Therapy of a rib fracture

A rib fracture is normally treated conservatively. A plaster cast or corset is not used for practical reasons: On the one hand, immobilizing the rib cage with a plaster cast would make breathing almost impossible. On the other hand a bandage would not last too long at this point.

The therapy therefore takes the form of immobilization and symptomatic treatment of the pain. For this purpose, analgesics (painkillers) of the NSAID class, such as ibuprofen or paracetamol, are usually used. Since these painkillers damage the stomach lining in the long term, they are always given with a “stomach protector” such as pantoprazole.If the initial pain is extremely severe, short-term treatment with a low-potency opioid such as tramadol may also be considered.

The duration of treatment for a rib fracture depends on the type of fracture and the age of the patient, but is usually in the range of 2-3 weeks. In the case of a serial rib fracture, conservative therapy is usually not sufficient, which is why it is often an indication for surgery. For this purpose, the broken ribs are surgically reduced, i.e. returned to their original position, and fixed in this position with screws or plates.

Artificial respiration may then be necessary. It must be remembered that the force applied in a serial rib fracture is usually so strong that the internal organs or other bones are usually involved anyway. It is then a polytrauma that requires intensive medical care.

Diagnosis of a rib fracture

The diagnosis is made relatively quickly and easily using x-rays or sonography. With the “X-ray thorax”, the patient stands in a shielded room and is X-rayed from the back towards the abdomen. This procedure takes only a few seconds, and the diagnosis of a rib fracture can be made within a few minutes. Sonography, i.e. an examination using an ultrasound machine, is also suitable for monitoring the progress of the procedure. Furthermore, the manual examination of the patient by the doctor, with scanning of the affected area, also provides a range of information: For example, crunching noises during movement, or abnormal position of the rib (e.g. penetration through the skin) are regarded as reliable signs of a fracture.