Rib Fracture

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1- Introduction

2- Anatomical Overview

3- Causes

4- Treatment 


The short, broad 1st rib, postero-inferior to the clavicle, is rarely fractured because of its protected position (it cannot be palpated). Consequently, a first rib fracture is commonly viewed as a hallmark of severe injury in blunt trauma.mucoid degeneration. Flexion of the wrist makes the cyst enlarge, and it may be painful.
© image from Color Atlas Of Anatomy

Anatomical Overview

structures crossing its superior aspect may be injured, including the brachial plexus of nerves and subclavian vessels that serve the upper limb. The middle ribs are most commonly fractured. Rib fractures usually result from blows or crushing injuries. The weakest part of a rib is just anterior to its angle; however, direct violence may fracture a rib anywhere, and its broken end may injure internal organs such as a lung and/or the spleen. Fractures of the lower ribs may tear the diaphragm and result in a diaphragmatic hernia. Rib fractures are painful because the broken parts move during respiration, coughing, laughing, and sneezing. Rib fractures have been surgically plated or repaired for this reason, but the practice remains controversial.


  • 1. Trauma

    • Direct Blows: A direct impact to the chest from an accident, such as a car crash, physical assault, or sports injury, can break ribs.
    • Falls: Falling onto a hard surface, especially in the elderly or individuals with osteoporosis, can result in rib fractures.
    • Crushing Injuries: Situations where the chest is compressed or squeezed, such as during a heavy object falling on someone, can cause rib fractures.

    2. Repetitive Stress

    • Coughing: Severe or chronic coughing, especially in individuals with conditions like chronic bronchitis or asthma, can cause rib fractures due to repetitive stress on the rib cage.
    • Sports Activities: Certain sports, especially those involving repeated movements or impacts, such as rowing, golf, or baseball pitching, can lead to stress fractures in the ribs.

    3. Bone Health Conditions

    • Osteoporosis: A condition that weakens bones, making them more susceptible to fractures. Even minor trauma or stress can cause a rib fracture in individuals with osteoporosis.
    • Bone Cancer: Metastatic cancer or primary bone cancer can weaken the ribs, leading to fractures even with minimal trauma.

    4. Childbirth

    • Labor and Delivery: The intense physical exertion during labor and delivery can occasionally cause rib fractures in the mother, especially if the labor is prolonged or involves intense pushing.

    5. Pathological Fractures

    • Diseases: Conditions like Paget’s disease of bone, rheumatoid arthritis, or infections such as osteomyelitis can weaken the bone structure, making ribs more prone to fractures.

    6. Iatrogenic Causes

    • Medical Procedures: Certain medical interventions, such as cardiopulmonary resuscitation (CPR), can result in rib fractures due to the force applied during chest compressions.



Treatment depends on the severity of the fracture:

    1. Pain Management:

      • Over-the-counter pain relievers: Such as ibuprofen or acetaminophen.
      • Prescription medications: For more severe pain.
      • Nerve blocks: In cases of severe pain not relieved by other methods.
    2. Rest and Activity Modification:

      • Avoid activities that worsen pain or risk further injury.
      • Gradual return to normal activities as pain improves.
    3. Breathing Exercises:

      • To prevent pneumonia and maintain lung function, deep breathing exercises or use of an incentive spirometer may be recommended.
    4. Surgical Intervention:

      • Rarely needed but may be required for multiple severe fractures or if there are complications like a punctured lung.
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