Rib fracture

A broken rib or a rib fracture is a violation of one or more ribs with partial or complete break ( fracture) the bone structure. If several adjacent ribs the same side of the body affected, it is called a serial rib fracture is a single rib repeatedly broken by a series of ribs fracture. Also, the cartilaginous portion of the ribs may be broken, but this is much rarer and more difficult to demonstrate.

Frequency and importance

Rib fractures are common. Because of their generally good healing of the course of the injury is often straightforward. However, a patient with rib fracture often has several days to weeks, depending on the daily activity, be sick, so the disease is health economics of considerable importance.

Risk Factors

A rib fracture is usually preceded by a significant trauma. Mostly rib fractures, the result of a thoracic trauma. If a rib fracture spontaneously or with an inadequate trauma, you have to think of an underlying disease such as osteoporosis or bone metastases.

Risk factors for rib fracture are:

• Certain sports
• Decrepitude
• Abuse
• Resuscitation
• Bone metastases
• Osteoporosis

Diagnosis

The diagnosis of rib fracture is often the palpation forth possible. The sharp pain and a grinding sound ( crepitus ) during movement are leading the way. With greater displacement of the ribs allows the fracture in thoracic radiographs demonstrate on several levels. The CT can show a rib fracture. Fractures without displacement ( displacement of the fracture margins) were previously often misinterpreted as a bruise, they are often only in the ultrasonic displayed ( Example: http://ultraschallkolloquium.de/fall-des-monats/fallarchiv-2012/februar-2012/ ). For the avoidance of further injury may be necessary, an ultrasound of the abdominal cavity, pleura and heart.

Treatment

Treatment is usually conservative. The patient is given an education about the disease and is alerted to an approximately two - to three-week course of the disease. The pain can be treated with painkillers. An immobilization by a plaster or a plating are not common. When complications such as severe shortness of breath, the patient must be re- x-rayed to rule out a collapse of the lung ( pneumothorax) or a bruise ( hemothorax ).

Complications

In general, rib fractures heal well. Sometimes, it comes within the scope of the rib fracture in a pneumothorax, pulmonary contusion or a hemorrhage in the lungs or chest. Feared is a violation of the spleen by a Einspießung the ribs or a standalone splenic rupture. In this respect, at a symptoms below the left costal margin hospitalization is advisable or are thorough, also repeated examinations sense.

Due to pain, it may be a decreased respiratory movement and thereby to a reduced ventilation of the lungs. This pneumonia may develop.

In extensive serial rib fractures, an unstable chest with paradoxical result respiration.

A subcutaneous emphysema, an accumulation of air under the skin that causes a crackling sound when the button is harmless but indicates a pneumothorax or a violation of other air-containing organs.