Rib Fracture

What is a rib fracture?

A rib fracture is the medical term for a broken rib. Rib fractures are usually caused by car accidents, sports injuries or other traumas. It’s possible to break a rib without experiencing trauma, too.

It’s rare to need surgery to repair a rib fracture, unless the injury that broke your rib damaged your internal organs. Unlike most other types of bone fractures, you probably won’t need treatment other than rest, ice and breathing exercises. Most people need at least a month to recover from a rib fracture.

Even if you can recover with at-home treatments, rib fractures can have life-threatening complications. See a healthcare provider or go to the emergency room if you’re experiencing symptoms like pain and tenderness around your ribs and chest, or if you have trouble breathing.

Types of rib fractures

A healthcare provider will classify your rib fracture based on the type of break you experienced. There are lots of different break patterns, but some of the most common include:

• Stress fracture.
• Avulsion fracture.
• Comminuted fracture.
• Floating fracture.

Displaced rib fractures vs non-displaced rib fractures

Displaced or non-displaced are words your provider will use to describe your fracture. A displaced fracture means the pieces of your bone moved so much that a gap formed around the fracture when your bone broke. Non-displaced fractures are still broken bones, but the pieces weren’t moved far enough to be out of alignment during the break. Displaced fractures are much more likely to require surgery to repair.

Who gets rib fractures?

Rib fractures — like all bone fractures — can affect anyone. This is especially true because they’re usually caused by car accidents and other traumas. People with osteoporosis (weakened bones) have an increased risk for all types of broken bones, including rib fractures. Athletes who play contact sports are more likely to break a rib than most people.

If you’re at risk for falls, you might be more likely to experience a rib fracture.

Children break ribs less often than adults because their bones are much more flexible than adults’.

How common are rib fractures?

Your ribs are some of the strongest bones in your body, so it’s rare to fracture a rib without experiencing a major trauma like a car accident or fall. Around 30% of people who experience a trauma to their chest break at least one rib.

Fractures caused without a traumatic injury are rare.

What are the symptoms of a rib fracture?

Symptoms of a rib fracture include:

• Pain (especially when you breathe, cough or move your chest and upper body).
• Tenderness.
• Bruising or discoloration.

What causes rib fractures?

Rib fractures are usually caused by something hitting your chest. Some of the most common causes include:

• Car accidents.
• Falls.
• Sports injuries.

Rib fractures can happen without a traumatic injury, too. These atraumatic (not caused by trauma) breaks are caused by:

• Cancers that have spread to your bones.
• Severe coughs.
• Osteoporosis.

Rib fracture complications

Organ damage

Rib fractures usually occur during traumas, which means there’s a chance you have other injuries. A broken rib can cause serious damage inside your body. Your ribs protect several of your most important organs, including your:

• Heart.
• Lungs.
• Liver.
• Kidneys.
• Spleen.

If the injury that caused the fracture pushed your ribs into your body, the pieces of bone can cut (lacerate), poke holes in (puncture) or bruise your organs.

Trouble breathing (pulmonary complications)

Breathing with a broken rib can be painful. If you don’t breathe as deeply as you usually do while your ribs are fractured, you have an increased risk of developing pneumonia.

Rib fractures can also lead to a collapsed lung (sometimes called pneumothorax).

How are rib fractures diagnosed?

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.

What tests are done to diagnose a rib fracture?

After a physical exam, you might need at least one of a few imaging tests:

• X-rays: An X-ray can confirm any rib fractures or other fractures and show how damaged your bones are.
• Magnetic Resonance Imaging (MRI): Your provider might use an MRI to get a complete picture of the damage to your bones and the area around them. This will show them tissue around your bones, too. This is especially important to determine if your muscles, connective tissue and organs were injured.
• CT scan: If you need surgery, your provider or surgeon needs to know exactly how damaged your bones are. A CT scan will give them a more detailed picture of your bones and the surrounding tissue than an X-ray. You might need a CT scan if your X-rays were inconclusive or to help your surgeon plan your surgery.

How are rib fractures treated?

How your rib fracture is treated depends on the severity of the original break. Your broken bones need to heal back together. If any of your organs were damaged during a trauma, you might need to stay in the hospital while those injuries are repaired.

Most rib fractures can be treated with rest, icing and over-the-counter (OTC) NSAIDs like aspirin or ibuprofen. Your provider will tell you how often to ice your injury, but in general, you can ice your ribs for 20 minutes at a time a few times a day.

You’ll probably need to do some breathing exercises or cough on purpose every few hours while you’re recovering. This helps prevent pneumonia and keeps your lungs and chest moving like they usually do. Pressing a pillow to your injured ribs can help cushion any pain during your breathing exercises.

