rib fracture


Also found in: Wikipedia.

rib fracture

a break in a bone of the thoracic skeleton caused by a blow or crushing injury or by violent coughing or sneezing. It may also be a pathological fracture secondary to metastatic disease. The ribs most commonly broken are the fourth to eighth; if the bone is splintered or the fracture is displaced, sharp fragments may pierce the lung, causing hemothorax or pneumothorax.
observations The patient with a fractured rib suffers pain, especially on inspiration, and usually breathes rapidly and shallowly. The site of the break is generally very tender to the touch, and the crackling of bone fragments rubbing together may be heard on auscultation. Breath sounds may be absent, decreased, or accompanied by rales and rhonchi. The location and nature of the fracture are determined by chest x-ray studies. The patient is observed for signs of hemoptysis, hemothorax, flail chest, atelectasis, pneumothorax, and pneumonia.
interventions Fractured ribs may be splinted with an elastic belt or bandage or adhesive strapping. To prevent irritation, the area may be shaved and painted with tincture of benzoin before the adhesive tape is applied. Increasingly, however, no splints are used, because they compromise chest expansion and predispose the patient to pulmonary complications. If hospitalization is required, the patient is placed in a semi-Fowler's position, and the blood pressure, pulse, temperature, respirations, and breath sounds are checked every 2 to 4 hours. An analgesic may be ordered, but morphine sulfate is avoided because it depresses respiration. If strapping and analgesic medication fail to relieve pain, the physician may perform a regional nerve block by infiltrating the intercostal spaces above and below the fracture site with 1% procaine.
nursing considerations The nurse assists in splinting the chest, administers the ordered medication, helps the patient to turn, and instructs the patient in how to perform deep breathing, coughing, and range-of-motion exercises of the extremities.
References in periodicals archive ?
The pensioner, of Laurel Gardens, Crook, was taken to the RVI in Newcastle suffering from a suspected broken nose and rib fracture.
Pacer Dale Steyn, who has a minor rib fracture, and AB de Villiers, who has had an operation to remove a plate from his hand, are expected to recover in time for the three-Test series.
10) The purpose of our recent experience is to evaluate epidural analgesia versus intravenous opioid analgesia for rib fracture pain.
The purpose of the study was to understand the internal mechanisms of injuries relating to specific seat geometries and to propose modifications to the cockpit/seat structure and/or restraint system in order to reduce the risk of injury, with a focus primarily and chest injury and rib fracture.
The victim had reportedly struck the ground head first, suffering a skull fracture, bleeding from the nose and ear, and a rib fracture.
2004: England beat Wales 2-0 in their World Cup qualifier at Old Trafford but the win was marred by a booking and a hairline rib fracture for captain David Beckham, who later admitted deliberately earning his yellow card to ensure suspension for the following week's qualifier against Azerbaijan.
By contrast, complications such as nonunion and plexus brachialis palsy have been reported in a few cases of first rib fracture (Edwards and Murphy, 2001; Ochi et al.
The singer was later taken to hospital where he was examined for a suspected rib fracture and ligament damage.
Palermo suffered a left femur fracture, a laceration over the left eyebrow, a left rib fracture and scrapes and bruises, the lawsuit said.
The precise reason behind the increased female rib fracture prevalence is not known, although several hypotheses have been presented.
A flail chest was defined as two or more rib fractures at two or more places; patients classified as having sustained a flail chest were not included in the rib fracture group.