Fractured Rib

Fractured Rib

Article
Bone, Muscle, & Joint
Diseases & Conditions
Contributed byMaulik P. Purohit MD MPHSep 14, 2018

What are the other Names for this Condition? (Also known as/Synonyms)

  • Broken Rib
  • Fracture of the Rib
  • Rib Fracture

What is Fractured Rib? (Definition/Background Information)

  • A Fractured Rib is a break or crack in one of the bones in the rib cage. Generally, men are more likely to experience Fractured Ribs than women
  • A majority of the injuries that cause Broken Ribs occur from high-energy impact to the chest due to accidents from athletic sports or motor vehicle collisions. Other reasons may also include falls from substantial heights
  • Nonsurgical methods are predominantly used to treat the condition; surgical methods are rarely used. Surgery is required if serious trauma to the chest has occurred, causing certain vascular and neurological complications
  • The prognosis of Fracture of the Ribs is usually excellent with appropriate early intervention

Who gets Fractured Rib? (Age and Sex Distribution)

  • Individuals who participate in athletic sports and activities are more likely to experience Fractured Ribs
  • Approximately 72% of Fractured Ribs occur in men
  • Elderly adults may be prone to Fractured Ribs due to a fall
  • Postmenopausal women have an increased risk for osteoporosis, and hence, they have an increased risk of Fractured Ribs

What are the Risk Factors for Fractured Rib? (Predisposing Factors)

Common risk factors of Fractured Ribs include:

  • Individuals over the age of 65 years
  • Participation in high-risk contact sports such as football and hockey
  • Reduced bone mass (due to osteoporosis) in postmenopausal women
  • A cancerous tumor in the ribs, which can weaken the bones, making one more vulnerable to a Rib Fracture
  • Prolonged coughing
  • Excessive body weight associated with obesity
  • Prior history of Rib Fracture

It is important to note that having a risk factor does not mean that one will get the condition. A risk factor increases ones chances of getting a condition compared to an individual without the risk factors. Some risk factors are more important than others. 

Also, not having a risk factor does not mean that an individual will not get the condition. It is always important to discuss the effect of risk factors with your healthcare provider. 

What are the Causes of Fractured Rib? (Etiology)

Rib Fractures may be caused by:

  • A direct fall onto one’s side or back from a significant height
  • Direct trauma to the chest such as due to an automobile accident
  • Domestic violence and street fights can also cause injuries such as Fractured Ribs
  • Participation in any rough or high-impact sports such as football or hockey

What are the Signs and Symptoms of Fractured Rib?

The signs and symptoms of Fractured Ribs may include:

  • Pain in the chest
  • Shortness of breath or difficulty breathing
  • Internal bleeding
  • In some cases, there may be a protrusion of bone through the skin

How is Fractured Rib Diagnosed?

Diagnostic methods that a physician may use to help diagnose Fractured Ribs include:

  • Physical examination: During a physical examination, the physician will gently press on the chest and examine the ribs and rib cage as the individual breathes. Individuals are also expected to provide an explanation of the circumstances that caused the injury. In addition to this, a complete medical history may aid in arriving at a definitive diagnosis
  • X-ray of the chest: X-rays are the most common imaging methods used in assessing a fracture. However, sometimes it is difficult to detect Fractured Ribs using this diagnostic test. However, chest x-rays are helpful in identifying a collapsed lung (if any due to the injury)

Many clinical conditions may have similar signs and symptoms. Your healthcare provider may perform additional tests to rule out other clinical conditions to arrive at a definitive diagnosis. 

What are the possible Complications of Fractured Rib?

Complications of Fractured Ribs depend on the ribs injured. Possible complications include:

  • Damage to the internal organs and blood vessels in the chest
  • Punctured or torn aorta: This can occur if one of the first three ribs at the top of the rib cage fractures completely
  • A punctured lung can occur if a sharp piece of the mid rib penetrates the lung
  • Fracture of a lower rib may result in serious injury to the spleen, liver, or kidneys

How is Fractured Rib Treated?

Conservative methods are usually used to treat Fractured Ribs. However, surgery may be required if serious injury to the ribs has occurred. 

Nonsurgical treatment methods for Fractured Ribs include:

  • Any activity that further aggravates the condition should be avoided. The physician usually recommends refraining from all such activities, until the symptoms get better and the ribs heal
  • Applying ice to the injured area can help reduce pain and swelling
  • Non-steroidal anti-inflammatory oral medications, such as ibuprofen or naproxen, may be used to treat Fractured Ribs. These medications can help decrease the pain and swelling

Surgical treatment methods for Fractured Ribs include:

  • Rib resection: Rib resection is a surgical procedure that involves the removal of part of a rib. This procedure is designed to treat fractures that have an increased risk of damaging lung tissue, removing parts of a rib damaged by diseases such as cancer, or to acquire bone for a bone graft. Rib resection may also be performed to treat individuals with thoracic outlet syndrome
  • Open reduction and internal fixation (ORIF): Open reduction is a surgical procedure to realign the fractured bone to its original position. Surgical hardware (such as plates, screws, or rods) is then used to stabilize the fractured bone under the skin

Note: A thoracic outlet syndrome results from the compression of the nerves or blood vessels in the passageway (called the thoracic outlet) between the clavicle (collar bone) and first rib. 

How can Fractured Rib be Prevented?

A few recommendations to help prevent Fractured Ribs include:

  • Individuals who participate in any high-risk sports should wear appropriate safety equipment to help prevent the possibility of such fractures
  • Wearing seat belts while driving or traveling in an automobile
  • Home and office spaces must be suitably designed or modified to prevent or avoid fall risks, especially for children and elderly adults
  • Consuming foods rich in calcium, such as milk, yogurt, and cheese, help build bone strength. Regular diet with appropriate calcium intake is recommended, even after a Fractured Rib. For women, the recommended amount of calcium increases with age and menopause
  • Perform weight-bearing exercises to strengthen bones and muscles
  • Avoid obesity or overweight conditions

What is the Prognosis of Fractured Rib? (Outcomes/Resolutions)

  • When properly diagnosed and treated, individuals usually make a full recovery
  • Fractured Ribs treated with nonsurgical methods usually require 6 to 10 weeks to heal. However, some cases may require lesser time
  • If Broken Ribs are treated using surgical methods, the injury should take approximately six weeks to heal, if no underlying complications due to surgery arise

Additional and Relevant Useful Information for Fractured Rib:

In most cases, the 1st and 2nd ribs are rarely fractured, and the 7th and 10th ribs are the most commonly Fractured Ribs.

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Maulik P. Purohit MD MPH

Assistant Medical Director, Medical Editorial Board, DoveMed Team

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