A rib fracture is a break in one of the bones of the rib cage. This injury often causes significant discomfort and can affect breathing. A “displaced” rib fracture means the broken ends of the bone have moved out of their normal alignment. This differs from a simple crack where the bone remains largely in place.
Causes and Symptoms of a Displaced Rib Fracture
Displaced rib fractures result from high-impact events that exert significant force on the chest. Automobile accidents, substantial falls, or direct blows in contact sports are frequent causes. Less common causes include severe, prolonged coughing that places repetitive stress on the rib cage.
Symptoms of a displaced rib fracture include sharp, localized pain that intensifies with movement, deep breaths, coughing, laughing, or twisting the torso. Shortness of breath may occur, as pain can make it difficult to fully expand the lungs. A visible deformity or lump on the chest wall may be present, and a crunching or grinding sensation, known as crepitus, may be felt when moving the injured area.
The Diagnostic Process
Diagnosing a displaced rib fracture begins with a physical examination. The doctor will inspect the chest for tenderness, swelling, or visible deformities. They will also listen to breathing and inquire about the pain’s nature and severity.
Following the physical exam, imaging tests are ordered to confirm the diagnosis. An X-ray is the initial imaging tool to visualize the broken bone. A computed tomography (CT) scan is often necessary for a suspected displaced fracture, providing a more detailed, cross-sectional view of bones and surrounding soft tissues. This detail helps determine the bone’s position and identify potential damage to internal organs that an X-ray might not reveal.
Potential Complications
The displaced nature of these fractures introduces specific risks, as the sharp, misaligned bone end can puncture or damage nearby structures. A serious complication is a punctured lung (pneumothorax), where air leaks into the space between the lung and chest wall, potentially causing lung collapse. Another concern is a hemothorax, involving bleeding into the chest cavity, often due to damaged blood vessels. Depending on the specific ribs involved, a displaced fracture can also injure abdominal organs like the spleen, liver, or kidneys.
Fractures of the lower ribs (7th through 10th) are associated with injuries to the diaphragm, liver, or spleen. Upper rib fractures (1st and 2nd) are rare but may affect nerves or major blood vessels. Beyond direct organ injury, intense pain from a rib fracture often leads to shallow breathing to avoid discomfort. This shallow breathing can prevent the lungs from fully expanding and clearing secretions, increasing the risk of pneumonia.
Treatment and Recovery
The primary goal in managing a displaced rib fracture is effective pain control, allowing deep breathing and complication prevention. Over-the-counter pain relievers like ibuprofen or acetaminophen are recommended. For more severe pain, stronger prescription medications or local nerve blocks can be considered.
Breathing exercises are an important part of recovery, involving an incentive spirometer to encourage deep breaths and maintain lung function. Ribs are no longer wrapped or taped, as this restricts breathing and increases pneumonia risk. While most rib fractures heal with conservative management, surgery, such as rib plating, may be required for severe cases like flail chest, where multiple adjacent ribs are broken in multiple places, creating an unstable chest wall segment. Surgery can also be considered for ongoing organ damage or significant respiratory compromise. Recovery is approximately six to eight weeks, during which activities involving twisting, lifting, or strenuous exertion should be avoided.