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Rib Fracture

Rib Fracture is a topic covered in the 5-Minute Emergency Consult.

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Basics

Description

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

Etiology

  • Blunt thoracic trauma:
    • Simple fall, fall from height
    • Motor 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.
  • Morbidity and mortality are twice that found in younger populations.

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Citation

Rosen, Peter, et al., editors. "Rib Fracture." 5-Minute Emergency Consult, 5th ed., Lippincott Williams & Wilkins, 2016. Emergency Central, emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307349/all/Rib_Fracture.
Rib Fracture. In: Rosen P, Shayne P, Barkin AZ, et al, eds. 5-Minute Emergency Consult. 5th ed. Lippincott Williams & Wilkins; 2016. https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307349/all/Rib_Fracture. Accessed April 26, 2019.
Rib Fracture. (2016). In Rosen, P., Shayne, P., Barkin, A. Z., Wolfe, R. E., Hayden, S. R., Barkin, R. M., & Schaider, J. J. (Eds.), 5-Minute Emergency Consult. Available from https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307349/all/Rib_Fracture
Rib Fracture [Internet]. In: Rosen P, Shayne P, Barkin AZ, Wolfe RE, Hayden SR, Barkin RM, Schaider JJ, editors. 5-Minute Emergency Consult. Lippincott Williams & Wilkins; 2016. [cited 2019 April 26]. Available from: https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307349/all/Rib_Fracture.
* Article titles in AMA citation format should be in sentence-case
TY - ELEC T1 - Rib Fracture ID - 307349 ED - Rosen,Peter, ED - Shayne,Philip, ED - Barkin,Adam Z, ED - Wolfe,Richard E, ED - Hayden,Stephen R, ED - Barkin,Roger M, ED - Schaider,Jeffrey J, BT - 5-Minute Emergency Consult UR - https://emergency.unboundmedicine.com/emergency/view/5-Minute_Emergency_Consult/307349/all/Rib_Fracture PB - Lippincott Williams & Wilkins ET - 5 DB - Emergency Central DP - Unbound Medicine ER -