(Broken Rib; Fracture, Rib)
A rib fracture is a break in a rib bone. Bruised muscles and damaged ligaments often happen with a rib fracture. With a rib fracture, the lungs and other organs can be injured. More than one rib fracture after a trauma can indicate serious internal injury.
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Rib fractures are caused by:
- A direct blow to the rib
- Crushing of the chest, such as in contact sports, a car accident, or having CPR
- Severe coughing incidents that can occur with lung problems or at high altitude
- Rib fractures in young children are often a sign of abuse
Rib fractures are common in people 65 years and older. Other factors that may increase the chance of a rib fracture include:
- Difficulty doing activities of daily living—generally with eldery people
- Playing contact sports
- Weak bones
- Chronic cough
Extreme repetitive upper body activity, such as in:
- Weight lifting
- Occupations involving a lot of overhead lifting
- History of rib or chest fracture
Rib fracture may cause:
- Pain in the ribs or upper chest area
- Pain when breathing or coughing
- Swelling and bruising in the fracture area
- Severe local tenderness in the fracture area
- Shortness of breath
- Internal bleeding
You will be asked about your symptoms and how the injury occurred. Your chest, lungs, and back will be examined.
Imaging tests can evaluate your chest and surrounding structures. These may include:
Treatment may include:
Rest, without physical activity until the pain has gone away.
A chest binder may need to be worn around the ribs to protect them. The binder may promote proper breathing. It is important to take deep breaths so that the lungs remain clear. Pneumonia can develop after rib fractures when breathing is not deep enough. A rib cage protector may need to be worn for 6-8 weeks when returning to contact sports.
Over-the-counter medication may be advised to help reduce inflammation and pain.
A physical therapist can teach breathing exercises. The therapist can also help maintain range of motion in the arm and shoulder joints.
Intercostal Nerve Blocks
Special injections with local anesthetic can temporarily relieve pain.
Sometimes, a temporary epidural catheter is used to place anesthetic near the spinal cord and nerves. This can help severe cases where the injury requires hospitalization.
Hospitalization is usually only needed if there are complications such as damage to organs in the chest.
Sometimes rib fractures cannot be prevented. To help reduce your chance of a rib fracture:
Ortho Info—American Academy of Orthopaedic Surgeons
Trauma—Care of the Injured
Canadian Orthopaedic Association
Canadian Orthopaedic Foundation
Boden BP, Osbahr DC, Jiminez C. Low-risk stress fractures. Am J Sports Med. 2001;29(1):100-111.
Broken or bruised ribs. NHS Choices website. Available at: http://www.nhs.uk/conditions/rib-injuries/Pages/Introduction.aspx. Updated April 29, 2015. Accessed August 30, 2017.
Fractures (broken bones). Ortho Info—American Academy of Orthopaedic Surgeons website. Available at: http://orthoinfo.aaos.org/topic.cfm?topic=A00139. Updated October 2012. Accessed August 30, 2017.
Gregoretti C, et al. Regional anesthesia in trauma patients. Anesthesiol Clin. 2007;25(1):99-116.
Rib fracture. Merck Manual Professional Version website. Available at: http://www.merckmanuals.com/professional/injuries-poisoning/thoracic-trauma/rib-fracture. Updated January 2017. Accessed August 30, 2017.
Rib fracture—emergency management. EBSCO DynaMed Plus website. Available at:http://www.dynamed.com/topics/dmp~AN~T903816/Rib-fracture-emergency-management. Accessed August 30, 2017.
1/4/2011 DynaMed Plus Systematic Literature Surveillancehttp://www.dynamed.com/topics/dmp~AN~T903816/Rib-fracture-emergency-management: Barrett-Connor E, Nielson CM, Orwoll E, et al. Epidemiology of rib fractures in older men: Osteoporotic Fractures in Men (MrOS) prospective cohort study. BMJ. 2010;340:c1069.
Last reviewed September 2018 by EBSCO Medical Review Board Warren A. Bodine, DO, CAQSM Last Updated: 8/4/2015