Fractured ribs. Causes. Diagnostics. First aid

Rib fractures are the most common injury to the chest. Rib fractures account for about 16% of the total number of fractures. In older people, rib fractures are more common, which is due to an age-related decrease in the elasticity of the bone structures of the chest. Rib fractures are accompanied by chest pain and lead to limited mobility of the chest, for this reason breathing becomes more shallow, which can cause impaired pulmonary ventilation. Multiple rib fractures can be accompanied by damage to the chest organs and pose a danger to the patient's life. The diagnosis of rib fracture is made on the basis of X-ray data; if necessary, ultrasound of the pleural cavity and its puncture are performed.

Anatomical certificate

The rib cage consists of twelve thoracic vertebrae, to which twelve pairs of ribs are attached through joints. In front is the sternum, to which the cartilaginous parts of the ribs adjoin.

All ribs are divided into three types: true (I-VII pair), false (VIII-X pair) and oscillating (XI-XII pair). The difference between them is that true ribs are connected to the sternum by their own cartilaginous plates, while false ribs are not directly connected to the sternum; their cartilaginous parts are fused with the cartilage of the ribs that are located above. Finally, the cartilaginous part of the oscillating ribs is generally devoid of articulation with anything.

On the inner side of the ribs there is a groove in which the neurovascular bundle is located. If a rib breaks, it is also often damaged, which can lead to bleeding and disruption of the nutrition of the intercostal muscles.

Causes of injury

Depending on the condition of the ribs, experts distinguish between two types of fractures. The first type is damage to healthy bones caused by mechanical trauma. The second is pathological fractures, which are caused by changes in the bones caused by various diseases or minimal physical impact.

Type 1 fractures can be caused by road traffic accidents; blow to the chest; falling from a height; injuries sustained during sporting events; gunshot wounds. In this case, the effects on the ribs can be indirect or direct. With indirect impact, the chest is compressed, causing the ribs to break on either side of the pressure point. As a rule, several ribs are affected at the same time. In the case of direct impact, the ribs break directly on the side exposed to this impact. In such a situation, debris can damage internal organs.

Type 2 fractures occur due to minimal mechanical impact on the ribs in patients suffering from osteoporosis, rheumatoid arthritis, osteomyelitis, genetic diseases and rib tumors.

Diagnostics

To diagnose rib fractures, the following examination methods are used:

Clinical examination. During a clinical examination, the doctor examines, listens to, and taps the chest. Using this, the degree of damage to the lungs and heart can be revealed, and accumulations of blood or air in the pleural cavity can be identified.

Chest X-ray. A simple plain X-ray of the chest cavity in the anteroposterior projection allows, in most cases, to identify the location and number of fractures, and to recognize the accumulation of blood and air in one of the pleural sacs. X-rays can also look for signs of pneumonia, damage to the heart and major blood vessels.

CT scan. Computed tomography is an examination method that is based on the use of X-rays, but which is more sensitive. Allows you to examine damaged ribs in detail and identify even minor changes in the structure of the lungs, heart, and blood vessels.

Ultrasound examination of the chest. Chest ultrasound is used to diagnose rib fractures in children, as well as to identify blood accumulations in the pleural cavity. As necessary, depending on the specific clinical situation, these examination methods can be supplemented by other, more specific and sensitive ones (MRI, angiography, etc.).

Classification of rib fractures and mechanism of injury

Experts classify rib fractures based on several criteria. This is the presence or absence of skin damage, the degree of damage, location, number of fractures, and the presence of displacement of bone fragments.

Thus, according to the presence of damage to the skin, injuries are divided into closed (without damage to the skin, since bone fragments are located in the thickness of the soft tissue) and open (with damage to the skin and soft tissues by bone fragments).

According to the degree of damage, complete fractures are distinguished, in which the bone is damaged throughout its entire thickness; subperiosteal fractures, in which bone tissue is damaged; cracks.

