At a Broken rib there is a fracture of one or more ribs, which in most cases is due to external violence. Rib fractures usually show a good course and heal without complications.
What is a broken rib?
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A Broken rib is a fracture of one of the twelve ribs of the human skeleton. Ribs have a bony and a cartilaginous area, and a fracture of the cartilaginous part is also referred to as a broken rib.
If, on the other hand, more than two adjacent ribs are broken, it is referred to as a series break. If a single rib has two fractures, so that part of the rib has broken out of the composite rib, it is referred to as a broken rib. In addition, a distinction is made between displaced and unshifted rib fractures. A broken rib manifests itself through local pain in the chest area, which is aggravated by breathing movements, especially deep inhalation, and coughing.
Depending on the type of rib fracture, various forms of breathing impairment can occur. In addition, if a rib breaks, there is an increased risk of damage to nearby organs such as the heart, spleen or aorta (main artery).
causes
In most cases, a Broken rib caused by external violence as a result of a fall on the chest area or an accident. Extreme violence, such as in traffic, riding or bicycle accidents, in many cases leads to serial rib breaks and / or broken ribs.
If the surrounding organs, especially the aorta, are injured as a result of the broken rib, it can lead to very heavy bleeding into the lungs (haematothorax) or the collapse of a lung (pneumothorax). Pain-related breathing can be severely impaired, depending on the shape and severity of the rib fracture.
For example, a rib series break can cause respiratory inhibition or inverse breathing, in which the chest, unlike normal breathing, pulls inwards when inhaling and expands outwards again when exhaling. If there is osteoporosis (bone loss), a broken rib can also be caused by a strong cough.
Symptoms, ailments & signs
This injury to the ribs causes pain in the affected area. Breathing and mobility are often restricted in a rib fracture. Simple rib fractures, however, are straightforward and do not require any special treatment. Broken ribs are the most common chest injuries and result from direct or indirect trauma.
Usually it is the fourth to the ninth rib. Ribs can break on the front, side, or back. If multiple ribs are affected, a series of ribs is present. The pain increases with movement, breathing, laughing, sneezing or coughing. The affected rib is tender to pressure.
When pressure is applied, a crunch can often be heard. Air that has accumulated in the skin can also be felt. Often the broken rib itself can also be felt externally. Further impairments can occur, particularly in the case of rib series breaks. This can lead to lung bruises, which is accompanied by increased breathing problems.
If severe pain and circulatory problems occur, the fracture of the rib is definitely in need of treatment. Breast fractures can damage the thoracic spine or bruise the heart. If the lower ribs are affected, the kidneys or liver may be affected.
Diagnosis & course
A Broken rib is diagnosed as part of an X-ray examination in which the thorax is recorded in two planes. If there are specific indications regarding the localization of the rib fracture, a target X-ray can be performed. Due to the existing risk of pneumothorax, an X-ray should be taken in inhalation (inhalation) and exhalation (exhalation).
If there is a suspicion of an undisplaced rib fracture, a control recording is indicated if the symptoms do not subside. With the help of a sonography (ultrasound examination) injuries to the surrounding organs can be determined. In addition, an EKG provides information about possible involvement of the heart.
If there is a serial break in the ribs, a CT (computer tomography) can provide a comprehensive overview of the severity and localization. As a rule, broken ribs (including serial and partial rib breaks) show a good course and heal without complications.
Complications
As a rule, broken ribs heal well. Sometimes air gets into the lungs (pneumothorax) as a result of the rib fracture, or bleeding occurs there or in the chest. Skin emphysema can also occur. Injury to the spleen cannot be ruled out either. In severe fractures, the spleen may rupture on its own.
An unstable chest with paradoxical breathing can also occur - shortness of breath and other complications are the result. If the ventilation of the lungs is reduced as a result of the decreased breathing movement, pneumonia can result. The surgical treatment of a broken rib can also lead to adverse events. Swelling occurs relatively often in the area of the procedure, caused by bruises or fluid accumulation.
Nerve pain or sensory disorders can also occur and sometimes persist for a long time. The fracture occurs less often. Hardening and wound healing disorders are also rare, but cannot be ruled out. In addition, the prescribed pain relievers and anti-inflammatory drugs can be associated with side effects and interactions. If you have pre-existing illnesses or allergies, further complications may arise here.
When should you go to the doctor?
