Rib Fracture



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


  • 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

Pediatric Considerations
  • 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

Geriatric Considerations
  • 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

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