Any injuries bring a lot of discomfort and pain to a person. Tendon strains 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 fracture or a closed one. It is also important in what place it is, because an injury to the leg and spine will have a completely different effect on the victim's future life.
Bone integrity disorder
Various accidents occur, as a result of which a person may be injured in the ribs. As a result, a complete or partial violation of the integrity of bone tissue occurs. When the rib is fused, and there are no deformations on it, this condition is described as primary fusion. If, at some stage of tissue regeneration, a displacement occurs, then this is already a consolidated fracture of the rib.
How does fusion occur?
Bones are fused in different ways, depending on the severity of the injury. When the fragments of the ribs are fully aligned, the blood circulation is not disturbed, then the primary fusion occurs. But there are cases when the injured area 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 formation of cartilage callus occurs in this area.
Bone restoration occurs due to the fact that cells of different layers of the bone multiply, and consolidation occurs. If, for some reason, a secondary injury occurred in this place, the doctor indicates the diagnosis: "consolidated fracture of the rib."
When a person has a violation of the integrity of the ribs, this can be accompanied by internal hemorrhages (usually this happens). And healing lasts long enough: at first the traumatic hematomas dissolve, the cells of the endosta and Haversian channels gradually multiply, and the connective tissue grows. But when the bone tissue is disturbed again at the restoration stage, they are diagnosed as consolidating fractures of the ribs.
How long does it take to join the bones?
The longest recovery periods are for injuries with fractures. Only on days 5-6, blood vessels grow between bone fragments, and the space is filled with osteoblasts, fibroblasts.
Any violation of the integrity of the bone tissue is fixed with plaster bandages, 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.
On the restored site, you can see a thickening, it is called bone callus. For complete restoration of the ribs, it takes about 3 weeks if there were no biases. But the reconstruction of bone marrow in the future may take several years. In this case, osteoblasts continue to work, they dissolve the excess bone marrow and fragments.
Rib fracture complications
Complications of bone fusion can be caused by concomitant diseases. Slow recovery is typical for patients with diabetes, depleted or suffering from vitamin deficiency. Older people and pregnant women may 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 so long.
In addition to concomitant diseases, there may be other causes of poor fusion of the ribs.
If the patient has multiple fractures, a serious circulatory disturbance, or soft tissue infection, then the bone marrow forms more slowly and regeneration slows down. At this point, a consolidated rib fracture may occur. The cause may be improper osteosynthesis or excessive patient activity.
If, by the time everything is supposed to grow together, pain or swelling remains, there is a chance that a shift has occurred and recovery does not occur as it should.
What to do with rib injury?
If after a trauma or a fall, the patient cannot breathe without pain, it is possible that he has a fracture. Any violation of the integrity of the bone can be seen on x-rays.
Until the patient reaches the emergency room, cold should be applied to the area of the injury. You can drink anesthetic, a sore spot tightly fixed with a cloth or tight clothing and then make as few movements as possible. After providing medical care, you must 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, an X-ray will be taken and a scheme for further actions will be proposed.
Recovery time
The recovery period depends on how difficult the displacement was:
- A complete fracture refers to one or more fault lines.
- With subperiosteal - partial destruction of bone tissue occurs.
- The easiest option is a crack.
By the way, according to statistics, the edges of the left side are broken much less often than on the right.
But a consolidated fracture also affects the duration of recovery. What does it mean? As already mentioned, at the place of tissue fusion (consolidation), a repeated rupture of structures occurs, which is why they called consolidated.
Accurate diagnosis
Thanks to the X-ray, you can see all the damage to the ribs, but sometimes not everything is so simple. Consolidated fractures of the ribs on the left may not be visible with a copy in direct projection. To do this, take a side shot. And the point is not in the professionalism of the doctor, but in the fact that at a certain angle the pathology is not visible, and for this you need to take a few pictures. And with a lateral projection, the edges can overlap in the picture on top of each other, and then you need to take another picture to see the edge from a different angle and only then do an X-ray description.
A consolidated fracture of the posterior segment of the rib can 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 to identify such an injury, you need to do not only the front direct shot, but also in an oblique projection. It is also worth remembering that injuries of this type are better visualized for 2-3 days, you can immediately not notice them.
Post-injury treatment
The difference between the treatment of the primary fracture and the consolidated one is small.
When doctors diagnose such injuries, they fix the bones with gypsum, knitting needles, screws - it all depends on the complexity. But if the fusion does not occur correctly, and this was discovered before the formation of bone callus, then doctors have to break the bone, producing an artificial consolidated fracture of tissues that grow together. The further fixation procedure is the same as in the previous case.
Broken ribs almost never fix, even if a consolidated fracture of the rib occurs. Treatment depends on the complexity of the injury. So, with repeated fracture at the site of bone callus formation, reduction of bone fragments may be necessary. Fixation of the ribs is carried out 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 tissue has a normal blood supply.
Life from the moment of injury
If the patient was injured with a cracked rib, then rehabilitation is carried out on an outpatient basis. When the fractures are complex, then the patient is drawn up in a hospital in order 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 expectorant drugs, analgesics, physiotherapy and physiotherapy, which is aimed at improving lung ventilation.
If there are small hemorrhages in the pleura, they can resolve themselves. When hemothorax is very pronounced, it is necessary to perform a puncture of the pleural cavity. Sometimes this procedure has to be carried out several times.
Consolidated fracture of the ribs may occur as a result of repeated injury or accident. If the full recovery has not yet passed and the injury has been re-inflicted, there may be a complication with intense pneumothorax. In this case, under local anesthesia, the pleural cavity is drained. The tube is inserted into the incision, and the second end is lowered into the vessel with the liquid. The drainage is removed after a few days, when the air will no longer leave the cavity, and the lung will decompose.
Patient status
Even if damage to the internal organs has not occurred, the patient still feels pain when coughing and even breathing. If the crack is on the front of the ribs, then the pain is intense, with damage to the inside of the ribs it is less pronounced.
It is difficult to sleep during this period, patients try to take a pose that allows them to reduce movements to a minimum, they fix the chest with their hands and lean toward broken ribs.
Painful sensations do not allow a person to breathe normally, superficial breaths so that the chest moves minimally. The skin around the fracture swells, and if it is affected mechanically, bruises also appear. If multiple ribs are damaged, chest shape may change .
In the case of fractures with damage to internal organs during coughing, blood may 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.