THORACIC rib fracture Flashcards
1
Q
rib fracture classic presentation
A
- a younger person comes in after traumatic blow complaining about posterolateral pinpoint severe pain that is worse on deep breathing or moving
- older (osteoporotic) women with lateral rib pain after having a nasty cold causing a lot of coughing
1
Q
similar DDX’s
A
- costochondritis (b/w 2-5 ribs)
- intercostal sprain strain
- Tietz’e syndrome
2
Q
supporting factors
A
- swelling over affected ribs
- guarded in lumbar regio but cerv. normal
- lateral rib pain
- intense pain
- bruising or swelling
3
Q
refuting factors
A
- abnormal neurological exam
- isidious onset
- pain worse on exhalation
4
Q
relevant orthos
A
- rib inhalation compression test
- sternal compression test
- DO NOT DO CHEST EXPANSION
5
Q
referrals
A
- x-rays to look for fracture
6
Q
contradications
A
- do not adjust fractured ribs
- be careful with side posture
7
Q
techniques
A
- adjust to patient tolerance
- might not want to take deep breaths
- no activator
8
Q
care plan
A
2 times a week for 4 weeks then progress
9
Q
recommendations
A
- avoid coughing, sneezing, and laughing
- avoid lying on back
- encourage gradual stretching
10
Q
prognosis
A
- pain last 1-2 months
- excellent (full recovery)
