The most common and serious injuries of the chest are often severe bruises and fractures. In many older people, such injuries occur much more often, since this is due to the age-related decrease in the elasticity of the main bone structures of the human chest. Even minor mechanical impacts can lead to severe bruising.
Both with a bruise and with a fracture of the chest, the symptoms are quite pronounced, the pain syndrome is increased, and the terms of treatment practically do not differ. An experienced specialist will refer the patient for x-rays to resolve doubts. At the same time, the absence of the main signs of a fracture on an x-ray does not completely exclude its true absence.
It is believed that the main reliable sign of an existing fracture of the ribs is the patient’s discomfort in the form of clicks, in other words, crepitation of serious fragments with small movements of the body, coughing or sneezing. However, x-rays are always indicated for chest pain.
Fracture of the chest
Such a common injury as a fracture of the ribs reaches about 16% of the total number of fractures. Uncomplicated fractures of usually one or two ribs absolutely do not pose a big threat to the very life and health of any person, since they grow together quickly and easily. It should be noted that impaired breathing and severe damage to many internal organs of a person are the main danger in this injury.
Often, a chest fracture is accompanied by severe damage to the lungs, pleura, and organs of the cardiovascular system. Multiple fractures are considered a serious injury, they cause the development of pleuropulmonary shock, due to a sharply increasing risk of complications. The main cause of a rib fracture is usually a direct blow to the center of the chest area, a fall, or compression of a person’s ribs.
In the place of the strongest bend, the ribs break along the lateral surfaces of the sternum. If only one rib is broken, then cases of mixing are extremely rare. With multiple fractures, displacement of fragments is almost inevitable. With their sharp ends, the ribs can damage the pleura, intercostal vessels and lungs. It should be mentioned that dangerous damage to the pleura or lungs is very often accompanied by the development of such serious complications as a dangerous hemothorax or pneumothorax.
In severe hemothorax, blood can accumulate in the inner and outer layers of the pleura. In this case, with pneumothorax, air accumulates in the chest. The lungs are compressed and reduced in volume, and the alveoli slightly collapse and completely cease to take a direct part in breathing.
In some cases, a fracture of the ribs, complicated by damage to one or two lungs, may be accompanied by a small penetration of air into the important subcutaneous tissue, which is called subcutaneous emphysema. If the intercostal vessels are damaged, then profuse bleeding is observed not only in all soft tissues, but also in the pleural cavity.
Symptoms of bruising and fracture of the chest
Often, all patients complain of severe or sharp pain in the chest. In this case, the pain is always aggravated by movements, the necessary breathing, talking and coughing. It decreases when a person is at rest or in a sitting position. The doctor diagnoses shallow breathing, and the chest lags behind when breathing on the side of the lesion. On palpation of a particular broken rib, there is a certain area of sharp pain.
In some cases, the doctor may detect a peculiar crunch of several bone fragments, which is called bone crepitus. As a rule, with significant damage to the posterior sections of the human ribs, the inevitable violation of pulmonary ventilation is always less pronounced. It is known that with multiple fractures, the patient’s condition often worsens, and not only shallow breathing and rapid pulse are observed, but also cyanotic or pale skin. Any movement causes severe pain.
Significant bruising and obvious swelling of the soft tissues are visible in the area of injury. Then, in the near future, after a direct injury to the chest, complications such as a dangerous pneumothorax and hemothorax develop, and after a few days, the appearance of post-traumatic pneumonia is not ruled out. In senile and advanced age, such complications are extremely difficult.
Severe pain syndrome significantly limits the movement of not only the chest, but also leads to a noticeable deterioration in the entire drainage function of the bronchi, which is accompanied by congestion in the human lungs. During this important period, an infection can join, leading to the development of pneumonia. Symptoms of pneumonia are deterioration of the general condition and difficulty breathing, fever and intoxication. In this case, self-treatment is strictly contraindicated.
In the vast majority of rib fractures, strong fixation is not required so as not to cause congestion in the lungs. Fixation is possible only with multiple costal fractures, but only in the medical conditions of a hospital. timely treatment completely eliminates the danger to life. Modern X-ray examination and ultrasound of the pleural cavity will allow to exclude pneumo- and hemothorax. if necessary, a pleural puncture may be prescribed.