rib fracture

肋骨骨折

WordNet

1. form vertical ribs by knitting; "A ribbed sweater"
2. a projecting molding on the underside of a vault or ceiling; may be ornamental or structural
3. support resembling the rib of an animal
4. any of the 12 pairs of curved arches of bone extending from the spine to or toward the sternum in humans (and similar bones in most vertebrates) (同)costa
5. a riblike supporting or strengthening part of an animal or plant
6. a teasing remark
7. cut of meat including one or more ribs
8. interrupt, break, or destroy; "fracture the balance of power"
9. breaking of hard tissue such as bone; "it was a nasty fracture"; "the break seems to have been caused by a fall" (同)break
10. fracture a bone of; "I broke my foot while playing hockey" (同)break
11. become fractured; "The tibia fractured from the blow of the iron pipe"
12. break (a bone); "She broke her clavicle"
13. break into pieces; "The pothole fractured a bolt on the axle"
14. violate or abuse; "This writer really fractures the language"
15. the act of cracking something (同)crack, cracking

PrepTutorEJDIC

1. 『肋骨』(ろっこつ),あばら骨 / (骨付きの)あばら肉 / 肋骨状の物;(船の)肋骨,肋材(ろくざい);(丸天井の)萩減(ろく)(建物・橋の)横ばり;(かさなどの) 骨 / 葉脈(vein) / (編物・織物の)うね / …‘に'肋骨(肋材)をつける / 〈編物〉‘に'うね模様をつける / 《話》…‘を'いじめる,からかう
2. 〈U〉(特に)骨を折ること;骨を折った状熊 / 〈C〉割れ(裂け)目,(鉱物の)破砕面 / 〈足・腕などを〉‘を'骨折する;…‘を'砕く / 骨折する;砕ける
3. roentgen / recto

Wikipedia preview

出典(authority):フリー百科事典『ウィキペディア（Wikipedia）』「2015/02/22 22:54:45」(JST)

wiki en

[Wiki en表示]

Rib fracture
An X ray showing multiple old fractured ribs of the person's left side as marked by the oval.
Classification and external resources
ICD-10	S22.3-S22.4
ICD-9	807.0, 807.1
DiseasesDB	11553
eMedicine	emerg/204 radio/609
MeSH	D012253

A rib fracture is a break or fracture in one or more of the bones making up the rib cage. The first rib is rarely fractured because of its protected position behind the clavicle (collarbone). However, if it is broken, serious damage can occur to the brachial plexus of nerves and the subclavian vessels. Fractures of the first and second ribs may be more likely to be associated with head and facial injuries than other rib fractures. The middle ribs are the ones most commonly fractured. Fractures usually occur from direct blows or from indirect crushing injuries. The weakest part of a rib is just anterior to its angle, but a fracture can occur anywhere. The most commonly fractured ribs are the 7th and 10th. A lower rib fracture has the complication of potentially injuring the diaphragm, which could result in a diaphragmatic hernia. Rib fractures are usually quite painful because the ribs have to move to allow for breathing. When several ribs are broken in several places a flail chest results, and the detached bone sections will move separately from the rest of the chest.

Causes

Rib fractures can occur without direct trauma and have been reported after sustained coughing and in various sports – for example, rowing, karting and golf – often in elite athletes. They can also occur as a consequence of diseases such as cancer or infections (pathological fracture).

Fragility fractures of ribs can occur due to diseased bone structure, e.g. osteoporosis and metastatic deposits.

Diagnosis

Broken ribs are often indicated by the following symptoms:

• Pain when breathing or with movement
• A portion of the chest wall moving separately from the rest of the chest (flail chest)
• A grating sound with breathing or movement
• Where the mechanism of injury would indicate substantial force to the ribs

Because children have more flexible chest walls than adults do, their ribs are more likely to bend than to break; therefore the presence of rib fractures in children is evidence of a significant amount of force and may indicate severe thoracic injuries such as pulmonary contusion. Rib fractures are also a sign of more serious injury in elderly people.

• Rib fractures

• Rib fractures

• Rib fractures

• Rib fractures

• Rib fractures as seen on plain X ray

Treatment

There is no specific treatment for rib fractures, but various supportive measures can be taken. In simple rib fractures, pain can lead to reduced movement and cough suppression; this can contribute to formation of secondary chest infection. Adequate analgesia can avoid this.

Flail chest is a potentially life-threatening injury and will often require a period of assisted ventilation. Flail chest and first rib fractures are high-energy injuries and should prompt investigation of damage to underlying viscera (e.g., lung contusion) or remotely (e.g., cervical spine injury).

Spontaneous fractures in athletes generally require a cessation of the cause, e.g., time off rowing, while maintaining cardiovascular fitness.

Treatment options for internal fixation/repair of rib fractures include:

• Acute Innovations RibLoc is a titanium U-shaped plate that is sized to match rib thickness and uses screws that fixate to anterior and posterior of plate and provide fixation without needing bone purchase for screws and without risking damage to the neurovascular bundle. These plates can be contoured to match the rib segment being plated and come in various lengths.
• Judet and/or Sanchez Plates/Struts are a metal plate with strips that bend around the rib and then is further secured with sutures.
• Synthes MatrixRIB Fixation System has two options: a precontoured metal plate that uses screws to secure the plate to the rib; and/or an intramedullary splint which is tunneled into the rib and secured with a set screw.
• Anterior locking plate are metal plates that have holes for screws throughout the plate. The plate is positioned over the rib and screwed into the bone at the desired position. The plates may be bent to match the contour of the rib section.

