Last reviewed:September 2019
Last updated:October  2019

Summary

Definition

History and exam

Key diagnostic factors

  • presence of risk factors
  • pain
  • dyspnoea

Other diagnostic factors

  • signs of impaired oxygenation
  • paradoxical chest wall motion

Risk factors

  • blunt chest trauma
  • physical abuse in children
  • osteoporosis
  • age >45 years
  • athletics
  • primary bone tumours
  • metastatic bone tumours
  • cardiopulmonary resuscitation (CPR)
  • severe cough

Diagnostic investigations

Investigations to consider

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

Treatment algorithm

Contributors

Associate Professor

Discipline of Orthopaedics & Trauma

University of Adelaide

Paediatric Orthopaedic Surgeon

Women's and Children's Hospital

Adelaide

Australia

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 & 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.

Associate Professor

Orthopaedics and Trauma 

University of Adelaide

Head of Orthopaedic Surgery and Major Trauma Service Co-Director

Women's and Children's Hospital

Adelaide

Australia

Disclosures

NW’s hospital, the Women's & Children's Hospital, Adelaide, receives institutional research support from medical supply companies and BioMarin Pharmaceutical Inc.

Dr Peter Cundy and Dr Nicole Williams would like to gratefully acknowledge Dr Paul Novakovich and Dr Brent Ponce, previous contributors to this topic. PN and BP declare that they have no competing interests.

Peer reviewersVIEW ALL

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.

President and Chief Executive Officer

American Board of Family Medicine

Lexington

KY

Disclosures

JP declares that he has no competing interests.

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