Rib Fracture

Rib Fracture is more frequent in older people

Rib fracture is a serious problem which is generally seen in older adults than other age group. Rib fracture is a break or fracture in one or more of the bones making up the rib cage. The ribs may be fractured in more than one place. Rib fractures are throbbing because the ribs have to move for breathing. If there is a small fracture, it can arouse a tendon and cripple an arm. When several ribs are broken in several places, a flail chest results, and the detached bone sections will move separately from the rest of the chest. Rib fracture usually takes 3 to 8 weeks to heal.

Basically, ribs have two major functions. They protect the organs in chest. They help person to breathe by keeping space open inside his chest while the muscles he uses to breathe squeeze in, or contract. This leaves plenty of space for lungs to fill up with air. The muscles used for breathing pull on the ribs, so breathing may be very aching when rib is broken. Flail chest is a serious condition that occurs when three or more ribs are broken in more than one place. If person have flail chest, the broken area can not hold its shape when he takes a breath.

Causes

Rib fractures can occur without direct trauma and patient complains after sustained coughing and in various sports for example, rowing and golf often in elite athletes. These fractures can also occur as a result of many diseases such as cancer or infections. Causes vary from a fall or a blow to the chest to hard coughing or sneezing. In children, there are more flexible chest walls than adults do, so their ribs are more likely to bend than to break. If rib fractures occur in children, it indicate that severe thoracic injuries such as pulmonary contusion. A rib fracture in a child is mainly caused by car accidents. Child abuse is also a common cause of rib fracture. Bone diseases, such as rickets or osteogenesis imperfecta (brittle bone disease), may also cause fractures in children. It is observed that rib fractures is more common in teenagers who are playing contact sports, such as football or hockey.

Signs/Symptoms

Patient with rib fracture suffer pain, especially when taking a breath or with movement. Other symptoms are tenderness and shallow breathing. A portion of the chest wall moves separately from the rest of the chest (flail chest). There is a grating sound with breathing or movement. Rib fractures are also a sign of more serious wound in elderly people. Patients also exhibit symptoms of anxiousness, restless, or scared. They complain for headache, feel dizzy, tired, or sleepy.

Diagnosis:

Medical practitioners carefully look at injury and do a physical exam. The doctor may push on chest to find out where you are hurt. He also checks breathe and listen to lungs to make sure air is moving in and out normally. Doctor listen to heart and check head, neck, spine, and belly to make sure there are no other injuries.
For proper diagnosis, patient is advised to have an X-ray or other imaging test if doctor is not sure about symptoms. But rib fractures do not always show up on X-rays.
Computerized tomography scan, also known as CAT scan is advised for patients of rib fracture. This is a type of x-ray that uses computers to take pictures of patient's chest. It can be used to know the status of injury.

Treatment

There is no definite treatment for rib fractures, but doctors advised to take various supportive measures. In simple rib fractures, pain can lead to reduced movement and cough suppression; this can contribute to formation of secondary chest infection. Adequate analgesia can avoid this problem. Flail chest is dangerous injury and will often require a period of assisted ventilation. Flail chest and first rib fractures are high-energy injuries and should prompt investigation of damage to underlying viscera (e.g., lung contusion) or remotely (e.g., C spine injury). Spontaneous fractures in sports people generally require a cessation of the cause, e.g. time off rowing, whilst maintaining cardiovascular fitness. If doctor diagnose that patients have internal injuries along with a fractured rib, he may be hospitalized. Caretaker may give medicine to decrease pain due to rib fracture. Since pain medicine can have side effects. Doctors may prescribe strong medicine to control pain. But most fractured ribs are treated at home and will heal on their own over time. Home remedies are more helpful to manage the pain. Pain relief can help patient feel better and let him take deeper breaths. A fractured rib usually takes at least 6 weeks for complete recovery. Patient can adopt many supportive techniques to alleviate pain. They can put ice on the injured area, take extra rest, and take pain medicine such as aspirin or ibuprofen. But it is strongly recommended that patients must take medication according to doctor's advice. In the process of healing, it is important for patients to cough or take the deepest breath at least once an hour. This can help prevent pneumonia or a partial collapse of the lung tissue. If person has fracture in ribs and he is not injured in neck or back, it is better to lie on injured side. This may be uncomfortable for some time but it will let patient take deeper breaths.

Earlier people use traditional technique for rib fracture. They tape or tightly wrap the injured rib area. But today, doctors do not recommend such technique even if it eases pain. It can keep patient from taking deep breaths, and it could lung to collapse or there are chances of developing pneumonia. Other line of treatment is deep breathing exercises. This exercise should be done once an hour to keep patient from getting a lung infection. Deep breathing opens the tubes going to lungs. Doctors advise to take 10 deep breaths in a row every hour while awake. Patient can support his ribs with his hands or a pillow while taking the deep breaths to help decrease pain. Another way to give relief to fractured rib is to put ice packs on fractured rib to decrease swelling, pain, and redness. Surgery is another option. It is done to fix a rib fracture or complications of a rib fractures. Many complications develop after surgery. It includes a blood vessel injury that may cause bleeding into his chest (hemothorax), a punctured lung that has allowed air to escape into his chest (pneumothorax). With treatment, such as rest and medicine, complications may be prevented and patient may continue his normal activities.

Patients who have rib fracture must avoid strenuous activity. Be careful not to bump the injured rib, eat a normal, well-balanced diet, drink plenty of fluids to avoid constipation, take deep breaths several times a day to keep the lungs free of infection, and do not wear a rib belt or binder. They may apply heat to the injury to help relieve pain. Always use a warm heating pad, whirlpool bath, or warm, moist towels. They can take over-the-counter pain-killers such as aspirin, acetaminophen, or ibuprofen. Patient must immediately call doctor when they suffer from a high temperature, develop a cough, cough up thick or bloody sputum, trouble breathing, develop nausea, vomiting, or abdominal pain and pain gets worse.

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