Fracture of ribs
Signs, symptoms, classification and treatment of rib fractures
What is a fractured rib?
Fracture of the ribs is the most common chest damage. Of the total number of fractures, about 16% is occupied by fractures of the ribs. In people of fairly advanced age or with certain chronic diseases, rib injuries occur much more often, as the elasticity of important bone structures of the chest decreases with age.
Fractures without complications, as a rule, are fractures of one or two ribs. They do not pose a threat to the health and life of a person and usually grow together quite well. The greatest danger associated with this damage is serious damage to the internal organs and a significant violation of breathing. Fractures without complications occur in about 40% of cases of chest damage. In the remaining 60%, internal organs are sensitively affected – lungs, pleura, and cardiovascular system are damaged.
Multiple rib fractures represent an incredibly serious injury that poses a great threat, since in this case the probability of the appearance of the most serious complications associated with life-threatening conditions.
Signs and symptoms of fracture of the ribs
With fractured ribs, many victims complain of considerable pain at the site of injury, they also have difficulty breathing, they can not breathe freely. A sharp pain causes even the slightest cough. Victims move very cautiously, afraid to feel the pain, slowly undress and dress. Also, because of the fear of experiencing severe pain, the breathing becomes superficial in the affected. If the broken rib was hurt by the lung, blood spitting appears.
After the injury, the victims almost immediately point to the classic signs of the trauma: a sharp pain appears in the chest, which when talking, coughing, breathing and movement is markedly increased and, accordingly, decreases when the patient lies or is in a sitting position. The breathing is rather superficial, and the whole human chest on the side of the fracture lags far behind when breathing.
Signs of fracture of the ribs from the side and the front suffer are especially difficult to endure, while breathing is disturbed. If there is a fracture of the rib from the back, the signs of this injury are not as pronounced, and significant violations of pulmonary ventilation do not usually occur.
If the patient injures several ribs, his condition becomes much worse. Breathing becomes very superficial, the skin becomes pale, acquiring a bluish shade, while the pulse is significantly faster. The patient tries not to move, preferring to sit still. The main signs of fracture of the ribs are the strongest bruising, marked swelling of the soft tissues. When listening, it is not always possible to determine breathing.
One of the dangerous complications of fracture of the ribs that can develop is a dangerous post-traumatic pneumonia. Usually this complication makes itself felt a few days after the injury. The development of this complication directly depends on the state of health and age, as a rule, elderly and senile patients are exposed to it.
If the patient’s condition worsens, there are severe symptoms of intoxication, body temperature rises, and breathing becomes heavy and difficult. In this case, we can talk about the development of dangerous pneumonia. However, do not forget that in weakened elderly patients, posttraumatic pneumonia does not always occur with a marked increase in temperature, sometimes only general deterioration and weakness are observed.
Posttraumatic pneumonia often occurs due to a significant decrease in ventilation in the lungs the side where there is damage to the ribs. The victim usually experiences severe pain in the fracture, so he tries to make shallow, superficial breaths. There are cases when in a certain area of the fracture a rather painful swelling of
is formed. If the victim tries to take a deep breath, there is always a lot of pain, and the attempt ends unsuccessfully. This particular symptom is called “interrupted inhalation.” This sign is not observed when there is a chest injury.
Another important feature of the fracture of the ribs is the so-called axial load symptom. They try to determine it by alternately squeezing the entire thorax. Since the thorax is an osseous ring, then when compressing one of its parts, the load on other parts is significantly increased. When the damage occurs, the victim feels pain in the place fracture, and not in the place where the compression occurred.
With proper palpation always reveal a sharp local soreness. A particular deformation in the form of a step at that point of maximum painfulness also indicates a fracture of the rib. Then, to avoid possible complications, you can perform palpation of not only the thorax, but the entire abdominal cavity, determine the frequency of cardiac contraction and blood pressure. A good assistant in the diagnosis of a fracture is a radiography.
True, there are reasons why it is not always possible to determine the fracture of the rib. Therefore, usually a dominant role in establishing the diagnosis still plays a specific clinical picture. If all signs indicate the presence of chest damage, you can in some cases do not perform X-ray examination. To reduce the risk of complications, urine analysis and a general blood test are performed to identify a more complete picture of the damage.
First aid for fracture of the ribs
Do not self-medicate for fracture of the ribs, but provide the first help need:
Give an anesthetic (eg ibuprofen) to a person.
Make a necessary bandage dressing from a towel and bandage.
The affected place needs to be held in the cold (it is best to enclose the ice)
Then, If the victim is taken to a hospital, it is necessary to carry it in a prone position or in a semi-sitting position.
Classification of fracture of the ribs
Impacts on the human ribs are divided into indirect and direct. With indirect action, the chest is squeezed, so the ribs break on both sides of the compression site. As a rule, several ribs break at once. In the case of direct impact, fragments of the ribs can damage the various internal organs, the lung, when the ribs bend in. There are bilateral fractures, which cause the chest to lose the necessary stability, and a dangerous violation of the ventilation of the lungs. Also there are so-called final fractures, i.e. fractures in two places on one side. Most often, rib fractures occur in people older than 40 years. This is due to changes in bone tissue that occur in the body due to age. As a child, fractures of the ribs are extremely rare, as the baby’s thorax has great elasticity.
There is also the following division of the rib fractures: ridge fracture, bone fracture (the so-called subperiosteal fracture) and complete rib fracture. The latter most often occurs at the site of the bending of the ribs. For all these cases, the same symptoms of fracture are characteristic. / h Treatment of fracture of the ribs
If there is a fracture of one or two ribs, the treatment can be carried out at home or in a clinic under the supervision of a specialist, the patient needs to apply a cast. If complications occur or a multiple fracture of the ribs occurs, the patient should be treated in a hospital.
As a modern medicine, 10 ml of 1-2% solution of procaine is administered, which is injected into the fracture site. Next, without removing the needle, quickly add 1 ml of 70% alcohol. In case of correctly administered medication, the pain syndrome practically disappears and the patient is able to breathe in full, and the cough does not cause such severe pain.
Also, in the treatment of fractures, the rib is prescribed an expectorant medicine, and the chest should be placed on the chest usual mustard plasters. It is necessary to perform with caution respiratory gymnastics, and UHF procedures (ultra-high-frequency therapy) are prescribed from the third day after the injury. Further in the fracture site, the use of electrophoresis of procaine and compulsory calcium chloride as a treatment is used, and then special therapeutic gymnastics is prescribed.
In particularly difficult cases, surgical treatment of the fracture is necessary. To exit the accumulated blood on the recommendation of the attending physician, if necessary, puncture. Typically, for recovery in simple cases, the patient needs about four weeks, with strict bed rest and complete rest required. For multiple fractures, the duration of treatment depends on the general condition of the patient himself.