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Rib Fracture

GENERAL INFORMATION:

What is a rib fracture? A rib fracture is a crack or break in a rib. Your ribs are the bones that connect from the front of your chest around to your spine (backbone). All of the bones of your ribs make your rib cage.


What causes a rib fracture?

  • Trauma: A direct blow to the chest may cause a rib fracture. There is a higher chance that other organs may be injured with this type of rib fracture. Flail chest may occur if 3 or more of your ribs are broken in 2 or more places. This condition may make it hard for you to breathe. When you take a breath, your rib cage expands (gets larger). The broken ribs with flail chest do not expand and may push inward on your organs.

  • Stress: Stress fractures happen when the muscles attached to your ribs are used often. These fractures are usually small and heal with rest but may worsen if you continue to use the muscles. Rib stress fractures are most common in people who play sports, such as baseball pitching, basketball, and rowing. A strong, long-term cough may also increase your risk of having a rib stress fracture.

What are the signs and symptoms of a rib fracture?

  • A lump that may be felt on your chest

  • Broken rib bone that has cut through your skin

  • Chest pain that worsens when you breathe

  • Chest pain when touched

  • A change in the shape of your chest

  • Shortness of breath or trouble taking deep breaths

How is a rib fracture diagnosed? Your caregiver will ask about your injury and examine you. He will ask about your breathing and pain. He will look for any signs of bleeding or bruising. You may need 1 or more of the following:

  • Chest x-ray: This picture of your chest may show broken ribs or fluid around your heart and lungs. Caregivers may use the x-ray to look for signs of infection, such as pneumonia, or to look for a collapsed lung.

  • CT scan: This test is also called a CAT scan. An x-ray machine uses a computer to take pictures of your ribs. The pictures may show broken ribs and injuries to other organs. These may include your heart, lungs, spleen, and liver. You may be given a dye before the pictures are taken to help caregivers see the pictures better. Tell the caregiver if you have ever had an allergic reaction to contrast dye.

  • Ultrasound: An ultrasound uses sound waves to show pictures on a monitor. An ultrasound may be done to show injuries to other organs.

  • Bone scan: This is a test done to look at the bones in your body. The bone scan shows areas where your bone is diseased or damaged. You will get a radioactive liquid, called a tracer, through a vein in your arm. The tracer collects in your bones. Pictures will then be taken to look for problems. Examples of bone problems include fractures (breaks) and infection.

How is a rib fracture treated?

  • Medicines:

    • NSAIDs: These medicines decrease swelling and pain. NSAIDs are available without a doctor's order. Ask your caregiver which medicine is right for you. Ask how much to take and when to take it. Take as directed. NSAIDs can cause stomach bleeding and kidney problems if not taken correctly.

    • Acetaminophen: This medicine decreases pain. You can buy acetaminophen without a doctor's order. Ask how much to take and how often to take it. Follow directions. Acetaminophen can cause liver damage if not taken correctly.

    • Pain medicines: You may be given a prescription medicine to decrease pain. Do not wait until the pain is severe before you take this medicine.

    • Intercostal nerve block: This is pain medicine that will make you numb for about 6 hours. It is given as a shot between 2 of your ribs in the fractured area. You may need this if your pain continues or is getting worse even after you take oral pain medicines.

  • Deep breathing: Your caregiver may give you a spirometer. A spirometer is a small tube that will help you with deep breathing. He may also do chest physiotherapy, which is light hand clapping on your back to help remove lung mucus.

  • Rest: Rest your ribs to decrease swelling and allow the injury to heal faster. This may take up to 6 weeks. Avoid activities that may cause more pain or damage to your ribs. As your pain decreases, begin movements slowly.

  • Ice: Ice helps decrease swelling and pain. Ice may also help prevent tissue damage. Use an ice pack or put crushed ice in a plastic bag. Cover it with a towel and place it on your fractured area for 15 to 20 minutes every hour as directed.

  • Physical therapy: A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.

  • Surgery: If many of your ribs are badly fractured, you may need surgery. Surgery is often needed for a flail chest. Broken ribs may be held together with plates and screws. An injury to an organ, nerve, or blood vessel may also be treated with surgery.

What are the risks of a rib fracture? You may bleed or get an infection if you have surgery. You may get a blood clot in your leg or arm. The clot may travel to your heart or brain and cause life-threatening problems, such as a heart attack or stroke. Without treatment, you may get an infection in your lungs or blood. Air or blood may also collect inside your chest after a rib fracture and cause increased trouble breathing. When this happens, you may need a drain put into your chest to remove the air or blood. Life-threatening injuries may also be present with a rib fracture. These may include injuries to your organs such as your heart, lungs, liver, and spleen.

When should I contact my caregiver? Contact your caregiver if:

  • You have a fever.

  • You have bruising on your chest.

  • You get a cold and are coughing a lot.

  • You have questions or concerns about your condition or care.

When should I seek immediate care? Seek care immediately or call 911 if:

  • You suddenly have more severe chest pain. You may cough up blood.

  • You have a fever or chills and increased shortness of breath.

  • You have abdominal pain.

  • You suddenly feel lightheaded and short of breath.

  • Your arm or leg feels warm, tender, and painful. It may look swollen and red.

CARE AGREEMENT:

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2014 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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