Materiały źródłowe

• #1 Broken ribs – Diagnosis and treatment – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/broken-ribs/diagnosis-treatment/drc-20350769

  During the physical exam, a health care provider might press gently on the ribs, listen to your lungs and watch your rib cage move as you breathe. […] One or more of the following imaging tests might help with the diagnosis: […] X-ray. Using low levels of radiation, X-rays allow the bones to be seen. But X-rays might not show a fresh break, especially if the bone is only cracked. X-rays also can help diagnose a lung that has caved in. […] CT scan. This often can find breaks that X-rays might miss. CT scans also make it easier to see injuries to soft tissues and blood vessels. […] MRI. This scan can look for harm to the soft tissues and organs around the ribs. It also can help find smaller breaks. […] Bone scan. This is good for viewing cracked bones, also called stress fractures. A bone can crack after repetitive trauma, such as long bouts of coughing. During a bone scan, a small amount of radioactive material is injected into your bloodstream. It collects in the bones, particularly in places where a bone is healing, and is detected by a scanner.

• #2 Rib Fracture (Broken Rib): Symptoms, Healing Tips & Treatment

  https://my.clevelandclinic.org/health/diseases/17434-rib-fracture-broken-rib

  Rib fractures can be caused by everything from a cough to a major trauma. […] If you dont have any other internal injuries, youll probably be able to recover at home with over-the-counter medicine, icing and breathing exercises. […] A rib fracture is the medical term for a broken rib. Rib fractures are usually caused by car accidents, sports injuries or other traumas. […] Its rare to need surgery to repair a rib fracture, unless the injury that broke your rib damaged your internal organs. […] Most people need at least a month to recover from a rib fracture. […] See a healthcare provider or go to the emergency room if youre experiencing symptoms like pain and tenderness around your ribs and chest, or if you have trouble breathing. […] A healthcare provider will diagnose a rib fracture with a physical exam. They might also use imaging tests to check for damage to your organs.

• #2 Broken, Fractured, & Cracked Ribs: Symptoms, Treatment, & Recovery

  https://www.webmd.com/a-to-z-guides/do-i-have-a-broken-rib

  Sharp chest pain happens with a broken rib. But its different from a heart attack: […] Your doctor will give you an exam. Theyll ask you what happened and will touch the painful area. Theyll want to listen to your lungs when you breathe and watch your rib cage as your chest goes up and down. […] If your doctor suspects a rib fracture, they will want to get images of your chest. If the broken rib is caused by blunt trauma or a serious accident, they will want to make sure theres is no other serious damage to internal organs. […] Your doctor might order one or more of these: X-ray. These catch 75% of all broken ribs. They can also show other problems, like a collapsed lung. […] CT scan. This type of image shows fractures that dont appear on X-rays. Your doctor will want you to get one if they think the X-ray missed something. It can also show damage to soft tissue and organs, like your lungs, liver, spleen or kidneys. […] MRI. Like a CT scan, these images can show fractures that X-rays miss. They can pinpoint damage to soft tissue and organs. […] Bone scan. If you have a stress fracture to a rib, or a history of prostate cancer, this may do a better job of showing where the damage is.

• #2 Rib Fracture (Broken Rib): Symptoms, Healing Tips & Treatment

  https://my.clevelandclinic.org/health/diseases/17434-rib-fracture-broken-rib

  After a physical exam, you might need at least one of a few imaging tests: X-rays, Magnetic Resonance Imaging (MRI), CT scan. […] Most rib fractures can be treated with rest, icing and over-the-counter (OTC) NSAIDs like aspirin or ibuprofen. […] Its rare to need surgery for a fractured rib. […] Your surgeon will realign (set) your bones to their correct position and then secure them in place so they can heal and grow back together. […] Rib fractures are usually caused by falls or other accidents, so theres not much you can to prevent them. […] If you have a rib fracture, you should expect to make a full recovery. […] Most people need at least a month to recover from a rib fracture. […] If you think you have a rib fracture or any other broken bone you need to see a healthcare provider as soon as possible. […] The most important thing is getting your ribs examined by a healthcare provider as soon as you notice any pain in your chest or have trouble breathing.

