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 Lv Yao
Orthopedics
53sec home-news-image

Can you move with a rib fracture?

The rib has suffered a fracture. Depending on the displacement of the fracture, whether it's a single rib or multiple ribs in multiple locations, and whether breathing is affected or there is a presence of blood or fluid in the chest cavity, a comprehensive analysis is required. If the fracture is a single rib or multiple ribs with hairline fractures, it is possible to move around, but rest is also important to avoid turning a stable fracture into one with significant displacement. If there are fractures in multiple ribs at multiple locations and a large amount of blood or fluid in the chest cavity, along with flail chest that significantly impacts breathing, it is not recommended to continue activities. Rest should be prioritized, and, if necessary, joint cavity puncture drainage may be performed to relieve symptoms.

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Written by Li Jie
Orthopedics
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How to treat rib fractures well?

Rib fractures are very common. We consider fractures of three or fewer ribs to be stable fractures, which generally only require local external fixation using a rib belt or chest wrap to stabilize the fracture and alleviate pain. Additionally, treatments can include drugs that activate blood circulation and reduce stasis, anti-swelling and pain relief drugs, or non-steroidal anti-inflammatory drugs. Then, the fractures can heal on their own. However, if more than three ribs are fractured, we consider it an unstable fracture, which may need to be fixed. Such cases might require surgery to reposition and stabilize the fractured bones. Rib fractures themselves are not very concerning; what is concerning are the complications, such as hemothorax or pneumothorax. If conditions like pleural effusion or pneumothorax occur, it is advised to perform closed chest drainage by inserting a drainage tube to release the accumulated blood and air to avoid severe complications. Rib fractures do not require special treatment; with effective stabilization and treatment, most can fully recover.

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Written by Wang Cheng Lin
Orthopedics
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Rib fractures are divided into several types.

The most common types of rib fractures in clinical practice are: The first is pathological fractures, the second is spontaneous rib fractures, the third is a single rib fracture, and the fourth is multiple rib fractures. Pathological rib fractures are due to inherent diseases, such as tumors leading to rib fractures. The second type, spontaneous fractures, occur due to intense activities or movements of the patient, such as severe coughing and sneezing, or sudden severe contraction of the chest muscles, causing the ribs to break due to tensile forces; this is called a spontaneous rib fracture. The third type is a single rib fracture, and the fourth type involves multiple rib fractures, both of which are commonly seen in rib fractures caused by trauma. These are the most common types of rib fractures currently seen in clinical practice.

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Written by Cheng Bin
Orthopedics
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Symptoms of rib fracture and pneumothorax

Patients who have suffered a rib fracture typically experience localized pain which affects their ability to turn, bend, or perform normal movements such as breathing and coughing. If the rib fracture is accompanied by a pneumothorax, symptoms like chest tightness and breathlessness often occur. Diagnosing a rib fracture with pneumothorax requires an assessment of the patient's clinical symptoms along with various supportive examinations. For example, a chest CT scan can confirm the presence of a pneumothorax and determine the severity of the condition. In cases where the pneumothorax is severe and the lung compression exceeds one-third, it is necessary to actively pursue thoracic closed drainage surgery as treatment.

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Written by Luo Peng
Thoracic Surgery
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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.