Rib fractures

Some important points to remember:

  • Significant force is required to break ribs in the young. Underlying injury is typical; especially lung contusions
  • Whilst less force is required in the elderly, even an isolated rib fracture can result in significant morbidity (pneumonia) particularly in those with pre-existing comorbidities
  • Have a low threshold to obtain a CT thorax in patients with rib fractures, especially the elderly
  • In addition to standard therapy, consider the role of patient-controlled analgesia, thoracic epidural and physiotherapy for vulnerable patients
  • Separation of costochondral junctions will not be seen on CXR, but will have the same significance as fractured ribs.
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