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Rib fracture

A rib fracture, commonly referred to as a broken rib, is a crack or break in one or more of the 12 pairs of bones that form the rib cage, which encases and protects vital thoracic organs including the heart and lungs.^[1] These fractures are among the most frequent thoracic injuries, occurring in approximately 10% of all trauma cases and up to 40% of severe trauma patients, with higher incidence and complications in the elderly due to reduced bone density.^[2] While most rib fractures result from direct blunt or penetrating trauma, they can also arise from atraumatic causes such as severe coughing, repetitive stress in athletes, or underlying conditions like osteoporosis or metastatic cancer.^[2]^[3] Symptoms of a rib fracture typically include sharp pain in the chest that intensifies with deep breathing, coughing, sneezing, or upper body movement, often accompanied by tenderness at the injury site and shallow breathing to minimize discomfort.^[1] In severe cases, such as multiple fractures or flail chest—where three or more adjacent ribs are broken in two places, creating a free-floating segment—patients may experience shortness of breath, rapid breathing, or hypoxia due to impaired lung expansion.^[2] Complications can arise if pain limits respiration, increasing the risk of atelectasis, pneumonia, or pneumothorax, particularly in older adults or those with pre-existing lung conditions.^[4]^[5] Diagnosis begins with a physical examination, where healthcare providers assess chest tenderness, breathing patterns, and lung sounds, followed by imaging to confirm the fracture and rule out associated injuries.^[4] Chest X-rays are the initial imaging modality of choice, though they may miss nondisplaced fractures; computed tomography (CT) scans provide more detailed visualization of bone breaks, soft tissue damage, or organ involvement.^[4] In cases of suspected stress fractures or when X-rays are inconclusive, MRI or bone scans may be employed.^[4] Treatment for uncomplicated rib fractures focuses on conservative management, emphasizing pain control to facilitate deep breathing and prevent respiratory complications, with most fractures healing within six weeks through rest, ice application, and activity modification.^[4] Analgesics such as acetaminophen or nonsteroidal anti-inflammatory drugs are commonly prescribed, while severe pain may require intercostal nerve blocks or opioids; breathing exercises and incentive spirometry are recommended to maintain lung function.^[5] Surgical intervention, such as rib plating, is reserved for unstable fractures, flail chest, or cases with significant displacement or underlying chest wall defects, which carry a mortality rate of 10-15% in flail chest scenarios.^[2]

Anatomy and Pathophysiology

Rib Cage Structure

The human rib cage, also known as the thoracic cage, consists of 12 pairs of ribs that form the bony framework of the thorax. These ribs are classified into three types based on their anterior attachments: true ribs (pairs 1 through 7), which connect directly to the sternum via individual costal cartilages; false ribs (pairs 8 through 10), which attach indirectly to the sternum through the shared costal cartilage of the seventh rib; and floating ribs (pairs 11 and 12), which lack any anterior sternal connection and instead end freely in the abdominal musculature.^[6]^[7] Each rib articulates posteriorly with the thoracic vertebrae at the costovertebral joints, where the rib head connects to the vertebral bodies and the tubercle attaches to the transverse processes, except for atypical ribs like the first, which articulates only with the T1 vertebra. The ribs exhibit increasing length from the superior first pair to the seventh, followed by a gradual decrease toward the floating ribs, and their curvature intensifies from superior to inferior, contributing to the conical shape of the thorax. Composed primarily of flat bones, ribs feature a thin outer shell of dense cortical bone surrounding a core of trabecular (spongy) bone, which provides structural support while housing red bone marrow in younger individuals.^[6]^[7]^[8] The rib cage encloses and safeguards vital thoracic organs, including the lungs and heart, forming a protective barrier against external forces. Additionally, the ribs serve as key attachment sites for the intercostal muscles, which fill the spaces between adjacent ribs to facilitate thoracic movement, and for the respiratory diaphragm, which anchors to the lower ribs to enable inhalation and exhalation. Biomechanically, the ribs function as semi-rigid levers that absorb and distribute impact energy while permitting elastic deformation to allow thoracic expansion during breathing, balancing rigidity for protection with flexibility for respiratory dynamics.^[6]^[7]

Fracture Mechanisms and Types

Rib fractures result from biomechanical forces that exceed the structural integrity of the thoracic bones, primarily through direct blunt trauma or indirect mechanisms. Direct blunt trauma involves localized impact to the chest wall, such as from a steering wheel during a motor vehicle collision, causing fractures at the point of contact due to compressive or shear forces on the rib. In contrast, indirect forces arise from transmitted loads, such as axial compression during a fall or torsional bending of the thorax, which can propagate stress across multiple ribs without direct surface impact. These mechanisms often lead to fractures in specific locations influenced by rib geometry; anterior fractures are more common with frontal impacts due to direct compression at the site of impact, while posterior fractures predominate in lateral or rotational forces, where the greater posterior curvature increases vulnerability to bending stresses.^[2]^[9]^[10] The upper ribs (1 through 3) are more difficult to fracture due to protection by the clavicle, scapula, and associated musculature, often requiring high-energy mechanisms.^[2] Rib fractures are classified by their morphology and displacement to guide clinical assessment and management. Simple fractures are nondisplaced, involving a single clean break without fragment separation, often healing conservatively. Displaced fractures feature misalignment of bone ends, potentially impinging on adjacent structures like the pleura. Comminuted fractures involve multiple fragmented pieces, increasing instability and complication risk. In children, greenstick fractures represent incomplete disruptions due to the pliability of developing bone, typically bending rather than fully breaking. Stress fractures, seen in athletes or from repetitive microtrauma, develop gradually as cortical microdamage accumulates. When multiple adjacent ribs fracture at two or more points each, a flail chest segment forms, characterized by paradoxical inward movement during inspiration, destabilizing the chest wall.^[2]^[9]^[11] The pathophysiological consequences of rib fractures stem from compromised chest wall mechanics, leading to immediate and secondary effects on respiration. Disruption of chest wall integrity causes severe localized pain, prompting reflexive splinting where patients limit thoracic expansion to avoid discomfort, thereby reducing tidal volume and impairing ventilation. This hypoventilation predisposes to atelectasis and pneumonia, while sharp bone edges may lacerate the lung, resulting in pneumothorax or hemothorax. In severe cases like flail chest, the unstable segment amplifies these issues by decoupling the affected area from the rest of the thorax, exacerbating respiratory compromise.^[2]^[9]^[12] Factors influencing fracture location include age-related bone changes and the direction of applied force. In the elderly, cortical thinning and osteoporosis weaken rib strength overall, making even low-energy impacts sufficient to cause fractures, often in the mid-to-posterior regions (e.g., from falls). Lateral impacts, common in side collisions, frequently fracture ribs 4 through 9 at the mid-axillary line, the point of maximal curvature and minimal muscular protection, due to concentrated bending moments.^[2]^[9]^[13]^[14]

