Rib fracture: Nursing

Rib fractures happen when one or more ribs break, and usually result from direct trauma or repetitive injury.

Now, there are 12 ribs on each side of the chest, with each rib attaching posteriorly to the thoracic vertebrae, and ending anteriorly as costal cartilage. There are three types of ribs: true, false, and floating ribs. The first seven pairs of ribs are true ribs, and they attach directly to the sternum through costal cartilages. The 8th, 9th, and 10th pairs of ribs are false ribs, and they attach indirectly to the sternum through the costal cartilage of the 7th rib. The last two pairs of ribs are called floating ribs because they don’t attach to the sternum at all.

Now, the ribs form the side component of the thoracic cage, which provides support and protection for the thoracic structures, such as the heart, lungs, and blood vessels. Other functions of ribs include increasing or decreasing the thoracic volume to facilitate breathing, in addition to providing attachment points for muscles.

The main cause of rib fractures is direct trauma to the chest, which can be caused by falls, child abuse, and car crashes. Rib fractures can also be caused by repetitive chest trauma, which might be due to recurrent cough or engagement in certain sports, such as golf or tennis.

Risk factors for rib fractures include modifiable ones, such as osteoporosis, engagement in contact sports, and malignant bone tumors involving the ribs; as well as non-modifiable ones, such as advanced age.

Regardless of the cause, fractures typically happen in ribs four through ten, and can be associated with several complications. A fractured rib that’s sharp, splintered, or displaced may damage or pierce nearby organs and tissues, such as the pleura or lungs, leading to pneumothorax, which is when there’s air from the injured lung leaking into the pleural cavity, and that doesn’t allow the lung on that side to expand properly. This may lead to atelectasis or collapse of the alveoli in the lung.