SIGNS & SYMPTOMS
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# Severe pain at the fracture site.
# Tenderness to the touch.
# A feeling that the "wind has been knocked out" (sometimes).
# Abdominal pain if the fractured ribs are below the diaphragm (the 11th and 12th ribs).
# Severe chest pain when coughing, sneezing or breathing deeply.
# A feeling of small air pockets under the skin of the chest or neck if the lung has been injured and leaked air.
# Swelling and bruising over the fracture site.
WHAT TO EXPECT
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APPROPRIATE HEALTH CARE
# Doctor's diagnosis.
# Application of a wide elastic wrap or chest binder to decrease movement of the chest muscles and reduce pain with breathing. The binder should be applied around the lower chest beneath the breasts, even if the rib fracture is in the upper chest.
# Hospitalization if symptoms of injury to the lung, spleen or liver appear. Blood or air in the chest may need to be removed if the lung is punctured from the raw edge of a fractured rib. A lacerated liver may need to be surgically repaired. A ruptured spleen frequently requires surgical removal.
DIAGNOSTIC MEASURES
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# Your own observation of symptoms.
# Medical history and exam by a doctor.
# X-rays of the ribs and vertebral column. Early X-rays may not show fractures if they are not dislocated, but repeat X-rays taken 4 or more days later usually reveal them. The early treatment for an uncomplicated rib fracture is the same as for bruised ribs, so a delay in diagnosis does not hinder treatment.
POSSIBLE COMPLICATIONS
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# Rupture of the lung with bleeding or escape of air into the chest wall or under the skin in the neck.
# Injury to the liver if the right 11th or 12th ribs are fractured and have jagged edges.
# Injury or rupture of the spleen if the 11th and 12th ribs on the left are fractured and have jagged edges.
# Prolonged pain and slow healing.
PROBABLE OUTCOME
If this is a first-time chest injury and there are no complications of internal injury, proper care and sufficient healing time before resuming contact sports should prevent later complications. Healing is usually complete in 4 to 6 weeks.
HOW TO TREAT
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NOTE -- Follow your doctor's instructions. These instructions are supplemental.
CONTINUING CARE
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# Use the binder or wrap as long as needed for pain and support--usually 4 to 6 weeks.
# Use an ice pack 3 or 4 times a day. Place chips in a plastic bag. Wrap the bag in a moist towel and place over the injured area. Use for 20 minutes at a time.
# After 2 or 3 days, if heat is more soothing than ice, use heat lamps, hot soaks, hot showers or heating pads.[/B]
