Any injury brings a person a lot of discomfort and pain. Tendon sprains are even worse tolerated, but fractures are the most unpleasant, since they take a person out of the usual rhythm of life for at least a month. Although in the case of bone displacement, there are also options of varying complexity. Of great importance for the patient is an open or closed fracture. It is also important where he is, because a leg and spine injury will have a completely different effect on the victim's future life.
Violation of the integrity of the bone
There are various accidents, as a result of which a person can be injured in the area of the ribs. As a result, there is a complete or partial violation of the integrity of bone tissue. When the rib grows together, and there are no deformations on it, then this state is described as primary splicing. If at some stage of tissue regeneration a displacement occurs, then this is already a consolidated fracture of the rib.
How is it happeningfusion?
Bones are fused in different ways, depending on the severity of the injury. When the fragments of the ribs are fully compared, the blood circulation is not disturbed, then the primary fusion occurs. But there are cases when the injured part of the bone with fragments cannot be fully compared, and they are relatively mobile. Normal blood circulation in this place is impossible. In this case, secondary fusion and the formation of cartilaginous callus occurs in this area.
Restoration of the bone occurs due to the fact that the cells of different layers of the bone multiply, and consolidation occurs. If for some reason a secondary injury occurred in this place, then the doctor indicates the diagnosis: "consolidated rib fracture".
When a person has a violation of the integrity of the ribs, this may be accompanied by internal hemorrhages (usually it happens). And healing lasts long enough: first, traumatic hematomas resolve, cells of the endosteum and Haversian canals gradually multiply, and connective tissue grows. But when, at the recovery stage, a violation of the bone tissue occurs again, they are diagnosed as consolidating rib fractures.
How long does it take for bones to heal?
The longest recovery times are for fractured injuries. Only on the 5th-6th day, vessels sprout between bone fragments, and the space is filled with osteoblasts, fibroblasts.
Any violation of the integrity of the bone tissue is fixed with plaster casts, but with the ribs everything is different. This fracture cannot be fixed, and therefore the patient himself must limit his movement and be extremely careful.
In the restored area, you can see a thickening, it is called a callus. It takes about 3 weeks to fully restore the ribs, if there were no displacements. But it may take several years to rebuild the callus in the future. In this case, osteoblasts continue to work, they absorb excess callus and fragments.
Complications of rib fractures
Complications in bone fusion can be caused by concomitant diseases. Slow recovery is typical for patients with diabetes mellitus, malnourished or suffering from beriberi. Elderly people and pregnant women can also face this problem. A person at risk is more likely to have a consolidated bone fracture, because the rehabilitation period is long, and it is very difficult to maintain relative immobility for such a long time.
In addition to concomitant diseases, there may be other reasons for poor fusion of the ribs.
If a patient has multiple fractures, severe circulatory problems, or soft tissue infections, callus formation is slower and regeneration slows down. In this place, a consolidated fracture of the rib can occur. The reason may be incorrectly performed osteosynthesis or excessive activity of the patient.
If by the time everything should grow together,pain or swelling remains, there is a possibility that a displacement has occurred and recovery is not going as it should.
What to do with a rib injury?
If, after an injury or a fall, the patient cannot breathe without pain, it is quite possible that he has a fracture. Any break in the integrity of the bone can be seen on x-rays.
Until the patient has reached the emergency room, you need to apply cold to the bruised area. You can drink an anesthetic, fix the sore spot tightly with a cloth or tight clothing and do as little movement as possible after that. After receiving medical attention, it is necessary to adhere to a calm lifestyle.
If during the rehabilitation period a person has a suspicion of a consolidated fracture of the rib on the right or left, then you need to urgently go to the hospital. There, he will be x-rayed and a plan of further action will be proposed.
Recovery time
The recovery period depends on the complexity of the shift:
- A complete fracture involves one or more fault lines.
- When subperiosteal - there is a partial destruction of bone tissue.
