Rib fractures in humans occur fairly often. They make up 5% of all fractures. Due to the decrease in the elasticity of the edges with age, often broken ribs in the elderly.
Rib fractures occur:
in the fall
with direct impact on the chest
with compression of the thorax.
Fracture of one rib is isolated, fractured several ribs - plural. There are:
crack
subperiosteal fracture when the broken bone and the periosteum remains intact
a complete fracture of the ribs.
By themselves, rib fractures are not dangerous and will heal quickly enough, the danger is a concomitant damage to internal organs.
Rib fractures are complicated injuries of lung membranes - pleura, the lungs themselves. If the damage the lungs and pleura there is a risk of hemothorax (accumulation of blood in the thoracic cavity between the inner and outer membrane of the lungs), pneumothorax (accumulation of air in the chest cavity). Sometimes the air from the lungs enters the subcutaneous tissue, which is called subcutaneous emphysema.
Rib fractures are accompanied by limited mobility of the chest, a decrease in respiratory lung volumes, especially in the elderly.
The most common fractures occur at the site of maximum bending of the edges - on the side surface of the chest. If one broken rib, the displacement of bone fragments are usually not the case. With multiple fractures of ribs fragments can move in different directions, hurt nearby tissues and organs and cause dangerous complications.
The patient is worried about the chest pain that increases with deep breathing, coughing, talking. Pain can be reduced with the patient sitting and increases with movement.
With multiple fractures, lung patient usually sits motionless, breathing shallow. When palpation of the chest revealed sharply painful fracture site. If the damage lung tissue and leaving the air in the subcutaneous tissue during palpation there is a specific fat creaking under the fingers - a crackling sound.
In multiple rib fractures may disrupt the patient's breathing, heart rate. The skin is pale with a bluish tint. If the fragments of ribs damage lung tissue - there is hemoptysis. Multiple rib fractures may be complicated by the development of pneumonia.
Diagnosis of rib fractures is carried out on the basis of radiologic studies. Produce images of the edges.
Treatment of fractures of the ribs.
When isolated and uncomplicated fractures of ribs hold the fracture analgesia. For this purpose, local procaine or alcohol-procaine block in the fracture of each edge. The patient is recommended to sit up in bed, breathing exercises assigned, expectorant drugs, physiotherapy, aimed at the prevention of stagnation in the lungs and improved ventilation.
Isolated and uncomplicated rib fractures often require hospitalization and patients can be treated as outpatients. In uncomplicated fractures for seam edges usually takes about one month.
Multiple and complicated fractures require fixation of the ribs, stretching to restore the integrity of the chest and the normalization of breathing, for which the patient must be hospitalized. Compression of the lungs with air or blood during pneumothorax and hemothorax should be eliminated. To do this, perform the puncture of the thoracic cavity, air or blood is removed. Sometimes the puncture has to do again. In severe cases, resorting to a ventilator.
