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.