Rib fractures are one of the most common bone breaks in older adults. While there's no direct treatment for fractured ribs that remain in alignment, medical care is still important to avoid serious complications, according to the October issue of Mayo Clinic Health Letter. Rib fractures can result from major trauma, such as a car crash. It is important to determine whether there is actually a popping sound or just a sensation of popping. Sometimes people imagine hearing a sound when the experience a popping sensation. Causes of Popping Sternum-Rib Sounds. There are many possible causes of popping sounds from the sternum and ribs.
It’s Dr. Parker again and in this post I’m going to talk about rib fractures. Rib fractures are a pretty common problem I see, and it’s not just the young dare-devil types! I often see folks in their 50s, 60s, 70s and 80s with multiple rib fractures. These are the result of a wide range of accidents – anything from falling off of a bench to getting bucked off of a horse. Of course, in Jackson in the winter time, skiers/snowboarders and snowmobilers are common recipients of a good ole’ fashioned butt kicking from mother nature.
Feb 03, 2017 Just getting back to feeling 99.9% normal after breaking three ribs in early December. (side note: do NOT get the flu on top of broken ribs. UGH!) I had the same pops and thunks throughout the healing process. Very strange feeling, especially the thunks.
Rib fractures can be mild to life threatening, depending on the severity of the injury and other associated injuries. I’m going to talk about common associated injuries in another post, so this one I’ll just stick to rib fractures.
Commonly, patients present with one or two non-displaced fractures (meaning the bones are still in the right place, they are just broken) and no other organ injury. This is the simplest form of rib fracture. The good news is, there is no surgery needed for something like this. The bad news is, there is no good way to splint the rib fractures. Some people may find some comfort in “taping the ribs or wearing a tight-fitting undergarment. If this works for you, great….if not….no big deal.
Our goal is to get you fairly comfortable using pain medication and avoid other complications commonly associated with rib fractures. The medication will not be able to take all of your pain away, but the main objective is to get you breathing and moving fairly easily. One of the main complications that can arise after rib fractures is pneumonia. When we have ribs fractured, we don’t want to take normal deep breaths. We often breathe much more shallow than normal. This lets the lung partially “collapse” in the bases and outer portion.
(Quick anatomy lesson….the lung is made of millions of microscopic sacs which take the oxygen in the air, and put it into the blood. If not kept inflated normally, these microscopic sacs can collapse. When they collapse, they are a good place for bacteria to attach to and start multiplying thus, causing pneumonia).
So to prevent pneumonia after rib fractures, I like to give patients a good amount of narcotic pain medication for the first 3 or so days. This is the time when the pain peaks and starts to subside. British enfield 303 no4 mk1. If we can keep you comfortable and breathing normally, we can lower your chance of pneumonia. In addition to breathing normally, we generally have patients use a “spirometer”. This is a little plastic machine that helps you determine exactly how much (in millilitres) you are breathing in when you take a deep breath. This just helps you monitor the deep breaths and actually put a number on them, instead of guessing.
The downside to taking narcotic pain medication is that it can make people very constipated. This is why I start a stool softener with everyone who has rib fractures and is taking narcotics. I generally give patients Senokot twice daily to prevent constipation. Some patients may need a little extra to keep them regular, and in this case, I start Milk of Magnesia twice daily as well. You should continue to take stool softeners as long as you are still taking narcotics.
The other main complication that is associated with rib fractures is “Deep Venous Thrombosis” or DVT. A DVT is basically a blood clot that usually start somewhere in the lower extremities. The dangerous part about a DVT is that it can break loose and then “embolize” or “travel through the blood stream” to the lungs. This is called a “Pulmonary Embolism”, or PE. PE’s can be very small and virtually have no symptoms, or they can be very large and result in death. So, we definitely want to prevent against a DVT and PE while you are in the hospital. There are a couple reasons people get DVTs after rib fractures. It’s not necessarily the ribs being broken which is the problem, but that the patient has sustained a significant trauma. Just like when you cut your finger accidentally, the body will try to “stop the bleeding” by producing blood clots. In a significant trauma, where ribs are broken and maybe even some other organs are bruised (skin, muscle, spleen liver), the body will try to “stop the bleeding” by forming clots. The body will be in a “hypercoagulable state” (coagulate = blood clotting). So, we develop a hyper-clotting state after major trauma, or even surgery. Depending on the trauma, the elevation of the clotting status will be variable, but combine that will laying in a hospital bed for a couple of days (the blood then doesn’t circulate as well….or as fast as if you were up walking or running around) and now we have a pretty good set up for blood clots….or DVTs and subsequent PEs.
