Fractured ribs - conservative treatment?

Re: Fractured ribs - conservative treatment?

Martin Atkinson — Tue, 11 Sep 2012 10:29:56 GMT

[quote user="KathW"]We took one of my daughters friends snowboarding for her 1st time and she fell over many times. Was very stiff and sore all holiday - daughter even paid for a massage for friend as imptompu Christmas present. Once home and still sore she discovered that she'd cracked her ribs and we just thought shes was being a bit wimpy and unfit. [/quote] All part of the fun, I don't feel I've done a skiing/snowboarding holiday justice unless I come back with at least one injury but I failed on my last trip on SPVS Snowscene in March when nearly everyone else hurt themselves - torn ligaments and fractured ribs abounded. I started in a little group of 4: a snowboarder broke his leg on the first day, the other 2 skiers hit each other in a high sped collision which ended in a garage sale of ski equipment on the slope, one was concussed and lost his memory which was a bit of a problem as it was Mike Guillard who was lecturing on orthopaedics and was a source of endless banter of course, and the other severely grazed his face so I was last man standing. I was actually better at the end of the week because my usual dodgy knee was swollen but less painful - Mike suggested it was all the extra effusion cushioning it (he'd recovered his senses by then)! Back to OP - glad to hear the (canine) patient is improving.

Re: Fractured ribs - conservative treatment?

KathW — Mon, 10 Sep 2012 22:36:55 GMT

Saw the dog again tonight. Doing v well with pain relief and rest Problem is getting it to rest! Now the bruising has settled and the sub cut emphysema has almost resolved. Chest wall moving normally ( it was looking like a flail chest on 1st presentation) .

Have advised continued rest + pain relief. Didnt get time to copy the x rays today sorry - another manic Monday. I'll re check them for any other injuries though!

Many thanks for all the advice and personal histories.

We took one of my daughters friends snowboarding for her 1st time and she fell over many times. Was very stiff and sore all holiday - daughter even paid for a massage for friend as imptompu Christmas present. Once home and still sore she discovered that she'd cracked her ribs and we just thought shes was being a bit wimpy and unfit.

Re: Fractured ribs - conservative treatment?

Martin Atkinson — Mon, 10 Sep 2012 09:22:57 GMT

I fractured mine skiing and I had a cold at the time so add cough to sneeze - ouch, also I wasn't going to waste a lift pass so carried on, every bump on the piste and every subsequent fall added to the pain. I've also crashed on my bike, broken ribs and taken all the skin off at the same time but I tell you what - none of these was as painful as the bout of shingles I had in April. Sleeping comfortably is the biggest issue I find.

Injury boasting apart a cautionary tail: I had a dog with a similar injury from a dog bite a few months ago and in addition to the fractured ribs there was a spinal fracture which I missed on the X-ray, the dog subsequently developed some neurological symptoms which at the last count were being treated by cage rest but by this time the case had been taken to the RSPCA as the client had no money and they picked up the spinal fracture - much egg on face!

Re: Fractured ribs - conservative treatment?

Malcolm Ness — Mon, 10 Sep 2012 08:25:14 GMT

[quote user="KathW"]QUestion is should I stabilise the 2 ribs or not[/quote]

Rib fractures very, very rarely benefit from surgical interference. The exception is a bad flail chest. Rest and good pain control.

Re: Fractured ribs - conservative treatment?

Alan Tevendale — Mon, 10 Sep 2012 07:00:23 GMT

I've done my own ribs twice now and both times the only treatment was pain relief. Sneezing hurts.....it really hurts.

Re: Fractured ribs - conservative treatment?

Michael Woodhouse — Sun, 09 Sep 2012 21:18:59 GMT

[quote user="james herriot lied"]Was this not just the signal for mass comedy amongst his 'friends'?[/quote]

Oh yes

Re: Fractured ribs - conservative treatment?

KathW — Sun, 09 Sep 2012 21:18:32 GMT

They are 2 single fractures. No overriding and there didnt feel to be any inward rotation of the edges. It's just the fact the edges aren't aligned and there is a gap at the fracture site in each rib between the two ends of rib that made me think maybe I should be aliginging them. I'll try and post the rads tomorrow. Thanks

Re: Fractured ribs - conservative treatment?

james herriot lied — Sun, 09 Sep 2012 20:39:50 GMT

[quote user="Michael Woodhouse"]

I have a friend who fractured 2 ribs. Was given paracetamol and told not to laugh.

[/quote]

Was this not just the signal for mass comedy amongst his 'friends'?

Kath, are these single fractures, or are there sections of flail? Is there any overriding (which is pretty unlikely with punctate lesions) and is there any degree of inward rotation of fracture edges? Laterally displaced fractures really do heal fine, but obviously any inward pointing can cause sleepless nights. Can you post the rads?

Re: Fractured ribs - conservative treatment?

Michael Woodhouse — Sun, 09 Sep 2012 17:09:59 GMT

I have a friend who fractured 2 ribs. Was given paracetamol and told not to laugh. They never even considered doing anything.