Etiology and Risk Factors

Traumatic Causes

Traumatic rib fractures primarily result from high-impact external forces that exceed the structural integrity of the rib cage, often exploiting vulnerabilities at the rib's curvature or attachment points.^[15] Motor vehicle collisions (MVCs) represent the leading cause of rib fractures, accounting for approximately 40-60% of cases in high-energy trauma scenarios. These injuries frequently occur due to direct impacts against the dashboard, steering wheel, or seatbelt forces that compress the chest during rapid deceleration.^[16] In restrained occupants, seatbelt loading can contribute to anterior rib fractures, while unrestrained individuals face higher risks from broader thoracic impacts.^[17] Falls from height are a significant cause, particularly among individuals over 65 years, where ground-level slips or standing-height falls predominate and account for up to 66% of rib fracture incidents in this demographic.^[18] Such falls often result in multiple rib fractures concurrent with other skeletal injuries, including hip fractures, due to the combined axial loading and lateral forces on the torso.^[19] Sports-related injuries, especially in contact sports like football and hockey, cause rib fractures through direct blows or tackles that deliver blunt force to the chest.^[1] Similarly, assaults involving blunt instruments, fists, or kicks produce localized compression leading to fractures, often in interpersonal violence scenarios.^[20] Penetrating trauma, such as stab wounds or gunshot injuries, can result in open rib fractures by directly lacerating the bone, though these account for a minority of cases (around 2-3%) compared to blunt mechanisms.^[21] Overall, rib fractures occur in up to 10% of patients with blunt chest trauma admissions.^[16] Severe traumatic rib fractures frequently co-occur with intrathoracic injuries, including pulmonary contusion in about 20% of cases with multiple fractures^[22] and hemothorax due to vascular damage from displaced bone fragments.^[23] These associations arise as the fracturing ribs disrupt adjacent lung parenchyma or intercostal vessels during high-impact events.^[24]

Non-Traumatic Causes

Non-traumatic rib fractures arise from intrinsic bone weaknesses or repetitive internal stresses rather than external blunt force, often linked to underlying medical conditions that compromise bone integrity. These fractures are particularly prevalent in populations with reduced bone density, such as the elderly, where osteoporosis plays a central role by diminishing bone mineral density and increasing fragility. Osteoporosis-related rib fractures are common in postmenopausal women due to accelerated bone loss from estrogen deficiency, with studies indicating that rib fractures account for approximately 24% of non-spine fragility fractures in older men and are associated with a history of prior osteoporotic fractures in over 50% of affected women. In elderly patients experiencing low-energy falls, rib fractures occur in up to 20% of cases, highlighting the role of osteoporosis in exacerbating minor impacts into pathological breaks.^[25]^[26]^[27] Stress fractures represent another key non-traumatic mechanism, typically resulting from repetitive microtrauma in athletes engaging in upper-body intensive activities. These fractures often affect the first rib in throwers or the lower ribs in rowers and golfers due to torsional forces from serratus anterior and intercostal muscle contractions during repetitive motions like rowing strokes or golf swings. Documented cases show that female rowers are particularly susceptible, with stress fractures occurring in the posterior aspects of ribs 5 through 9 from overuse, leading to insidious onset of localized pain during activity. A review of 196 athletic cases underscores that such fractures are underdiagnosed without targeted imaging, as they stem from cumulative stress rather than acute overload.^[28]^[29]^[2] Malignancy contributes to non-traumatic rib fractures through metastatic invasion that erodes bone structure, creating pathological sites prone to fracture under normal physiological loads. Breast and lung cancers frequently metastasize to the ribs, weakening the cortex and leading to spontaneous breaks, with rib involvement seen in up to 30-40% of advanced breast cancer cases with skeletal metastases. Metabolic diseases, such as hyperparathyroidism, further predispose to these fractures by inducing excessive bone resorption and osteomalacia, resulting in softened bones susceptible to insufficiency fractures even without trauma. For instance, primary hyperparathyroidism elevates parathyroid hormone levels, accelerating cortical thinning and increasing non-vertebral fracture risk, including in the ribs, as evidenced in clinical series of patients presenting with multiple fragility sites.^[2]^[30]^[31] Cough-induced rib fractures, though rare, occur from the intense, repetitive intrathoracic pressure generated during prolonged severe coughing episodes, often in patients with underlying respiratory conditions like chronic bronchitis or whooping cough. These fractures are more common in smokers or those with osteoporosis, where the forceful expiratory efforts exceed bone tolerance, typically affecting the middle ribs laterally. Case reports document such events in otherwise healthy individuals during acute exacerbations, emphasizing the role of pre-existing bone fragility in amplifying the risk.^[32]^[33]^[2] Iatrogenic causes encompass medical interventions that inadvertently fracture ribs, such as during thoracotomy procedures or cardiopulmonary resuscitation (CPR). In thoracotomy, rib fractures occur in nearly half of cases due to retractor placement and surgical manipulation, particularly in older patients with compromised bone density. Similarly, CPR-induced fractures arise from chest compressions, with autopsy studies revealing rib breaks in up to 80% of cases, though many remain undetected on initial imaging; these are more frequent in the elderly and those with osteoporosis.^[34]^[35]^[36]

Clinical Presentation

Symptoms

The primary symptom of a rib fracture is sharp, localized pain at the site of injury in the chest wall, which intensifies with deep inspiration, coughing, sneezing, laughing, or any movement that expands the rib cage.^[1]^[37]^[2] This pain often leads patients to adopt a guarding posture, holding the affected side rigidly to minimize chest expansion and avoid exacerbating discomfort.^[37]^[38] Patients frequently report dyspnea or shortness of breath resulting from pain-induced shallow breathing, which can contribute to systemic symptoms such as fatigue, particularly in cases of multiple rib fractures.^[2]^[37] Referred pain may occur to the abdomen, shoulder, or back, further complicating the presentation.^[38] In children, rib fractures are uncommon due to the flexibility of their rib cage but, when present, often manifest as irritability, crying during movement, or refusal to ambulate or be touched, signaling significant underlying trauma, and in young children, they are highly suggestive of non-accidental injury (child abuse), necessitating evaluation for abuse.^[2] Elderly patients may exhibit more subtle symptoms, such as understated pain complaints or minimal guarding, which can mask the injury's severity and increase the risk of overlooked complications from restricted breathing.^[39]^[2] Red flags include severe or rapidly worsening shortness of breath, which may indicate associated conditions like pneumothorax or hemothorax requiring immediate evaluation.^[2]^[37]