According to the location, fractures are divided into unilateral (the integrity of one or more ribs is broken on only one side of the chest); bilateral (ribs are damaged on both the right and left), as well as fenestrated (damage to the ribs occurs on one side of the chest, but in two or more places, resulting in a movable bone fragment).

Based on the number of fractures, injuries are divided into single and multiple.

Based on the presence of displacement of bone fragments, fractures can be either displaced or non-displaced.

Most often, the fracture occurs in the area of ​​greatest bending, in other words, along the line of the armpit on the lateral surface of the chest. The most severe fractures for the patient are fractures in the lateral and anterior parts of the costal arch; the symptoms for them are very pronounced, and first aid should be provided immediately. With fractures in the posterior part of the costal arch, the symptoms are blurred, since during breathing the bone fragments in this area are less mobile.

What to do if a rib is broken

In order to know what signs can be used to identify a rib fracture and identify complications, it is important to consult a doctor in a timely manner.

Diagnostics

To make a diagnosis, it is necessary to first find out the patient’s complaints, as well as medical history. The doctor clarifies the nature and conditions of the injury, as well as the duration of its impact. If the damage is pathological, the dynamics of the disease, possible contact with a person infected with tuberculosis, as well as the woman’s gynecological history are clarified.

During examination, the condition of the skin is assessed, with the possible detection of cyanosis. The pathological focus is palpated, with an assessment of pain and crepitus, as well as displacement of bone fragments.

During the inspection, methods are used to suggest the presence of damage. These include:

• Assessment of Payr's symptom. The patient is advised to lean in the opposite direction. In this case, severe pain or inability to bend is noted.
• Symptom of axial load. The doctor gently compresses the chest in different directions. Damage to bone tissue is manifested by severe pain and easier mobility of the area.
• Symptom of interrupted inspiration. An attempt to do something deep ends in sharp pain. To confirm the diagnosis of a rib fracture, as well as to clarify the nature of the injury and identify possible complications, laboratory and instrumental studies can be used. These include:
• General clinical blood test. The laboratory method is used if bleeding is suspected. By measuring hemoglobin levels, ongoing blood loss can be detected.
• Chest X-ray. This non-invasive test is the most common in clinical practice. For a more accurate diagnosis and assessment of severity, radiography in several projections is prescribed. The images are examined by several specialists.
• Computer or magnetic resonance imaging. The radiation method is used in case of difficulties in making a diagnosis that arise during radiography. These studies are less common due to their high cost.
• Ultrasound scan of the chest. A non-invasive and widespread study is indicated for diagnosing damage to internal organs, as well as identifying the severity of the hematoma.

In a hospital setting or at home, treatment for a rib fracture is selected only after a complete diagnosis.

If there is a crack, the symptoms may have mild manifestations. In this case, there is no violation of the integrity of the skin and bone structures. The formation of a hematoma is possible, but the pain gradually subsides. It bothers the patient for several hours.

A fracture is characterized by damage to the bone, but preservation of its anatomical location. The disease is often confused with a bruise, since the pain syndrome may be insignificant, and the patient is more concerned about hematoma and tissue swelling.

Violation of integrity is distinguished by the specificity of clinical manifestations, as well as increasing pain and possible respiratory failure.

The decision of the attending physician determines how to treat a rib fracture at home or in a hospital setting. This is due to the fact that treatment of rib fractures at home is possible only after diagnosis.

