Injury to Bones and Joints: Fractures and Dislocations - Injury to the rib cage

Accidents, athletic injuries, and fights account for most injuries to the rib cage. Any blow to the chest can cause rib fractures, which hurt when one coughs or inhales. Hairline and incomplete fractures are less serious than complete fractures, where the fragments are usually sharp and pointed. Such fractured ribs can tear the lungs, causing air to leak into the pleural space, with possibly serious results. The lung can collapse as a result of being punctured. Punctured blood vessels can hemorrhage into the pleural space. The accumulated blood may have to be withdrawn before it reduces the capacity of the lungs to carry out their normal function.

Severe chest injuries—crush injuries with multiple fractures—require hospitalization. The patient must be confined to bed and kept under constant medical observation and treatment. If the lung has collapsed, it has to be reinflated. In simple rib fractures the chest may be strapped to immobilize the fragments and promote rapid healing. Generally, analgesics alone are enough to relieve pain.

Fractures of the sternum are caused by direct blows to the sternal area, as is usually the case with automobile accidents when the steering wheel hits the driver's chest. This injury can be avoided if the driver wears a shoulder-restraining belt, and if his car is equipped with a collapsible steering column.

Chest pains following a blow to the area of the sternum should be medically investigated by means of X-ray diagnosis for possible fracture. The fracture fragments may have to be wired together and remain in place until the injury has healed. For simple fractures, rest may be the only treatment required. The serious complication of a fractured sternum in a steering-wheel accident is contusion of the heart; it should be evaluated by means of an electrocardiogram.

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