The sharp fractured end of the rib can puncture the lung, causing air leakage, a condition called a pneumothorax, which is potentially life threatening. If the fractures are complex, the patient may suffer from additional damage to underlying structures. Pain is typically elicited with breathing or coughing. The most common symptom of rib fractures is pain. CT scans are useful to determine if underlying lung injury is present, known as a contusion, or to identify if air has escaped the lung as a pneumothorax. Other imaging modalities such as CT scans also diagnose rib fractures and are more sensitive to identify them. Floating segments of ribs, known as a flail chest, can also be easily seen on x-ray. Displaced fractures appear to lack contour along the edge of the rib on x-ray. Simple (non-displaced) fractures appear as cracks in the rib or a jagged edge. Rib fractures are typically diagnosed on chest x-ray and the severity of the fracture is easily seen. Patients with advanced age, osteoporosis or osteopenia have an increased risk of number and severity of fractures. Although the injury mechanism itself is an important consideration when discussing rib fractures patient specific considerations are also important. Approximately 10% of all patients admitted for blunt chest trauma have one or more rib fractures. Blunt trauma causes rib fractures by exerting direct pressure on the rib causing it to break. automobile accidents, falls from height, assault, or even severe coughing). The most common mechanism causing rib fractures is blunt trauma (i.e. A lower rib fracture is more likely associated with injuries to the diaphragm, liver or spleen. Fractures of the first and second ribs are rare but may be associated with serious damage to the brachial plexus of nerves, the subclavian vessels or associated with head, facial or thoracic aorta injuries. The most common ribs fractured are the 7th through 10 th ribs. It occurs when multiple adjacent ribs are broken in multiple places, separating a segment which is free-floating and moves independently. A serious condition involved with rib fractures is called ‘flail chest’. More complex fractures can cause the edges of the bone to become misaligned or displaced. Ribs usually fracture at the point of impact or in the back where structurally they are weakest. Rib fractures that are single and non-displaced are classified as hairline fractures or simple fractures. A rib fracture, simply put, is a break in the rib. They are also attached to the spine for added stability. The ribs are connected to each other by several layers of muscles which assist with breathing. The chest cavity contains vital organs and is protected by a bony rib cage.
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December 2022
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