Rib fracture
| Classification according to ICD-10 | |
|---|---|
| S22.3 | Rib fracture |
| S22.4 | Serial rib fracture |
| ICD-10 online (WHO version 2019) | |
A rib fracture or rib fracture is an injury to one or more ribs with a partial or complete break (fracture) of the bone structure. If a plurality of adjacent ribs of the same side of the body concerned, it is called a serial rib fracture , a single rib repeatedly broken, of a row of fins fracture . The cartilaginous part of the ribs can also break, but this is far less common and difficult to detect.
Frequency and importance
Rib fractures are common. Because they usually heal well, the course of the injury is often uncomplicated. However, a patient with a rib fracture often has to be written incapacitated for several days or weeks, depending on the daily activity, so the clinical picture is of considerable importance in terms of health economics.
Risk factors
A rib fracture is usually preceded by considerable force. Most rib fractures are the result of a chest trauma . If a rib fracture occurs spontaneously or as a result of inadequate trauma , an underlying disease such as osteoporosis or bone metastases must be considered.
Risk factors for a rib fracture are:
- Certain sports
- Old age
- Abuse
- resuscitation
- Bone metastases
- osteoporosis
- Severe cough
diagnosis
The diagnosis of a rib fracture is often possible just by touch. The severe pain and a grinding noise ( crepitation ) when moving are groundbreaking. If the ribs are displaced, the fracture can be demonstrated in multiple planes in chest x-rays . CT imaging can also reveal a rib fracture. In the past, fractures without dislocation (shifting of the edges of the fracture) were often misinterpreted as contusions; they can often only be visualized with ultrasound . Ultrasound of the abdomen, pleura and heart may be necessary to rule out further injuries .
treatment
Treatment is usually conservative. The patient is informed about the disease and is made aware of the course of the disease, which will last about two to three weeks. The pain can be treated with pain relievers . Immobilization with plaster of paris or plating is not common. In the event of complications such as severe shortness of breath, the patient must be x-rayed again to rule out a collapse of the lungs ( pneumothorax ) or a bruise ( hemothorax ).
Complications
In general, broken ribs heal well. Sometimes a rib fracture results in a pneumothorax , lung contusion, or bleeding into the lungs or chest. It is feared that the spleen will be injured by impaling the ribs or rupturing the spleen on its own . In this respect, if there are symptoms under the left costal arch, inpatient admission is advisable or thorough, even repeated examinations are useful.
The pain can lead to reduced breathing movement and thus reduced ventilation of the lungs. This can cause pneumonia to develop.
Extensive serial rib fractures can result in an unstable chest with paradoxical breathing .
A subcutaneous emphysema , an accumulation of air under the skin, causing a crackling sound when keys is harmless, but indicates a pneumothorax, or a violation of other air-containing organs out.