• #3 Broken or bruised ribs

  https://www.nhs.uk/conditions/broken-or-bruised-ribs/

  Bruised or broken ribs can be very painful, but usually heal by themselves. […] Broken or bruised ribs are usually caused by a fall, a blow to the chest or severe coughing. […] Symptoms include: strong pain in your chest area, particularly when you breathe in or cough; swelling or tenderness around the affected ribs; sometimes bruising on the skin; feeling or hearing a crack if it’s a broken rib. […] Ribs cannot be easily splinted or supported like other bones, so they’re usually left to heal naturally. […] There’s often no need for an X-ray. […] Broken or bruised ribs usually get better by themselves within 2 to 6 weeks. […] You might need stronger painkillers or have a chest infection that needs antibiotics. […] It could mean a broken rib has damaged something else, like your lung, liver or spleen.

• #4 Cracked Rib: Symptoms, Diagnosis, Treatment, and More

  https://www.verywellhealth.com/broken-ribs-symptoms-1298895

  A fractured rib is diagnosed with a physical exam and imaging tests. During the physical exam, a healthcare provider will listen to your lung sounds, press gently on the ribs, and watch as your rib cage moves. […] The imaging test options include: X-ray: This is the initial imaging used to detect a fractured rib or its complications, such as a pneumothorax. […] Computed tomography (CT): This imaging test composites multiple X-rays and can detect smaller cracks that an X-ray can sometimes miss. […] Magnetic resonance imaging (MRI): This imaging test is especially good at imaging soft tissues and can often detect smaller breaks or cartilage disruption. […] Bone scan: This imaging test uses a radioactive tracer to better visualize the structure of bones and is good at finding smaller stress fractures. […] Since the only way to tell if a rib is broken is with an X-ray, it’s important to go to the emergency department if you suspect you’ve sustained a rib injury.

• #5 Rib Injury | Rib Injury Clinic

  https://www.ribinjuryclinic.com/conditions/rib-injury/

  The diagnosis of a rib injury is what doctors call a clinical one; that is taking a precise history of the injury coupled with a careful physical examination with a doctor familiar with chest wall injuries is usually all that is required, particularly if its a minor rib injury. […] Radiological assessment (chest x-ray) may be helpful to assess the severity of the rib injury and identify other associated problems such as fluid in the chest or a collapsed lung. […] The most sensitive radiological investigation particularly if more than one or two rib injuries is suspected, is a Chest CT scan. […] Following the Chest X-ray of the middle aged-man with pain and breathing issues he underwent a Chest CT scan and 3D reconstruction of his chest wall. This demonstrated 4 broken ribs from his fall.

• #6 Rib Fractures – Injuries and Poisoning – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/injuries-and-poisoning/chest-injuries/rib-fractures

  A rib fracture is a crack or break in the bones enclosing the chest. […] A chest x-ray is usually taken. […] Doctors suspect rib fracture when one or more ribs are very tender in one particular spot. […] Doctors do not always need to confirm rib fractures with an x-ray because the presence of rib fractures does not change the way a chest injury is treated. […] Nonetheless, doctors usually do a chest x-ray to detect serious problems that can accompany rib fractures, such as a bruised or collapsed lung. […] Sometimes computed tomographic (CT) scans are done. Not all rib fractures can be seen on a chest x-ray. […] Diagnosis of rib fractures by x-rays is unnecessary.

• #7 Rib Fracture Workup: Imaging Studies

  https://emedicine.medscape.com/article/825981-workup

  Anteroposterior (AP) and lateral chest films are used routinely to assist in the diagnosis of rib fractures, yet sensitivity as low as 50% has been reported. Delayed or follow-up radiographs can be very helpful. […] Chest radiographs are much more useful in the diagnosis of underlying injuries, including hemothorax, pneumothorax, lung contusion, atelectasis, pneumonia, and vascular injuries. […] Diagnostic sensitivity is higher in rib radiographs than in chest radiographs; however, with a high clinical suspicion, treat for fracture regardless of the radiographic result. […] In a study of rib fractures in stable adult outpatients presenting with chest pain, a retrospective analysis of chest radiography and a dedicated rib series of 339 patients found that 53 (15.6%) had at least one rib fracture.