First aid to the victim

Before a rib fracture is treated, first aid is provided to the victim. To do this, it is necessary to initially assess the severity of the pathological process, as well as the presence of complications. Those around you need to identify the characteristic symptoms of fractured ribs and sternum. The basic rules of first aid include:

• Anesthesia. If there are no signs of respiratory dysfunction, the patient is prescribed available analgesics. These include non-steroidal anti-inflammatory drugs.
• Call an ambulance. To prevent complications, treating broken ribs at home is unacceptable. The patient requires diagnostics. Experts explain in detail what to do if the victim has broken ribs.
• Local cold exposure. Applying ice to the site of injury can relieve the severity of a hematoma or hemothorax. Prehospital treatment of a thoracic rib fracture reduces the intensity of pain.
• Limitation of motor activity of the chest. If there are no signs of violation of the integrity of the skin, a tight bandage may be applied. Tight bandaging helps solve several problems, such as treating a rib fracture by allowing the fragments to heal more quickly and preventing damage to internal organs.
• Find a comfortable position. It is preferable to remain in a sitting position to transport the patient.
• Applying a sterile dressing. If there is an open fracture, it is necessary to apply a sterile napkin in order to prevent infection from entering the body. It is prohibited to remove bone fragments or pieces of clothing, as well as foreign objects.

In order to find out what those around you do when a rib is broken, just call the ambulance service.

Which specialist should I contact?

In order to establish a diagnosis and determine how to treat the pathology, you need to seek help from a surgical or trauma center. Depending on the level of the clinic, a traumatologist or surgeon deals with the problem. During examination and diagnostics, he determines how to treat a rib fracture at home. The diagnosis can be made by a clinic doctor for minor injuries.

Signs and symptoms of injury

How severe the symptoms of a rib fracture are depends on the location of the injury, its severity, and whether nearby organs are damaged or not.

Pain

Immediately after receiving an injury, a dull pain appears in the area of ​​the injured rib. It is caused by the fact that bone fragments irritate the nerve endings of the pleura and intercostal muscles. When a person takes a deep breath or coughs, the pain intensifies. If the fracture is located on the front of the chest, the pain is more intense, and in the case of damage to the rib bones on the back of the chest, the pain is less pronounced. The victims move very slowly, sparing their movements. When the patient lies or sits, the pain usually decreases.

Shallow breathing and interrupted inspiration syndrome

Due to the fact that with a deep breath the pain intensifies significantly, the patient tries to breathe so that the movement of the chest is minimal. It is noteworthy that on the side where the fracture is located, the chest seems to “lag behind” in breathing.

In addition, patients experience the so-called “interrupted inspiration syndrome.” The person tries to take a deep breath, but due to increased pain, he abandons this attempt. It is the presence of the “interrupted inspiration” syndrome that makes it possible to differentiate a rib fracture from just a severe contusion of the chest.

Sometimes the inability to take a deep breath can provoke a panic attack in a person, attacks of uncontrollable fear, which must be stopped as soon as possible so that the patient’s condition does not worsen.

Forced pose

To reduce the intensity of pain, the victim subconsciously tries to take a position that would help minimize chest movement. As a rule, a person leans in the direction where the ribs are broken, or wraps his hands around the chest, as if holding it.

Visual changes in the area of ​​the rib injury

At the site of the lesion, even with a closed fracture, swelling appears, hematomas are noticeable, more or less pronounced.

Breast deformity

If several ribs are damaged at once, a visual change in the shape of the breast may occur. This symptom is especially pronounced in thin people - they experience not only deformation of the chest, but also a kind of “erasing” of the spaces between the ribs.

Crepitus

If a person has received multiple fractures without displacement, when palpating the damaged area, a specific crunching sound appears, caused by the friction of the contacting bones.

Cough

In some cases, the patient has coughing attacks, which are quite painful. If bone fragments damage internal organs, hemoptysis is possible.

Axial load syndrome

An important sign of rib fracture is the so-called “axial load syndrome.” They check it by squeezing the entire chest one by one. Since it is a bone ring, when some of its parts are compressed, the load on others increases significantly. If a person’s ribs are broken, then when compressed, the victim feels pain not at the point of compression, but directly at the site of the fracture.

Payra's symptom

When trying to tilt in the direction opposite to the fracture, the patient experiences sharp pain.

Other common symptoms include pale skin, tachycardia, and possible loss of consciousness.