Physical Examination Findings

During the physical examination of a patient suspected of having a rib fracture, clinicians assess for localized tenderness by gently palpating along the rib cage, where point-specific pain at the fracture site is a hallmark finding.^[2]^[13] Ecchymosis, swelling, or bruising may be visible along the course of the affected rib, particularly in cases of blunt trauma.^[2]^[4] Bony crepitus, detected as a palpable or auscultatory grating sensation or click over the fracture, further supports the diagnosis.^[2]^[13] In severe cases involving multiple fractures, such as flail chest—defined by three or more consecutive ribs fractured in at least two places—paradoxical movement of the chest wall segment is observed, where the affected area moves inward during inspiration and outward during expiration due to the loss of structural integrity.^[40]^[13] This instability may become more apparent as intercostal muscles fatigue, though it can be masked initially by pain-induced splinting and shallow breathing.^[40] Respiratory evaluation often reveals decreased or diminished breath sounds on the affected side, attributable to pain limiting chest expansion or associated injuries like pneumothorax or hemothorax.^[13]^[4] Tachypnea, use of accessory respiratory muscles, and signs of respiratory distress are common, especially in elderly patients or those with multiple fractures, reflecting increased work of breathing.^[40] Vital signs may show hypoxia, with oxygen saturation below 92% indicating potential pulmonary compromise.^[13] Subcutaneous emphysema, presenting as palpable crepitus under the skin from air tracking into soft tissues, suggests underlying tracheobronchial or pleural injury.^[2]^[13] Specific maneuvers, such as the rib compression test—where lateral or anteroposterior pressure is applied to the chest wall—elicit sharp, localized pain confirming the fracture site.^[2] Observation of chest wall movement during breathing helps identify asymmetry or paradoxical motion.^[4] To differentiate rib fractures from soft tissue injuries, clinicians note that fractures produce focal, point-specific tenderness and crepitus upon palpation, whereas contusions or strains cause more diffuse soreness without bony signs.^[2]

Diagnosis

Clinical Assessment

The clinical assessment of a suspected rib fracture commences with a thorough history to elucidate the mechanism of injury, including the timing, force, and nature of the trauma, such as blunt chest impact from falls, motor vehicle collisions, or even repetitive stress like severe coughing in vulnerable patients.^[41] Comorbidities, particularly osteoporosis or chronic lung disease, are elicited as they predispose individuals, especially the elderly, to fractures from relatively minor forces.^[42] Associated symptoms beyond localized pain, such as hemoptysis, raise suspicion for concurrent vascular or pulmonary injuries like lacerations or contusions.^[43] Risk stratification follows, with heightened suspicion in elderly patients or those with multiple trauma, as each additional rib fracture elevates the risk of pneumonia by approximately 27% and mortality by 19% in older adults.^[44] Tools such as the Rib Fracture Frailty Index aid in identifying geriatric patients at elevated risk for complications based on factors like age, comorbidities, and injury severity.^[45] Symptoms like sharp, pleuritic chest pain exacerbated by breathing or movement, along with physical signs such as tenderness on palpation, guide this initial evaluation. Vital signs are monitored closely, with hypotension signaling potential internal bleeding from associated vascular damage and reduced oxygen saturation indicating respiratory compromise due to pain-limited ventilation or underlying lung injury.^[2] Differential diagnosis is refined through history, distinguishing rib fracture from conditions like pleurisy (often inflammatory without trauma history), myocardial infarction (typically featuring central pressure-like pain radiating to the arm, unrelated to movement), or pulmonary embolism (presenting with acute dyspnea and risk factors like immobility, but lacking direct chest wall trauma).^[46]^[47] Documentation of the injury pattern is essential, noting whether it involves a single rib (often lower suspicion if isolated), multiple ribs (increasing complication risk), or bilateral involvement (suggesting higher-impact trauma).^[48] This includes specifying the affected side, rib number, and location (anterior, lateral, or posterior) to inform subsequent care.^[48]

Imaging and Diagnostic Tests

Plain radiographs, particularly posteroanterior (PA) and lateral chest X-rays, serve as the initial screening tool for suspected rib fractures, though their sensitivity is limited to approximately 50% for detecting isolated or non-displaced fractures.^[2] These views are effective for identifying associated thoracic injuries such as pneumothorax or hemothorax but often miss subtle fractures due to overlapping structures and poor visualization of the posterior ribs.^[9] According to the American College of Radiology (ACR) Appropriateness Criteria, chest radiography is usually appropriate (rating 7-9) as the first-line imaging modality for minor blunt trauma or post-CPR scenarios, balancing diagnostic yield with low radiation exposure.^[49] Computed tomography (CT) of the chest is considered the gold standard for confirming rib fractures, enabling precise assessment of fracture location, displacement, and complications like pulmonary contusions or vascular injuries.^[13] Non-contrast CT is particularly valuable in trauma settings, as it delineates cortical disruptions and segmental patterns not visible on plain films, though it involves higher radiation doses (relative level ☢☢☢).^[9] The ACR rates CT without contrast as usually appropriate (7-9) for suspected pathologic fractures and may be appropriate (4-6) after CPR, but it is generally not recommended for isolated minor trauma due to overutilization risks.^[49] Ultrasound provides a rapid, radiation-free bedside alternative for detecting rib fractures, especially in emergency or resource-limited settings, with reported sensitivity of 97% (95% CI 0.93-1.00) and specificity of 89% (95% CI 0.83-0.96) compared to radiography.^[50] It visualizes fracture lines as cortical discontinuities or associated hematomas and is useful for guiding interventions, though it is operator-dependent and less effective in obese patients or for posterior ribs.^[9] The ACR deems chest ultrasound usually not appropriate (1-3) for initial evaluation in most variants, reserving it for point-of-care use when radiography is inconclusive.^[49] For stress fractures, often seen in athletes or from repetitive trauma, magnetic resonance imaging (MRI) is preferred due to its ability to detect bone marrow edema and non-displaced fractures without radiation, serving as the modality of choice when management decisions depend on confirmation.^[13] Bone scintigraphy (bone scan) remains useful for pathologic or early stress fractures, highlighting areas of increased uptake, but is less specific than MRI and involves radiation (☢☢☢); the ACR rates it usually appropriate (7-9) for suspected pathologic cases.^[49] Rib-specific radiographs are rarely indicated, with may-be-appropriate ratings (4-6), as they offer limited additional benefit over chest views.^[49] Laboratory tests are not routinely required for uncomplicated rib fractures but support evaluation of associated injuries; a complete blood count (CBC) assesses for anemia from hemorrhage or signs of infection, while troponin levels are checked if cardiac contusion is suspected.^[2] Routine D-dimer testing is discouraged unless pulmonary embolism is clinically suspected, to avoid unnecessary further imaging.^[13]

