Symptoms causes and treatment of rib fracture

Rib fracture: symptoms and treatment - an important section of traumatology and surgery, affecting many people's interest, as these injuries are quite common and can occur in people of any age. If the injury is not accompanied by dysfunction of other organs, these defects are restored independently and do not require special medical intervention.

Problem fractures of the ribs becomes quite serious if the damage to the bone is accompanied by damage to surrounding tissues. In this case complications can lead to hazardous health diseases. All of this indicates that when the rib fracture is necessary to consult specialists and undergo a serious examination.

The structural features of the ribs

In the General case, the fracture is a mechanical damage to the cartilage or rib bone, leading to disruption of its integrity. The frequency of occurrence of this type of injury is 15% of all bone fractures.

Features of defeat of the system of ribs are connected with their anatomical structure. All a person has 12 pairs of ribs: 1-7-th pair is true, 8-10-th pair is about 11-12 and the second pair of oscillating fins. True types are connected with the breastbone own cartilage plates. The false ribs have no direct connection with the sternum is cartilaginous, their end is connected with the cartilage above, ribs, and cartilage sprung ribs do not articulate.

Between the ribs are placed related muscles: external and internal intercostal muscles, subcostal and transverse thoracic muscles. Internal rib area of the chest is covered with strong fascia. Such a fixation rib system provides the conditions under which fragments of ribs do not diverge, while in muscle-fascial neighborhood.

All edges are composed of cartilage and bone parts and their structure are the following areas - the neck, head, body, and tubercle. On the inner part of them is a bundle of nerves and blood vessels lying in the costal groove. Broken ribs are subjected to and the defeat of the beam, which can cause impairment of muscle blood flow and pain.

Features of fracture of ribs

Most frequently the fracture is found in 7-10's ribs, which caused the greatest width of the chest in this area and the greatest bending of the ribs along the back axillary line on the side of the sternum. Less likely to suffer the 11-12-th of the edges with increased mobility.

There are two main mechanisms of damage - direct and indirect type. A direct mechanism is characterized bydepression of ribs (one or more) inside the chest under the action of mechanical forces (e.g., shock). If the impact force exceeds the strength of an element, then a fracture occurs. And bend the bone may cause damage to the pleura and lung, and the number of broken bones depends on the area of impact and body strength. With a very strong dramatic impact is a double fracture - window type. In this case, the area of bone with two sides separated from the edges (forming a window).

The indirect type occurs when a significant compressive load on the chest during fixation of the back. A vivid example of accident - clamping the wheel or hitting the wheel. Fractured ribs occur on both sides of the contractive plane. With a very strong compressive stress occurs when damage type is "crushed Breasts" when there are multiple double fractures.

Very dangerous to have a floating destruction when a rib is broken in two places and freely hangs on the fascia. In this case, when you inhale the chip falls inside, and when exhaling - bulges outward. Such flotation movement may cause lung disease. The greatest danger in terms of the impact on cardiac function represent the front left, and bilateral damage to the window type, which can cause even death. In similar injuries, but the rear location, the prognosis is more optimistic due to the locking of the role of the dorsal muscle.

Classification of fractures

The nature of the lesion, localization and severity of rib fractures have several classifications:

1. According to the type of lesion: closed (without damage of skin layers and soft tissues) and open (with an open wound and visible lesions) types.
2. According to the degree of lesions: complete destruction of the whole body) and subperiosteal (bone tissue injury) and fractures of the ribs, and cracked.
3. As fragments: fracture without displacement and fracture of the ribs with an offset.
4. Localization of damage: window (the defeat of the ribs on one side of the thorax) and two way (lesion on both sides of the chest) types.
5. Quantitative factor: single and multiple rib fractures.

Causes of fractures

A rib injury can happen under two conditions: exposure to excessive loads (point or distributed), superior strength, bone structure, or the application is not very strong efforts on the atrophied bone. In the latter case may affect the age factor or the weakening of the bone as a result of disease (osteoporosis, tumors).

rib" alt="traffic accidents as a cause of broken ribs">the impact of excessive workloads are allocated shocks, falls from height, dynamic and kinetic compression. In children thorax has a high elasticity, which reduces the frequency of lesions in childhood, but of 40-45 years have significantly reduced the elasticity of the ribs (although increasing their strength), so that the number of chest injuries increases.

Statistics indicate that the most common reasons are domestic, then there is an accident, then a work injury. Natural disasters also adds to the list of causes of rib fractures.