It is noteworthy that with so-called simple fractures (injury to one rib without displacement), characteristic symptoms may be completely absent or appear only a considerable time after the injury. Therefore, for any chest injuries, it is advisable to perform radiography.

Matrix system:

The materials used to fix the ribs are perhaps the most important component of success when performing rib osteosynthesis, along with the qualifications of the surgeon. Until 2010, the materials used in our country were far from perfect. Their flexibility left much to be desired, complicating the surgeon’s work when installing them. However, in July of this year, the Matrix-Rib system from the Swiss-American company Synthesis became available in Russia.

The Matrix system is a complex of fixing materials for the rib frame, which includes metal plates and other auxiliary elements.

A special feature of the Matrix system is the absence of contraindications for use in all cases of damage to the rib frame. Thus, it can be used after resection of the ribs in the treatment of tumor diseases localized in the chest area. Reliable and safe materials have four important advantages:

• the composition allows the surgeon to bend the metal plates with greater ease, giving them the most convenient shape for connecting several parts of the rib
• the strength of the metal plates guarantees the impossibility of their displacement or deformation during the entire period of presence in the human body
• The thickness of the plates is only 1.5 mm, so the plates are lightweight compared to all previously used materials for fixing the ribs and do not “weight down” the rib frame
• the harmless composition does not cause any rejection in the human body, eliminates the possibility of allergic reactions to plates and other fixing elements

During surgery, a thin metal plate is placed on each damaged rib and secured with many small screws spaced as closely as possible to resist movement of the plate and parts of the rib. The plates have different lengths. On one rib with many damages, it is possible to install several small plates that fix each section.

The use of the Matrix-Rib system has proven its reliability. The flexible but durable material of the fixing plates affects not only the patient’s well-being and the final result of the operation in the form of restoration of the rib frame and elimination of pseudarthrosis if present, but also the overall duration of the surgical intervention. In Russia, rib osteosynthesis for multiple rib fractures was performed for the first time using the Matrix-Rib system by thoracic surgeon V.A. Kuzmichev.
Back to section

Possible complications of rib fractures

With serious rib fractures, the risk of complications increases significantly, which pose a serious threat to the patient's life. It should be borne in mind that some of these pathologies develop rapidly, and therefore the person providing first aid to the victim must be aware of the likelihood of their development.

So, the victim may develop pneumothorax - an accumulation of air between the layers of the pleura, as a result of which respiratory function is impaired. The lung contracts, becoming unable to perform its gas exchange functions. If the pressure in the pleural area increases further, the mediastinal organs will shift to the opposite side, as a result of which hemodynamics will be impaired and cardiac arrest will occur. To save a person, a closed pneumothorax should be made open by performing a puncture in the anterior wall of the chest, as a result of which a hole appears for air to escape out.

The development of hemothorax, an accumulation of blood in the pleural sheets, is also likely. This makes it difficult for the patient to breathe. If the accumulated blood is not immediately removed by puncture, respiratory failure begins.

If the nearby ribs of the aorta and vena cava are damaged, severe bleeding may develop. Due to excessive accumulation of blood in the pericardial sac, there is a possibility of developing so-called cardiac tamponade. If the blood is not removed immediately, the likelihood of death is very high. When the fragments are displaced, bone fragments can hit large vessels, nerves or vital organs.

Most often, conditions that threaten the patient's life occur in the case of open rib fractures. In this case, bone fragments are displaced into the mediastinum, as a result of which soft tissues and nearby organs can be damaged.

The most dangerous injuries to internal organs are:

1. Lung damage. Victims develop subcutaneous emphysema, as a result of which breathing is sharply impaired and air gets under the skin. When you cough, blood may be released from your respiratory tract.
2. Damage to the aorta, in which, due to massive blood loss, the victim may die on the spot. Fortunately, such injuries are quite rare, only if a fracture of the lungs is combined with a fracture of the spine or if, due to the impact and compression of the chest, many fractures have formed on the left.
3. Damage to the heart that leads to the immediate death of the patient and occurs when a combination of fractures of the ribs and sternum. Heart contusions are also possible, which significantly reduce the patient’s life expectancy.
4. Liver damage that results in severe blood loss.

