First of all, talk about which ribs are easy to fracture. These 1-3 ribs are thick and short, protected by clavicle and scapula, and are not easy to fracture; 4-7 ribs are long and thin, and they are the easiest to break. If they rupture, it is easy to cause damage to abdominal organs and diaphragm. The costal cartilage at the front end of the 8th-10 rib is connected to the sternum, while the front end of the 8th-1-12 rib is free, which is elastic and difficult to fracture. So the most prone to fracture is 4-7 ribs. Multiple rib fractures will soften the chest wall without complete rib support, leading to abnormal respiratory movement, that is, the chest wall in the softened area invaginates when inhaling and protrudes when exhaling, which is called cheap bear (PS: sorry, wrong number, flail chest).

Secondly, talk about clinical manifestations. This fracture will hurt if the intercostal nerve is stimulated. If it is not unusually painful, it will get worse when breathing, coughing and rotating. Chest pain makes breathing shallow, cough weak, respiratory secretions increase and stay, which easily leads to atelectasis and lung infection. The inward displacement of the front end of the fracture can puncture the pleura, intercostal blood vessels and lung tissue, leading to hemothorax, pneumothorax, subcutaneous emphysema or hemoptysis. Late fracture after injury is considered to lead to delayed hemothorax or hemopneumothorax. Abnormal flail chest breathing can affect lung ventilation, leading to carbon dioxide retention and hypoxia in the body, and severe respiratory failure and circulatory failure. Flail chest is often accompanied by extensive lung contusion, pulmonary interstitial or alveolar edema in the contusion area, which leads to oxygen diffusion disorder, that is, the obstacle of oxygen delivery to other parts of the body, resulting in hypoxemia.

Then talk about how to treat it. The principle of this treatment is to relieve pain, clear respiratory secretions, fix the chest and prevent complications. Analgesics can be used to relieve pain, and encourage patients to cough and expectorate, get out of bed early and reduce respiratory complications. The method of fixing the chest is as follows: 1. Closed single rib fracture, that is, one is broken and the bone stubble is not exposed. This kind of fracture usually has few dislocations and can basically heal itself. The purpose of fixing the chest is to reduce the activity of broken ribs and relieve pain. The contour can be fixed with wide adhesive tape, multi-adhesive tape or elastic chest strap. You can usually buy an elastic chest strap when you go to the hospital. This method is also suitable for patients with multiple rib fractures in the chest back and chest side wall, and the abnormal respiratory movement of children in the softening range of chest wall is not serious. 2. Closed multiple rib fracture: For flail chest patients with large chest wall softening and abnormal respiratory movement, it is necessary to place a traction bracket on the injured chest wall, use towel tongs or introduce stainless steel wires on the body surface, and grasp the free ribs and fix them on the traction bracket to eliminate abnormal respiratory movement of the chest wall. 3. Open rib fracture: What you said will not be open, so the word XX is omitted here.

As long as you are fixed, have a reasonable rest and exercise properly, you can be cured as soon as possible and reduce complications. I hope the patient will recover soon, thank you.