• #8 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Multiple rib fractures (≥3) or fractures in the upper or lower rib cage are associated with internal injuries such as liver or spleen lacerations, mediastinal injury, pneumothorax, hemothorax, flail chest, and pulmonary contusions. […] Chest radiographs (all patients) — In patients with suspected rib fractures or chest wall trauma, chest radiographs (CXRs) are obtained primarily to rule out associated injuries (eg, pneumothorax, hemothorax) with a secondary goal of confirming the presence of rib fractures. […] In most cases when CXR is not sufficient for the identification of traumatic rib fractures, chest computed tomography (CT) should be performed next. […] Chest CT is highly accurate for showing the location and number of rib fractures but should not be performed for the sole purpose of assessing potential isolated rib fractures.

• #9 Broken or Bruised Ribs: Symptoms, Diagnosis, Treatment

  https://patient.info/bones-joints-muscles/rib-injuries

  Broken or bruised ribs occur when there is a force to the chest such as from a fall, road accident or assault. […] A bruised rib usually heals itself in 2-3 weeks; pain killers may help with the symptoms. […] Complications can occur if internal organs are damaged by the sharp end of a broken rib. […] How are broken or bruised ribs diagnosed? […] Usually, a broken or bruised rib diagnosis is made from the details given to a doctor (history) plus an examination. […] The diagnosis usually based on this. […] A chest X-ray is not required unless there are suspected complications (detailed below). […] If a broken rib is suspected, the main purpose of a chest X-ray is to look for complications rather than to diagnose the fracture itself. […] Complications can occur if internal organs are damaged by the sharp end of a broken rib.

• #10 Rib Fracture Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/395172-overview

  Thoracic trauma may present as an isolated rib fracture, a chest contusion, or a laceration; however, significant thoracic trauma often involves multiple organ systems and several anatomic regions. […] Rib fractures are among the most common of these injuries, with an occurrence as high as 60%. […] Radiographs can depict bony trauma, and rib fractures are among the most commonly identified injuries to the chest. […] The American College of Radiology has published the following guidelines regarding rib fracture imaging: A radiograph of the chest is usually appropriate for the initial imaging of suspected rib fractures from minor blunt trauma (injury confined to ribs). […] Chest CT is considered the gold standard of detecting rib fractures, but the fractures may not be clinically significant.

• #11 Rib Fracture Workup: Imaging Studies

  https://emedicine.medscape.com/article/825981-workup

  Chest CT scan is more sensitive than plain radiographs for detecting rib fractures. […] If complications from rib fractures are suspected clinically or diagnosed by plain radiographs, a chest CT scan may be helpful to document specific injuries, to characterize extent of injury, and to plan for definitive management. […] A reduced-dose chest CT scan may detect rib fractures in infants with high suspicion for nonaccidental trauma. […] Because first and second rib fractures are often associated with vascular injury, ED physicians should consider angiography for such patients, especially if symptoms and signs of neurovascular compromise are present. […] A bone scan of the chest wall is the preferred instrument to diagnose rib stress fractures early in the pathologic process. […] Although MRI is not used as a primary means of detecting rib fractures, displaced or angulated lateral rib fractures as well as posterior rib fractures can be detected by MRI. […] Laboratory studies are generally not useful for evaluation of isolated rib fractures.

• #12 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Rib radiographs (sometimes referred to as a „rib series”) have limited utility and should only be obtained if there is high clinical suspicion for pathologic or multiple rib fractures not apparent on CXR, detection of additional fractures would alter management, and CT is not available. […] Emergency physician-performed bedside ultrasound is both sensitive and specific for identifying rib fractures. […] In patients with concern for stress fracture in whom definitive diagnosis will change management, magnetic resonance imaging (MRI) has become the modality of choice. […] Bone scintigraphy (ie, bone scan) of the chest wall has traditionally been the preferred instrument to diagnose rib stress fractures early in the pathologic process due to its high sensitivity and ease of interpretation.