Management

Conservative Treatment

Conservative treatment forms the cornerstone of management for most rib fractures, particularly isolated or stable cases without significant complications, emphasizing pain control to facilitate breathing and mobility while preventing secondary issues such as atelectasis or pneumonia from inadequate ventilation.^[2] Pain management typically involves multimodal analgesia, starting with oral non-opioid agents like acetaminophen and nonsteroidal anti-inflammatory drugs (NSAIDs) to minimize reliance on opioids, which can cause respiratory depression and impair clearance of secretions.^[51]^[52] Adjunctive measures include applying ice packs to the affected area for 20 minutes at a time to reduce swelling and discomfort, along with elevating the upper body during rest to ease breathing.^[2] Respiratory support is critical to counteract the natural tendency to splint painful breaths, which can lead to atelectasis and pneumonia; this involves instructing patients on deep breathing exercises and the use of incentive spirometry devices, aiming for 10 repetitions per hour with inspiratory volumes of at least 15 mL/kg ideal body weight.^[52]^[51] Pulmonary toilet techniques, such as directed coughing and postural drainage, further aid in mobilizing secretions and maintaining lung expansion, often guided by respiratory therapists to optimize oxygenation and ventilation.^[2] These interventions help avert acute respiratory complications by promoting consistent diaphragmatic excursion.^[52] Activity modification centers on rest to allow fracture healing, with patients advised to avoid strenuous physical activities for approximately 4 to 6 weeks, gradually resuming normal movements as pain subsides.^[52] Bracing or taping the chest is not recommended, as it restricts ventilatory mechanics and exacerbates hypoventilation risks.^[2] Monitoring includes serial clinical examinations to detect any worsening respiratory status or pain escalation, with discharge typically considered for patients with stable single rib fractures after 24 hours of observation showing no deterioration in vital signs or oxygenation.^[52] In elderly patients, who face heightened risks of deconditioning, multidisciplinary care incorporates physiotherapy to preserve mobility and strength, often involving early mobilization protocols coordinated with pain specialists, respiratory therapists, and nutrition support to reduce overall hospital stay and complication rates.^[51]^[52]

Interventional and Surgical Options

Interventional options for rib fracture management primarily target severe pain that impairs respiration and leads to splinting, where patients restrict breathing to minimize discomfort. Thoracic epidural analgesia involves catheter placement in the epidural space to deliver local anesthetics, providing broad coverage for multiple rib levels and effectively reducing pain scores while improving pulmonary function in patients with three or more fractures.^[53] Intercostal nerve blocks, administered via ultrasound guidance with agents like liposomal bupivacaine, offer targeted relief for specific fracture sites, demonstrating comparable analgesia to epidurals with fewer hemodynamic side effects such as hypotension.^[54] These blocks decrease splinting by providing rapid and effective pain relief, facilitating deeper breathing and early mobilization.^[55] For prolonged pain control beyond 24-48 hours, cryoablation of intercostal nerves emerges as an adjunctive technique, freezing nerve tissue to disrupt pain signals for weeks to months without permanent damage. Performed percutaneously or intraoperatively, cryoablation has shown sustained reductions in pain scores and opioid use in rib fracture patients at one month post-procedure.^[56] This method is particularly useful in cases refractory to standard blocks, reducing the need for ongoing infusions and associated complications.^[57] Surgical fixation, known as surgical stabilization of rib fractures (SSRF), employs open reduction and internal fixation (ORIF) using plates and screws to stabilize displaced segments, indicated in flail chest—defined as three or more consecutive ribs fractured in two places—or multiple displaced fractures involving more than three ribs causing respiratory compromise. According to recent guidelines from the World Society of Emergency Surgery (WSES) and Chest Wall Injury Society (CWIS), published in 2024 and updated in 2025, SSRF is recommended for patients failing conservative management, such as those unable to wean from mechanical ventilation or with severe chest wall deformity. The 2025 ACS Best Practices Guidelines emphasize early multidisciplinary evaluation for SSRF in flail chest and severe cases to optimize outcomes.^[58]^[59] These procedures restore thoracic mechanics, with bicortical screw fixation preferred for posterior fractures to ensure durability.^[58] For rib fractures complicated by associated thoracic injuries, thoracotomy allows direct access for interventions like hemothorax drainage or repair of lung lacerations, particularly in hemodynamically unstable patients requiring urgent exploration. Minimally invasive video-assisted thoracoscopic surgery (VATS) serves as an alternative for stable cases, enabling rib plating and evacuation of retained hemothorax through small incisions, with success rates exceeding 90% in selected multiple fracture cohorts.^[60] Clinical trials demonstrate that SSRF reduces mechanical ventilation duration by an average of 4-7 days and lowers pneumonia incidence by approximately 43% (relative risk 0.57) compared to non-operative care, particularly in flail chest patients.^[61] These benefits extend to shorter intensive care unit stays and decreased mortality in severe cases.^[62] Contraindications to surgical options include active infection or contaminated wounds, where prosthetic implantation risks deep wound or hardware-related infections at rates up to 2-3%.^[58] Conservative measures, such as oral analgesics, may complement post-procedural pain control.

Complications

Acute Respiratory Complications

Rib fractures can lead to acute respiratory complications primarily due to pain-induced shallow breathing, which impairs ventilation and clearance of secretions, increasing the risk of pulmonary issues in the immediate post-injury period.^[2] These complications are more prevalent in cases of multiple fractures and underscore the need for vigilant monitoring, particularly in vulnerable populations.^[12] Atelectasis and pneumonia are common sequelae, arising from reduced lung expansion and retention of secretions caused by splinting of the chest wall. In patients with multiple rib fractures, the incidence of these complications ranges from 5% to 30%, with pneumonia occurring in approximately 6% of all hospitalized cases but rising significantly in those with more than six fractures.^[16] Risk factors include advanced age over 65 years, which doubles the likelihood compared to younger patients, and smoking history, which exacerbates impaired mucociliary clearance.^[63]^[64] Pneumothorax and hemothorax occur when fractured ribs lacerate the pleura or lung parenchyma, allowing air or blood to accumulate in the pleural space and compromise lung expansion. Pneumothorax involves free air leading to lung collapse, while hemothorax results in blood accumulation, potentially causing hemodynamic instability if significant.^[24] Chest tube insertion is indicated for pneumothorax causing greater than 20% lung collapse or symptomatic tension physiology, and for hemothorax with ongoing bleeding or retained collections exceeding 1.5 L initially or 200-300 mL per hour.^[65] These injuries are reported in up to 32% of rib fracture cases with associated thoracic trauma.^[66] Flail chest, defined by fractures of three or more consecutive ribs at two or more sites each, creates an unstable chest wall segment that moves paradoxically during respiration, leading to inefficient ventilation, hypoxia, and potential respiratory failure. This condition affects approximately 7-15% of severe blunt chest trauma cases and is often complicated by underlying pulmonary contusion.^[67] In severe instances, it can precipitate acute respiratory distress syndrome (ARDS), characterized by diffuse alveolar damage and refractory hypoxemia, with mortality rates of 10-15% even with supportive care.^[2]^[68] Aspiration-related sepsis may develop secondary to altered mental status or vomiting in traumatized patients, leading to bacterial translocation from the lungs and systemic infection. In elderly patients with rib fractures and pulmonary complications, mortality rates of 30-40% or higher have been reported, particularly with multiple fractures, often compounded by comorbidities and delayed recognition.^[64]^[69] Prevention of these acute complications focuses on maintaining adequate ventilation through early mobilization to promote lung expansion and prophylactic antibiotics if risk factors for pneumonia are present, such as prolonged mechanical ventilation. Multimodal analgesia facilitates deep breathing exercises and incentive spirometry, reducing atelectasis risk by up to 50% in monitored settings.^[12]^[70] Elderly patients face a five-fold higher mortality risk compared to younger individuals, adjusted for injury severity and comorbidities, emphasizing the need for aggressive complication prevention.^[64]

