Rib fracture: what to do? (How does it heal?)

Chest and rib injuries can affect anyone. And it must be admitted, have broken ribs is extremely painful. The fracture costal nor is it always benign. Some complications, especially respiratory, are sometimes associated with it. To learn more, discover in this article the symptoms of a rib fracture, Its causes, these are diagnostic as well as treatments considered.

What is a rib fracture?

La fracture de Cote designates a fissure or an break in the continuity of a coast.

This fissure se locates the level of impact point, if the mechanism of the fracture is explained by a direct shock. On the other hand, in other cases, such as in the case of a compression anteroposterior, breaks are Outputs and are located at the level of lateral arches of the ribs.

Recall that ribs, With the vertebrae and thorax, are elements of the rib cage. The human body has 12 pairs of ribs in total.

Those are bones flattened, oblique, arched. They are oriented downwards. They are each connected anteriorly with the sternum, except for the case of the floating ribs (11th and 12th rib). And in their posterior part, each of them articulates with a dorsal vertebra.

Forming a cage, these bones hold a primary role in protection of vital organs inside the thorax (the heart, lungs and great vessels).

Sometimes the fracture may concern several ribs at a time. Most often affected are those located between the 4th and 10th^e coast. This is explained by the fact that the upper ribs are protected by the shoulder girdle, and those below are relatively mobile.

What are the main causes of a rib fracture?

Here are some common circumstances atorigin of a rib fracture.

• The shock suffered during accidents, falls (especially if the height of the fall is much greater than the height of the individual), the shots and assaults.

• Le port of belts of sécurité is partly responsible for the fracture costal during car accidents.

• The contacts violent generated by the sports and forte solicitation of the upper part of the body in the baseball, rowing… The repetition de trauma de repayments intensities during these activities can lead to a rib fracture.

• La embrittlement bones, caused by factors such as osteoporosis (decreased bone density), or cancer metastasis. In these cases, even a low intensity blow can induce the breaking of a rib (a small fall and even a cough).

What are the symptoms ?

A fracture costal manifested mainly by sharp pains which are sometimes unbearable. They are more intense when breathing deep and also when the patient coughing, sneeze ou rit.

The patient may also have difficulties respiratory. “Breathing” becomes painful and very tiring. 

In complicated cases, others symptoms appear:

• hematoma in the lungs;
• pneumothorax and collapsed (collapsed) lungs: due to the effusion of air and blood into the chest cavity;
• collapse (loss of lung volume);
• atelectasis (retraction of the pulmonary alveoli);
• pneumonia: infection of the lungs by bacteria or a virus.

In more serious cases, as in the case of concurrent fractures (several simultaneous fractures), one could observe:

• a dyspnea (shortness of breath) ;
• the presence of a thoracic flap, what released totally one costal fragment;
• a worsening of vascular risks;
• a damage to other organs (such as liver, spleen), especially in the case of lower rib fractures.

As regards the complications, we fear above all the dangers:

• acute respiratory failure;
• accidents caused by the scattering of sharp bone fragments resulting from the breaking of the ribs. The latter can threaten the neighboring organs such as the heart, the aorta… Thus, the rib fracture can be fatal.

The complications are, however, quite rare and are only found :

• in the elderly;
• in the case of multiple fractures;
• in the case of people who already suffer from cardio-respiratory comorbidities.

How is a rib fracture diagnosed?

As soon as these symptoms appear, and the causes are obvious, it is wise to entrust a medical professional for the diagnosis.

The exam clinical begins with the observation of the general condition of the patient, through an interrogation and an assessment of his health. To do this, the doctor performs palpations and exercises pressures on game thoracic. He diagnoses a fracture costal if it detects a breaking next to, and if the patient feels some pain or tenderness in the face of pressure.

The exams imaging are not not mandatory. Yet a radiography is a great help to have more details on the characteristics of the fracture : its location, its complications and the affected organs. 

Some doctors prefer ultrasound. It is more sensitive and clearly shows undisplaced fractures, costal cartilages and lesions. In addition, the patient would not be exposed to radiation. The only downside is that its realization is difficult in addition to being expensive and painful. 

The recommended treatment

To relieve pain, the doctor often suggests analgesics. These vary according to the intensity of the pain. We opt for paracetamol, tramadol and codeine for pain of low or moderate intensity. We resort to the opioids - (like morphine) to calm severe pain.

