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A rib fracture is a crack or break in one of
the bones of the rib cage. A break in the thick tissue (cartilage) that connects the ribs to the breastbone
may also be called a fractured rib, even if the bone itself is not
The most common cause of a fractured rib is a direct blow
to the chest, often from a car accident or a fall. Coughing hard can also
fracture a rib. This is more likely to happen if you have a disease that has
made your bones weak, such as
osteoporosis or cancer.
Your ribs have two main jobs:
The muscles used for breathing pull on the ribs, so
breathing may be very painful when you have a fractured rib.
It is important
to see a doctor after a rib injury. A blow that is hard enough to fracture a
rib could also injure your lungs, spleen, blood vessels, or other parts of your
body. A common injury when you have a fractured rib is a punctured or collapsed lung (pneumothorax).
Flail chest is a serious problem that happens when three or more ribs are
broken in more than one place. If you have flail chest, the broken area can't
hold its shape when you take a breath. This leaves less space in your chest for
your lungs to open and air to flow in. It also makes it harder for the muscles
to work well, so it's harder to take a breath.
A fractured rib may cause:
If you can't breathe normally because of your injuries, you may:
How is a fractured rib diagnosed?
Your doctor will ask questions about your injury
and do a physical exam. The doctor may:
You may need to have an X-ray or other imaging test if your
doctor isn't sure about your symptoms. But rib fractures don't always show up
on X-rays. So you may be treated as though you have a fractured rib even if an
X-ray doesn't show any broken bones.
Most fractured ribs are treated at home and will heal on their own
over time. Home treatment will help you manage the pain while you heal. Pain
relief can help you feel better and let you take deeper breaths.
A fractured rib usually takes at least 6 weeks to heal. To help manage
the pain while the fracture heals:
While you are healing, it is important to cough or take the
deepest breath you can at least once an hour. This can help prevent pneumonia
partial collapse of the lung tissue.
you have fractured your ribs and you have not injured your neck or back, it is
a good idea to lie on your injured side. This may seem odd at first, but it
will let you take deeper breaths.
In the past, it was common to
tape or tightly wrap the injured rib area. But you should not do this, even if it eases your pain. It can keep you from
taking deep breaths, and it could cause parts of your lung to collapse or could
increase your risk for pneumonia.
The American Academy of Orthopaedic Surgeons (AAOS)
provides information and education to raise the public's awareness of
musculoskeletal conditions, with an emphasis on preventive measures. The AAOS
website contains information on orthopedic conditions and treatments, injury
prevention, and wellness and exercise.
Other Works Consulted
Brunett PH, et al. (2011). Pulmonary trauma. In JE Tintinalli, ed., Emergency Medicine: A Comprehensive Study Guide, 7th ed., pp. 1744–1758. New York: McGraw-Hill.
Collier BR, et al. (2007). Injuries to the thorax
section of Wilderness trauma, surgical emergencies, and wound management. In PS
Auerbach, ed., Wilderness Medicine, 5th ed., pp.
488–489. Philadelphia: Mosby Elsevier.
Hemmila MR, Wahl WL (2010). Thoracic injuries section of Management of the injured patient. In GM Doherty, ed., Current Diagnosis and Treatment Surgery, 13th ed., pp. 188–193. New York: McGraw-Hill.
McGillicuddy D, Rosen P (2007). Diagnostic dilemmas
and current controversies in blunt chest trauma. Emergency Medicine Clinics of North America, 25(3): 695–711.
Tzelepis GE, McCool FD (2010). The lungs and chest wall diseases. In RJ Mason et al., eds., Murray and Nadel's Textbook of Respiratory Medicine, 5th ed., vol. 2, pp. 2067–2083. Philadelphia: Saunders Elsevier.
April 16, 2012
William H. Blahd, Jr., MD, FACEP - Emergency Medicine & Kenneth J. Koval, MD - Orthopedic Surgery, Orthopedic Trauma
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