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Fraturas das costelas

Last reviewed: 21 Sep 2025
Last updated: 19 Sep 2025

Summary

Definition

History and exam

Key diagnostic factors

  • história de trauma
  • presença de fatores de risco
  • dor
  • dispneia
Full details

Other diagnostic factors

  • sinais de oxigenação comprometida
  • contratilidade paradoxal da parede torácica
Full details

Risk factors

  • traumatismo torácico contuso
  • ressuscitação cardiopulmonar (RCP)
  • abuso físico em crianças
  • osteoporose
  • idade >65 anos
  • participação em esportes
  • tumores ósseos primários
  • tumores ósseos metastáticos
  • tosse intensa
Full details

Diagnostic investigations

1st investigations to order

  • radiografia torácica
  • radiografia pélvica
Full details

Investigations to consider

  • tomografia computadorizada (TC) do tórax
  • ultrassonografia do tórax
  • angiografia
  • TC do crânio, coluna cervical, tórax, abdome e pelve
  • radiografia de esqueleto (crianças)
Full details

Treatment algorithm

ACUTE

todos os pacientes

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 organisation 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.

Peer reviewer acknowledgements

BMJ Best Practice topics are updated on a rolling basis in line with developments in evidence and guidance. The peer reviewers listed here have reviewed the content at least once during the history of the topic.

Disclosures

Peer reviewer affiliations and disclosures pertain to the time of the review.

References

Our in-house evidence and editorial teams collaborate with international expert contributors and peer reviewers to ensure that we provide access to the most clinically relevant information possible.

Key articles

American College of Radiology. ACR appropriateness criteria: rib fractures. 2018 [internet publication].Full text

American College of Surgeons. ACS trauma quality programs: best practices guidelines for acute pain management in trauma patients. Nov 2020 [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.Full text  Abstract

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

Reference articles

A full list of sources referenced in this topic is available to users with access to all of BMJ Best Practice.
  • Fraturas das costelas images
  • Differentials

    • Contusão da parede torácica
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  • Guidelines

    • ACS trauma quality programs best practices guidelines: acute pain management in trauma patients
    • ACR appropriateness criteria: rib fractures
    More Guidelines
  • Videos

    Inserção de dreno intercostal, técnica aberta: vídeo de demonstração

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