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Rib fracture: symptoms, diagnosis, treatment

 
, medical expert
Last reviewed: 07.07.2025
 
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Rib fractures usually occur with blunt trauma to the chest, often due to significant external force (e.g., a sudden stop of a car, a hit with a baseball bat, or a fall from a height). However, in older people, rib fractures can also occur with minor external impact (e.g., a simple fall). Associated injuries may include ruptures of the aorta, subclavian artery, heart injury (uncommon, but may occur in some cases with sudden braking, especially with a fracture of the first or second ribs), injury to abdominal organs, especially the spleen (with a fracture of any rib from the seventh to the twelfth), pulmonary contusion, pneumothorax, and other tracheobronchial injuries (rare).

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Symptoms of a Rib Fracture

The pain is severe, increases with coughing and deep breathing, and lasts for several weeks. Respiratory restriction (incomplete inhalation due to pain) can lead to atelectasis or pneumonia.

Diagnosis of rib fractures

Diagnostics are aimed at excluding associated injuries. Chest X-ray is mandatory. The appointment of other diagnostic tests depends on the presence of clinical symptoms of associated injuries.

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Treatment of rib fractures

Treatment should include opioid analgesics. Because inhalation causes severe pain and opioid analgesics depress respiration, patients should consciously and frequently (e.g., once per hour) breathe deeply or cough. Patients with fractures of 3 or more ribs or with signs of cardiopulmonary insufficiency should be hospitalized. Immobilization (e.g., tight bandaging) of rib fractures should be avoided because it limits respiratory movement and predisposes to atelectasis and pneumonia.

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