Bruised ribs
Last reviewed: 23.04.2024
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The contusion of the ribs is considered a normal injury, which does not have such serious consequences as a bruise of the head, knee, elbow or other joints. However, for all its "trouble-free" in the sense of complications, the bruise of the ribs is accompanied by intense long pain and a long recovery period. In addition, the injury can be combined with other more serious injuries, such as fracture, trauma to the tissues of internal organs.
The severity of the injury depends on the strength of the impact, the localization of the trauma and the presence of concomitant diseases, for example acute respiratory processes, pneumonia, cardiovascular pathologies.
[Edema of the rib: symptoms
The contusion of the ribs can affect the soft tissues of the sternum, which are not so much in this part of the body, as a rule the subcutaneous layer of the cellulose and a group of muscles are damaged, which immediately swell after swelling. The second manifestation of a bruise is pain, sometimes very intense, due to hemorrhage in the intercostal space, the third are problems with breathing. The pain manifests itself almost gradually and can intensify with deep breaths or exhalations, coughing, sneezing. Also, painful sensations are present in the dynamic load - bends, inclinations and even when the area of damage is palpated. Skin covers in the place of bruising are often swollen, as a rule, extensive hematoma develops, atypical densification can be palpated. The differentiation of the contusion and fracture of the rib is not carried out independently. One of the menacing signs that requires immediate medical attention is a severe cough, accompanied by pain and discharge from bloody sputum. In the chest area, the accumulation of air is distinctly visible, which, like palpation, "creaks" (crepitus). This indicates a possible damage to the lung and developing emphysema. Delay is dangerous, since this condition leads to heart failure, the pulse decreases sharply, breathing is frequent and superficial. The victim should be raised, in order to avoid the burden on the heart and urgently call an ambulance. A simple bruise of the ribs can also be accompanied by a cough, but neither the pulse nor the pressure changes, and the pain symptom subsides within 24 hours.
How to recognize a rib bruise?
The first thing the doctor does after visual examination and questioning of the patient is to diagnose the state of cardiac and pulmonary activity. Obligatory is the x-ray of two projections - direct and laterally, the safety of the injured rib is more accurately determined and the risk of mechanical pneumothorax (accumulation of air and exudate in the pleura) is excluded. It is also important to exclude the presence of blood in the pleura - the hydrothorax, which often happens in the cracks of the rib or its fracture.
Treatment of bruised ribs
If the bruise is insignificant, the pain and swelling gradually subsides during the day, possibly self-treatment, which consists in complete rest and the imposition of a cold compress. This can be chilled water in a flat container, an ice pack or a simple wet, cold compress. Cold helps to stop the spread of hemorrhage into the subcutaneous layer, partially reflexively relieves painful sensations. The cold should be kept for no more than an hour, periodically replacing it with a new compress, it is important not to allow thermal impact on the injured area during the first day.
With severe pain, you can take antispasmodics and non-steroidal anti-inflammatory drugs, such as naproxen, orthophene, diclobarle or diclofenac. Limiting the movement should be maximum, it is better to take a horizontal position, slightly raising the upper body to reduce the burden on the lungs. Lying should be at least three days, then restore the motor activity very carefully, without making sudden movements. If possible, it is best to show the traumatologist in order to get a professional consultation and exclude possible risks. As a rule, the bruised ribs are treated with conservative methods. In all other cases, if an extensive fluctuation hematoma develops (the liquid under the skin seems to move, the hematoma spreads), if the pulse falls and the pain does not subside within two days, you need to call a doctor or call an ambulance for hospitalization of the patient. Fluctuation haematomas are usually punctured to aspirate its contents, prescribe symptomatic treatment, and the thorax is fixed with gypsum.
If the bruise is strong enough and leads to the formation of pneumothorax or hemorrhage in the pleura (hemothorax), thoracotomy (surgical intervention) can be indicated.
The contusion of the uncomplicated ribs passes definitively within a month, more serious, complicated cases are supervised by doctors, and the effectiveness of treatment depends on the severity of the injury.