The most common internal organ damage caused by rib fractures is the lungs. Their damage is fraught not only with pneumothorax and hemothorax, but also with respiratory failure, which is manifested by increased breathing, pallor of the skin, and increased heart rate. It is also possible to develop pleuropulmonary shock if a large amount of cold air enters the pleural cavity. Respiratory failure, severe cough, and limbs become cold. If you do not quickly help a person, he will die.

It is also worth mentioning one more dangerous complication of a rib fracture, which can make itself felt several days after the injury if first aid was provided poorly or with delay. This is pneumonia, which appears due to a sharp restriction of movement as a result of pain, inability to breathe normally, a bandage that is too tight and damage to the lung tissue. The development of this complication often depends on the patient’s health status and his age—elderly people are more susceptible to this disease. They may experience intoxication, body temperature rises, breathing becomes difficult, and general weakness appears. If measures are not taken in time, death is possible.

Stages of healing of a rib fracture

In total, a rib fracture goes through three stages on the way to full recovery. The duration of a particular interval depends on the initial severity of the injury, the patient’s health condition, age and compliance with the doctor’s recommendations.

Stages of fracture healing:

1. When blood accumulates and connective tissue cells enter, a connective tissue callus is formed.
2. Bone tissue—osteoid—is formed due to the accumulation of mineral salts and inorganic substances, which are deposited in the callus formed at the first stage.
3. The osteoid mineral hydroxyapatite forms a stronger callus. Its dimensions exceed the size of the broken rib, but then it will shrink slightly.

Treatment for rib fractures takes an average of 3-4 weeks; in young people and children, the bones heal in two to three. For older people, the treatment process is longer, it can take up to 1.5 months.

First aid rules

When providing first aid to a person with a broken rib, you need to know exactly what measures should be taken in each specific case. At first glance, in general terms they are all similar, however, depending on the nature of the fractures, they may differ. Thus, with single fractures and cracks, a minimum of actions aimed at alleviating the patient’s condition is sufficient, but with more complex injuries it is necessary to perform a clear sequence of actions as quickly as possible. Therefore, further we will talk about the features of first aid, depending on the type of rib fracture.

Uncomplicated closed fracture

An uncomplicated closed fracture is the simplest and least dangerous type of injury. In this case, one or two ribs on one side are usually affected. Complications develop very rarely, and the victim, as a rule, is quite able to get to a medical facility on his own. However, even in this case, first aid must be provided to him.

First of all, the patient should be given pain medication. This could be Ibuprofen, Analgin or Diclofenac. As a result, the pain symptom will decrease, and the person will be able to adequately assess his condition.

The next step is immobilization of the damaged area. If the injury is mild, then it is enough to stick several wide strips of adhesive tape on the injured area. This will help reduce the mobility of bone fragments.

The victim is helped to take a comfortable position in which pain will be minimal. It is best to sit half-sitting or roll over onto your injured side so that the broken ribs are fixed.

Cold is applied to the injury site. This could be an ice pack or a heating pad with very cold water. As a result, sensitivity in the injured area will decrease and blood vessels will narrow. As a result, bleeding, if any, will slow down, swelling will subside, and the development of a hematoma can be prevented.

After taking all these measures, the victim must be sent to the hospital. Please note that despite the comparative “lightness” of such an injury, a person should not be allowed to drive on his own - his condition may unexpectedly and very quickly worsen.

Multiple closed fracture

Unfortunately, often due to injury, several ribs can be damaged at once. These multiple fractures are very serious because rib fragments can damage internal organs. That is why assistance for closed multiple fractures should be provided immediately.

