What should I do if I have a rib fracture?

Written by Nie Lei Sheng
Orthopedics
Updated on October 26, 2024
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Firstly, a clear diagnosis should be made for rib fractures to determine whether the fractures have caused damage to internal organs, leading to complications such as pneumothorax or hemopneumothorax, which are more serious conditions. Active treatment for internal organ damage and management of pneumothorax or hemopneumothorax should be pursued, along with treatment for the rib fractures.

If the rib fracture is merely a simple, non-displaced fracture and the number of fractured ribs is less than three, wearing a chest brace for protection can be sufficient. Supportive symptomatic treatment and bed rest should be adopted. Generally, the fracture can begin to heal within four to six weeks.

In cases of multiple rib fractures where the chest wall is unstable, with symptoms like abnormal breathing, surgery may be necessary to stabilize the chest wall and ensure respiratory and circulatory function. Therefore, treatment for rib fractures should be tailored based on the condition of the patient.

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Is a rib fracture serious?

Whether a rib fracture is serious depends mainly on the extent of the fracture and the damage to the surrounding tissues. Generally, a single rib fracture or a non-displaced rib fracture is not serious and requires conservative treatment. However, if there are multiple rib fractures occurring at once, breaking several ribs, including possibly the sixth rib, the consequences can be very serious because it may result in a flail chest. Secondly, a rib fracture can potentially damage surrounding structures such as the pleura, lung tissue, and blood vessels, resulting in conditions such as pneumothorax, pleural effusion, and even active hemothorax, which must be promptly treated to avoid life-threatening situations. Thirdly, if a rib fracture heals in a deformed manner and is not treated, it can compress blood vessels and nerves, causing a persistent type of intercostal neuralgia even after healing. Apart from the local deformity, this situation often stimulates the intercostal nerves and may require surgical intervention. Therefore, the severity of a rib fracture depends mainly on the degree of the fracture and its aftermath, and typically requires assessment by a professional 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 Li Jie
Orthopedics
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Can you move with a rib fracture?

After a rib fracture, the patient's limbs can still move, and movement of the limbs should generally not pose major problems. However, excessive movement can sometimes cause pain, as well as movement and displacement at the fracture ends. Therefore, it is generally advised that after a rib fracture, the patient should primarily rest and minimize movement, especially within the first two weeks of the acute phase, where bed rest is strongly recommended. Avoid strenuous activities, although some gentle exercise can be appropriate, but vigorous physical labor is not advised.

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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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How to care for a rib fracture

After a rib fracture, it is recommended to adhere to the following aspects in terms of care. Firstly, after a rib fracture, a chest bandage can be used to protect and stabilize the area, which generally requires about four to six weeks. Secondly, in terms of diet, it is important to enhance nutrition. Consume foods rich in high-quality proteins, calcium, and vitamins. These foods aid in recovery by providing nutrients and energy, helping to promote the healing of fractures. Additionally, symptomatic medication treatment, such as non-steroidal anti-inflammatory painkillers and traditional Chinese medicine that invigorates blood circulation and removes blood stasis, can be used to facilitate recovery. During the recovery period of the fracture, it is advised to start rehabilitation exercises as soon as possible and encourage activities such as coughing and expectorating to prevent complications such as dependent pneumonia and atelectasis. (Please consult a professional physician for specific medication usage and avoid self-medication.)