This is the 3627th article of Da Medical Care
Rib fractures (rib fractures) are the most common chest injuries, caused by violence directly acting on the ribs, causing the ribs to bend inwards at the stressed point, and squeezing the ribs outwards and bending them outwards. Severe rib fractures can cause respiratory failure and shock.
Rib fractures often present with pain, local pain at the fractured end of the rib, exacerbated by deep breathing, coughing, or turning positions. Significant tenderness at the fracture site, worsening pain at the site of indirect squeezing of the fracture, and may be accompanied by chest pain when puncturing the pleura or lungs. Abnormal breathing; two or more fractures of each of the two or more adjacent ribs, so that the local chest wall loses the intact rib support and softens, and the chest wall of the softening area is inverted during inhalation during spontaneous breathing, and the relative protrusion is relative to the extrusion when exhaling. In severe cases, respiratory failure and shock may occur. The fractured end punctures the pleura, intercostal blood vessels, and lung tissue, resulting in hemothoracosia, pneumothorax, subcutaneous emphysema, or haemoptysis. In rib fractures, pulmonary contusion with fluid pneumothorax, heart injury, clavicle fracture, shoulder blade fracture and tuberculous pleurisy pleural hypertrophy are prone to misdiagnosis.
Rib fractures in the process of healing, at both ends of the fracture to form an inflated scab, similar to nodular intrapulmonary lesions, especially the elderly, in the absence of obvious history of trauma, easy to misdiagnose as intrapulmonary nodular lesions, especially when the ribs are transverse fractures, in the case of difficult to diagnose, CT examination should be done, CT examination resolution is high, bone trabeculae through the fracture seam is clearly visible.
So how can rib fractures be prevented?
1. Pay attention to sports and travel safety
Rib fractures are common in sports injuries, traffic accidents, and routine work. Sports injuries are common in high-intensity sports such as basketball, soccer, and rugby. In strenuous exercise, it is especially necessary to pay attention to sports protection and prevent rib damage during exercise. In addition, compliance with traffic laws, legal and safe operation are also important factors in avoiding rib fractures. In addition, falls in the home of the elderly, especially in the bathroom, kitchen and other places are also very common. Providing a safe home environment is very important to reduce the occurrence of fractures. The prevention of such fractures is relatively common.
2. Encourage multi-activity
Moderate exercise can strengthen bone strength on the one hand, and on the other hand, it can also maintain muscle strength and a good sense of balance, reducing the chance of falls. This is also one of the methods of prevention of fractures.
3, to develop good living habits
People with long-term smoking, excessive alcohol consumption, less movement and more sitting, and low-calcium diet and other bad living habits are prone to osteoporosis in old age. So don't smoke, drink less, don't drink strong tea, and don't eat too many high-protein foods.
4. Prevention of falls in elderly patients
The elderly are loose and the ribs are very fragile, so it is necessary to use some walkers, crutches and other aids as much as possible, and install more handrails or anti-slip devices in the city to avoid dangerous behaviors such as riding mopeds and prevent falls and accidents.
Rehabilitation of rib fractures
1. Fracture fixation, rib fracture location is more special, rib fracture appears obviously misaligned, surgical reduction of steel plate internal fixation, so that the broken end to restore function or anatomical position as soon as possible to heal. Chest straps can be used to secure without significant misalignment.
2. Avoid strenuous activities, avoid chest expansion exercises, avoid lifting heavy objects, and avoid high-intensity exercise.
3. Active cough and sputum, rib fracture patients, especially elderly patients, should regularly take deep breaths, active cough and excrete sputum, to prevent lung infection, atelectasis and so on.
4. Reasonable diet, rib fracture should be light at the beginning; after two weeks of diet fracture, you can eat high-energy, high-protein foods to promote the recovery of vitality; eat more foods rich in vitamin C to promote the body's absorption of calcium.
I hope that all patients with rib fractures can gain something after reading it and recover as soon as possible.
Author: Shanghai Seventh People's Hospital
Ju Yufeng Tian Tianning