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A rib fracture can cause severe pain, difficulty breathing and injuries to internal organs, including perforation in the lung, when the fracture has an irregular border. However, when the rib fracture does not have separate bones or an uneven edge, it is simpler to resolve without major health risks.
The main cause of rib fracture is trauma, caused by car accidents, aggression or sports in adults and young people, or falls, more common in the elderly. Other possible causes include weakening of the bones by osteoporosis, a tumor located in the rib or fracture by stress, which appears in people who do repetitive movements or exercises without adequate preparation or in an excessive way.
To treat a rib fracture, the doctor will usually indicate painkillers to relieve pain, in addition to rest and physical therapy. Surgery is indicated only in some cases, in which there is no improvement with the initial treatment, or when the fracture causes severe injuries, including perforation of the lungs or other viscera of the chest.
Main symptoms
The most common symptoms of a rib fracture include:
- Chest pain, which worsens with breathing or palpation of the chest;
- Breathing difficulty;
- Bruises on the chest;
- Deformity in the coastal arches;
- Crep sounds during chest palpation;
- The pain gets worse when trying to twist the trunk.
Usually, the rib fracture is not severe, however, in some cases, it can cause perforation of the lungs and other organs and blood vessels in the chest. This situation is worrisome, as it can cause life-threatening bleeding, so a quick medical evaluation and the start of treatment is necessary.
The fracture is more common in young people who suffer a car or motorcycle accident, but in the elderly it can happen due to falls, and in the baby or child, there is a suspicion of mistreatment, since the ribs in this phase are more accommodating, indicating the repetition of pushing or direct trauma to the chest.
When to go to the doctor
You should go to the doctor if you experience symptoms such as:
- Severe chest pain (localized or not);
- If you have had any major trauma, such as a fall or accident;
- If it is difficult to breathe deeply because of the increased pain in the rib region;
- If you are coughing with green, yellow or bloody phlegm;
- If there is a fever.
In such cases, it is recommended to go to the Emergency Unit (UPA) closest to your home.
How to confirm the fracture
The diagnosis of a fracture in the chest is made by the physical assessment of the doctor, who may also order exams such as chest X-rays, to identify the injury sites and observe other complications such as bleeding (hemothorax), air leak from the lung to the chest ( pneumothorax), pulmonary contusion or aortic injuries, for example.
Other tests that can also be done are chest ultrasound, which can more accurately identify complications such as air leakage and bleeding. Chest tomography, on the other hand, can be performed when there are still doubts about the injuries in patients at higher risk and in patients with indication for surgery.
However, X-rays detect less than 10% of fractures, especially those that are not displaced, and ultrasonography also does not show all cases, which is why physical evaluation is of great importance.
How the treatment is done
The main way to treat fractures of the ribs is with conservative treatment, that is, only with pain-relieving medications, such as Dipyrone, Paracetamol, Ibuprofen, Ketoprofen, Tramadol or Codeine, for example, in addition to resting, organism will be in charge of healing the injury.
It is not recommended to tie anything around the chest because it can hinder the expansion of the lungs, causing major complications, such as pneumonia, for example.
In cases of severe pain, it is possible to make injections, called anesthesia blocks, to relieve pain. Surgery, on the other hand, is not usually routinely indicated, however, it may be necessary for more severe cases, in which there is heavy bleeding or involvement of the rib cage organs.
Physiotherapy is also very important, as exercises that help maintain muscle strength and amplitude of the chest joints are indicated, as well as breathing exercises that help to find better ways to expand the chest.
Day-to-day care
- During recovery from the fracture it is not recommended to sleep on your side or on your stomach, the ideal position is to sleep on your stomach and place a pillow under your knees and another on your head;
- It is also not recommended to drive in the first weeks after the fracture, nor to twist the trunk;
- If you want to cough, it can help lessen the pain if you hold a pillow or blanket against your chest at the time of coughing. When you feel your chest you can sit in a chair, reclining your torso forward to be able to breathe better;
- Do not practice sport or physical activity until the doctor's release;
- Avoid staying in the same position for a long time (except during sleep);
- Do not smoke, to help heal faster.
Recovery time
Most rib fractures are healed within 1-2 months, and during this period it is very important to control pain so that you can breathe deeply, avoiding complications that may arise because of this difficulty in breathing normally.
What are the causes
The main causes of rib fracture are:
- Trauma to the chest due to car accidents, falls, sports or aggression;
- Situations that cause repetitive impacts on the ribs, due to coughing, sportsmen or when performing repetitive movements;
- Bone tumor or metastasis.
People with osteoporosis are at increased risk of developing rib fractures, as this disease causes bone weakness and can cause fractures even without impact.