DESCRIPTIONA rib fracture is a complete or incomplete fracture of any of the 12 ribs on either side. Most rib fractures are accompanied by sprain or rupture of muscles, tendons,
or ligaments between the ribs (intercostal structures). Rib fractures are relatively common injuries in athletes, particularly those who compete in contact sports.
Appropriate health care includes:
Doctor care and X-rays to confirm the diagnosis.
Application of a wide elastic binder to decrease movement of chest muscles and reduce pain with breathing.
Hospitalization if symptoms of lung, spleen, or liver injury appear.
SIGNS & SYMPTOMSSevere pain at the fracture site.
Tenderness to the touch.
A feeling that the "wind has been knocked out" of the child (sometimes).
Abdominal pain if the fractured ribs are below the diaphragm (the 11th and 12th ribs).
Severe chest pain when the child coughs, sneezes, or breathes deeply.
A feeling of small air pockets under the skin of the chest or neck if the child's lung has been injured and has leaked air.
Swelling and bruising over the fracture site.
CAUSESDirect blow to the child's chest from a blunt object, such as a steering wheel.
Compression of the chest, such as being crushed in a sports pileup.
Contact sports, especially football, hockey, boxing, wrestling, or rugby; history of bone or joint disease; poor nutrition, especially calcium deficiency; reckless driving.
PREVENTING COMPLICATIONS OR RECURRENCEUse seat belts and shoulder restraints in your automobile.
MEDICAL TESTSYour own observation of symptoms; medical history and physical exam by a doctor; repeated X-rays of the child's 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 COMPLICATIONSRupture of the child's 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.
If this is a child's first-time chest injury and there are no complications of internal injury. Healing is usually complete in 4 to 6 weeks.
FIRST AIDIf injury to the lung, liver, or spleen is suspected, transport the child to the nearest emergency facility.
Use the chest binder as long as needed to ease the child's pain and provide 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 to the child than ice, use heat lamps, hot soaks, hot showers, or heating pads.
MEDICATIONFor minor discomfort, use aspirin, acetaminophen, or ibuprofen; topical liniments and ointments.
Your doctor may prescribe stronger pain relievers.
Injection of long-acting local anesthesia into the fracture site to reduce the child's pain and allow normal breathing (sometimes).
Your child can resume normal activities gradually after clearance from the doctor.
DIET & FLUIDS
OK TO GO TO SCHOOL?Yes, when condition and sense of well-being will allow.
CALL YOUR DOCTOR IF
Your child has symptoms of a fractured rib.
Any of the following occur after diagnosis: shortness of breath; uncontrollable chest pain; sudden or severe abdominal pain; nausea or vomiting; swelling of the abdomen.
New, unexplained symptoms develop. Drugs used in treatment may produce side effects.