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Rib fractures

Last reviewed: 5 Oct 2024
Last updated: 18 Apr 2024

Summary

Definition

History and exam

Key diagnostic factors

  • history of trauma
  • presence of risk factors
  • pain
  • dyspnea
Full details

Other diagnostic factors

  • signs of impaired oxygenation
  • paradoxical chest wall motion
Full details

Risk factors

  • blunt chest trauma
  • cardiopulmonary resuscitation (CPR)
  • physical abuse in children
  • osteoporosis
  • age >65 years
  • participation in sport
  • primary bone tumors
  • metastatic bone tumors
  • severe cough
Full details

Diagnostic tests

1st tests to order

  • CXR
  • x-ray pelvis
Full details

Tests to consider

  • CT chest
  • ultrasound chest
  • angiography
  • CT of head, cervical spine, chest, abdomen, and pelvis
  • skeletal survey (children)
Full details

Treatment algorithm

ACUTE

all patients

Contributors

Authors

Garth H. Utter, MD, MSc

Professor of Surgery

University of California

Davis

California

CA

Disclosures

GHU has been paid as a consultant by the US Agency for Healthcare Research and Quality (AHRQ) for their Healthcare Cost and Utilization Project (HCUP) Tools Program. His organization has received contract funding on his behalf from the US Centers for Medicare and Medicaid Services, and AHRQ for their Quality Indicators programs and AHRQ's Patient Safety Network program.

Acknowledgements

Dr Garth H. Utter would like to gratefully acknowledge Dr Peter Cundy, Dr Nicole Williams, Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic.

Disclosures

PC is on the boards of MIGA (medical indemnity insurance) and Orthopaedics SA. He owns stock though a personal superannuation fund. PC’s hospital, the Women's and Children's Hospital, Adelaide, receives institutional support from medical supply companies for salary of research scientists. PC received payment from a medical supplier for two lectures on wound dressings in 2017. PC declares that none of the above are relevant to the Rib Fractures topic and that he receives no other money from suppliers. NW’s hospital, the Women's and Children's Hospital, Adelaide, receives institutional research support from medical supply companies and BioMarin Pharmaceutical Inc. PN and BP declare that they have no competing interests.

Peer reviewers

Gino Kerkhoffs, MD, PhD

Orthopaedic Surgeon

Department of Orthopaedic Surgery & Orthopaedic Research Center

Academic Medical Center

Meibergdreef

Amsterdam

The Netherlands

Disclosures

GK declares that he has no competing interests.

James Puffer, MD

President and Chief Executive Officer

American Board of Family Medicine

Lexington

KY

Disclosures

JP declares that he has no competing interests.

  • Rib fractures images
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    • Western Trauma Association critical decisions in trauma: management of rib fractures
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