Rib fractures and their consequences - how to treat correctly

Fractured ribs – 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.

Causes

Any impact can provoke a fracture, such as a direct blow aimed at the ribs or a fall; in addition, excessive compression of the chest area can be a possible cause. The most common type of fracture is a fracture within the area of greatest bending, that is, along the lateral surfaces of the chest.

Pathological rib fractures can also occur in the presence of the following concomitant ailments:

Rheumatoid arthritis. Rheumatoid arthritis is a common connective tissue disease that affects internal organs, bones and joints. Rib fractures are the most common
Metastases of malignant tumors in bones. Most malignant tumors are capable of metastasizing - forming a tumor focus distant from the original localization of the pathological process due to the migration of cancer cells with the blood or lymph flow. Metastasis to the bones of the chest can occur with the development of prostate cancer, breast cancer, kidney cancer and some other organs. In a metastatic focus, the structure and function of the bone are disrupted, and normal tissue is replaced by pathological tissue. This causes the bone to weaken significantly and lose its resistance to external stimuli.
Primary tumors of bone tissue or bone marrow. When cancer occurs in the bone or bone marrow, which is found in the structure of most bones, the nutrition and function of the bone is disrupted.
Osteoporosis. Osteoporosis is a pathological condition in which, for some reason, the functional and structural properties of bones are disrupted, which undergo a number of changes and become more fragile. In most cases, this pathology is associated with impaired calcium metabolism, hormonal disorders, and genetic abnormalities. Osteoporosis often develops in old age, thereby representing one of the forms of physiological aging of bones.
Congenital or acquired absence of the sternum. For the normal functioning of the chest, its anatomical integrity is necessary. In the absence of the sternum, the element that holds the anterior ends of the ribs together, the chest becomes much less resistant to mechanical stress. The sternum may be absent due to congenital anomalies or after certain surgical interventions.
Genetic abnormalities of skeletal development. Some genetic abnormalities are accompanied by inadequate development of skeletal structures, which leads to bones becoming more fragile and breaking even under the influence of relatively small forces.

Nutrition during rehabilitation

You should know that rib fracture and subsequent recovery makes some adjustments to the nutritional process. Large portions are often unacceptable, as they cause discomfort and sometimes chest pain, so you should reduce their size by increasing the number of daily doses to 6-7 times. This will allow you to receive nutrients in full. We must remember that proper nutrition for bone fractures helps speed up tissue healing and improves the condition of the entire body. When choosing products, you need to know that human bone consists of mineral and organic substances. Minerals include calcium, phosphorus and some trace elements, all of which contribute to bone strength. Organic substances include collagen, which ensures their elasticity.

You must understand that rehabilitation for a fracture of a rib, arm or leg requires a person to eat food that promotes a speedy recovery, enriched with useful micro- and macroelements. The main goal is to obtain the necessary amount of nutrients required for recovery. When a bone is broken and the resulting tissue damage, the human body loses a lot of protein.

This loss must be compensated for by the protein found in food, otherwise the body will have to consume it from its own tissues, mainly muscle tissue. As a result, rehabilitation will slow down significantly. To prevent this from happening, it is necessary to include in the diet foods with an increased amount of complete protein: milk and other products based on it, fish and other seafood, eggs and lean meats. Required for preventive purposes, to take care of microelement and vitamin deficiency.

Another material for bone restoration is calcium. If it enters the body in sufficient quantities, then rehabilitation after a rib fracture occurs quickly. The main sources of calcium are dairy products and sea fatty fish. There is calcium, although in small quantities, in products of plant origin, but it is easily absorbed. These products include: asparagus, broccoli, carrots, parsley, dill, celery, seaweed, currants, cherries, grapes, gooseberries and strawberries.

Recovery after a rib fracture will not be complete without a certain set of products containing vitamins:

Vitamin D helps absorb calcium and promotes bone growth. Its main sources are: fish oil, cod liver, fish (halibut and cod), beef liver, egg yolk, vegetable oil.
Vitamin C helps restore connective tissue. Most of it is found in citrus and sweet peppers.
Vitamin B6 (pyridoxine) and folic acid are involved in the creation of collagen bone structure. Pyridoxine is found in seafood, eggs, liver and sunflower seeds. The main sources of folic acid are: liver, leafy vegetables, broccoli and Brussels sprouts.

