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
55sec home-news-image

How to care for a rib fracture

After a rib fracture, if it is a single or multiple closed fractures and there are no internal injuries with the fracture in a good position, this situation can be treated conservatively using a chest strap for stabilization. If there are multiple rib fractures accompanied by abnormal breathing, open fractures, or associated internal injuries, surgical treatment is mainly adopted. During the recovery period of the fracture, it's important to rest. If there is pain, non-steroidal anti-inflammatory analgesic drugs can be used to alleviate the pain. During recovery, it is encouraged to cough and expectorate to avoid complications such as lung infections or atelectasis. Additionally, it is necessary to focus on a nutritious diet; generally, rib fractures can effectively recover in about four to six weeks. (Specific medications should be used under the guidance of a physician.)

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Written by Li Jie
Orthopedics
1min 13sec home-news-image

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 Guan Jing Tao
Orthopedics
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How long does the pain from a rib fracture last?

Taking a single rib fracture as an example, the pain generally lasts for one to two weeks. Then, over two to four weeks, the pain at the site of the rib fracture gradually eases and stabilizes. In the later stages, as the fracture healing progressively strengthens, the pain will gradually lessen until there is no significant pain. This period is generally about one to three months after the fracture, meaning that the most significant pain from a rib fracture usually lasts from one to two weeks, and then, as the fracture heals, the pain gradually decreases and improves.

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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 Lv Yao
Orthopedics
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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.