In fractured ribs, there is a break in any of the bones that are part of the rib cage. It can involve one or more ribs at the same time.. Also, there may be complete breakage or splitting into very small pieces.
The most common cause of rib fractures is chest trauma. Most of the time it is a closed trauma, i.e. without internal tissues communicating with the outside.
How can trauma cause fractured ribs?
Fractured ribs as a result of chest trauma can appear in the following scenarios:
- Direct trauma: This is the case with traffic accidents, physical assaults or falls.
- Repetition: in high impact sports or in chronic cough pictures. Repeated minimal trauma culminates in a stress fracture.
- indirect trauma: broken ribs occur indirectly from trauma that does not affect the chest. This transmission of forces can also occur in car accidents.
complications
Broken ribs in older adults that fall tend to be based on osteoporosis. In young children, they are secondary to lack of bone consolidation.
Depending on the involvement of other organs, the risks and recovery can be variable. However, the older the patient, the more the higher the risk of getting pneumonia as a complication.
Symptoms and diagnosis
Rib fractures tend to be very painful. and even interfere with normal breathing patterns. Also, what is called can be highlighted bib. It occurs when two or more successive ribs break into multiple pieces, creating instability of the chest.
The result is that the chest moves in the opposite direction to the rest of the rib cage when you take deep breaths. This prevents adequate expansion of the lungs and is associated with severe adjacent lung injury.
On physical examination, there is usually pain on palpation or inspiration, coughing, sneezing, or performing any Valsalva maneuver. People often feel stiff when breathing, due to discomfort.
A chest X-ray is taken to diagnose fractured ribs. However, if the image shows no alterations, but suspicion is high, continue with a computed tomography.
Tips for recovering fractured ribs
Treatment of fractured ribs includes pain control and breathing exercises to prevent complications. The pharmacological basis is non-steroidal anti-inflammatory drugs and incentive spirometric therapy.
The healing process usually takes 6 to 8 weeks. Breathing exercises are used to keep the lungs from expanding to avoid the buildup of secretions, which can be complicated by pneumonia.
Pain management is key
Broken ribs can be so painful that they prevent proper inhalation and expansion of the lungs. This is why pain management is needed.
Prescription pain relievers include nonsteroidal anti-inflammatory drugs (ibuprofen and diclofenac). When they are not enough, opioids such as tramadol are added (only under strict supervision and medical indication).
Sometimes gabapentin is also indicated. Anyway, There is no scientific data on this option to validate it its full utility. Muscle relaxants are effective in enhancing the effect of analgesics aforementioned.
Surgery is not usually indicatedunless the displacement of one of the fractured ribs punctures the lung. In this case, the ribs are fixed with metal plates.
local cold
It is recommended to apply cold compresses for 20 minutes every hour, without interrupting sleep, the first two days. Then it is reduced to 20 minutes, three times a day.
This helps reduce pain and inflammation. The cold compress must be wrapped in a cloth before applying it, as it can cause skin burns.
active rest
Broken ribs take time to heal. Complete rest is recommended for the first week and then incorporate low impact exercises. They are suspended in case the pain increases.
Staying active after the first week of rest will reduce your risk of getting pneumonia or other respiratory infections. Just as the risk of producing emboli decreases.
Breathing exercises are the main rehabilitation of rib fractures
THE breathing exercises, in combination with pain relievers, are the ones that will really help fractured ribs heal. Chest stretching exercises can also be used.
It should be done slowly and gently, with a gradual increase in difficulty. However, no routine should be started if your doctor indicates it’s still unsafe.
Use of the incentive spirometer
The incentive spirometer is a device that helps you take deep inspirations correctly. It is recommended to perform 10 to 15 breath cycles every 1 to 2 hours.
During its use, the mouthpiece of the incentive spirometer is placed in the mouth, keeping it sealed with the lips. The exercise consists of inhaling (inspiring) deeply. You should try to lift the parts of the spirometer as high as possible. You can also try keeping one of the pieces in the center.
In the most critical patients, an alternative is the positive pressure bottle. It has proven useful when there are more than 3 rib fractures at the same time.
diaphragmatic breathing
Also known as belly breathallows for full expansion of the lungs. Inspired air is able to reach the largest part of the lung parenchyma. This prevents trapped air from causing any future problems or complications.
Bucket handle breathing
This type of breathing exercise seeks elevation and expansion of the ribs. Increases the transverse diameter of the rib cage, allowing deeper inspirations.
yoga positions
There are some yoga poses that can strengthen the muscles between the ribs (intercostal muscles):
- charge or bhujangasana.
- cat/cow or marjaryasana/bitilasana.
- extended dog or adho mukha svanasana.
They must be practiced carefully and under the guidance of a master of the discipline. Overstretching can make the injury worse.
Broken ribs recover steadily
Breathing exercises and even yoga for broken ribs require persistence. There will be no immediate scars. Perhaps these aids can reduce the discomfort, but it is prudent to consider that 6-8 weeks is the time needed.
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