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Rib Fractures

By

Thomas G. Weiser

, MD, MPH, Stanford University School of Medicine

Last full review/revision Jun 2020| Content last modified Jun 2020
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Topic Resources

A rib fracture is a crack or break in the bones enclosing the chest.

  • Rib fractures cause severe pain, particularly when a person breathes deeply.

  • A chest x-ray is usually taken.

  • People are given pain relievers and are asked to cough or breathe deeply about once an hour to prevent lung problems.

Rib fractures usually result from strong blunt force, such as a fall from a height, a motor vehicle crash, or a hit with a baseball bat. However, sometimes in older people who have osteoporosis Osteoporosis Osteoporosis is a condition in which a decrease in the density of bones weakens the bones, making breaks (fractures) likely. Aging, estrogen deficiency, low vitamin D or calcium intake, and... read more Osteoporosis , only a slight force (as occurs in a minor fall) is required.

Flail chest can result if several adjacent ribs are broken in more than one place. In flail chest, a segment of the chest wall separates from the rest and moves in the opposite direction from the rest of the chest wall when a person breathes. Breathing becomes more difficult and tiring. Usually, a blow strong enough to cause flail chest also bruises the lung beneath the injured area (called pulmonary contusion Pulmonary Contusion A pulmonary contusion is a bruise of a lung, which causes bleeding and swelling. People have pain, usually due to the chest wall injury, and often feel short of breath. Doctors make the diagnosis... read more ).

Symptoms of Rib Fractures

Rib fractures cause severe pain, particularly when people breathe deeply. The pain lasts for weeks.

  • Older people

  • People with several rib fractures

Because older people are more likely to develop these complications, they also have a higher risk of death due to a rib fracture than do younger people.

Diagnosis of Rib Fractures

  • A doctor's evaluation

Doctors suspect rib fracture when one or more ribs are very tender in one particular spot. Sometimes doctors can feel the broken ribs when they gently push the injured area. Doctors do not always need to confirm rib fractures with an x-ray because the presence of rib fractures does not change the way a chest injury is treated. Nonetheless, doctors usually do a chest x-ray X-Rays of the Chest Anyone thought to have a heart disorder has chest x-rays taken from the front and the side. Typically, the person is standing upright, but chest x-rays can be done with people lying in bed if... read more X-Rays of the Chest to detect serious problems that can accompany rib fractures, such as a bruised or collapsed lung. Not all rib fractures can be seen on a chest x-ray.

Did You Know...

  • Diagnosis of rib fractures by x-rays is unnecessary.

Treatment of Rib Fractures

  • Pain relievers

  • Coughing and deep breathing

Regardless of whether rib fractures are identified, people are given pain relievers (analgesics Treatment of Pain In some cases, treating the underlying disorder eliminates or minimizes the pain. For example, setting a broken bone in a cast or giving antibiotics for an infected joint helps reduce pain.... read more ). Those with severe pain are usually given opioid pain relievers such as oxycodone or hydrocodone. Sometimes hospitalized people who have severe pain are treated by numbing the nerve to the affected ribs or with injection of drugs around the spinal cord (epidural analgesia).

People with a rib fracture are asked to cough or breathe deeply about once an hour while they are awake to keep the air sacs in the lung open and prevent pneumonia Prevention Pneumonia is an infection of the small air sacs of the lungs (alveoli) and the tissues around them. Pneumonia is one of the most common causes of death worldwide. Often, pneumonia is the final... read more Prevention .

People with several rib fractures may need to be treated in the hospital.

People with flail chest often need to have their breathing supported with a ventilator Mechanical Ventilation Mechanical ventilation is use of a machine to aid the movement of air into and out of the lungs. Some people with respiratory failure need a mechanical ventilator (a machine that helps air get... read more until the injuries heal. Some people with flail chest may need surgery to reduce the risk of complications, including pneumonia, lengthy hospital stays, and death.

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Test your knowledge
Fractures of the Jaw and Midface
Fractures to one or more facial structures can result from a single injury. Jaw fractures may occur to the mandible, or lower jaw, or to the maxilla, bone of the upper jaw. Other structures susceptible to fracture include the eye sockets, nose, and cheek bones. Which of the following facial structures is most likely to fracture if a person falls from a great height or hits the windshield of a car face-first during a motor vehicle accident?
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