Chronic and Other Complications

Chronic complications of rib fractures encompass long-term sequelae that persist beyond the acute phase, including persistent pain and structural deformities that can significantly impair quality of life. Radiographic nonunion occurs in approximately 43% of patients with multiple rib fractures at six months post-injury, with 12% of individual fractures demonstrating nonunion, particularly in ribs 7 through 10 and those with displacement or offset.^[71] This nonunion or malunion often results in post-traumatic chest wall deformity and chronic pain, affecting up to 64% of patients with isolated rib fractures, while disability is reported in 67% of such cases.^[72] Poor healing, defined as displacement greater than 1 cm or angular deformity exceeding 10 degrees, is observed in about 6.4% of conservatively managed cases and is associated with adverse outcomes like persistent pain.^[73] Intercostal neuralgia, arising from nerve entrapment or injury during the fracture, manifests as persistent neuropathic pain along the affected intercostal distribution and is a recognized chronic sequela following rib trauma, including cough-induced fractures.^[74] Management typically involves pharmacological agents such as gabapentin for neuropathic pain control, alongside interventional options like intercostal nerve blocks.^[75]^[2] High-impact rib fractures are frequently associated with injuries to underlying structures, such as splenic rupture in cases involving lower ribs (e.g., ribs 9-12) or aortic dissection with first or second rib fractures, which can contribute to long-term disability through reduced exercise tolerance and overall functional impairment.^[2]^[76]^[77] These associated injuries exacerbate chronic morbidity, with up to 67% of patients experiencing ongoing disability that limits physical activity.^[72] The psychological impact of rib fractures includes anxiety and reduced mental well-being stemming from chronic pain, particularly in active individuals where persistent symptoms hinder return to prior activity levels.^[78] In rare instances, pathological rib fractures may mimic malignancy on imaging, such as bone metastases, necessitating careful diagnostic evaluation to differentiate from neoplastic processes.^[79] Acute respiratory complications, such as pneumonia, can occasionally progress to chronic fibrosis, further compounding long-term pulmonary restrictions.^[73]

Prognosis and Prevention

Healing and Recovery

The healing process for rib fractures typically occurs through a natural sequence of biological stages, beginning with an inflammatory phase in the first 1 to 7 days where hematoma formation and inflammation initiate repair.^[80] This is followed by the reparative phase from weeks 2 to 6, during which soft callus forms and transitions to hard callus via endochondral ossification, stabilizing the fracture site.^[81] The remodeling phase then extends over several months, where excess callus is resorbed and bone is restructured to restore original strength and shape.^[81] For simple, nondisplaced rib fractures, natural healing via callus formation generally takes 4 to 6 weeks in healthy individuals.^[4] Multiple or displaced fractures often require longer, extending to 8 to 12 weeks or more due to increased instability and tissue disruption.^[82] Factors that accelerate healing include younger age, as pediatric and adolescent bones heal faster owing to higher metabolic activity and richer vascular supply in the periosteum.^[83] Adequate nutrition, particularly calcium and vitamin D, supports mineralization and callus maturation during repair. Conversely, diabetes impairs healing by disrupting osteoblast function and increasing inflammation, leading to higher rates of delayed union compared to non-diabetic patients. Elderly patients face higher risks of complications, with pneumonia rates up to 30% and mortality of 5-10% in severe cases, prolonging recovery.^[2] Monitoring typically involves clinical assessment rather than routine imaging for isolated fractures, though follow-up X-rays may be performed at around 4 weeks in cases involving surgical intervention to evaluate union progress.^[2] Return to activity guidelines emphasize gradual resumption, avoiding contact sports or heavy lifting until the patient is pain-free and has full range of motion, often achieved within 6 to 8 weeks for uncomplicated cases.^[13] Outcomes for isolated rib fractures are favorable, with over 85% achieving full recovery without complications through conservative management.^[84] In diabetics, however, delayed union rates are substantially elevated, contributing to prolonged pain and functional limitations. According to 2025 guidelines from the Surgical Critical Care Initiative, early rehabilitation—including multimodal pain control, incentive spirometry, and prompt mobilization—can reduce hospital length of stay and accelerate overall recovery by supporting pulmonary function and preventing secondary complications.^[85]

Risk Reduction Strategies

Preventing rib fractures involves multifaceted strategies targeting high-risk populations and activities, with evidence supporting interventions that address falls, bone density, trauma mechanisms, and occupational hazards. In older adults, who are particularly susceptible due to osteoporosis and impaired balance, fall prevention programs incorporating home modifications—such as installing grab bars, removing tripping hazards, and improving lighting—combined with balance and strength training exercises can significantly reduce fall incidence. These exercises, including tai chi or targeted balance routines, have been shown to decrease the rate of falls by approximately 24% and injurious falls by about 22% in community-dwelling elderly individuals, thereby lowering the risk of associated rib fractures.^[86]^[87]^[88] Routine osteoporosis screening using dual-energy X-ray absorptiometry (DXA) scans is recommended for postmenopausal women under 65 at increased risk and all women over 65 to identify low bone density early, enabling preventive measures like bisphosphonate therapy. Bisphosphonates, such as alendronate and risedronate, reduce the risk of nonvertebral fractures, including those of the ribs, by about 40% in individuals with osteoporosis by inhibiting bone resorption and preserving bone mass.^[89]^[90] Maintaining bone health through lifestyle modifications further mitigates rib fracture risk. Smoking cessation is associated with a significant reduction in overall fracture risk, with former smokers showing approximately 8% lower risk for vertebral fractures compared to current smokers, as nicotine impairs bone formation and increases resorption. Weight-bearing exercises, such as walking or jogging, stimulate bone remodeling and help prevent osteoporosis-related fractures by increasing bone mineral density, particularly in the axial skeleton. Additionally, vaccination against pertussis (whooping cough) prevents severe respiratory infections that can lead to violent coughing and subsequent rib fractures; pertussis outbreaks have been linked to cough-induced rib and vertebral fractures, and immunization with DTaP or Tdap vaccines reduces disease incidence by over 80% in vaccinated populations.^[91]^[92]^[93] Vehicle safety measures substantially lower rib fracture risk in motor vehicle crashes (MVCs), a leading cause of thoracic trauma. Proper seatbelt use, particularly three-point belts combined with airbags, reduces the risk of moderate-to-severe chest injuries by about 50% and fatal outcomes by 45%.^[94] In sports like rowing, where repetitive stress contributes to rib stress fractures, protective gear such as padded chest orthoses or vests can dissipate forces during strokes, complementing strengthening exercises to prevent overuse injuries.^[95]^[96] For manual laborers exposed to heavy lifting and repetitive motions, ergonomic training programs emphasizing proper lifting techniques, posture, and workstation adjustments reduce musculoskeletal injury rates, including those from falls or impacts that could fracture ribs, by up to 42% in office settings, with similar benefits expected in high-risk occupations. Public health campaigns promoting trauma awareness, such as National Trauma Awareness Month initiatives, educate communities on safety protocols like helmet use and fall-proofing environments, contributing to broader reductions in injury incidence through policy and behavioral changes.^[97]^[98]^[99] Emerging technologies, including wearable devices for real-time impact detection, offer promising tools for high-risk activities; as of 2025 reviews, sensors in vests or wristbands integrated with AI can alert users to excessive forces during sports or construction, potentially preventing rib fractures by enabling immediate adjustments or evacuations in hazardous scenarios.^[100]