In addition, the following microelements are required for proper nutrition during rehabilitation:

Zinc - accelerates the growth of callus. The human body receives it primarily from animal products. It is also found in legumes, as well as sunflower and pumpkin seeds.
Phosphorus – promotes bone growth and contributes to metabolic processes. Its deficiency in bone tissue leads to fragility. The main supplier of phosphorus to the human body is: seafood, especially a lot of it in sturgeon caviar, cheese, beef liver and egg yolk. It is also found in legumes, buckwheat, oatmeal, walnuts and pumpkin.
Potassium – takes part in the regeneration of bone tissue; dairy products and dried apricots are especially rich in it.

Along with foods that promote faster bone healing, there are also those that you should avoid. First of all, you should never drink alcohol during rehabilitation for a rib fracture. It is also necessary to give up foods that wash calcium out of the human body, such as carbonated drinks, strong black tea, coffee, and chocolate. You should limit your intake of fatty and overly sweet foods.

Classification of rib fractures

Impacts on human ribs are divided into indirect and direct. With indirect impact, the chest is compressed, so the ribs break on either side of the compression site. As a rule, several ribs break at once. In the case of direct impact, rib fragments can damage various internal organs, the lung when the ribs bend inward. There are bilateral fractures, as a result of which the chest loses the necessary stability, and a dangerous violation of pulmonary ventilation occurs. So-called fenestrated fractures also occur, i.e. fractures in two places on one side. Most often, rib fractures occur in people over 40 years of age. This is due to changes in bone tissue that occur in the human body due to age. In childhood, rib fractures are extremely rare, since the child's chest has great elasticity. There is also the following division of rib fractures: rib crack, bone fracture (so-called subperiosteal fracture) and complete rib fracture. The latter most often occurs at the site of the bend of the ribs. All these cases are characterized by the same symptoms of a fracture.

How to recover after a broken rib

After a rib fracture occurs, recovery occurs rather slowly, on average about a month, to this period should be added the rehabilitation period, which is another 3 to 4 weeks. During this time, the displaced intercostal and spinal-costal joints should restore their anatomical position.

To speed up the recovery process you need to:

eat foods rich in proteins and calcium, which accelerate the regeneration of soft and bone tissue, as well as accelerate the growth of callus;
perform exercise therapy, breathe and sleep correctly;
take procedures that stimulate blood and lymph flow.

Symptoms

Symptoms that accompany a hip fracture:

Pain - it occurs in the area of the fracture, intensifies with movements, inhalation and exhalation, and coughing. Reducing pain is possible at rest and in a sitting position.
Shallow breathing and lag in breathing of the half of the chest where there is injury.
Swelling of tissue in the area of injury.
Hematoma at the fracture site is relevant in case of a traumatic fracture resulting from direct mechanical impact.
The sound of rubbing bones or a crunch during injury is important for fractures with a large number of fragments, or for multiple fractures of one rib without displacement of individual parts of the damaged bone.

With multiple and complicated fractures, the following signs may appear:

Subcutaneous emphysema - when the lung is damaged, air can gradually enter under the skin.
Hemoptysis - when coughing, blood is released from the respiratory tract. This symptom indicates damage to the lung tissue.

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.).

Rehabilitation

Broken ribs heal slowly: if treatment of a fracture takes about 1 month, depending on the age of the patient and the resulting complications, the recovery period may take another 3-4 weeks. Rehabilitation after a rib fracture includes a diet rich in protein and calcium, as well as exercise to help oxygenate the body, heal injuries and increase body mobility. Traditional medicine in the form of ointments and compresses can also be used to restore the body. All procedures and medications must be agreed upon with the attending physician.

To restore the normal functioning of the lungs, it is recommended to visit sanatorium-type boarding houses on sea coasts or in coniferous forests.

Daily walks in the fresh air increase the body's hemodynamics and, through sunbathing, promote the absorption of calcium by the body, which has a beneficial effect on restoring the patient's health.

If a plaster cast was applied to the patient during treatment for a rib fracture, it is removed by the time of rehabilitation.

Physiotherapy

Exercise therapy for healing rib fractures is possible, starting from the period when pain in the sternum and back stops. Recovery after a rib fracture begins no earlier than a month after the first days of the main treatment and takes place individually under the supervision of a doctor.

The primary goal of physical therapy is to restore proper breathing through deep breathing and exercise exercises that eliminate congestion and the risk of chronic lung diseases. Next, the load is supplemented with a set of exercises to restore mobility and flexibility of the shoulder area and correct posture.

