Ribs are the collective term used to describe set of 12 bones that encloses the thoracic region. They combine with the vertebral column in the posterior side and in the anterior side they emerge as costal cartilage. Totally there are 12 pairs of ribs. True ribs or costae verae is the first 7 sets which are attached with the sternum directly. Among these except for the first pair all of them are curved and the first set assumes “C” shape.
The next is the set of 5 ribs known as false ribs, out of which 3 pairs have common connection with the sternum and the last 2 pairs have separate connection with the vertebrae. The length of first 7 pairs grows in size and the last 5 pairs decreases lengthwise. As one grows, all the ribs would take up oblique shape. Thoracic diaphragm separates the rib case from the abdomen.
Function :
Ribs does the function of offering support to the internal cartilages, help in breathing by facilitating movement of the ribcage in coordination with the chest expansion and finally they offer protection for vital organs like heart, lungs and kidneys. Direct blow or injury on the chest region is the main cause of broken ribs. Broken rib is also called as fractured rib in which one or more of the bones of the ribcage get cracked or fractured.
In severe cases, the loose end of broken ribs can pierce the muscles and blood vessels of lungs or even heart. Sometimes even the cartilages can get broken inside the ribcage. Broken ribs can cause varying degree of pain. Mild form of broken ribs would often heal without any treatment. Surgery is limited only for serious cases in which internal organs are affected.
Consequences of broken Ribs :
If one or more ribs get broken, it can cause breathing problem. The available space inside the chest gets constricted and the lungs may not be able to contract and expand freely as before. In some cases, the loosened end of the broken ribs can pierce the muscles of lungs or even blood vessels of the aorta causing complications. The lungs can get punctured leading to Pneumothorax. In rare cases the last 2 pairs of ribs can get broken to cause potential complications to liver, kidneys and Spleen.
Symptoms :
Broken ribs can cause mild to moderate chest pain. The intensity of pain increases when one breathe. For some people the pain can be felt when touched in the chest area. In serious injury, the broken ribs can cause shortness of breath, breathing difficulty and choking. The person may become restless, tired and often dizzy. A lump or tender spot can be felt in the rib area after injury. If you experience any of the above signs after sudden fall or trauma in the chest region you need to seek medical attention quickly.
Causes :
Forceful blow on the chest can cause rib fracture. If three or more rib bones get broken it is known as flail chest. This can cause intense pain when one breathes and difficulty in breathing. Excess of stress in the chest region may induce ribs to get broken. This is called Stress Fracture and in most of the cases it would be mild fracture which heals on its own. Sports personalities can get this type of stress fracture easily. Stress fracture with mild breakage of ribs can also be caused if you take long-term cough with force. People living with Osteoporosis are more prone to develop broken ribs than others since the bones can be weak with less density.
Tests :
The doctor would first listen to your heart and gently push on the chest region. He would find out if the lungs are moving normally without interruption. Depending on the site and extent of injury, he may order for imaging tests like X-rays and CT scan. X-ray cannot reveal broken ribs but CT scan gives accurate picture of blood vessel leak or soft tissue injury. Stress fracture can be detected through bone scan.
Treatment :
Most of the broken ribs are only mild and needs no treatment. It would heal automatically within few weeks or a month. Over the counter painkillers can provide relief from pain. Conservative treatments like applying ice packs on the injured area are effective. Compression wraps were used in olden days for treating broken ribs but it can prevent you from breathing deeply. In severe cases of pain, your doctor may give you a shot of intercostal nerve block for numbing the broken rib area for few hours.
Spirometer can be helpful in taking deep breath. Taking complete rest is highly recommended in case of rib injury. You can begin activities slowly after few weeks with the help of therapist. Only for bad fracture of broken ribs surgery is done. The surgeon would bond the broken ribs with proper plates and screws. Other complications like blood vessel piercing or injury to vital organs will be repaired promptly during surgery.
Tips for Prevention :
Sports persons must wear proper equipment during sports. One can prevent fall during old age by walking firmly and keeping the home clean and illuminated.