References

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Broken ribs - Symptoms and causes - Mayo Clinic
Feb 15, 2023 · A broken rib is a common injury that occurs when one of the bones in the rib cage breaks or cracks. The most common causes are hard impacts from falls, car ...
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Rib Fracture - StatPearls - NCBI Bookshelf
Aug 8, 2023 · Rib fractures can be traumatic or atraumatic. Most rib fractures are due to direct penetrating or blunt trauma to the chest.
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Rib Fracture | Thoracic Surgery | SUNY Upstate Medical University
Causes. Rib fractures may be caused by: A direct blow to the rib, such as from a motor vehicle accident or contact sports; Repetitive trauma from sports ...
[4]
Broken ribs - Diagnosis and treatment - Mayo Clinic
Feb 15, 2023 · Most broken ribs heal on their own within six weeks. Being less active and icing the area regularly can help with healing and pain relief.Missing: definition | Show results with:definition
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Rib fracture - aftercare: MedlinePlus Medical Encyclopedia
Apr 3, 2024 · A rib fracture is a crack or break in one or more of your rib bones. Your ribs are the bones in your chest that wrap around your upper body.Missing: causes | Show results with:causes
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Anatomy, Thorax, Ribs - StatPearls - NCBI Bookshelf - NIH
The ribs are the bony framework of the thoracic cavity. Generally, there are twelve pairs of ribs. Each rib articulates posteriorly with two thoracic vertebrae.
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The Thoracic Cage – Anatomy & Physiology - UH Pressbooks
The thoracic cage (rib cage) forms the thorax (chest) portion of the body. It consists of the 12 pairs of ribs with their costal cartilages and the sternum.The Thoracic Cage · Sternum · Ribs
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[PDF] MICROSTRUCTURAL AND MECHANICAL PROPERTIES OF ...
Apr 22, 2003 · Bone Microstructure. The human rib is composed of cancellous bone surrounded by a thin cortical shell. The cancellous core is created by an ...
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https://pubs.rsna.org/doi/full/10.1148/rg.2017160100
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Morphology of direct and indirect rib fractures - PubMed
Sep 14, 2020 · Fresh human ribs (n = 312) were divided into two groups and broken through local force (direct) and bending (indirect) in anterolateral areas.
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Rib Fracture - DynaMed
Oct 7, 2024 · Types ; type A: nondisplaced rib fracture. 1. transverse/greenstick; 2. oblique; 3. wedge (butterfly) fragment ; type B: displaced rib fracture (> ...
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Chest Trauma: Current Recommendations for Rib Fractures ... - NIH
Jan 15, 2020 · This article provides an overview of the common and important chest injuries that the anesthesiologist may encounter in patients following trauma.
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Initial evaluation and management of rib fractures - UpToDate
Jan 14, 2025 · Traumatic fractures most often occur at the site of impact or the posterolateral bend, where the rib is weakest. (See "Initial evaluation ...
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Traumatic Rib Injury: Patterns, Imaging Pitfalls, Complications, and ...
Feb 10, 2017 · Rib injuries can be separated into specific morphologic fracture patterns that include stress, buckle, nondisplaced, displaced, segmental, and pathologic ...Missing: curvature | Show results with:curvature
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Rib Fracture: Background, Pathophysiology, Etiology
May 15, 2025 · Motor vehicle accidents were associated with 51.6% of injuries, and blunt chest injury accounted for 95% of rib fractures. In a study by ...Missing: collisions | Show results with:collisions
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Fatal blunt chest trauma: an evaluation of rib fracture patterns and age
Jul 14, 2022 · While seat belts load the thorax during crash impacts, the likelihood of rib fracture is not greater with restraint use compared to no restraint ...
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Morbidity and Mortality After Rib Fracture in Elderly Patients (>65 ...
Oct 31, 2022 · 9.4%), while ground-level falls caused most rib fractures in the elderly group (66.0% vs. 11.3%). While the overall mortality rate was ...
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Circumstances of falls causing hip fractures in the elderly
Aug 5, 2025 · However, hip and ankle fractures are also common in same level falls, and fractures to the vertebral column, ribs and skull have also been ...<|separator|>
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Blunt trauma related chest wall and pulmonary injuries: An overview
Apr 20, 2020 · Blunt chest trauma is usually caused by motor vehicle accident, falling from height, blunt instrument injury and physical assault. As a ...
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An analysis of 214 cases of rib fractures | Clinics - Elsevier
In 5 (2.3%) patients, the rib fractures were due to penetrating trauma. Blunt trauma caused rib fractures in 209 (97.7%) patients. The patients were ...
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Rib fracture characteristics increasing the risk of hemothorax - NIH
Nov 30, 2024 · Hemothorax typically originates from damage to intercostal or parenchymal vascular structures caused by a rib fracture. Although this connection ...
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Chest Trauma - StatPearls - NCBI Bookshelf
Feb 27, 2025 · [4][5] Motor vehicle collisions (MVCs) are the leading cause of chest trauma. Most acute traumatic aortic injury cases also result from MVCs.Missing: sports | Show results with:sports
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What Accounts for Rib Fractures in Older Adults? - PMC - NIH
Rib fracture risk increased with age (HR per 10 years, 1.7; 95% CI, 1.5–2.0) and was slightly less in men than women (P = 0.331). The determinants of a rib ...
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Epidemiology of rib fractures in older men: Osteoporotic ... - PubMed
Mar 15, 2010 · Results: The incidence of rib fracture was 3.5/1000 person years, and 24% (126/522) of all incident non-spine fractures were rib fractures.Missing: elderly | Show results with:elderly
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Low-trauma rib fracture in the elderly: Risk factors and mortality ...
Rib fracture is common in the elderly, accounting for 7% of all fragility fractures. · Risk factors for rib fracture were old age, osteoporosis, prior fracture ...Missing: statistics | Show results with:statistics
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Stress fracture of the ribs in female rowers - PubMed
We have documented seven cases of stress fractures of the lower ribs in female athletes; four were elite rowers and three were engaged in tennis, golf, and ...
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Rib Stress Fractures and a Novel Muscle-Sparing Rib Fixation ... - NIH
Athletes from throwing sports typically sustain first rib fractures, and rowers have shown upper and lower rib stress fractures. Golf and tennis activities have ...
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Bone metastasis pattern of cancer patients with bone ... - NIH
Jan 23, 2019 · Although thoracic bones are predilection sites of these two cancers, we found breast cancer was more likely than lung cancer to metastasize to ...
[29]
Pathological subtrochanteric fracture revealing a primary ... - NIH
Primary hyperparathyroidism is associated with an increased risk of vertebral and non-vertebral fractures due to a reduction of volumetric densities at both ...
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Rib fracture secondary to cough‐induced trauma - PMC - NIH
Apr 26, 2024 · Non‐traumatic rib fracture typically results from factors like osteoporosis, medication use, and persistent coughing.
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Spontaneous rib fractures - PubMed