So prevention measures consist of two things. First, we get you walking as soon as possible, and we thin your blood just a little bit to prevent excessive clotting. The walking prevents DVTs by keeping good blood flow and circulation. The slower the blood flow, the easier it is for your body to make clots, so the walking prevents against that. Second, is the blood thinner. It’s a little stronger than aspirin, and not quite as strong as Coumadin (if you are familiar). Everyone who sustains a significant trauma (including rib fractures) will receive this blood thinner while in the hospital. When you go home, we typically stop the blood thinner because you are generally more active at home than in the hospital. Ppsspp iso. Those are the main complications we are trying to avoid with rib fractures, so when I come in and ask how your deep breathing and walking is going, you’ll know why.
Lastly, patients always want to know “when they can get back to normal activity”. Well, unfortunately the only thing that is going to heal those ribs is time. In general, bones take about 6-8 weeks to heal well. You, of course, will be feeling much better in about 1-2 weeks, but you should gradually increase your activity during those 6-8 weeks. It’s fairly normal to have a few good days followed by a really bad day (as far as pain is concerned). As long as you are improving week to week, you are on the right track.
I hope this has given you a little insight to the natural course of rib fractures and what to expect while you are in the hospital.
-Dr. Buck
-Dr. Buck
P.S. Please leave comments or questions for me below. Thanks!
I had a bad fall about a month ago. Broke 3 ribs. I'm slowly healing, doing better. Tho the ribs are around back, I have pain in front from sternum outward. I've been told I probably tore Costochondral cartiledge - the connecting cartiledge to the breastbone and between ribs. I've had good answers from my docs, with one exception.. A weird popping or thunking sensation around my ribs in several places.Sometimes when I move there's a painless pop, or thunk, or clunk kind of feeling in different spots. It feels kind of linear .. Like along a rib. I've googled a lot to find explanations, and get partial answers, but nothing that quite describes what I feel.
Anyone have experience with this?
Thanks.
Yeah, not uncommon. Perhaps you'll be luckier, but mine never went away. It doesn't hurt, right? You'll get used to it, and a day will come when, while you will still be aware of it, it won't bother you. No big deal.
posted by halogen at 9:31 PM on February 3, 2017 [1 favorite]
posted by halogen at 9:31 PM on February 3, 2017 [1 favorite]
Halogen - just where you broke the rib or in other spots too?
posted by ecorrocio at 9:35 PM on February 3, 2017
posted by ecorrocio at 9:35 PM on February 3, 2017
Treatment For Fractured Rib
I fell and broke my leg three years ago, right across the neck of the femur. It was surgically repaired, and when I could walk again, my hip would occasionally pop. It felt and sounded much like cracking a knuckle, but quite a bit louder, presumably because it's a much larger joint. It's been gradually going away. I think it's been several months now since the last time it happened.
posted by Bruce H. at 12:06 AM on February 4, 2017
posted by Bruce H. at 12:06 AM on February 4, 2017
I had the same pops and thinks when I broke two ribs a year ago, so my NotADoctor assessment is that it's probably typical. They did eventually go away, but it took quite some time, six months maybe.
posted by scantee at 6:56 AM on February 4, 2017 [1 favorite]
posted by scantee at 6:56 AM on February 4, 2017 [1 favorite]
Just getting back to feeling 99.9% normal after breaking three ribs in early December. (side note: do NOT get the flu on top of broken ribs. UGH!) I had the same pops and thunks throughout the healing process. Very strange feeling, especially the thunks. Beginning in January they started to diminish and find that I might have it happen once a week or so especially when exerting myself.
My doctor said this is totally normal.
posted by WalkingHorse at 7:09 AM on February 4, 2017 [1 favorite]
My doctor said this is totally normal.
posted by WalkingHorse at 7:09 AM on February 4, 2017 [1 favorite]
I broke a rib lifting weights (spotter walked away) many years ago. Still occasionally get a knuckle-crack-like pop in my sternum.
posted by notsnot at 7:29 AM on February 4, 2017
posted by notsnot at 7:29 AM on February 4, 2017
Data points: took months to go away for me, and years for a friend.
posted by Leon at 10:39 AM on February 4, 2017
posted by Leon at 10:39 AM on February 4, 2017
I had a pin put into a broken bone beside a joint (in a limb) and I got the 'thunk' sensation too, for months afterwards. It felt to me like a ligament was twanging over the end of the pin. In my case it hurt like crazy but gradually hurt less, then not at all, then eventually either stopped or I stopped noticing it. Might be something like that with soft tissue rubbing over the end of a broken bone?
posted by spraypaint at 12:23 PM on February 4, 2017
posted by spraypaint at 12:23 PM on February 4, 2017
Thanks bone breakers!
posted by ecorrocio at 4:33 PM on February 4, 2017
posted by ecorrocio at 4:33 PM on February 4, 2017
Thanks for this question. Costal cartilege injury seems to be the answer for my chest pain - I couldn't find the right answer with google.
posted by bendy at 5:55 PM on February 4, 2017
posted by bendy at 5:55 PM on February 4, 2017
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Fractured Ribs Clicking
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