- Rib fracture - if you hurt when you breathe
The causes and mechanisms of fracture of ribs
Fracture of the ribs may occur in cartilage and in the bone part. If a fracture is not accompanied by complications, sometimes it takes its own, without medical assistance. But there are also single fractures that disrupt the function of the respiratory system, and multiple rib fractures can lead to severe respiratory distress.
Fracture of the ribs may occur in the fall, when struck on the chest, while squeezing the chest. Most observed fractures secondary ribs (IV to VII), as less protected (upper edges are covered with a thick layer of muscles and bones of the shoulder girdle and the bottom have a greater elasticity due to considerable length of cartilaginous part), on the back and axillary lines - in the areas of maximum bending ribs. In the direct mechanism of injury (eg, direct blow) one or more edges bend inwards - towards the chest cavity, often damaged respiratory system.
In the indirect mechanism of damage to the edges (for example, by squeezing the chest) chest flattened and broken ribs on both sides of the direct impact of force. With such a mechanism more likely to occur multiple rib fractures.
Fractures are single (isolated) and double (two or more ribs on one side of the chest), bilateral (on both sides of the chest), fenestrated (edge breaks on both sides, and a fragment of the rib falls into the chest), such as cracks, subperiosteal (broken bone, and the periosteum remains intact - often a fracture occurs in young people). When there are sometimes severe respiratory distress, oxygen starvation and shock.
Signs of fracture rib
At the turn of the ribs is always a pain at the fracture site - alone blunt and sharp at the height of inspiration. The pain is worse when breathing deeply, coughing, straining when trying to probe the site of injury. But sometimes it still manages to feel the fracture site in the form of a ledge. Breathing with a broken rib is superficial because of the pain, and the injured side of the chest behind the sound. At the site of injury often can be found subcutaneous hemorrhage - hematoma. One of the hallmarks of rib fracture: while gently compressing the breast between your hands away from the damage occurs "reflection" pain in the rib fracture.
Rib fracture itself is not dangerous, it heals relatively quickly, the danger are related damage to internal organs. If one broken rib displacement of bone fragments usually do not happen. When multiple fractures of the ribs fragments can move in different directions and compress and injure adjacent tissue and organs and cause dangerous complications.
Confirms the diagnosis of rib fractures using radiographic studies.
Broken ribs may be complicated by damage to surrounding tissues and organs: lungs, heart, liver, kidneys, gastrointestinal tract, blood vessels and so on.
If damaged lung and pleura may hemothorax (blood in the chest cavity) or pneumothorax
Pneumothorax - when help is needed immediately
(accumulation of air in the chest cavity), and subcutaneous emphysema (accumulation of air in the subcutaneous tissue).
When subcutaneous emphysema detectable specific creaking of fat under your fingers - crepitus
Crepitus - a very serious symptom
. If there is damage to the pleura (the bag, which lies light) or light, it may appear hemoptysis.
Deep breathing disorders arise when multiple fractures of the ribs. It is hard to occur, and end the double fractures, forming the movable portions of the ribs, for which there is proper ventilation of the lungs. More favorable double fractures occur on the back of the chest, as there is a sufficiently powerful muscle layer that allows you to record the chest with the patient on his back.
Sometimes rib fractures heart and major blood vessels are displaced in a healthy way that creates a circulatory disorder. The most severe fractures that affects the respiratory and cardiovascular system - a double fracture on both sides of the chest to form a complex rib-sternum (breastbone - a bone in the middle of the front surface of the chest to which the ribs are attached). The patient's condition may be exacerbated by highly sensitive nerve endings irritation of the pleura, in response to which also impairs the function of breathing and blood circulation.
Isolated fractures of the ribs do not normally require hospital treatment, the treatment can be performed at home (fracture usually heals within a month). If in this case there is a pain, the pain relief is carried out (for example, by local administration of novocaine). Then appoint a special breathing exercises, sitting up in bed, physiotherapy - all of this is aimed at the prevention of pulmonary congestion.
Multiple and complicated fractures treated at the hospital where the patients underwent special treatment depending on its existing complications.