• #13 The benefits and limitations of ultrasound in the diagnosis of rib fractures from the emergency department to the sports field: A narrative review | British Columbia Medical Journal

  https://bcmj.org/articles/benefits-and-limitations-ultrasound-diagnosis-rib-fractures-emergency-department-sports

  Ultrasound promises to be a rapid, radiation-free alternative to chest X-ray for the diagnosis of rib fractures in blunt chest trauma, and this promise has been raised repeatedly over the last decade. […] The mainstay of rib fracture diagnosis has been the chest radiograph. […] However, there has been growing evidence over the past 2 decades that ultrasound is superior to X-ray in the detection of chest wall fractures, including fractured ribs. […] While the weight of evidence has been in favor of ultrasound as the more sensitive technique in several previous reviews, none has concluded that ultrasound should replace, or join, conventional chest X-ray as a first-line diagnostic study for rib fractures following minor chest trauma. […] The results of the literature search support the view that ultrasound is a more sensitive and accurate modality for the diagnosis of rib fractures with 12 of the 13 included studies concluding ultrasound was superior to chest X-ray.

• #14 Diagnosis of Rib Fracture and Related Complications in Patients with Blunt Chest Wall Trauma Using Point-of-Care Ultrasound vs. Computed Tomography Scan

  https://brieflands.com/articles/semj-138379

  One of the most common reasons for the referrals of patients to the trauma center is blunt chest injury. […] To determine and compare the diagnostic value of point-of-care ultrasound (POCUS) and computed tomography (CT) scans in detecting rib fractures and their complications in patients with blunt chest wall trauma. […] A total of 113 patients with a mean standard deviation (SD) age of 44.07 20.07 years were enrolled, of whom 75 (66.3%) and 62 (54.9%) patients had at least one broken rib based on CT scan and sonography, respectively. […] The overall sensitivity of ultrasound was calculated to be 81.58%, and with an increasing number of broken ribs, the sensitivity of ultrasound also increased (73.08% for identifying patients with one damaged rib versus 100% for detecting patients with five or more broken ribs).

• #15 Rib Fracture Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/395172-overview

  The location of specific rib fractures is an important indicator of related injury. […] A rib score may be used to predict adverse pulmonary outcomes. […] Fractures of the first rib are rare. […] The significance of a first rib fracture is the association with cervical spine trauma, multiple rib fractures, or life-threatening vascular injuries. […] Fractures of the fifth to ninth ribs can be single or multiple. […] An inward displacement of the rib fracture fragments at the time of the injury may lacerate the lung parenchyma and produce a pneumothorax, with a possible hemothorax. […] The incidence of a pneumothorax is not as high with one rib fracture, but the risk increases as the number of broken ribs increases. […] The incidence of hemopneumothoraces in patients with rib fractures is 30%.

• #16 Rib fractures – Symptoms, diagnosis and treatment | BMJ Best Practice

  https://bestpractice.bmj.com/topics/en-gb/3000236

  Rib fractures may be due to blunt force injury, falls, non-accidental injury, CPR, or more rarely, sporting activities, or metastatic lesions and primary bone tumours. […] Assessment includes identification of the fracture itself and any concurrent injuries. These include pneumothorax, haemopneumothorax, pulmonary contusions, and a flail chest, as well as possible non-thoracic injuries. […] Chest radiography or computed tomography are the first-line imaging modalities in patients presenting with blunt chest trauma. […] A rib fracture is a break in one of the rib bones of the thoracic skeleton. Rib fractures are common injuries that most frequently are due to blunt force trauma (including falls and non-accidental injury), but can also occur as a result of aggressive cardiopulmonary resuscitation, athletic activities, or primary bone tumours and metastatic lesions (’pathological fractures’).

• #17 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures/print

  In patients with concern for stress fracture in whom definitive diagnosis will change management, magnetic resonance imaging (MRI) has become the modality of choice. […] A skeletal survey should be obtained in infants with rib fractures, especially multiple fractures in various stages of healing, since this raises suspicion for abuse.

