The Symptoms, Treatment, and Prognosis for Broken Ribs

Rib fractures are injuries that occur to the chest wall. The most common cause of a rib fracture is a traumatic injury to the chest, such as from a fall, automobile crash, or another blunt force injury. 

Much less common is overuse rib stress fracture, an injury that can result from specific sports activities such as competitive rowing.

Rib fractures seldom require specific intervention or treatment themselves, but they can be a sign of injury to the organs of the chest and abdomen.

If a trauma caused sufficient force to cause a rib fracture in someone with normal bone density, injury to the other structures of the chest and abdomen must be ruled out.

Rib fractures sometimes occur without major overuse or trauma. Pathologic fractures can happen if the bone is weak and can break with little or no trauma.

Pathologic rib fractures are most common in people with poor bone density or osteoporosis. Infections, tumors, and other conditions that weaken bone can also make someone more likely to develop this type of fracture.

Symptoms

The primary symptom of a broken rib is chest pain, which is almost always worse when taking a deep breath or during other sudden movements of the chest, such as sneezing or coughing.

People may have pain directly over the broken rib bone. Sometimes, the fracture can be felt—as there is little soft-tissue between the skin and bone. 

In more severe injuries, a deformity of the chest wall can be seen. When there are multiple ribs fractured in more than one location (a condition called 'flail chest'), chest wall movement may be abnormal with breathing (paradoxical chest motion).

Treatment

The most common treatment for a fractured rib is supportive care. Unlike a broken arm that heals in a cast, the chest wall cannot be immobilized, as it needs to move for you to breathe.

As mentioned, injury to other structures in the chest and abdomen often take precedence over the broken rib.

For example, if a fractured rib punctures a lung, a hemothorax or pneumothorax can develop.

People with a broken rib tend to avoid taking deep breaths, putting them at risk for developing pneumonia and atelectasis. People may be advised to use an incentive spirometer or periodically take deep breaths or cough to avoid these complications.

Surgery

Surgical treatment of a fractured rib is rarely necessary and is only considered in specific or unusual circumstances. The two most common reasons are a flail chest or a chest wall deformity.

The implants typically used to treat broken ribs include metal plates, intramedullary rods, and bioabsorbable plates. These implants are generally not removed, however, in some cases they may cause irritation.

Symptoms, such as pain and trouble breathing, may not occur until a year or more after the implant is placed. When severe, a surgeon may decide taking the implant out is the best course of action.

Prognosis

Isolated rib fractures in young, otherwise healthy people usually heal completely with no longterm problems. Older adults and people with severe chest wall trauma are more at risk for complications, specifically lung problems like a hemothorax or pneumonia.

Treatment is supportive and focused on minimizing complications. Pain medication can help, but healing from a rib fracture primarily takes time.