Rib Fractures Flashcards
What is a rib fracture?
A break in the bony segment of any rib
What are rib fractures most commonly due to?
Blunt trauma to the chest wall
What other ways can rib fractures commonly occur?
Spontaneously
Pathologically
What are the spontaneous causes of rib fractures?
Occur following coughing or sneezing
What is there usually a PMH of in someone with a spontaneous rib fracture?
Osteoporosis, steroid use or chronic obstructive pulmonary disease
What are the pathological causes of rib fractures?
Can occur due to cancer metastases
What cancer metastases can result in rib fractures?
Prostate in men
Breast in women
What are the main clinical features of rib fractures?
Severe, sharp chest wall pain
chest wall tenderness
Crackles or reduced breath sounds
What can exaccerbate the chest wall pain?
Deep breaths or coughing
What might be visible over the sight of the fracture?
W
Visible brusing of te skin
What might be heard on auscultation of the chest?
Crackles or reduced breath sounds
Indicate underlyin glung injury
What is a possible serious complcation of rib fractures?
Pneumothorax
What are the possible signs of a pneumothorax?
reduced chest expansion
reduced breath sounds
hyper-resonant percussion on the affected side
What is another major complication of multiple rib fractures?
Flail chest
What is flail chest due to?
Two or more rib fractures along three or more consecutive ribs, usually anteriorly
How can flail chest present?
The flail segment moves paradoxically during respiration and impairs ventilation of the lung on the side of injury
What can the segment in flail chest result in if left untreated?
Serious contusional injury to the underlying lung if left untreated
What is the management of flail chest?
Invasive ventilation and surgical fixation
What is the best imaging to diagnose rib fractures?
CT chest
How can the majority of rib fractures be managed?
Conservatively with analgesia and ensuring breathing isn’t affected
What can inadequate ventilation result in?
Chest infections
What can be considered if the pain isn’t controlled with analgesia?
Nerve block
When might surgery be considered for rib fractures?
If pain is still an issue and the rib fractures haven’t healed by 12 weeks
What other complications can result from a rib fracture?
Haemothorax
