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 Broken ribs

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Broken ribs Empty
PostSubject: Broken ribs   Broken ribs EmptyWed Jan 05, 2011 9:33 pm

A broken rib, or fractured rib, is a
common injury that occurs when one of the bones in your rib cage breaks
or cracks. The most common cause of broken ribs is trauma to the chest,
such as from a fall, motor vehicle accident or impact during contact
sports.

Many broken ribs are merely cracked. While still painful, cracked ribs
aren't as potentially dangerous as ribs that have been broken into two
or more pieces. In these situations, a jagged piece of bone could damage
major blood vessels or internal organs.

In most cases, broken ribs usually heal on their own in one or two
months. Adequate pain control is important, so you can continue to
breathe deeply and avoid lung complications, such as pneumonia.


Symptoms

Symptoms of a broken rib may include:

* Pain when you take a deep breath
* Pain that gets worse when you press on the injured area, or when you bend or twist your body

When to see a doctor
See your doctor if you have a very tender spot in your rib area that
occurs after trauma or is present with deep breaths or hinders your
breathing.

If you experience pressure, fullness or a squeezing pain in the center
of your chest that lasts for more than a few minutes, pain that extends
beyond your chest to your shoulder or arm, and increasing episodes of
chest pain, get medical attention immediately. These symptoms may
indicate a heart attack.

Causes

Broken ribs can be caused by direct impact or repetitive trauma.

Direct impact

* Motor vehicle accidents
* Falls
* Child abuse
* Contact sports

Repetitive trauma

* Sports such as baseball, basketball, golf or rowing
* Severe and prolonged coughing spells


Risk factors

The following factors can increase your risk of breaking a rib:

* Osteoporosis. Having osteoporosis, a disease in which your bones
lose their density, makes you more susceptible to a bone fracture.
* Sports participation. Participating in contact sports, such as
hockey or football, increases your risk of trauma to your chest, which
can result in a rib fracture.
* Cancerous lesion in a rib. A cancerous lesion can weaken the bone, making it more susceptible to breaks.

Complications

Broken ribs that are in more than one piece, as opposed to just being
cracked, can injure blood vessels and internal organs. The risk
increases with the number of broken ribs. Complications vary depending
on which ribs have been broken. To aid in identification, ribs are
numbered sequentially from the top down.

Upper ribs
It takes more force to break any of your first three ribs, because
they're protected by your collarbone and shoulder blades. But if one of
these upper ribs is broken, a jagged edge can pierce a major blood
vessel, such as the aorta.

Middle ribs
Your middle ribs are the most likely to be broken by blunt trauma. The
broken ends of these ribs can cause bleeding or puncture your lung and
cause it to collapse.

Lower ribs
Your bottom two ribs are less likely to break, because they aren't
attached to your breastbone (sternum) and this makes them more flexible.
But if any of your lower ribs do break, the broken ends can cause
serious damage to your spleen, liver or kidneys.


Preparing for your appointment

Because many broken ribs are caused by motor vehicle accidents, you may
find out you have a broken rib in a hospital's emergency department. If
your broken rib was caused by repetitive stress over time, you may seek
advice from your family physician.

What you can do
You may want to write a list that includes:

* Detailed descriptions of your symptoms
* Information about medical problems you've had
* Information about the medical problems of your parents or siblings
* All the medications and dietary supplements you take
* Questions you want to ask the doctor

What to expect from your doctor
Your doctor may ask:

* Where exactly does it hurt?
* When did the pain start?
* Did anything precipitate it?
* Does any action make the pain better or worse?

During the physical exam, your doctor will press gently on your ribs. He
or she may also listen to your lungs and watch your rib cage move as
you breathe.


Tests and diagnosis

Your doctor may order one or more of the following imaging tests:

X-ray
Using low levels of radiation, X-rays are a good tool to visualize bone.
But X-rays often have problems revealing fresh rib fractures,
especially if the bone is merely cracked. X-rays are also useful in
diagnosing a collapsed lung.

Computerized tomography (CT)
CT scans can often uncover rib fractures that X-rays might miss.
Injuries to soft tissues and blood vessels are also easier to see on CT
scans. This technology takes X-rays from a variety of angles and
combines them to depict cross-sectional slices of your body's internal
structures. The test is painless and usually takes less than 20 minutes.

Bone scan
This technique is good for viewing stress fractures, where a bone is
cracked after repetitive trauma — such as long bouts of coughing. During
a bone scan, a small amount of radioactive material is injected into
your bloodstream. It collects in the bones, particularly in places where
a bone is healing, and is detected by a scanner.


Treatments and drugs

Most broken ribs heal on their own within six weeks.

Medications
It's important to obtain adequate pain relief because if it hurts too much to breathe deeply, you may develop pneumonia.

* Over-the-counter drugs. Acetaminophen (Tylenol, others) and
nonsteroidal anti-inflammatory drugs (NSAIDs) — such as ibuprofen
(Advil, Motrin, others) and naproxen (Aleve) — may help relieve
discomfort as you wait for the fracture to heal.
* Other pain medications. If NSAIDs or acetaminophen don't work well
enough, your doctor may prescribe stronger pain medications.
* Nerve blocks. If the pain is severe, your doctor may suggest
injections of long-lasting anesthesia around the nerves that supply the
ribs.

Therapy
In the past, doctors would use compression wraps — elastic bandages that
you can wrap around your chest — to help "splint" and immobilize the
area. Compression wraps aren't recommended for broken ribs anymore
because they can keep you from taking deep breaths, which can increase
the risk of pneumonia.

Prevention

The following measures may help you prevent a broken rib:

* Protect yourself from athletic injuries. Wear protective equipment when playing contact sports.
* Take steps to decrease your risk of household falls. Remove
clutter from your floors and clean spills promptly, use a rubber mat in
the shower, keep your home well lit, and put skid-proof backing on
carpets and area rugs.
* Decrease your chance of getting osteoporosis. Getting enough
calcium in your diet is important for maintaining strong bones. Aim for
about 1,200 milligrams of calcium daily from food and supplements.
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