Nutrition

Simultaneously with the beginning of therapeutic physical exercises, the patient is prescribed dietary nutrition, which replenishes the lack of calcium in the body

During the initial period of recovery, when the pain in the sternum, side and back subsides, it is necessary to eat protein foods high in collagen, such as meat broths, cooked on the bone, jellied meat, jellied jelly dishes, etc. Protein and collagen can build up cartilage tissue in places where the ribs are destroyed.

Read also: Methods of treating osteochondrosis with folk remedies

In subsequent periods of rehabilitation, foods and preparations containing calcium and silicon are introduced into the diet. The diet should include nuts, green vegetables, seafood, and dairy products. Among medications, vitamins and calcium supplements are recommended for use. An important role is also played by nutritional supplements that promote the healing of damaged bones.

ethnoscience

Traditional medicine recipes are considered alternative methods for rehabilitation after severe injury. The use of traditional medicine, which at first glance seems harmless, requires prior medical approval.

Folk remedies that promote fracture healing are divided into internal and external. For internal use, crushed eggshells, vitamin mixtures consisting of honey, fruits and nuts, and an aqueous solution of mumiyo are used. External effects are exerted by ointments, compresses made from potatoes, mumiyo, spruce resin, and geranium.

Treatment

Multiple bilateral and bicuspid fenestrated fractures require surgical intervention (osteosynthesis using special metal staples) or traction of a segment separated from the chest. Emergency care for hemothorax and pneumothorax involves puncture of the chest and aspiration of blood or air. Such patients require specialized treatment in the appropriate department. Isolated uncomplicated fractures of one or two ribs, as a rule, do not require hospitalization and are treated on an outpatient basis.

Even a single isolated rib fracture is accompanied by severe pain, so first aid includes pain relief by novocaine blockade of the corresponding intercostal nerve. If the pain syndrome returns, the blockade can be repeated two to three times. Adequate anesthesia helps to increase the excursion of the chest during breathing, straighten the lung on the affected side and expectorate secretions accumulated in the bronchi. Thus, pain relief for a rib fracture not only improves the patient’s general condition, but is also a worthy prevention of post-traumatic hypostatic pneumonia. As a rule, uncomplicated fractures of one or two ribs heal well and do not require any special manipulations. The victims are recommended to take a gentle regimen, breathing exercises, and expectorants to prevent hypostatic pneumonia.

Since diaphragmatic breathing predominates during rib fractures, increasing intra-abdominal pressure should be avoided. A split nutritious meal is recommended; the diet should not contain foods that cause flatulence.

A course of treatment

First of all, the doctor will most likely prescribe painkillers, because... it is difficult for the patient to breathe fully, and the lack of oxygen has a bad effect on the condition of the body as a whole and can lead to complications. Also popular are external remedies - ointments that relieve pain.

The damaged area is always strengthened with a bandage or bandage, and an x-ray is also taken to rule out internal damage and a simple rib crack. After making a diagnosis and performing the steps described above, analgesics are prescribed to relieve symptoms, exercise therapy and breathing exercises to perform independently. The patient requires rest and mostly bed rest. At home, you should take a lying position so that your body is horizontal and your head is well raised. According to your feelings, you need to find a point where it will be comfortable to stay for a long time without experiencing severe discomfort.

To help the body restore bone tissue, it will be extremely useful to adjust your diet:

try to add sources of gelatin to your diet; it is found in bone broth, aspic, and jellied dishes;
It is better to replace sweets with cottage cheese, sour cream with honey, fruits or nuts;
you will have to avoid drinking alcohol. Of course, there is an opinion that it helps to get rid of pain, but it does not bring any benefit to the body, and a drunk person loses coordination, a sense of security and can be even more injured;
it is advisable to exclude salt and marinades from the diet for the entire recovery period;
Lean meat and fish are very healthy, no matter whether it is sea or river.

Coffee and chocolate slow down the recovery of bone tissue; it is better to abstain from them. Fruit and vegetable salads will fill the need for tasty food, while being healthy. Natural juices will provide the necessary vitamins to restore a weakened body, and will also increase its immune properties.

On average, broken ribs take about a month to heal, with proper treatment and no re-injury. Often patients try to ensure complete rest for themselves without moving at all, shifting all care to loved ones. However, doctors say that movement is absolutely necessary; in a gentle manner, the patient can carry out complete self-care calmly and without jerking, and this is even beneficial for him.