy way.

Swelling of tissues in the area of ​​damage.

Subperiosteal Fracture - Bone Damage

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