Other than trauma, rib fracture can occur spontaneously due to a severe cough or sneeze. In this study, patients with spontaneous rib fractures were ...
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Incidence and impact of involuntary rib fracture after intercostal ... - NIH
Jul 27, 2024 · Our study demonstrated that rib fracture occurs in almost half of the thoracotomies. Older patients are more likely to develop this event.
[33]
Iatrogenic Rib Fractures and the Associated Risks of Mortality - PMC
Jan 26, 2021 · Cardiopulmonary resuscitation (CPR) is known to be associated with IRF. CPR is a life-saving procedure, necessitating forceful compressions to ...
[34]
A Systematic Review and Pooled Analysis of CPR-Associated ... - NIH
The majority of rib fractures (86%) found during autopsies of patients after CPR were not detected with antero-posterior chest radiographs. Standard chest ...
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Rib Fracture (Broken Rib): Symptoms, Healing Tips & Treatment
There are lots of different break patterns, but some of the most common include: Stress fracture. Avulsion fracture. Comminuted fracture. Floating fracture.
[36]
Rib fractures – Patient education series: understanding trauma and ...
Sep 13, 2024 · Rib fractures can be very painful. The pain is usually worse with movement, coughing, and deep breathing. Sometimes the pain can be severe to ...
[37]
Helping elderly patients with rib fractures avoid serious respiratory ...
May 3, 2019 · A variety of factors contribute to rib fracture risk in older adults, such as polypharmacy, chronic health conditions, frailty, increased ...Missing: mid- axillary<|separator|>
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Flail Chest - StatPearls - NCBI Bookshelf
Jun 22, 2025 · Flail chest is a severe form of blunt thoracic trauma defined by fractures of 3 or more consecutive ribs in at least 2 places, resulting in a free-floating ...Flail Chest · Pathophysiology · Treatment / Management
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Rib Fracture Clinical Presentation: History, Physical Examination
May 15, 2025 · Patients with rib fracture frequently complain of pain on inspiration and dyspnea. Rib fractures have been reported after coughing spells without other ...Missing: referred | Show results with:referred
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Rib Fracture Management in Older Adults: A Scoping Review - NIH
One cohort study estimated a rib fracture incidence of 3.5 per 1,000 persons per year, with 24% of all non-spinal fractures being rib fractures. Up to 94% of ...
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Massive hemoptysis secondary to hemorrhagic traumatic pulmonary ...
Jan 12, 2024 · TPP is a severe form of pulmonary injury caused by blunt chest trauma accompanying pulmonary contusion or rib fractures. This entity is rare ...
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Rib fractures in the elderly: physiology trumps anatomy
Mar 12, 2019 · Criteria included blunt mechanism and ≥ 1 rib fracture identified by CT. ... history of comorbidities, history of smoking and associated injuries.Missing: hemoptysis | Show results with:hemoptysis
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A risk stratification tool for geriatric patients with multiple rib fractures
We aimed to develop and validate the Rib Fracture Frailty (RFF) Index, a practical risk stratification tool specific for geriatric patients with rib fractures.Missing: criteria | Show results with:criteria
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Pleuritic Chest Pain: Sorting Through the Differential Diagnosis - AAFP
Sep 1, 2017 · Pleuritic chest pain is characterized by sudden and intense sharp, stabbing, or burning pain in the chest when inhaling and exhaling.Missing: fracture | Show results with:fracture
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Approach to chest pain - EMCrit Project
Jan 15, 2025 · There are many life-threatening entities on the differential diagnosis of chest pain. However four in particular should be borne in mind.
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Physiotherapy management of rib fractures - ScienceDirect.com
If the rib fractures and associated injuries are severe enough to compromise ventilation, patients may require ICU admission and mechanical ventilation.Missing: assaults | Show results with:assaults<|separator|>
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Rib Fractures - AC Search
Rib fractures typically affect the fifth through ninth ribs. This may be due to the fact that the shoulder girdle affords relative protection to the upper ribs, ...
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The benefits and limitations of ultrasound in the diagnosis of rib ...
Mar 2, 2021 · Ultrasound promises to be a rapid, radiation-free alternative to chest X-ray for the diagnosis of rib fractures in blunt chest trauma.
[49]
None
### Summary of Conservative Treatment for Rib Fractures (Vanderbilt University Hospital Protocol, 2021)
[50]
[PDF] Management of rib fractures - Western Trauma Association
ABSTRACT: This is a recommended management algorithm from the Western Trauma Association addressing the management of adult patients with rib fractures.
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https://www.vumc.org/trauma-and-scc/sites/default/files/public_files/Protocols/Rib%20Fracture%20Guideline%202021.pdf
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A Comparison of Intercostal Nerve Block and Thoracic Epidural ...
Apr 2, 2025 · Intercostal nerve block with liposomal bupivacaine vs epidural analgesia for the treatment of traumatic rib fracture. Sheets NW, Davis JW ...
[53]
Comparison of the analgesic efficacy of ultrasound-guided ...
Mar 13, 2025 · S-SAPB provides prolonged analgesia and may be preferable for managing rib fracture pain beyond the initial 8 h. However, ICNB offers superior pain relief.
[54]
Role of intercostal nerve block and cryoneurolysis in the ...
Aug 30, 2025 · Role of intercostal nerve block and cryoneurolysis in the management of rib fractures: a narrative review.
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Intercostal nerve cryoablation during surgical stabilization of rib ...
Intercostal nerve cryoablation is an adjunctive measure that has demonstrated pain control, decrease in opioid consumption, and decrease in hospital length of ...
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Surgical stabilization of rib fractures (SSRF): the WSES and CWIS ...
Oct 18, 2024 · This consensus document addresses the key focus questions on surgical treatment of rib fractures. The expert recommendations clarify current evidences.
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Outcomes of internal rib fixation through complete video-assisted ...
Jan 9, 2025 · Internal rib fixation through complete VATS is a feasible and safe approach for treating multiple rib fractures and flail chest in patients with severe chest ...
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A meta-analysis and trial sequential analysis of randomised ...
Mar 19, 2024 · Meta-analysis of large-scale trials showed that surgical stabilization of multiple rib fractures shortened the duration of mechanical ventilation and reduced ...
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Surgical Rib Fixation in Isolated Flail Chest Improves Survival
Jun 28, 2021 · demonstrated that operative fixation results in a lower rate of pneumonia, fewer mechanical ventilation days, and shorter hospital stay but ...
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Risk of pneumonia in patients with isolated minor rib fractures
Furthermore, the incidence of pneumonia reached 51% in elderly patients with more than six rib fractures.23 Pre-existing comorbidities, such as congestive ...Materials And Methods · Study Sample Size And... · Results
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Rib Fracture Management in Older Adults: A Scoping Review
Jul 1, 2023 · Older adults are at higher risk of rib fracture even with minor trauma and also at increased risk for complications. Although the number of ...Missing: axillary | Show results with:axillary
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Hemothorax and Occult Pneumothorax, Management of
