Rib Fractures

Question 1

What is a rib fracture?

Answer 1

A break in the bony segment of any rib

Question 2

What are rib fractures most commonly due to?

Answer 2

Blunt trauma to the chest wall

Question 3

What other ways can rib fractures commonly occur?

Answer 3

Spontaneously
Pathologically

Question 4

What are the spontaneous causes of rib fractures?

Answer 4

Occur following coughing or sneezing

Question 5

What is there usually a PMH of in someone with a spontaneous rib fracture?

Answer 5

Osteoporosis, steroid use or chronic obstructive pulmonary disease

Question 6

What are the pathological causes of rib fractures?

Answer 6

Can occur due to cancer metastases

Question 7

What cancer metastases can result in rib fractures?

Answer 7

Prostate in men
Breast in women

Question 8

What are the main clinical features of rib fractures?

Answer 8

Severe, sharp chest wall pain
chest wall tenderness
Crackles or reduced breath sounds

Question 9

What can exaccerbate the chest wall pain?

Answer 9

Deep breaths or coughing

Question 10

What might be visible over the sight of the fracture?

W

Answer 10

Visible brusing of te skin

Question 11

What might be heard on auscultation of the chest?

Answer 11

Crackles or reduced breath sounds

Indicate underlyin glung injury

Question 12

What is a possible serious complcation of rib fractures?

Answer 12

Pneumothorax

Question 13

What are the possible signs of a pneumothorax?

Answer 13

reduced chest expansion
reduced breath sounds
hyper-resonant percussion on the affected side

Question 14

What is another major complication of multiple rib fractures?

Answer 14

Flail chest

Question 15

What is flail chest due to?

Answer 15

Two or more rib fractures along three or more consecutive ribs, usually anteriorly

Question 16

How can flail chest present?

Answer 16

The flail segment moves paradoxically during respiration and impairs ventilation of the lung on the side of injury

Question 17

What can the segment in flail chest result in if left untreated?

Answer 17

Serious contusional injury to the underlying lung if left untreated

Question 18

What is the management of flail chest?

Answer 18

Invasive ventilation and surgical fixation

Question 19

What is the best imaging to diagnose rib fractures?

Answer 19

CT chest

Question 20

How can the majority of rib fractures be managed?

Answer 20

Conservatively with analgesia and ensuring breathing isn’t affected

Question 21

What can inadequate ventilation result in?

Answer 21

Chest infections

Question 22

What can be considered if the pain isn’t controlled with analgesia?

Answer 22

Nerve block

Question 23

When might surgery be considered for rib fractures?

Answer 23

If pain is still an issue and the rib fractures haven’t healed by 12 weeks

Question 24

What other complications can result from a rib fracture?

Answer 24

Haemothorax