• #18 Flail Chest: Causes, Symptoms, Diagnosis & Treatment

  https://my.clevelandclinic.org/health/diseases/23994-flail-chest

  Flail chest is a medical emergency that happens as a result of a trauma. Due to 3 or more ribs broken in 2 or more places, your chest wall becomes unstable. Youre in pain and cant breathe deeply. […] Flail chest is a traumatic disorder that happens when three or more ribs located next to each other are fractured in two or more places. This causes your chest wall to become unstable, interfering with breathing. […] Your healthcare provider will diagnose flail chest mainly by observing your breathing. The breaks in your ribs show up when you breathe in and out. The line of your chest will pop out more during exhaling and go in farther during inhaling if you have flail chest. […] Your healthcare provider may order chest X-rays. These will show bone breaks but not changes in cartilage. Chest X-rays are also likely to show bruises to your lung.

• #19 Rib Fractures: Diagnosis and Management in the Emergency Department

  https://www.ebmedicine.net/topics/trauma/rib-fracture

  Rib fractures that result from blunt thoracic trauma are painful injuries that can signal life-threatening cardiopulmonary injury, and quick recognition of the risk factors and optimal diagnostic imaging and treatment are essential to avoid significant morbidity and mortality. […] This issue reviews the most recent evidence on diagnosis and management of rib fractures, including the following: […] Using the NEXUS Chest Decision Instrument to determine the need for radiography, and using the NEXUS Chest CT Decision Instrument to determine the need for CT imaging. […] When chest radiography alone is sufficient, when CT is indicated, and when ultrasound can be useful. […] Recent evidence and guidelines on early operative fixation of acute rib fractures that point toward improved outcomes.

• #20 Rib Fractures: Diagnosis and Management in the Emergency Department

  https://www.ebmedicine.net/topics/trauma/rib-fracture

  Using the Battle score, Forced Vital Capacity pathway, or the RibScore Criteria tools to determine whether ICU admission is necessary. […] Given the risk for morbidity and mortality, the emergency clinician must be swift and thorough in diagnosing and managing these injuries. […] Society guidelines have been published to assist in determining best-practice approaches to pain control, imaging, and treatment. […] This issue reviews the recent studies and evidence for multimodal pain control, decision tools for diagnostic imaging, ventilatory support, and operative fixation.

• #21 Treatment of traumatic rib fractures: an overview of current evidence and future perspectives – Franssen – Journal of Thoracic Disease

  https://jtd.amegroups.org/article/view/88701/html

  Operative management of rib fractures has gained significant popularity over the last years, however, it remains a controversial topic, due to the substantial heterogeneity among rib fracture patients with considerable differences in epidemiology. […] Nowadays, computed tomography (CT) has been shown to be most practical and sensitive for detecting rib fractures, of which up to 50% is missed on other imaging modalities. […] The importance to detect rib fractures is underlined by the fact that the pulmonary morbidity and mortality directly increases with each additional rib fracture, approaching a mortality of 40% if more than six ribs are fractured. […] In the absence of a flail chest or chest wall deformity (including e.g., severely displaced ribs), non-operative management remains the standard treatment of thoracic injuries at most institutions.

• #22 Rib Fracture Diagnosis & Treatment: A Comprehensive Guide

  https://cpraedcourse.com/blog/a-complete-guide-to-cracked-ribs-diagnosis-and-treatment/

