What to do in case of rib fracture
Author: Surgeon Denisov MM
The publication briefly presents information on what should be done at the fracture of the ribs. So, on average, rib fractures account for 15% of all types of bone damage. The mechanism of injury in this pathology can be both direct and indirect. An example of an indirect mechanism is a fracture of the ribs in the lateral parts during compression of the chest in the anteroposterior direction. Due to the fact that the ribs are well connected with each other, the displacement of fragments in significant volumes does not occur.
Immediately after the fracture, the victim complains of shortness of breath, which he characterizes as the inability to breathe and severe pains localized at the site of injury. When coughing, the pain intensifies and becomes sharp. Therefore, the patient’s entire behavior is sparing: he moves slowly, takes off his clothes, breathes shallowly to reduce the volume of respiratory movements. If, in case of fractures of the ribs, the lungs are involved in the process, then hemoptysis begins, and the development of subcutaneous emphysema in the area of the fracture is also possible. Detailed information in the material is emergency care for pulmonary hemorrhage .
When the victim goes to the doctor, the conditions and the nature of the injury are assessed and clarified (on which side he fell, from what height, with which the blow was struck, and so on). On examination, attention is drawn to the involvement of the chest in the act of breathing, namely the uniformity of the right and left halves.
Often in the area of the fracture is found painful swelling. The doctor asks the victim to take a deep breath. At this attempt, at the height of inhalation, a sharp pain occurs, in connection with which the patient stops the continuation of inhalation. This symptom is called the "interrupted breath." It should be noted that this symptom is absent in case of rib bruises.
On palpation, the doctor reveals pain, at the point of maximum pain - deformity in the form of steps, indicating a fracture.
If the doctor suspects complications, in addition to the examination and palpation, an ultrasound examination of the chest and abdominal organs is performed. The best method is radiography.
The main complications are pneumothorax (accumulation of gas in the pleural cavity), injury and contusion of the lung and heart, rupture of the intercostal artery, leading to internal bleeding. Quality material on the symptoms of internal bleeding will help to avoid mistakes.
In addition, damage to the abdominal organs and retroperitoneal space (spleen, kidney, liver) is possible. Therefore, in order to avoid diagnostic errors, minimal manipulations should include an examination of the state of the chest organs, pulse, blood pressure, blood and urine analysis.
Particular attention is paid to multiple fractures, as they pose a huge threat to the life of the victim, leading to the development of acute respiratory failure and pleuropulmonary shock.
With a satisfactory condition of the victim, fractures of no more than two ribs and the absence of complications, treatment at home is possible. In other cases, the patient must be hospitalized.
First aid begins with the introduction of pain medication (for example, promedol). During transportation, the chest must be tightly bandaged. In older people, such a manipulation is not worth it, because of the high risk of developing pneumonia.
Therapeutic treatment is the use of alcohol-procaine blockade, which consists in the introduction of procaine and alcohol at the site of the fracture, after which the pain completely disappears. Mandatory is the appointment of expectorant drugs (Bromhexine, tussin), respiratory and therapeutic exercises.
The fusion of the ribs occurs within one month.
If the fusion does not occur for a long time, then the ribs fix the plastic tire. To do this, heat a special plastic plate in hot water and impose on the chest in the area of the fracture, simulating its shape along the contour of the body surface. Then, by piercing the skin with a semi-oval surgical needle, the splint is fixed with sutures. The tire is removed after 3 weeks.
If the rib fracture occurred to the left or right of the sternum, skeletal traction is resorted to. The essence of this procedure lies in the fact that using a needle under local anesthesia around the sternum, wire with anti-corrosive properties is drawn and transferred to the block. Traction is performed within two to three weeks.
Allocate so-called fenestrated fractures, which are characterized by fracture of the ribs in several places, which leads to the loss of its smaller part. An effective method of treatment in this situation is osteosynthesis, which is carried out using a special apparatus, thanks to which the free part is fixed. By stitching in this way even half of the broken ribs along two lines, a good fixation of the moving segment is ensured.
author: doctor Maslak A.A.
Very often, if there is pain in the chest, first think about heart problems and turn to a cardiologist. However, it is not rare that the case is not in the heart, but in the intercostal nerves, which for some reason are compressed and irritated by either a pathologically modified spine or strained muscles.
Author: doctor Deryushev A.N.
The ribs belong to the skeleton of the bone, and form in the human chest, which is shaped like a truncated cone, with the base directed downwards. In front, the rib cage is formed by the sternum, and in front from the sides and behind by twelve pairs of ribs and their cartilage, and behind by the spine.
author: doctor Angela Apercha
Usually a certain localization of pain indicates a problem in any organ located in this area. Accordingly, with the localization of pain in the right hypochondrium, the pathology of the liver, gallbladder and biliary tract should first be assumed. At the same time, the presence of any other symptoms accompanying the tingling in the right side under the ribs helps to understand in which organ exactly the pathological process that caused the onset of pain develops.
Author: doctor Kashirina E.U.
Under the ribs to the right in the human body are organs - the gallbladder, liver, right side of the diaphragm, part of the intestine. To make it a little clearer, what are these organs below are brief descriptions of them.
author: doctor Ambrosova I.A.
The nose is one of the prominent parts of the face, and, in the literal sense of the word. According to experts, the nose fractures account for almost 40% of facial injuries.
It should be noted that a person who does not suffer from diseases of the bone tissue gets a fracture of the nose due to injury (fight, fall, accident, etc.), since other causes of nosebleeds require prerequisites.
author: doctor Kuznetsov M.A.
Despite the fact that the skeleton of the legs is more massive than the upper limbs - injuries of the lower extremities, in particular the lower legs, are quite common among the population.
Doctor A. Deryushev
The restoration of bone integrity depends on a number of both general and a number of local factors. Among the common factors, it is worth mentioning the age of a sick person, his physical and neuropsychiatric condition, the constitution of a person matters, how well his endocrine system, metabolism, etc. function.
Doctor A. Deryushev
The rib fracture occurs under the influence of a traumatic agent of considerable strength and area, which in a certain direction squeezes the chest. At the same time, chest deformity develops and in the places of the greatest curvature a rib fracture occurs. This is usually the anterior and posterior ribs.