The victim is given an anesthetic to relieve pain, after which the chest is freed from excess clothing, facilitating the flow of air. The patient must be immobilized by first positioning him as comfortably as possible. The optimal position is half-sitting or lying on the injured side. In order to fix the ribs, a tight bandage should be applied, which, however, should not interfere with breathing movements. To avoid displacement of fragments, the patient's arm can be used as a splint.

In order to reduce the intensity of pain and relieve swelling, dry cold should be applied to the injured area. After this, you need to call an ambulance and carefully monitor the patient’s condition until the doctors arrive. If first aid was provided correctly, this will facilitate further treatment and reduce the risk of soft tissue damage during transport of the patient to a medical facility.

Open fracture

An open fracture is an injury that entails a much greater number of risks. Delay in this case can cost the patient’s life, and therefore first aid should be provided as quickly, smoothly and qualified as possible.

First of all, the bleeding should be stopped. Please note that no foreign objects or bone fragments should be removed from the wound. It must be covered with a sterile bandage, having previously been treated with disinfectants and hemostatic agents.

After this, you need to apply a fixing bandage. You can use a wide bandage or a piece of fabric of suitable width for these purposes. The victim takes as deep a breath as possible, after which the person providing assistance bandages him from the healthy area to the fracture site from left to right. The bandage should not sag, but it should not be too tight. It is advisable to cover the layer of bandages with a material that does not allow air to pass through, for example, cellophane.

Next, the patient is given an anesthetic. You can also give an injection of a non-narcotic pain reliever. In order to reduce bleeding and pain, dry cold is applied to the wound. The patient is helped to take the most comfortable position that would prevent the movement of debris. After this, you should call an ambulance - the sooner the better, since bleeding or infection in the wound can have fatal consequences for the victim. Therefore, he should be transferred to the care of doctors as soon as possible and transported to the surgical department.

First aid for pneumothorax and shock

As noted above, with serious fractures, the development of pneumothorax is likely - accumulation of air in the pleural cavity. In this case, measures should be taken as soon as possible, because the slightest delay could cost the patient his life.

At the first signs of pneumothorax, the main task is to stop the penetration of air into the pleural cavity. A tight, airtight bandage will help with this. Most likely, you will have to use improvised means: a scarf, a T-shirt or a shirt. Of course, in this case there is no need to talk about complete sterility, but take into account that only the cleanest part of the used tissue should come into contact with the wound.

In order to make the bandage completely airtight, you can apply plastic film on top.

To make it easier for the victim to breathe, he must be positioned so that the upper part of the body is elevated. If a person has lost consciousness, he should be brought back to consciousness as soon as possible by bringing a product with a pungent odor to his nose. In the absence of ammonia, this could be nail polish remover, perfume, or even gasoline. Keeping the victim conscious is one of the main tasks.

Traumatic shock is another dangerous consequence of rib fractures. This condition is extremely undesirable because it can lead to the death of the victim. Therefore, action should be taken immediately.

Traumatic shock has several stages. At the initial stage, the patient is very agitated and complains of pain. A panic attack and manifestations of aggression may occur. The skin is pale, blood pressure is slightly increased, the pupils are dilated. An increase in heart rate may occur. The next stage is to plunge the patient into apathy. The patient does not complain of pain, although it does not decrease. Heart rate increases, blood pressure decreases. Body temperature drops, the patient stops responding to sounds and light.

In such a case, the victim is placed on his back, with his head slightly lowered and his legs raised approximately twenty centimeters. To protect the patient from hypothermia, he is covered with blankets. It is necessary to provide the person with complete peace, stop panic attacks and attacks of fear. It is imperative to stop the bleeding and give pain relief.

Cost of treating a rib fracture

Rules for transporting to hospital

The question of how to transport a victim with a rib fracture to the hospital is very relevant. Proper delivery of a person with broken ribs to a medical facility is possible only if a number of rules are observed. In addition, it will prevent the displacement of fragments and damage to soft tissues.