The impact of the main reasons it should be noted types of loads: strikes the subject with a small area (e.g. a fist) and fall on a sharp object causes a single damage; while attacks wide objects (e.g., a plane of bricks) or the fall on the plane can occur conclusive defeat. In addition, we should distinguish the direction of the impact load from the front or side. The compression also acts differently at different direction of effort. Grip front raises bilateral disease, and compression on both sides - two window fracture.

Symptoms of broken ribs

When was the turning point, symptoms do not always manifest themselves clearly, often the damage can be set indirectly. The most common symptoms of rib fracture - sharp pain in the affected location with increased deep breathing, coughing, turning torso, strained defecation.

Typical symptoms occur in the form of an interrupted breath, when the victim during a slow inhalation of breath is suddenly interrupted because of the pain in the abdomen, and in some cases when breathing is possible to distinguish between clicking in the affected rib. When breathing possible asymmetric movement of the different sides of the chest. Sure signs - shallow breathing and a noticeable reflexive attempt to alleviate any impacts on the affected side.

If a fracture of his posterior region, to determine the symptoms becomes more difficult as these areas are less involved in breathing. In addition, when lying on the back on the affected area is immobilized, and subsiding pain. An important indicator of a fracture is a symptom of axial load. This test is performed by alternately compressing the chest front, back and sides - pain in the location of the defect increases.

For the purpose of clarification should be palpated, and the affected area will be felt swelling. Another important test symptom of Payr, i.e. the identification of the pain syndrome in the tilt toward the unaffected half. These two tests give absolute signs of fracture. Most reliablethe diagnosis is made after removing x-rays.

Possible complications

Broken ribs dangerous risk of internal injuries when ceasing the bones inside, this is especially dangerous on the left, as it can affect cardiac function. Possible complications damage to the ribs include:

1. Pneumothorax: air leak into pleural cavity when damage to the lung or tissues with a sharp piece of bone.
2. Hemothorax: the penetration of the blood mass in the pleural cavity.
3. Respiratory failure: violations occurred in the respiratory system, there is a pallor or even cyanosis of skin, there is tachycardia.
4. Pleuropulmonary shock: large amount of air in the pleural cavity, coughing, a large pneumothorax, cold hands and feet.
5. Pneumonia: pneumonia occurs against a background of hypotonia and other symptoms of pathology.
6. Subcutaneous emphysema: air penetration under the skin layer as a result of pulmonary lesions.
7. Discharge of blood when coughing.
8. Flotation of the area of the chest wall.
9. Disturbances in the cardiovascular system, kidneys, gastrointestinal system, liver, spleen.

Treatment of rib fracture

When suspected broken ribs, the treatment cannot be clean in order to avoid complications. The necessary treatment and time can be set only doctor. As first aid you can take painkillers, apply a pressure bandage on the chest and transported the victim to the nearest medical facility.

The stage of fusion of the ribs:

In uncomplicated fracture of the ribs gradually heal by themselves in 3 stages:

1. Step 1: connecting the corn - at the junction accumulates the blood mass flow applied to fibroblasts (cells that can generate connective tissue).
2. Step 2: osteoid corn - corn on the connecting deposited mineral salts that make up the osteoid.
3. Stage 3: callus on the surface of osteoid fixed hydroxyapatite increasing corn strength, gradually, the structure becomes ossified and dimensions of the ribs.

Medical treatment

In severe pain and other symptomatic manifestations to treat lesions of the chest should be in the hospital. Treatment is based on symptomatic therapy and immobilization of the affected area. First of all, is alcohol-prokaieva the blockade by administering to the site of the lesion procaine and ethyl alcohol (70% at a dose of 1 ml). Immobilization is carried out using an elastic bandage,superimposed on the chest.

If manifests respiratory failure, inhalation of oxygen. In the case of pneumothorax and hemothorax requires puncture of pleural cavity for aspiration of penetrating to air and blood supply. If the hemothorax is not received extensive in nature, that the puncture should not be pursued, because the body itself to cope with a small presence of blood, Rassolov her. The recovery time of broken ribs is usually 20-30 days, while uncomplicated injuries are treated at home.

https://www.youtube.com/watch?v=Q7J2EajM4l0

As the prevention of complications affected recommended gentle common mode, carrying out exercises of respiratory gymnastics are assigned expectorants to exclude hypostatic pneumonia. In post-traumatic period is dominated by diaphragmatic breathing, it is necessary to avoid increasing intra-abdominal pressure by optimizing nutrition. It is advisable to arrange fractional full-fledged food menu should not include foods that cause flatulence.