  A cracked rib is extremely painful and debilitating. It is a very common injury that can happen due to accidents, injuries and impacts. These fractures can significantly affect your way of life and make simple life tasks like breathing, coughing or sneezing unbearably painful. […] Hence it is important to be able to precisely diagnose and effectively treat broken ribs, before things get complicated. In this guide, we will explore in-depth cracked rib fractures, its treatment and diagnosis. […] To diagnose rib fractures, one needs a combined knowledge of clinical studies, imaging assessment and specialized tests. To prevent potential complications, prompt and accurate diagnosis is a must. Here’s how healthcare professionals usually diagnose and treat rib fractures: […] Clinical Assessment: Patient History: Inquire about the mechanism of injury, any associated symptoms, and medical history. Physical Examination: Palpate the chest wall for tenderness, deformities, crepitus, and localized swelling. Assess respiratory effort and auscultate for abnormal breath sounds. […] Imaging Studies: X-rays: Conventional chest X-rays are often the initial imaging modality used to evaluate rib fractures. They can detect most fractures and assess for associated complications like pneumothorax or hemothorax. CT Scans: Computed tomography (CT) scans provide detailed images and are more sensitive than X-rays in detecting rib fractures, especially non-displaced or hairline fractures. CT scans are particularly useful for assessing multiple or complex fractures. […] Specialized Tests: Ultrasound: Ultrasonography can be employed for point-of-care assessment, especially in situations where other imaging modalities are unavailable or contraindicated. It is particularly useful for detecting underlying pneumothorax. MRI: Magnetic resonance imaging (MRI) may be utilized in certain cases, especially when assessing for soft tissue injuries or suspected complications such as nerve or vascular involvement. […] Differential Diagnosis: It’s important to consider other conditions that may mimic rib fractures, such as musculoskeletal injuries (e.g., costochondritis, muscle strain), pleuritic pain, or referred pain from other organs (e.g., abdominal conditions). […] Consultation: Depending on the complexity of the case or associated injuries, consultation with specialists such as orthopedic surgeons, pulmonologists, or radiologists may be warranted to ensure comprehensive management.

• #23 Bruised vs. Broken Ribs: What’s the Difference?

  https://www.verywellhealth.com/bruised-broken-or-fractured-ribs-4582241

  Broken and bruised ribs are different injuries. […] Without a proper diagnosis, it can sometimes be difficult to tell one from the other. […] Rib injuries can often be diagnosed based on your symptoms and a physical exam. […] Different forms of medical imaging can be used to confirm the diagnosis, including: X-ray: The first-line option for diagnosis of bruised or fractured ribs. […] The treatment involves time, rest, and pain management.

• #24 Rib Fracture Imaging and Diagnosis: Practice Essentials, Radiography, Computed Tomography

  https://emedicine.medscape.com/article/395172-overview

  Rib fractures are associated with pulmonary contusions in 20-40% of cases. […] The number of rib fractures correlates with mortality in adult trauma patients, rising sharply in patients with more than 6 fractured ribs. […] The patient’s medical history and physical examination findings should suggest the diagnosis of a rib fracture. […] The standard chest radiograph is useful in the recognition of preexistent or coexistent disease. […] If the identification of occult rib fractures is clinically important, as in a case of suspected child abuse or for medicolegal reasons, radionuclear bone scanning with technetium-99m methylene diphosphonate (99mTc MDP) is often successful. […] Rib fractures may be seen by using bone window settings on a chest CT scan; however, an occult rib fracture is not an indication for thoracic CT scanning. […] Chest CT is considered the gold standard of detecting rib fractures, but the fractures may not be clinically significant.

• #25 Broken ribs – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/broken-ribs/symptoms-causes/syc-20350763

  A broken rib occurs when one of the bones in the rib cage breaks or cracks. […] A broken rib is a common injury that occurs when one of the bones in the rib cage breaks or cracks. […] Many broken ribs are simply cracked. […] Usually, broken ribs heal on their own in about six weeks. […] See a health care provider if part of your rib area is tender after an accident or if you have trouble breathing or pain with deep breathing. […] Direct impact such as from a car accident, a fall, child abuse or contact sports is the most common cause of broken ribs. […] A broken rib can harm blood vessels and internal organs. […] Complications depend on which ribs break. […] Possible complications include: […] A sharp end from a break in one of the first three ribs at the top of the rib cage could pierce a major blood vessel, including the aorta. […] The jagged end of a broken middle rib can punch a hole in a lung and cause it to cave in. […] The bottom two ribs rarely break because they can move more than the upper and middle ribs. […] But the ends of a broken lower rib can cause serious harm to the spleen, liver or a kidney.