Best materials of the month

• Coronaviruses: SARS-CoV-2 (COVID-19)
• Antibiotics for the prevention and treatment of COVID-19: how effective are they?
• The most common "office" diseases
• Does vodka kill coronavirus?
• How to stay alive on our roads?

At the same time, transportation performed without following the algorithm can aggravate the patient’s condition. Therefore, if you cannot count on the arrival of an ambulance and you have to take the patient to the doctors on your own, you should remember several aspects.

Transportation should be as careful and smooth as possible. It is best if the person is in a semi-sitting position.

If the patient is unable to move independently, he is carried on a stretcher half-sitting.

If the patient is unconscious, in shock, or has serious injuries, transportation should take place in a supine position or on the injured side of the body. Many people mistakenly believe that it is necessary to lie down on the healthy side, but the lungs on this side will experience additional stress, which is completely unnecessary.

Treatment at home

If it is determined that 1–2 ribs are damaged, but internal organs are not damaged, the injury is classified as mild. In this case, treatment at home is indicated.

The patient is prescribed rest, cold on the affected area and breathing exercises. During treatment you will need to refrain from physical activity and sudden movements. Motor activity is limited. Bed rest is indicated for the first 3–5 days.

In order for the bones to heal properly, the victim is given a hard and even bed. If the ribs are damaged in the front, it is recommended to sleep on your back in a reclining position. If the lateral ribs are injured, you need to lie and sleep on the opposite side.

Medicines and drugs

After the examination, the doctor will explain how to treat a cracked rib.

NSAIDs and analgesics are used as anti-inflammatory and analgesic drugs:

• Diclofenac;
• Nurofen;
• Ketoprofen;
• Nimesulide;
• Ibuprofen;
• Ketorolac.

Mucolytics are prescribed to remove sputum. They facilitate the process of expectoration, which is impaired due to limited mobility of the chest. For severe pain, mucolytics are not prescribed; in this case, the doctor may even prescribe drugs that block the cough reflex.

To relieve inflammation in soft tissues, local NSAID-based medications are prescribed - ointments, gels, creams. The most popular are Diclofenac, Ketoprofen, Fastum-gel.

To resolve hematomas and restore local blood flow, ointments with the active ingredient heparin are prescribed - Heparin ointment, Heparoid.

Treatment with folk remedies for cracked ribs

In the first 2-3 days, it is recommended to apply cold every hour, keeping the compress on the sore spot for 20-30 minutes. After the swelling subsides, begin rubbing with warming ointments based on red pepper, bee venom, camphor, and fir oil. Warm the affected area with heated salt.

Shilajit is used as an anti-inflammatory and immunomodulatory agent, which is diluted at the rate of ⅕ g of mumiyo per 50 ml of water (the dosage is indicated for an adult, for a child it is 1/10 g per 50 ml of water). Take the drug one hour before meals.

Rosehip decoction speeds up the healing process. A tablespoon of berries is poured into 500 ml of boiling water and left overnight in a thermos. Drink instead of water or tea.

The use of bone broths, jelly, and jelly accelerates bone healing.

After the pain subsides, treatment for a cracked rib includes breathing exercises.

Do the following exercises in a sitting position:

1. inhale through the nose, exhale through the mouth, pursing the lips;
2. cough with exhalation “heh”, “cough”;
3. while inhaling, raise the shoulders, while exhaling, lower them;
4. arms are extended along the body with palms down, while inhaling, palms are turned upward;
5. alternately bend your arms at the elbows;
6. Place your hands on top of each other, while inhaling, raise them to shoulder level, and while exhaling, lower them.

A very effective exercise is inflating balloons. Breathing exercises eliminate congestion in the bronchi and lungs, stimulate the circulatory system, and increase the elasticity of connective tissues.