- The easiest option is a crack.
By the way, according to statistics, the ribs on the left side break much less often than on the right.
But the duration of recovery is also affected by a consolidated fracture. What does it mean? As already mentioned, at the site of tissue fusion (consolidation), a repeated rupture of structures occurs, which is why it was called consolidated.
Accurate diagnosis
Thanks to the X-ray, you can see all the damage to the ribs, but sometimes not everything is so clear. Consolidated rib fractures on the left may not be visible on AP scan. To do this, you need to take a side shot. And the point is not the professionalism of the doctor, but the fact that at a certain angle the pathology is not visible, and for this you need to take several pictures. And with a lateral projection, the ribs can overlap each other in the image, and then you need to take another shot to see the rib from a different angle, and only after that do an x-ray description.
A consolidated fracture of the posterior segment of the rib can also be seen on a direct radiograph. But the back segments are narrower than the front ones, they give more intense shadows in the picture. And in order to identify such an injury, it is necessary to take not only an anterior direct picture, but also in an oblique projection. It is also worth remembering that injuries of this type are better visualized on days 2-3, they may not be noticed right away.
Treatment after injury
The difference between the treatment of a primary fracture and a consolidated one is small.
When doctors diagnose such injuries, they fix the bones with plaster, knitting needles, screws - it all depends on the complexity. But if the fusion is wrong, and this was discovered before the formation of the callus, then the doctors have to break the bone, producing an artificial consolidated fracture of the tissues that grow together. Further fixation procedurethe same as in the previous case.
Broken ribs are almost never fixed, even if a consolidated rib fracture occurs. Treatment depends on the severity of the injury. So, with a repeated fracture at the site of callus formation, it may be necessary to reduce the bone fragments. Rib fixation is performed only in cases where there are multiple fractures.
Fracture of the ribs is dangerous because the heart and lungs are nearby, and bone fragments can damage these internal organs. Therefore, the patient needs maximum immobility so that he does not harm himself even more. Doctors make sure that the affected tissues have a normal blood supply.
Life since injury
If a patient is injured with a cracked rib, then rehabilitation is carried out on an outpatient basis. When the fractures are complex, the patient is admitted to the hospital to provide qualified assistance. As a rule, local anesthesia or vagosympathetic blockade according to Vishnevsky is performed. The second option is difficult to perform and has a number of contraindications.
The complex of treatment also includes expectorants, analgesics, physiotherapy and therapeutic exercises, which is aimed at improving ventilation of the lungs.
If there are small hemorrhages in the pleura, they can resolve themselves. When the hemothorax is severe, it is necessary to puncture the pleural cavity. Sometimes this procedure has to be carried out several times.
Consolidated rib fracture may occur inas a result of repeated injury or accident. If full recovery has not yet taken place, and the injury has been re-inflicted, there may be a complication with a tension pneumothorax. In this case, under local anesthesia, drainage of the pleural cavity is performed. The tube is inserted into the incision, and the other end is lowered into a vessel with liquid. The drainage is removed after a few days, when the air will no longer leave the cavity, and the lung will straighten out.
Patient's condition
Even if there is no damage to the internal organs, the patient still feels pain when coughing and even when breathing. If the crack is on the front of the ribs, then the pain is intense, if the inside of the ribs is damaged, it is less pronounced.
Sleep during this period is difficult, patients try to take a position that allows them to reduce their movements to a minimum, they themselves fix the chest with their hands and lean towards broken ribs.
Painful sensations do not allow a person to breathe normally, breaths are superficial, so that the chest moves minimally. The skin around the fracture swells, and if it is mechanically affected, bruises also appear. If several ribs are damaged, the shape of the chest may change.
In case of fractures with damage to internal organs, coughing may cause blood to appear, breathing is sharply disturbed. When the aorta and blood vessels are damaged, there is a large loss of blood. When exposed to the heart, death can occur, as with damage to the liver.
