Do rib fractures require surgery?

Written by Lv Yao

Orthopedics

Updated on September 01, 2024

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If there is a fracture of a single rib or a single spot with minor displacement, conservative treatment can be chosen without the need for surgery. However, if multiple ribs are fractured in multiple sections, it affects breathing, clinically known as flail chest. This condition can cause severe pain and breathing difficulties, and possibly fluid accumulation in the chest cavity. In such cases, surgery is required to reposition and stabilize the fractures, facilitating recovery. Therefore, whether surgery is needed should be based on the analysis of the injury.

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Written by Li Jin

Orthopedics

49sec

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Is a rib fracture serious?

Rib fractures are a relatively common type of fracture, mainly caused by direct or indirect violent injuries. The severity of a rib fracture depends on the specific condition. For example, a simple rib fracture usually achieves good results with conservative treatment. It can be treated by using a chest bandage for protection, resting, and gradually recuperating. If there are multiple rib fractures accompanied by thoracic deformity, abnormal breathing, and organ damage, this situation is relatively serious. Such fractures generally require surgical treatment. After the fracture, it is important to take good care of the patient, enhance nutrition in the diet, and start coughing up phlegm as soon as possible to prevent complications like lung infections. These measures help promote the recovery from the fracture.

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Written by Luo Peng

Thoracic Surgery

32sec

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Common sites of rib fractures

The most common sites for rib fractures are the fourth to tenth ribs, as they are more prone to fractures. The first to third ribs are relatively short and are protected by the scapula and clavicle. Additionally, the 11th and 12th ribs are quite mobile, making them less likely to fracture when subjected to external forces. Among the fourth to tenth ribs, the fourth to seventh ribs are the most susceptible to fractures, because their internal cartilage is relatively short, making these ribs the most likely to break when impacted.

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Written by Na Hong Wei

Orthopedics

2min 2sec

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What are the symptoms of a rib fracture?

Symptoms of rib fractures include, firstly, there is usually a clear history of trauma, either from direct impact or from falling and the ribs making contact with the ground, etc. Secondly, the main symptoms of a rib fracture include three points: The first is local deformity. If it is a single rib fracture, this deformity is generally not easy to detect. However, after multiple rib fractures, this deformity becomes readily apparent, and you can see that the chest cage is abnormal, with a caved-in appearance. Moreover, in cases like flail chest, breathing is also abnormal. Normally, when inhaling, the ribs should expand outward, but if flail chest occurs, the chest cage appears to expand inward during inhalation; therefore, such a condition often requires surgical treatment, otherwise the consequences are very serious. The second symptom is friction sound and bone rubbing sensation. Some people, after fracturing a rib, during deep breathing or activity, hear cracking sounds from within. This occurs because the continuity and integrity are disrupted by the fracture, and then during breathing or during movement, there is friction between the bones. The third point is abnormal movement, which occurs at locations without joints, resembling joint movements. Normally, a person has 12 ribs on each side. If the continuity and integrity of the ribs are not damaged, there should be no abnormal movement; that is, pressing on the ribs should not cause sensations similar to joint movements at places where there are no joints. Therefore, the symptoms of a rib fracture include three points: the first point being local deformity; the second, bone friction sounds and sensations; and the third, abnormal movement. If any of these three symptoms are present, it is generally indicative of a rib fracture.

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Written by Zhang Zhi Gong

Cardiothoracic Surgery

1min 54sec

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Complications of rib fractures

Rib fracture complications. Structurally, each rib is located above the intercostal arteries, veins, and nerves. Therefore, the most critical issue with rib fractures is that they can cause severe pain for the patient. Thus, the main complication of a rib fracture is pain. This pain persists 24 hours a day, especially when the patient takes deep breaths, coughs, or turns over while sleeping during the night, which can awaken them due to the severe pain. Additionally, because of this pain, the patient is unable to cough effectively. Therefore, a large amount of phlegm, especially in smokers, accumulates in the lungs, leading to complications such as lung infections and pneumonia. Besides pain, another complication of rib fractures is the potential puncture of intercostal arteries or veins, which can cause hemothorax. This condition can result in a significant accumulation of blood in the pleural cavity, and a severe hemothorax can be life-threatening, especially a progressing hemothorax. Therefore, for patients with fractures of three or more ribs, it is recommended, according to the 2017 US guidelines for the treatment of internal fractures and the 2018 consensus from Chinese experts on internal fracture treatment, to actively proceed with surgical interventions. Studies have found that active surgical intervention for fractures of more than three ribs can significantly reduce the patient's pain, shorten hospital stays, and improve quality of life. In summary, the main complications of rib fractures include pneumothorax, hemothorax, pain, and resultant lung infections and pneumonia. These complications are crucial in the treatment of rib fractures and need to be actively addressed.

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Written by Lv Yao

Orthopedics

35sec

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Do rib fractures require surgery?

If there is a fracture of a single rib or a single spot with minor displacement, conservative treatment can be chosen without the need for surgery. However, if multiple ribs are fractured in multiple sections, it affects breathing, clinically known as flail chest. This condition can cause severe pain and breathing difficulties, and possibly fluid accumulation in the chest cavity. In such cases, surgery is required to reposition and stabilize the fractures, facilitating recovery. Therefore, whether surgery is needed should be based on the analysis of the injury.