• #26 Diagnosis and management of a trapped lung or diaphragm by fractured ribs: analysis of patients undergoing rib fracture repair | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-019-0581-x

  There are few reports regarding a lung or diaphragm trapped by a fractured rib. This study aimed to describe the clinical presentations, diagnosis, and management of these intrathoracic pathologies. […] A total of 38 consecutive patients who underwent SSRF were analyzed. Three patients had a trapped lung and one had a trapped diaphragm. […] A definitive diagnosis was made during thoracoscopic exploration. […] As per our analysis, the incidence of a trapped lung or diaphragm was 10.5%. If a patient presents with persistent intractable dynamic pain, thoracoscopic exploration with concurrent SSRF may be a feasible and effective treatment option. […] The aim of the study was to describe cases with a trapped lung or diaphragm, including the mechanism of trauma, diagnosis, surgical approaches and outcomes, development of the condition over time, and presentation.

• #27 Diagnosis and management of a trapped lung or diaphragm by fractured ribs: analysis of patients undergoing rib fracture repair | BMC Surgery | Full Text

  https://bmcsurg.biomedcentral.com/articles/10.1186/s12893-019-0581-x

  The median duration between injury and surgery was 25 days. The patients with trapped lungs underwent repair and resection. The patient with a trapped diaphragm underwent thoracoscopic release. […] A surgical diagnosis was mandatory for such intrathoracic pathologies. Repair and resection for a trapped lung and surgical release for a trapped diaphragm are both feasible and safe. Concurrent ORIF for rib fractures can stabilize the chest wall; it may also help to achieve bone union and facilitate the process of recovery.

• #28 Initial evaluation and management of rib fractures – UpToDate

  https://www.uptodate.com/contents/initial-evaluation-and-management-of-rib-fractures

  Initial evaluation and management of rib fractures […] Rib fractures are common injuries that occur most often following blunt thoracic trauma but can also result from severe coughing, athletic activities (eg, rowing, swinging golf clubs, throwing, which can cause rib stress fractures), and nonaccidental trauma (ie, child abuse). […] This topic will review the initial evaluation and management of isolated rib fractures (including stress fractures) not involving intrathoracic injury. […] A clinical diagnosis of isolated rib fractures can be made in a patient with rib point tenderness, particularly with a history of trauma. A definitive diagnosis of rib fractures can be made with advanced imaging (ie, computed tomography [CT] scan), but advanced imaging is often not necessary for isolated (one or two ribs) fractures once associated injury has been adequately excluded, typically with a chest radiograph (CXR).

• #29 Rib fracture detection system based on deep learning | Scientific Reports

  https://www.nature.com/articles/s41598-021-03002-7

  Rib fracture detection is time-consuming and demanding work for radiologists. This study aimed to introduce a novel rib fracture detection system based on deep learning which can help radiologists to diagnose rib fractures in chest computer tomography (CT) images conveniently and accurately. […] The constructed Rib Fracture Detection System has a comparable performance with the experienced radiologist and is readily available to automatically detect rib fracture in the clinical setting with high efficacy, which could reduce diagnosis time and radiologists workload in the clinical practice. […] Therefore, it is essential to accurately diagnose the location and the number of rib fractures in the clinical setting. […] Despite the best human effort, a misdiagnosis rate between 19.2 to 26.8% was reported with chest CT for rib fractures, some of which may potentially lead to serious consequences.

• #30 Rib fracture detection system based on deep learning | Scientific Reports

  https://www.nature.com/articles/s41598-021-03002-7

  Therefore, it is essential to develop an assistant machine learning detection system for rib fractures to minimize misdiagnosis. […] This study constructed a deep-learning Rib Fracture Detection System and its performance was assessed in comparison to radiologists. It was concluded that this deep-learning model had the ability to detect rib fractures with high precision and recall (precision: 0.869, recall: 0.913), which had a comparable diagnostic precision with both the junior and the experienced radiologists and was superior in term of recall ability. […] This Rib Fracture Detection System detected 458 suspected fractures and 398 true fractured ribs from these cases. […] This emphasized the possibility of model triage, as a total of 80.9% of images were predicted as negative with 96.9% true-negatives, this left the other 19.1% images as high-risk images with a potential rib fracture. […] This Rib Fracture Detection System is readily available in the clinical setting.