Persistent retained hemothorax, seen on plain ?lms, after placement of a thoracostomy tube should be treated with early VATS, not a second chest tube (Level 1).
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The morbidity and mortality of rib fractures - PubMed
Among the patients with rib fractures, 84 (12%) died, 670 (94%) had associated injuries, 274 (32%) had a hemothorax or pneumothorax, and 187 (26%) had a lung ...
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Flail Chest - Trauma - Orthobullets
Sep 23, 2024 · Flail chest is a traumatic chest injury defined as segmental fractures of 3 or more consecutive ribs and is often associated with pulmonary ...Missing: ARDS | Show results with:ARDS
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RIB PLATING IMPROVES SURVIVAL BUT INCREASES RISK OF ...
Oct 18, 2020 · While rib plating resulted in improved survival for patients with rib fractures, it increased the risk of ARDS.
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Rib Fracture Treatment & Management - Medscape Reference
May 15, 2025 · Respiratory care, including use of incentive spirometry to prevent atelectasis and its complications, is often important. Holding a pillow or ...
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Radiographic rib fracture nonunion and association with ... - PubMed
Conclusions: Forty-three percent of patients with multiple rib fractures had radiographic nonunion six months after trauma. Fractures in ribs seven to 10 and ...Missing: incidence | Show results with:incidence
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Expert consensus guidance on respiratory physiotherapy and ...
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Analysis of risk factors for poor healing and long-duration pain ... - NIH
Dec 20, 2024 · Additionally, the trauma of rib fractures can cause pneumothorax, hemothorax, and lung contusions. However, most pulmonary-related complications ...
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Treatment of Intercostal Neuralgia Following Cough-induced Rib ...
Jun 4, 2025 · This case report describes a 48-year-old woman who developed persistent intercostal neuralgia after sustaining bilateral multiple rib fractures
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Intercostal Neuralgia - StatPearls - NCBI Bookshelf - NIH
Intercostal neuralgia is characterized by neuropathic pain in the distribution of affected intercostal nerve(s) (along the ribs, chest, or abdomen)
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The progression of traumatic Stanford type A acute aortic dissection
Jun 13, 2023 · An 85-year-old woman was diagnosed with traumatic ascending aortic dissection, right clavicle and left first rib fracture, and abdominal ...
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A fracture of the first or second rib is predictive of injury to the thoracic aorta and its major branches.Missing: dissection | Show results with:dissection
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Comprehensive Review of Current Pain Management in Rib ...
Jan 4, 2023 · It is noted that in the elderly, each rib fracture increases developing pneumonia by 27% and the risk of dying by 19%. From a public health ...Missing: chronic | Show results with:chronic
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Rib Fractures Mimicking Bone Metastases in 18F-PSMA-1007 PET ...
We present a case of a 69-year-old man with history of prostate adenocarcinoma who underwent F-PSMA-1007 PET/CT due to suspected biochemical recurrence.Missing: mimicry | Show results with:mimicry
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Nov 25, 2022 · This process begins with hemorrhage and progresses through three stages: inflammatory; reparative; remodeling. This process can be supported by ...
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Fracture Healing Overview - StatPearls - NCBI Bookshelf
Apr 8, 2023 · Fracture healing is complex, and it involves the following stages: hematoma formation, granulation tissue formation, callus formation, and bone remodeling.
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Care options for patients with rib fracture - Mayo Clinic
Feb 12, 2025 · A patient with a rib fracture not only experiences pain but also is at risk of pneumonia, as poorly controlled pain can affect respiratory ...
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How Long Does a Fracture Take to Heal? - Mass General Brigham
Oct 30, 2025 · In children, bone healing happens much faster than in adults. Young kids have a thick layer of blood-rich connective tissue around their bones ...
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Fractured Ribs Still Painful After 2 Months? You May Need Surgery
Mar 24, 2016 · You are going to need time to heal. While 85 percent of rib fractures heal on their own, in more extreme cases surgery may be needed.
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None
### Summary of Rib Fractures (2025 Guidelines)
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Exercise Can Help Decrease Fall Risk for Elderly People
May 23, 2023 · By improving range of motion, older adults can improve their ability to move safely and avoid falls caused by limitations in mobility. 6. Use of ...Missing: rib | Show results with:rib
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Balance training seems to prevent falls, injuries in seniors
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Osteoporosis to Prevent Fractures: Screening - uspstf
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Bisphosphonates: What They Are, Uses, Side Effects & Types
Alendronate reduces vertebral (spine) fracture risk by about 50%. · Risedronate reduces the risk of vertebral and nonvertebral fractures by about 40%.
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Apr 30, 2024 · Regardless of 20PY, all smoking cessation subgroups showed significantly less risk of fractures than current smokers with ≥ 20PYs. Smoking ...
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Apr 11, 2021 · Numerous studies have shown that weight-bearing exercise can play a role in slowing bone loss, and several show it can even build bone.
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The potential dangers of whooping cough: a case of rib fracture and ...
Nov 13, 2024 · This case report details possible complication in a 48-year-old woman, involving a cough-induced rib fracture and recurrent pneumothorax.
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The Impact of Seatbelt Use on Broken Bones in Car Accidents
Dec 26, 2024 · Rib Fractures: Seatbelts that restrain your chest can sometimes cause stress fractures to ribs during high-impact collisions. Wrist and Arm ...How Seatbelts Reduce The... · Common Broken Bone Injuries... · Seeking Legal Help As An...
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[PDF] Effect of seatbelt and airbag loads on thoracic injury risk in frontal ...
The fatality risk for occupants wearing a seatbelt in a vehicle fitted with air bags in frontal crashes is reduced by 61 percent compared to occupants not ...
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Rib stress fracture in rowers - Physiopedia
This mechanical connection enables the ribcage to provide protection to the thoracic region by redistributing the transmitted forces to the thoracic spine.
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Ergonomic Training Reduces Musculoskeletal Disorders among ...
Ergonomic training significantly reduced musculoskeletal disorders, especially in the neck region, and improved workstation habits among office workers.Missing: rib fractures
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The History And Purpose Of National Trauma Awareness Month For ...
Apr 2, 2025 · National Trauma Awareness Month aims to promote education, treatment, and safety protocols to reduce the risk of sustaining such injuries or to ...
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2025 Top Wearable Safety Technology - SlateSafety
These sensors, embedded in vests and wristbands, use AI to detect movement patterns and issue immediate alerts to reduce collision risks.The Growing Role Of Safety... · Ai Integration & Predictive... · Multi-Functionality &...<|separator|>