12. Rib fracture classification, treatment and prognosis

Question 1

How can rib fractures be classified?

Answer 1

Location of fracture:
* Simple
* Displaced

Amount of fractures:
* single/isolated
* Multiple
* flail chest (more than 3 adj ribs)

Question 2

What is the risk of displaced rib fractures?

Answer 2

• Pneumothorax
• Hemothorax
• Intrathoracic vessel tears
• Liver injury
• Spleen injury

Question 3

What is the treatment for rib fractures?

Answer 3

Analgesia (NSAID, Opiates, local nerve blocks)

Surgical (if displaced, or multiple fractures)
* plate and screws ALONG or BETWEEN ribs

• flail chest tx: positive pressure ventilation (PPV)

Question 4

which rib fracture can cause spleen rupture

Answer 4

8-11th left rib

Question 5

which rib fracture can lead to liver rupture?

Answer 5

9-11th right ribs

Question 6

which fracture can lead to kidney laceration?

Answer 6

12th rib fracture

Question 7

is 1st rib fracture common?

Answer 7

No, rare bcz its protected behind the clavicle
but if it breaks can damage brachial plexus and subclavian vessel

Question 8

most common rib fractures

Answer 8

7th and 10th middle ribs
from direct blows or indirect crushing injury

Question 9

are rib fracture painful

Answer 9

yes bcz ribs move with breathing

(on inspiration?)