• #31 Rib Fracture Diagnosis & Treatment: A Comprehensive Guide

  https://cpraedcourse.com/blog/a-complete-guide-to-cracked-ribs-diagnosis-and-treatment/

  Administering the appropriate first aid for rib fracture can help a great deal with the pain along with preventing complications and supporting the healing process. Rib fractures demand proper therapy and intervention, but immediate first aid can provide comfort and stability till medical help arrives. […] After initial first aid, encourage the individual to follow up with a healthcare provider for further evaluation and management of the rib fracture. Emphasize the importance of adhering to any prescribed treatment plan and instructions for optimal recovery. […] The successful treatment for a cracked rib requires a multidisciplinary approach. It involves collaboration between healthcare professionals, effective communication and patients. It is also exceptionally important to adhere to evidence based practices. The empowerment of individuals and the awareness of first aid for cracked ribs can facilitate timely intervention and management of common yet challenging injury.

• #32 Rib Fracture (Broken Rib) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/rib-fracture

  A hallmark of a rib fracture is that a deep breath makes the pain worse. […] Any rib injury should be evaluated by a physician. […] Your rib fracture may be complicated by other injuries. […] If you have broken or cracked three or more adjacent ribs in two places, you may experience a condition called flail chest. […] It is important to see a doctor immediately, seeking emergency care if your rib fracture is accompanied by: […] A doctor can assess the severity of your rib fracture by performing a physical examination and by looking at a chest X-ray. […] The doctor will determine if the fracture is serious enough for hospitalization and if there are additional injuries, says Dr. Maung. […] Most people with rib fractures are sent home with advice on taking care of themselves. […] Surgery for rib fractures may be recommended only for the most complex cases, including when the injury has made breathing so difficult that a respirator is necessary. […] Yale New Haven Hospitals Level 1 Trauma Center has trauma surgeons available 24-7 to provide immediate care for patients with rib fractures.

• #33 Diagnosis of Rib Fracture and Related Complications in Patients with Blunt Chest Wall Trauma Using Point-of-Care Ultrasound vs. Computed Tomography Scan

  https://brieflands.com/articles/semj-138379

  Ultrasound offers high sensitivity, specificity, and diagnostic power in diagnosing fractures and their complications, but considering the setting of our study, care should be taken when generalizing the findings of this study. […] The present study aimed to determine and compare the diagnostic value of POCUS and CT scans in discovering rib fractures and related complications in patients with blunt chest wall trauma. […] Compared with the CT scan, POCUS delivered a specificity of beyond 97% and an accuracy of 84% in identifying all types of fractures and complications of fractures. […] Moreover, the results showed that the greater the number of broken ribs, the greater the sensitivity of POCUS in correctly detecting fractured ribs. […] The results of this study showed that POCUS, conducted using a portable US machine and by emergency physicians in the ED, could precisely recognize rib fractures, hemothorax, and subperiosteal hematomas in patients with blunt chest wall traumas.

• #34 Rib Fracture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541020/

  When enough force is placed on the rib, the rib will fracture. […] Most isolated rib fractures can be managed expectantly. However, certain patterns of rib fractures are associated with higher morbidity and mortality and will need further evaluation for other underlying injuries and emergent treatment. […] Rib fractures occur when a significant enough force directed at the rib causes a break. […] Most rib fractures are due to direct penetrating or blunt trauma to the chest. […] Rib fractures can be diagnosed clinically based upon history and physical exam without imaging. […] If there is suspicion for multiple rib fractures or significant trauma with underlying organ damage, imaging can be the next step. […] For simple, isolated rib fractures, conservative therapy is usually adequate which includes appropriate analgesia, rest, and ice.

• #35 Rib Fracture – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK541020/

  When conservative management fails or for more severe rib fractures, surgical stabilization can be an option. […] The most severe complications related to rib fractures are the flail chest and damage to the underlying structures. […] Given that rib fractures in the elderly are associated with higher mortality and morbidity, particular attention and resources need to be directed towards fall prevention to reduce the incidence of rib fractures. […] Early identification of potential patient decompensation should receive attention as a team, and possible interventions such as intubation, chest tubes, thoracotomies should be a team discussion to achieve optimal patient care and clinical results.

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