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Orthopedic Services
Glendale Adventist Medical Center
1509 Wilson Terrace
Glendale, CA 91206
Ph: (818) 409-8000

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My wife was involved in a motorcycle accident that left her with all the ribs broken on her right side. How in the world do they treat this problem? She's in with the doctors right now while I search for information on the Internet to help us deal with this.

The first thing the emergency medical team does with traumatic motor vehicle (including motorcyle) accidents is to stabilize the patient. With so many broken ribs, there may be other serious injuries as well. At the same time, the medical team is aware that any broken rib that becomes displaced (separated or shifted apart) has jagged edges that can puncture a lung or cut into nearby nerves, muscles, or ligaments. Depending on the location of the fractured rib, other structures such as the diaphragm or other organs can be injured as well. Once the patient is stabilized, treatment for the rib fractures will be determined. Most rib fractures can really be treated nonoperatively. The ribs heal on their own without being wired together (or held together with any other type of fixation device such as pins or metal plate and screws). Conservative care simplifies everything -- without the need for surgery, the risk of infection is much less and the risk of injury to the surrounding tissues is eliminated. And, of course, there's no need for another surgery later to remove the hardware holding the ribs together. The trick with treating rib fractures conservatively is that just the act of breathing (with motion of the ribs up and down, in and out to move the chest wall) can cause the fractured pieces to displace or move apart. Even a small amount of displacement can result in malunion (bones heal but don't line up properly) or even nonunion (failure of the bones to knit back together). Every now and then surgery is indicated for rib fractures. The usual procedure is called an open reduction and internal fixation or ORIF. The chest is opened and the ends of the displaced bones are brought together and held in place until healing occurs. There's no clear cut list of what type of patients will need operative care -- it's going to depend on the pattern of fracture, the patient's age, general health and overall medical condition, and symptoms. No doubt the physician who is assessing your wife will let you know her status and suggest the best plan of care given her circumstances. Even with so many ribs involved, with time, the body's unique ability to heal will be to her advantage.


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