Bruise and fracture of the chest
The most common and serious chest injuries are often severe bruises and fractures. In many older people, such injuries are much more common, as it is due to age-related decrease in the elasticity of the main bone structures of the human chest. Even minor mechanical stress 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 duration of treatment is practically the same. An experienced specialist will refer the patient for an x-ray 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 rib fracture is the patient's discomfort in the form of clicking, in other words, crepitus of serious fragments with small body movements, coughing or sneezing. However, x-rays are always indicated for chest pain.
- Chest fracture
- Symptoms of a bruised and fractured chest
Such common damage as rib fractures reaches about 16% of the total number of fractures. Uncomplicated fractures, usually of one or two ribs, absolutely do not pose a great threat to the very life and health of any person, since they quickly and easily grow together. It should be noted that respiratory failure and severe damage to many internal organs of a person are the main danger in this injury.
Often, a fracture of the chest is accompanied by severe damage to the lungs, pleura and organs of the cardiovascular system. Multiple fractures are considered serious trauma, they cause the development of pleuropulmonary shock, due to the sharply increasing risks of complications. The main cause of rib fracture is usually a direct blow to the center of the chest area, falling or squeezing 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 mixing is 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 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 be directly involved in breathing.
In some cases, a rib fracture, complicated by damage to one or two lungs, may be accompanied by a slight penetration of air into the important subcutaneous tissue, which is called subcutaneous emphysema. If the intercostal vessels are damaged, then there is profuse bleeding not only into all soft tissues, but also into the pleural cavity.
Symptoms of a bruised and fractured chest
Often, all patients complain of severe or sharp chest pain. In this case, the pain always intensifies with movements, 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 affected side. On palpation of a particular broken rib, there is a certain area of sharp pain.
In some cases, the doctor may detect a kind of crunch of several bone fragments, which is called bone crepitus. As a rule, with significant damage to the posterior parts of human ribs, the inevitable impairment of pulmonary ventilation is always less pronounced. It is known that with multiple fractures, the patient's condition often worsens, with not only shallow breathing and a rapid pulse, but also cyanotic or pale skin. Any movement causes severe pain.
In the area of injury, significant bruising and obvious swelling of soft tissues are visible. Then, in the near future, after a direct trauma of the chest, complications such as dangerous pneumothorax and hemothorax develop, and after a few days the appearance of post-traumatic pneumonia is possible. In old age and old 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 in breathing, the temperature rises and intoxication is observed. In this case, self-medication is categorically 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 rib fractures, but only in a hospital setting. timely treatment completely eliminates the danger to life. Modern fluoroscopy and ultrasound of the pleural cavity will exclude pneumo- and hemothorax. if necessary, a pleural puncture can be prescribed.
Article author: Mochalov Pavel Alexandrovich | d. m. n. therapist
Education: Moscow Medical Institute. IM Sechenov, specialty - "General Medicine" in 1991, in 1993 "Occupational Diseases", in 1996 "Therapy".