Rib fracture treatment - conservative or surgical

Rib fracture treatment - conservative or surgical treatment

Treating broken ribs in the rib cage includes two types of treatment: conservative treatment and surgical treatment. Rib fractures in the chest are usually treated conservatively without resorting to surgery.

that rib fracture treatment It differs from the treatment of the rest of the bone fractures in the body because the splint cannot be used to treat broken ribs because the broken rib usually moves with every breath or cough that the patient takes, so wrapping the trunk tightly is not very useful, but may cause difficulty in breathing as well, and there are other treatments for this Fractures such as using medications or doing some breathing exercises are useful to treat broken ribs

In this article, we will learn how to treat rib fractures conservatively. And when do we resort to surgery to treat a broken rib? How to perform surgeries to stabilize fractures?

Conservative treatment of fractured ribs

Conservative treatment, such as placing a belt, which supports and treats fractures and dislocations of the ribs and breastbone, and helps to join and compress the chest wall, is not very useful. Instead, the treatment of fractures of the ribs and breastbone is usually by relieving the pain of the fracture, doing breathing exercises and rest, and avoiding doing some activities. The broken ribs heal on their own, simple, uncomplicated fractures that do not threaten the patient's life.

Activities to avoid when treating a rib fracture

When one of the ribs in the rib cage is broken or cracked, it is always best to take adequate rest because this reduces the pain and speeds up the healing process. Certain activities should be avoided, such as:

  • Lifting heavy weights of more than 10 kilos
  • Doing physical contact sports
  • Doing activities that require pushing or pulling, such as abdominal exercises
  • Practicing sports that require great effort, such as horseback riding or running, as well as golf, because bending during a golf game may cause severe pain when there is a broken rib

How to relieve pain during rib fracture treatment

When the ribs are fractured, the most important symptom is pain, which is graded according to the type of fracture, its severity, the causes of the pain, and the most important ways to relieve the pain are:

  • When the pain is very severe, analgesics can be usedBone pain treatment or Such as the use of opioid analgesics to reduce fracture pain, which is used by prescription
  • Use of non-steroidal anti-inflammatory drugs such as ibuprofen or naproxen, which do not require a prescription
  • It would be best if you informed the doctor when the pain persists or when it gets worse
  • An ice bag can also be placed on the fracture area for 20 minutes each time and repeated three times a day
We notice from the picture that the ice bag is placed on the fracture area for 20 minutes and repeated three times a day to reduce swelling
Image showing how to apply an ice pack to treat a broken rib

The importance of deep breathing in the treatment of broken ribs

When there are fractures in the ribs, deep breathing, which expands the lungs, often causes severe pain, so the patient takes a superficial breath, which may cause pneumonia and some other respiratory diseases. Therefore, taking painkillers after consulting a doctor and before doing breathing exercises is recommended, speeding up breathing duration Rib fracture treatment.

Breathing exercise for rib cage fractures

It is recommended during the recovery period to take deep, steady, and slow breaths, which are added to the recovery plan as follows:

  • Start by breathing deeply for three seconds.
  • Switch to calm breathing for three seconds.
  • Make a few puffs, short breaths, and a slight cough.
  • Finish the exercise by breathing calmly for three seconds.
  • Repeat the previous steps several times a day.
We notice from the picture the steps of breathing exercises when treating broken ribs, where breathing must be controlled, deep breaths taken, then coughing or puffs of air, then controlling calm breathing
Image of breathing exercises for broken ribs

Surgical treatment of rib fracture

A rib fracture is a rib fracture in the rib cage in two or more pieces Therefore Treatment of rib fractures He may need surgery in cases of multiple rib fractures or the case of a flail fracture to protect the patient from complications Rib cage fracture And rib fractures, where a rib fracture may cause life-threatening complications when the heart or lungs are affected.

indication Surgical treatment of rib fracture

Rib fractures are treated with surgery if one or more of the following are present:

  • Flail chest, which is a segmental fracture of 3 consecutive ribs diagnosed on radiographs or clinically.
  • Multiple rib fractures or alternating fractures
  • Altered rib fractures associated with sternal fractures
  • When the broken end of the rib is sharp, which may cause damage to the organs of the body
  • Chest wall deformity
  • Conservative treatment failed, and fracture pain persisted

Contraindication Surgical treatment of fractured ribs

Many risks prevent the surgeon from operating to fix the rib cage fractures, the most important of which are:

  • Circulatory instability due to hemorrhagic shock or other causes
  • Low Glasgow traumatic brain injury score scale
  • Presence of infections such as severe pneumonia, mediastinitis, and pleurisy
    Existence Pelvic fractures Or in an unstable spine because these fractures must be stabilized first by operations such as Lumbar spine fusion
  • Long-term need for artificial ventilation

method Surgical treatment of fractured ribs

The surgical treatment is determined after confirming the diagnosis by X-ray or CT scan, and depending on the fracture site, the patient's position and the location of the incision are determined, and then the following is followed:

  • Giving general anesthesia makes the patient not feel pain during the operation, then making a surgical incision according to the location of the fracture and the Banishment of the muscles and tissues surrounding the rib.
  • Titanium plates are used after choosing their length and circumference to stabilize the rib fractures. The plates are fixed on both sides of the broken rib by means of special screws.
  • After fixing the ribs and obtaining the normal shape of the rib cage, the surgical incision site is closed by stitching the incision.
  • during Surgical treatment of rib fracture Not all fractures may be repaired, but the surgeon will immobilize the necessary ribs to restore the stability of the chest wall.
From the radiograph, we can see how to fix the broken ribs with titanium plates fixed by special screws and restore the shape of the rib cage to its normal shape.
Radiograph after surgical rib fracture treatment

Postoperative treatment of rib fracture

The doctor may recommend taking anti-inflammatory and pain-relieving medications when needed and doing daily breathing exercises. It is also important to avoid lifting heavy objects and practicing sports activities and strenuous work during recovery, which may take approximately six weeks.

At the end of the article, we conclude that the treatment of broken ribs is often conservative, depending on the type of fracture, such as using pain relievers to treat fracture pain or using ice bags and breathing exercises after seeking medical advice, which is the ideal treatment for simple rib fractures. As for Surgical treatment, when there is a danger to the important organs of the body, such as the heart and lungs, and thus threaten the patient's life, we rarely resort to surgery except but in the case of serious fractures.


Sources:

  1. NCBI
  2. Dr. Pakula
  3. Healthline

Common questions

This is related to the type and severity of the fracture, but in general, rib fractures usually heal within about six weeks.

Rib fracture is diagnosed through a clinical examination by a doctor and radiography of the area of pain.

Symptoms vary according to the type of fracture, but the most important of them is the presence of severe pain in the bruised area and swelling or bruising around the fracture area.

The treatment is by taking pain-relieving medications, such as cetamol, or by placing ice packs on the fracture site for an hour, and repeating that three times a day, after medical consultation.

Make an appointment with Dr. Çetin Işık
In Istanbul

Make an appointment with Dr. Çetin Işık
In Istanbul

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