(See also Introduction to Chest Injuries Introduction to Chest Injuries Chest injuries most often affect the ribs, upper part of the abdomen, lungs, blood vessels, heart, muscles, soft tissues, and breastbone. Sometimes the esophagus, collarbone, or shoulder blade... read more .)
Rib fractures usually result from strong blunt force, such as a fall from a height, a motor vehicle crash, or a hit with a baseball bat. However, sometimes in older people who have osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more , only a slight force (as occurs in a minor fall) is required.
The fracture itself is rarely serious, although the force that caused the fracture occasionally causes other problems, such as a bruised lung (pulmonary contusion Pulmonary Contusion A pulmonary contusion is a bruise of a lung, which causes bleeding and swelling. People have pain, usually due to the chest wall injury, and often feel short of breath. Doctors make the diagnosis... read more ) or a collapsed lung (pneumothorax Traumatic Pneumothorax Traumatic pneumothorax occurs when air accumulates between the chest wall and the lung because of an injury. It causes the lung to collapse partially or completely. People have chest pain and... read more ). An injury that fractures the lower ribs sometimes also damages the liver Liver Injury Liver injuries are characterized in several key ways: People have tenderness and pain in the abdomen that sometimes radiates to the shoulder. Doctors use computed tomography (CT) or ultrasonography... read more or spleen Spleen Injury Because of the spleen’s position in the upper left side of the abdomen, a severe blow to the stomach area can damage the spleen, tearing its covering, the tissue inside, or both. An injured... read more . The more ribs that are broken, the more likely lungs or other organs are to be damaged.
Flail chest can result if several adjacent ribs are broken in more than one place. In flail chest, a segment of the chest wall separates from the rest and moves in the opposite direction from the rest of the chest wall when a person breathes. Breathing becomes more difficult and tiring. Usually, a blow strong enough to cause flail chest also bruises the lung beneath the injured area (called pulmonary contusion Pulmonary Contusion A pulmonary contusion is a bruise of a lung, which causes bleeding and swelling. People have pain, usually due to the chest wall injury, and often feel short of breath. Doctors make the diagnosis... read more ).
Rib fractures cause severe pain, particularly when people breathe deeply. The pain lasts for weeks.
Because of the pain, people may breathe less deeply, increasing the risk of complications, such as collapse of parts of the lung (atelectasis Atelectasis Atelectasis is a condition in which all or part of a lung becomes airless and collapses. Blockage of the bronchial tubes is a common cause of atelectasis. Shortness of breath can develop if... read more ) and pneumonia Overview of Pneumonia Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more . Complications are more likely to occur in
Because older people are more likely to develop these complications, they also have a higher risk of death due to a rib fracture than do younger people.
Doctors suspect rib fracture when one or more ribs are very tender in one particular spot. Sometimes doctors can feel the broken ribs when they gently push the injured area. Doctors do not always need to confirm rib fractures with an x-ray because the presence of rib fractures does not change the way a chest injury is treated. Nonetheless, doctors usually do a chest x-ray X-Rays of the Chest Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if... read more to detect serious problems that can accompany rib fractures, such as a bruised or collapsed lung. Not all rib fractures can be seen on a chest x-ray.
Regardless of whether rib fractures are identified, people are given pain relievers (analgesics Treatment of Pain In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain.... read more ). Those with severe pain are usually given opioid pain relievers such as oxycodone or hydrocodone. Sometimes hospitalized people who have severe pain are treated by numbing the nerve to the affected ribs or with injection of drugs around the spinal cord (epidural analgesia).
People with a rib fracture are asked to cough or breathe deeply about once an hour while they are awake to keep the air sacs in the lung open and prevent pneumonia Prevention Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more .
People with several rib fractures may need to be treated in the hospital.
People with flail chest often need to have their breathing supported with a ventilator Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get... read more until the injuries heal. Some people with flail chest may need surgery to reduce the risk of complications, including pneumonia, lengthy hospital stays, and death.