Healing time
The duration of the healing process is also adapted to the severity of the injury and the accompanying diseases. In general, rib fractures take a little longer than other bone fractures until they are completely healed, as they cannot be permanently immobilized because they are needed for breathing and for most everyday movements. If simple bone fractures in other parts of the body require only about 6 weeks to heal without symptoms, a simple rib fracture takes about 12 weeks to heal before normal physical activity is possible without pain.
During these 12 weeks, only the two opposite fracture surfaces resulting from the fracture are broken down by giant scavenger cells, so-called macrophages. Subsequently, a first bone replacement material, the callus, is created in their place. This serves to bridge the fracture for the first time, but is far less hard and resilient than actual bone tissue.
The bridging connection of the callus is completed in 3-4 weeks for simple, uncomplicated rib fractures. After this time, there is already a significant reduction in the patient’s pain and complaints. Following callus formation, the body uses bone-forming cells, the osteoblasts, to convert the callus material into hard, normal bone tissue (secondary healing of the fracture).
It takes up to 12 weeks for a continuous costal arch to mature. The duration of healing naturally increases with the severity and number of fractured ribs. An accompanying hemato- or pneumothorax usually heals in 7-10 days. After a bloodless or airless pleural gap has been seen in the x-ray, the drainage tube is clamped with a clamp, the patient waits two days to see if a spontaneous recurrence occurs, and if it does not, the drainage tube is removed at the end of the second observation day.
Prognosis
The prognosis for rib fractures is usually very good. Uncomplicated, simple rib fractures usually heal completely without surgery and without leaving any symptoms. If concomitant diseases such as lung contusion, hemato- or pneumothorax or the unstable thorax are recognized and treated in time, the healing process is prolonged, but patients who have recovered completely are also cured.
Rib fractures are only dangerous in the form of serial rib fractures, large vascular and organ injuries and, if inverse breathing develops in an unstable thorax, these are not detected and treated in time. In these cases, the course can be lethal. However, due to the good medical care available in our hemisphere, this occurs very rarely (in less than 0.1% of cases).