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
58sec home-news-image

How to treat rib fractures?

For the treatment of rib fractures, if it is a single or multiple closed fractures, and if there are no internal organ injuries, and the fracture alignment is good, non-surgical treatment can generally achieve good results. For example, using a chest bandage to secure and protect the area, generally immobilizing it for about 4 to 6 weeks, can effectively aid recovery. For multiple rib fractures, especially those accompanied by abnormal breathing, open fractures, or concurrent internal organ injuries, surgical treatment is primarily adopted. During the recovery period from the fracture, rest is important. If there is pain, some non-steroidal anti-inflammatory pain relief medications can be used to alleviate the pain. Additionally, during the recovery period, coughing should be encouraged to prevent complications such as lung infections or atelectasis. (Please use medication under the guidance of a doctor)

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Written by Wang Cheng Lin
Orthopedics
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Hazards of Rib Fractures

The most severe case of rib fracture is what we call the occurrence of pneumothorax. Pneumothorax is caused by the puncture of the pleural cavity due to the fractured end, resulting in pneumothorax or hemothorax compressing the lung tissue, causing severe systemic respiratory and circulatory disorders. Severe pneumothorax can directly endanger life; this is the most serious harm of rib fractures. However, generally speaking, it is rare for a rib fracture to result in severe pneumothorax; most cases involve only a small amount of effusion or a small amount of air accumulation. Thus, generally, the harm from rib fractures is not very significant; the most severe harm is causing severe pneumothorax, affecting the overall respiratory and circulatory functions, and endangering life.

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Written by Guan Yu Hua
Orthopedic Surgery
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Rib fractures are most commonly seen in which ribs?

Rib fractures often occur in ribs 4 to 10, while ribs 1 to 3 are protected by the clavicle at the front. Because the clavicle is more prominent and forward, if there is trauma, it is likely to bear the force first, making clavicle fractures more probable, whereas ribs 1 to 3 are less likely to fracture. If it is the back, the shoulder blade can provide protection, hence, the shoulder blade is likely to fracture first, making fractures of ribs 1 to 3 very unlikely. Furthermore, ribs 11 to 12 are floating ribs with greater mobility, thus the chance of fracture is very low, which is quite rare. After a fracture, radiographic examination is required for a clear diagnosis, and it is also necessary to rule out injuries to organs, such as pneumothorax or rupture of the liver or spleen, which requires an ultrasound for differentiation.

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Written by Li Jin
Orthopedics
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How to recuperate from a rib fracture

After a rib fracture, it is suggested to pay attention to the following aspects in terms of care: Firstly, after a rib fracture, it is advisable to use a chest binder for protection, which generally needs to be fixed for about four to six weeks. Secondly, in terms of diet, it is important to enhance nutrition. Foods rich in high-quality protein, calcium, and vitamins should be consumed more frequently. These foods help provide nutrients for the recovery of the fracture and promote healing. At the same time, symptomatic medication treatment can be used. For example, anti-inflammatory and analgesic drugs, and traditional Chinese medicines that promote blood circulation and remove blood stasis can facilitate recovery. During the recovery period of the fracture, it is recommended to start rehabilitative exercises as soon as possible and encourage activities like coughing and expectorating to avoid complications such as obstructive pneumonia and lung collapse.

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Written by Na Hong Wei
Orthopedics
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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.