Rib fracture surgery

It’s rare to need surgery for a fractured rib. You’ll only need surgery if you have serious internal injuries, or if your bones haven’t healed back together properly (a complication called nonunion or malunion).

Internal fixation

The most serious fractures require surgery. 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. They usually perform what’s called an internal fixation, which means your surgeon inserts pieces of metal into your bone to hold it in place while it heals. You’ll probably need to limit how much you use the surgically repaired part of your body to make sure your bone can fully heal.

Internal fixation techniques include:

• Plates and screws: Metal plates screwed into your bone to hold the pieces together and in place.
• Pins and wires: Pins and wires hold pieces of bone in place that are too small for other fasteners. They’ll typically be used at the same time as either rods or plates.

Some people live with these pieces inserted in them forever. You might need follow-up surgeries to remove them.

Bone grafting

You might need bone grafting if your rib fracture is severely displaced or if your bone isn’t healing back together as well as it should. Your surgeon will insert additional bone tissue to rejoin your fractured bone. After that, they’ll usually perform an internal fixation to hold the pieces together while your bone regrows. Bone grafts can come from a few sources:

• Internally from somewhere else in your body — usually the top of your hip bone.
• An external donor.
• An artificial replacement piece.

Complications of rib fracture treatment

Rib fracture surgery complications include:

• Malunion: This happens when your broken bones don’t line up correctly while they heal.
• Nonunion: Your bones may not grow back together fully or at all.
• Bone infection (osteomyelitis): If you have an open fracture (the bone breaks through your skin) you have an increased risk of bacterial infection.

How soon after treatment will I feel better?

It’ll take a few weeks for your symptoms to improve. Contact your healthcare provider right away if you experience intense pain that doesn’t get better or if you’re having trouble breathing.

How can I reduce my risk for rib fractures?

Follow these general safety tips to reduce your risk of an injury:

• Always wear your seatbelt.
• Wear the right protective equipment for all activities and sports.
• Make sure your home and workspace are free from clutter that could trip you or others.
• Always use the proper tools or equipment at home to reach things. Never stand on chairs, tables or countertops.
• Follow a diet and exercise plan that’ll help you maintain good bone health.
• Talk to your provider about a bone density test if you’re older than 50 or if you have a family history of osteoporosis.
• Use a cane or walker if you have difficulty walking or have an increased risk for falls.

How can I prevent a rib fracture?

Rib fractures are usually caused by falls or other accidents, so there’s not much you can to prevent them. Use a cane or walker to increase your stability and prevent falls.

If you have osteoporosis, treating it will prevent future bone density loss.

What can I expect if I have a rib fracture?

If you have a rib fracture, you should expect to make a full recovery.

How long does it take a rib fracture to heal?

Most people need at least a month to recover from a rib fracture.

There are lots of factors that can affect how long it takes your body to heal. It can take longer to recover if you experienced other internal injuries during a trauma. Talk to your provider or surgeon about a timeline that fits your specific situation.

Will I need to miss work or school?

Your specific injuries will impact how long you’ll need to miss work, school and other activities. If you fracture a rib without damaging organs or other parts of your body, you shouldn’t have to miss work or school while you’re recovering.

Talk to your surgeon or healthcare provider before resuming any physical activities while you’re healing.

Can I exercise with a fractured rib?

Stay active while you’re recovering. Avoid intense workouts and playing sports, but moving and breathing as close to normally for you is an important part of your recovery. Talk to your provider about how much activity you should do with a broken rib.

When should I go to the emergency room?

If you think you have a rib fracture — or any other broken bone — you need to see a healthcare provider as soon as possible. Go to the emergency room if you experience any of the following:

• Intense pain.
• You have trouble breathing.
• You can’t move a part of your body that you normally can.
• A part of your body looks noticeably different or out of its usual place.
• You can see your bone through your skin.
• Swelling.
• New bruising that appears at the same time as any of these other symptoms.

Go to the emergency room right away if you’ve experienced trauma.

What questions should I ask my doctor?

• Will I need imaging tests?
• Did the fracture injure any of my organs?
• Will I need surgery?
• Which exercises should I do while I’m recovering?
• How long will it take to recover?
• When can I resume physical activities?

A note from Cleveland Clinic

Rib fractures can range from a small crack caused by a random cough to a severe injury after trauma. 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.

Talk to your provider about how you can keep your bones strong and healthy and get regular bone density screenings if you’re older than 50 or have a family history of osteoporosis.