Highlights & Basics
- Rib fractures may be due to blunt force injury, falls, nonaccidental trauma, aggressive CPR, or more rarely, severe coughing, athletic activities, or metastatic lesions and primary bone tumors.
- Among infants younger than 12 months presenting with rib fractures, as many as 82% sustained these injuries non-accidentally (i.e., through physical abuse).
- Assessment includes identification of the fracture itself and any concurrent injuries. These include pneumothorax, hemopneumothorax, pulmonary contusions, and a flail chest, as well as possible nonthoracic injuries.
- Chest radiography is the first-line imaging modality in patients presenting with known or possible trauma, followed by a chest CT if needed.
- Treatment includes pain control, lung volume expansion exercises and/or ventilatory support, physical therapy, mobilization, and treatment of concomitant injuries.
Quick Reference
History & Exam
Key Factors
Other Factors
Diagnostics Tests
Treatment Options
Definition
Epidemiology
Etiology
Pathophysiology
Images
CT scan showing large left-sided pneumothorax
CXR depicting the same pneumothorax as shown on CT
CXR showing right first rib fracture
CXR showing multiple posterior left-sided rib fractures
Anteroposterior CXR multiple left-sided rib fractures with chest tube in place
CT scan showing bilateral posterior rib fractures
CT showing right anterolateral rib fracture
CT showing left posterior segmental rib fracture
Citations
American College of Radiology. ACR appropriateness criteria: rib fractures. 2018 [internet publication].[Full Text]
Kasotakis G, Hasenboehler EA, Streib EW, et al. Operative fixation of rib fractures after blunt trauma: a practice management guideline from the Eastern Association for the Surgery of Trauma. J Trauma Acute Care Surg. 2017 Mar;82(3):618-26.[Abstract][Full Text]
Pieracci FM, Majercik S, Ali-Osman F, et al. Consensus statement: surgical stabilization of rib fractures rib fracture colloquium clinical practice guidelines. Injury. 2017 Feb;48(2):307-21.[Abstract]
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