Pain in the hip area, shortness of breath and discomfort suggest a broken rib. A medical examination is recommended in the event of persistent complaints that cannot be alleviated by rest and other general measures. Affected patients are best advised to consult their family doctor or the hospital directly. See a doctor immediately if symptoms are related to a fall or accident involving the ribs. The same applies if there is acute shortness of breath or bleeding occurs. People who constantly cough because of a chronic respiratory disease or who notice the symptoms mentioned after a chest compressions are particularly at risk.
A broken rib is treated by an orthopedic surgeon or surgeon. Most patients require physiotherapy after the procedure. After the treatment of the rib fracture, the patient only needs to have one or two follow-up checks. If the prescribed pain medication causes problems, the doctor must be informed so that the medication can be adjusted.
Treatment & Therapy
Unshifted Broken ribs are usually treated conservatively with pain-relieving drugs such as ibuprofen, novalgin or tramadol. If a dry cough is present at the same time, expectorant cough suppressants such as Paracodin N drops are also used to reduce the cough.
If there is no breathing due to the broken rib, the person concerned should be checked regularly for infections in order to avoid pneumonia (pneumonia) or to be able to treat it in good time. In the case of a mantle pneumothorax (collapsed lung of minor extent), X-ray follow-ups should be taken at regular intervals to check the improvement in lung function. In the case of a pneumothorax, on the other hand, the collapsed lung has to be brought to unfold again by means of a chest drain.
For this purpose, as part of a minimally invasive procedure, a tube is placed in the pleural space (gap in the pleura) through which the air in the pleura is sucked out by the negative pressure, the affected lung is relieved so that it can unfold again. In elderly people with a broken rib, respiratory therapy measures are recommended in many cases, as there is a risk of hypoventilation (limited ventilation of the lungs) or atelectasis (collapsed sections of the lungs) as a result of pain-related breathing.
In addition, a broken rib can cause painful damage to nerves in the intercostal area (intercostal neuralgia), which must be treated accordingly (e.g. with non-steroidal anti-inflammatory drugs).
prevention
One one Broken rib A preventive measure is, for example, wearing protective clothing in so-called contact sports such as football or martial arts to avoid injuries to the chest. Elderly people who have an increased risk of skeletal injuries due to osteoporosis should use walking aids (walkers) when walking unsteadily in order to avoid falls and thus broken ribs.
Aftercare
In the case of a broken rib, targeted physiotherapy makes sense to relieve pain, shorten the healing process and restore full mobility of the chest and thoracic spine. Pain after a broken rib is usually caused by the breathing movement of the chest. Therefore, breathing therapy is useful.
The patient learns important self-help techniques to avert shortness of breath. The physiotherapist also shows the correct execution of everyday movements and the correct breathing technique to keep the diaphragm and chest flexible. Aftercare for a broken rib also includes manual therapy, massages and heat applications. They relieve pain-related tension in the shoulders, arms and thoracic vertebrae.
Physiotherapists often use kinesio tapes. The self-adhesive, elastic cotton tapes fix the bones easily and stabilize the corresponding parts of the body. In addition, they relieve pain and prevent edema from developing. The tapes are applied directly over the break point to ensure full mobility in the affected area.
Many therapists offer magnetic field therapy for broken ribs. Bone and tissue healing is stimulated and pain is reduced. Prior consultation with the attending physician is recommended. In order for a broken rib to heal smoothly, all strenuous physical activity should be avoided. For example, heavy carrying or lifting is prohibited even in the aftercare phase.
You can do that yourself
A simple broken rib usually heals by itself with a few weeks of rest. However, if there is severe pain, circulatory problems or breathing problems, the affected patient should seek medical treatment. The break may be complicated and / or injured adjacent organs. If multiple ribs are affected, the chest may have become unstable, affecting breathing and lungs. Surgeons or orthopedists can deal with this properly.
If the rib fracture or rib series fracture is medically treated or uncomplicated, the patient can relieve his pain by taking anti-inflammatory painkillers. Cooling, light pads also have a pain-relieving effect. Since coughing shakes the chest, it is advisable to take cough suppressants if you have a cold at the same time. Bandages and bands are no longer used to treat a broken rib because they hinder breathing more than they stabilize the chest.
Exercise is taboo in the first four weeks after the break, but moderate exercise outdoors is advisable. Longer walks activate the immune system and make you feel better about life. Patients should also not withdraw or take excessive care. It can take up to eight weeks for a broken rib to heal, but the worst is over in three weeks.
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