Rib fractures are commonly caused by trauma to the chest wall. Extremely painful, rib fractures can represent an isolated injury or be part of a larger multi-system injury. A rib may be fractured in one place, two places (flail), or be shattered.
Rib fractures are most commonly caused by blunt injuries to the chest caused by a car accident, fall or assault. Penetrating injuries such as gunshot wounds are a less frequent cause. When severe, rib fractures can lead to flail chest (open chest wound) and cause breathing issues, pulmonary contusion, bleeding and pneumothorax. When untreated, rib fractures will lead to serious short-term consequences such as severe pain when breathing, pneumonia and, rarely, death. Long-term consequences include chest wall deformity, chronic pain and decreased lung function.
The Lung Center at Brigham and Women’s Hospital (BWH) offers proven treatments for patients with fractured ribs. Our board-certified thoracic surgeons use rib plating, a pioneering technique for repairing broken ribs that dramatically reduces pain and recovery time. Although most broken ribs heal without surgery, a severely crushed chest with many broken ribs will likely benefit from this new operative technique.
The following tests help determine whether ribs are fractured:
- Chest X-ray uses invisible radiation energy beams to produce images of internal tissues, bones, and organs on film or digital media.
- Rib films are a specific type of X-ray test that clearly show all the ribs.
- Computerized tomography (CT scan) uses a combination of X-rays and computer technology to produce horizontal, or axial, images of any part of the body, including the bones, muscles, fat and organs.
Pain after rib fracture is most severe two to three days after an injury. Patients with multiple fractures are often hospitalized for observation and pain control. If there is a physical deformity to the ribcage, impaired breathing may result. Ribs can take up to six months to heal.
For select patients, thoracic surgeons at BWH offer a newer, more improved way of stabilizing broken ribs:
- Rib plating is an operation performed under anesthesia that involves an incision made over the broken ribs. Plates and screws are used to stabilize the broken ribs and reduce the deformity of the ribcage, while allowing patients to breathe normally.
In the past, pain medication was the primary treatment as ribs were left to heal by themselves. Patients with flail chests (a condition of several rib fractures that prevent the affected part of the chest from moving correctly during breathing) were hospitalized in an intensive care unit until their chest wall stabilized, the pain on breathing decreased and their lung injury improved. Rib plating speeds up the healing process. Patients are able to wean off mechanical ventilation faster, get discharged from the hospital sooner, return to work earlier and suffer less chronic pain and chest wall deformity.
When you become a patient of The Lung Center you will meet with many members of the team who specialize in rib fractures and stabilization. Careful monitoring and the collaboration of thoracic surgeons, pulmonologists and cardiovascular medicine physicians is important to the successful outcome for patients with rib fractures.
An experienced, board-certified thoracic surgeon will perform any surgery recommended. In addition to your surgeon, a team that includes a pulmonologist and anesthesiologist, as well as nurses and physician assistants who specialize in rib fractures will provide comprehensive care throughout your recovery.
Patients with rib fractures benefit from the wide range of specialists at The Lung Center, including pulmonologists, thoracic surgeons, cardiovascular medicine physicians and thoracic imaging experts. This collaboration ensures comprehensive and effective evaluation, treatment and pain management. If your care team discovers an underlying illness or concern, you will be referred to an appropriate BWH physician for an expert evaluation.
Go to our online health library to learn more about thoracic diseases and tests.
Visit the Kessler Health Education Library in the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.
This page was last modified on 6/22/2016