The nonsteroidal anti-inflammatory drugs (NSAIDs) are also effective in relieving pain, inflammation and possible breathing difficulties. However, they are harmful to the digestive system and the kidneys.

Furthermore, the use of muscle relaxants as well as substances anesthetics, a injection or patch also brings great relief even if they are controversial.

Le treatment of symptoms with physiotherapy also proves conclusive, often after an initial period of immobilization. In the case of a rib fracture, one often opts for the contention elastic by bandage, transcutaneous neuro-electrical simulation or TENS and respiratory physiotherapy.

What about natural remedies?

Although they are not supported by solid scientific evidence, several natural products and home remedies are used to treat pain related to rib fracture and to speed healing. This is because many patients want to find natural alternatives to drugs.

If you are considering taking natural products, it is essential to consult a doctor beforehand, mainly to avoid drug interactions and side effects.

Here is a non-exhaustive list of plants and essential oils that are effective in controlling pain and inflammation. The products are available on the site Country. Use promo code LOMBAFIT15 if you wish to obtain one of the following products, or any remedy aimed at relieving your symptoms and improving your quality of life:

• Turmeric. Thanks to its antioxidant and anti-inflammatory powers very powerful, turmeric is one of the most used plants in a culinary and therapeutic context. The composition of turmeric is essentially made of essential oils, vitamins (B1, B2, B6, C, E, K) and trace elements. But it is to its composition rich in curcumin and curcuminoids that we owe them and calm skin of this spice.
• Ginger. In addition to the special flavor it brings to the kitchen and its aphrodisiac properties, ginger is a root well known for its anti-inflammatory powers. the gingerol gives it its anti-inflammatory action. It is an active component acting on the inflammatory pain related to chronic joint inflammatory diseases, including rheumatoid arthritis, lupus, rheumatic diseases, etc. It has been proven that this active element is also effective in acting on the inflammation linked to arthritis and sciatica. Ginger also has other benefits thanks to its high potassium content and its richness in trace elements (calcium, magnesium, phosphorus, sodium) and vitamins (provitamin and vitamin B9).
• Omega-3s. Omega-3s are polyunsaturated fatty acids that play a very important role in the functioning of our body. They are provided by food in three natural forms: docosahexaenoic acid (DHA), alpha linolenic acid (ALA) and eicosapentaenoic acid (EPA). Beyond their action on the brain and the cardiovascular system, omega-3s prove very effective against inflammation. Indeed, they have the ability to act on the inflammatory mechanisms in osteoarthritis by slowing down cartilage destruction, thus they reduce the intensity of osteoarthritis pain. Sciatica, being most often linked to an inflammation secondary to a herniated disc, it can also respond to omega-3 provided it is consumed regularly. 
• Lemon eucalyptus. Eucalyptus is a plant most often used in the form of herbal tea or essential oil. She would have anti-inflammatory effects which give it the ability to act on the bone and joint pain in general and the pain of sciatica in particular.
• wintergreen. Wintergreen is a shrub from which a very interesting essential oil is extracted. It is one of the most used essential oils in aromatherapy. This oil extracted from the shrub bearing the same name, is used in massage to relieve sciatica and act like a analgesic. Indeed, it provides a heating effect thanks to its ability toactivate blood circulation locally.

Remember that these products do not replace medical treatment. Do not hesitate to consult for support adapted to your condition.

Management of severe rib fractures

Concerning treatment of fracture-related injuries severe costal disease, disease-modifying therapy is based in certain rare cases on surgery. It consists of stabilize and to stare the broken bones. It should be noted that this intervention is especially indicated in the case of a deformation from wall thoracic, or if there is a complication significant.

In extreme cases (for example if the fracture is accompanied by severe breathing difficulties), the patient should be assisted with a respirator while the lesions heal. In case of pleural detachment, placing a drain in the pleural space can be useful to puncture the air that is inside.

To reduce the risk of pneumonia, the patient should take a deep breath at least once an hour to ensure sufficient oxygenation of the tissues of the respiratory system.

References

https://www.msdmanuals.com/fr/accueil/l%C3%A9sions-et-intoxications/l%C3%A9sions-thoraciques/fractures-des-c%C3%B4tes

https://www.institut-kinesitherapie.paris/pathologies/douleurs-thorax-et-cotes/fracture-cotes/