Rib Fracture

Description

• Result of major or minor thoracic trauma
• Can be classified as traumatic or pathologic

Etiology

• Blunt thoracic trauma:
  • Simple fall, fall from height
  • Vehicle crash
  • Assault
  • Missile
  • CPR-related
• Penetrating trauma is a less likely cause:
  • Ribs usually break at the point of impact or the posterior angle, the structurally weakest region
• Stress fractures in upper and middle ribs can occur with recurrent, high-force movements:
  • Athletic activities: Golf, rowing, throwing
  • Severe cough
• Pathologic fractures associated with minor trauma or significant underlying disease:
  • Advanced age, osteoporosis, neoplasm

• Relatively elastic chest wall makes rib fractures less common in children
• Consider nonaccidental trauma for infants and toddlers without appropriate mechanism
• Obtain a skeletal survey to assess for other fractures in infants suspected of being abused

• Elderly are more prone to rib fractures as well as atelectasis, pneumonia, respiratory failure, and other associated complications
• Have been consistently shown to have poorer outcomes following rib fractures