See also

• Pulmonary hygiene

References

UpToDate Contents

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• 1. 肋骨骨折の初期評価およびマネージメント initial evaluation and management of rib fractures
• 2. 外傷性肋骨骨折の入院マネージメント inpatient management of traumatic rib fractures
• 3. 小児における胸壁損傷 chest wall injuries in children
• 4. 成人における胸壁外傷の初期評価およびマネージメント initial evaluation and management of chest wall trauma in adults
• 5. 成人における鈍的胸部外傷の初期評価およびマネージメント initial evaluation and management of blunt thoracic trauma in adults

English Journal

• Alcohol level and injury severity: is the floppy patient myth true?

• Valdez C1, Radomski M1, Renne C1, Amdur R1, Dunne J1, Sarani B2.
• The Journal of surgical research.J Surg Res.2016 Feb;200(2):664-8. doi: 10.1016/j.jss.2015.10.001. Epub 2015 Oct 13.
• BACKGROUND: The impact of inebriation on severity of injury is unclear. The few studies to date on this topic are limited to a particular mechanism of injury (MOI), injury pattern, or blood alcohol level (BAL). Therefore, we sought to determine the impact of BAL on injury pattern and severity across
• PMID 26521676

• Clinical Outcome of Stereotactic Ablative Body Radiotherapy for Lung Metastatic Lesions in Non-small Cell Lung Cancer Oligometastatic Patients.

• De Rose F1, Cozzi L2, Navarria P2, Ascolese AM2, Clerici E2, Infante M3, Alloisio M3, Testori A3, Toschi L4, Finocchiaro G4, Santoro A4, Scorsetti M2.
• Clinical oncology (Royal College of Radiologists (Great Britain)).Clin Oncol (R Coll Radiol).2016 Jan;28(1):13-20. doi: 10.1016/j.clon.2015.08.011. Epub 2015 Sep 15.
• AIMS: The aim of this observational study was the evaluation of toxicity, local control and overall survival in non-small cell lung cancer (NSCLC) oligometastatic patients who had undergone stereotactic ablative body radiotherapy (SABR) for lung metastatic lesions.MATERIALS AND METHODS: SABR was car
• PMID 26385822

• Predictors of Chest Wall Toxicity after Lung Stereotactic Ablative Radiotherapy.

• Thibault I1, Chiang A1, Erler D1, Yeung L2, Poon I1, Kim A1, Keller B1, Lochray F1, Jain S3, Soliman H1, Cheung P4.
• Clinical oncology (Royal College of Radiologists (Great Britain)).Clin Oncol (R Coll Radiol).2016 Jan;28(1):28-35. doi: 10.1016/j.clon.2015.06.009. Epub 2015 Jun 28.
• AIMS: To determine the incidence and predictive factors of rib fracture and chest wall pain after lung stereotactic ablative radiotherapy (SABR).MATERIALS AND METHODS: Patients were treated with lung SABR of 48-60 Gy in four to five fractions. The treatment plan and follow-up computed tomography sc
• PMID 26129745

Japanese Journal

• 第1肋骨疲労骨折の臨床的特徴

• 日本臨床スポーツ医学会誌 24(1), 24-28, 2016
• NAID 40020729889

• エドキサバンが効果的であった右上半身深部静脈血栓症の1 例

• 脳卒中 advpub(0), 2016
• NAID 130005153305

• 胸部外傷後に発症した肺ヘルニア嵌頓の1例

• 日本呼吸器外科学会雑誌 30(4), 454-457, 2016
• NAID 130005150983

Related Links

• Rib Fracture: Background, Pathophysiology, Epidemiology

Simple rib fractures are the most common injury sustained following blunt chest trauma, accounting for more than half of thoracic injuries from nonpenetrating trauma. Approximately 10% of all patients admitted after blunt ...

• Rib fracture - definition of rib fracture by Medical dictionary

rib fracture, a break in a bone of the thoracic skeleton caused by a blow or crushing injury or by violent coughing or sneezing. It may also be a pathologic fracture secondary to metastatic disease. The ribs most commonly broken are ...

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★リンクテーブル★

リンク元	「肋骨骨折」
関連記事	「fracture」「rib」

「肋骨骨折」

　　[★]

英

rib fracture, fracture of the ribs

関

骨折、肋骨、動揺胸郭

• 中位(第4～9肋骨)に多い。

治療

• 除痛
• 保存療法：背側で1-2本程度の骨折の場合
• 固定：

• 外固定：前方～側方の多発骨折の場合。バストバンドか絆創膏固定により外固定を行う。
• 内固定：動揺胸郭がある場合

「fracture」

　　[★]

• n.

• 骨折

　 　 　 　 　 　 　 　 　

「rib」

　　[★] 肋骨