In principle, the healing process after a bone fracture is very complex. It is a dynamic process in which old bone tissue is broken down and then new bone tissue is built up. The healing process of a rib fracture is no exception and, like any other fracture, takes place in successive regular phases.
Depending on the type of fracture, primary or secondary bone healing occurs. With both types of bone healing and the severity of the fracture, the healing time varies. In general, however, 12 weeks is considered a rough guide.
A simple rib fracture usually heals more quickly, as primary bone healing occurs. Characteristic of primary or direct bone healing is the absence of a callus reaction and the fact that the fracture gap between the two broken ends is a maximum of 0.5 mm. The term callus describes the scar tissue of the healing bone, which can be visualized by X-ray diagnosis.
However, the callus tissue is typical for secondary wound healing. Secondary or indirect bone healing is relevant if the broken ribs are too far apart and the fracture gap is too large, so that mechanical fixation of the fracture ends is insufficient. This type of bone healing can be divided into 4 phases: The initial phase starts about 8 hours after the fracture and includes clearing the fracture hematoma.
The duration of the initial phase varies depending on how pronounced this is. This is followed in the first two weeks after the rib fracture by the callus formation phase, during which a connective tissue callus develops. With the beginning of callus formation, the pain is relieved for the first time by the relief and partially regained stability.
Following callus formation, calcium crystals are deposited in the callus tissue until the 6th week. From this point on, there is a mechanically firm connection between the rib ends for the first time. This stability increases in the last phase, the definitive bone callus formation, as the bone gains in differentiation.
In general, a simple fracture usually heals quickly and without complications. More difficult are serial rib fractures or fractures that are more likely to be in the anterior thoracic region. On the back, the more pronounced musculature has a more relieving and supportive effect than muscles in the front part.
If the rib fracture is a serial or splinter fracture, surgery may be indicated. The bone is realigned and held in this position by means of screws and plates. This healing process sometimes takes somewhat longer than conservative treatment.
The type of fracture and its location are therefore decisive for the duration of the operation. However, other factors can also influence the healing time. Age, osteoporosis and a poor nutritional status (underweight and overweight) are considered to be factors that have a negative or unfavorable effect on the duration of recovery from a rib fracture.
In addition, complications in the form of injuries to other organs such as the liver, spleen, lung or heart can prolong the healing process. On the other hand, a calcium-rich and balanced diet can have a positive influence. Since rib fractures are very painful injuries, patients often tend to adopt a relieving posture to ease the symptoms.
However, the breathing excursion and the position of the ribs are often unfavorably changed, so that breathing training can be helpful in order not to impair the bony healing process. It may be possible to shorten the healing time by paying attention to your sleeping position at night. If you try to fall asleep on the side of the rib fracture, the load will put the fracture ends in their physiological position and can thus have a positive influence on the healing process. During the healing process you should avoid carrying heavy things and instead allow yourself to rest and spare the affected ribs by reducing physical activity.