Fractured Ribs

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Re: Fractured Ribs

Postby find_bruce » Mon Jul 21, 2014 5:04 pm

trailgumby wrote:Sorry to hear about the ribs. I haven't broken any, but landing on the end of my mountain bike handlebars with my ribs and the related cartilage damage was bloddy painful and took months to recover from. In some ways, bone fractures you recover from faster. So I appreciate your pain.

I'm not a fan of ER doctors for some things. They stuffed the relocation of my dislocated shoulder, and knocked loose some of the cartilage (location of damage could only have occurred on re-insertion) and told me to not move for two weeks and then go see a physio. I ended up with frozen shoulder and needed surgical intervention. I should have seen the physio immediately.

If you can afford it, I would encourage you strongly to go see a specialist, quickly.

On the other hand, ER registrars are quite good for things like wound infections because they get lots of experience dealing with that in hospitals.

My dearly departed Dad was a butcher who told me the reason a mate's ribs hurt after Dad reduced his dislocated shoulder was that was where he put his foot to apply traction. Took me years to realise he was pulling my leg :D
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by BNA » Mon Jul 21, 2014 6:41 pm

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Re: Fractured Ribs

Postby chriscole » Mon Jul 21, 2014 6:41 pm

Glad he was pulling your leg.... but chucking a foot in the armpit and pulling the arm was/is a valid technique for shoulder reduction... known as the Hippocratic method. :-)
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Re: Fractured Ribs

Postby sogood » Mon Jul 21, 2014 7:12 pm

chriscole wrote:Glad he was pulling your leg.... but chucking a foot in the armpit and pulling the arm was/is a valid technique for shoulder reduction... known as the Hippocratic method. :-)

Yes, well known reduction technique. But could never bring myself to sticking my socks covered foot into a patient's armpit. Not elegant with all the tugging and screams. Far easier to strap a heavy sandbag to the patient's arm and let it dangle and swing after a good shot of analgesia and muscle relaxant. Leg gravity do the work. Takes a little longer and has never failed.
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Re: Fractured Ribs

Postby CKinnard » Mon Jul 21, 2014 7:57 pm

It's said reduction of an anterior dislocation is prevented by a spasmed biceps tendon. Is this right?
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Re: Fractured Ribs

Postby sogood » Mon Jul 21, 2014 9:17 pm

Then just "un-spasm" it! In a dislocation, the pain gets all the muscles into spasm. To reduce, one will have to either un-spasm them by brute force or passively with the aid of pharmaceutics. I am not a footie forward and prefer the later solution. Brute force always worry me for the risks of inducing more injuries or causing more harm to undiagnosed issues. In A&E, often one can resolve the issue before an X-ray can be taken. As such, the only X-ray taken is a post-reduction one. :)

Ah yes, lots of memories of watching failed brute force reduction. Two guys, one sweaty and one screaming, making a scene. Not clever... LOL
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Re: Fractured Ribs

Postby anthcon » Tue Jul 22, 2014 7:03 am

I was hit by a car 4 weeks ago in the Brissie To The Bay... Multiple broken ribs. broken clavicle and a pneumothorax (collapsed lung) and cuts to the face.
Strapping the chest was not recommended to me but I believe that was due to the collapsed lung and there fear of infection. Good luck with managing the pain, the ribs are a head **** IMO. Everything you do pretty much causes pain.... Hope you heal well.
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Re: Fractured Ribs

Postby CKinnard » Tue Jul 22, 2014 9:47 am

@anthcon ..My hospital drs didn't say anything about strapping or compression bandaging. It was the private physio and osteo. I was talking about this to some friends on the w/e and a mate's wife told a story about falling and landing on stairs and breaking ribs several years ago. She had to fly to the USA the next day on business, and wasn't managing due to pain with movement. The physio strapped the ribs and it made all the difference to movement and breathing. When I had my ribs strapped, they also showed ways to use a pillow to support my painful side to breathe deeper. Maybe hospital interventions have changed due to time and cost pressures!
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Re: Fractured Ribs

Postby CKinnard » Tue Jul 22, 2014 9:52 am

sogood wrote:Then just "un-spasm" it!


This guy seems to have un-spasming down to a fine art, no traction, no analgesia

http://journals.lww.com/em-news/Fulltex ... ess.1.aspx
https://www.youtube.com/watch?v=d9HjtQr0c64
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Re: Fractured Ribs

Postby sogood » Tue Jul 22, 2014 10:48 am

CKinnard wrote:This guy seems to have un-spasming down to a fine art, no traction, no analgesia

I think it varies a lot out there. Some people with recurrent dislocation can even dislocate and relocate themselves, without any assistance. Some skinny and small individuals can be more easily handled for a reduction. Then there are those big guys with massive muscle bulges coming in with a dislocation... Good luck on getting anywhere with them without some serious help. The problem with some of the so called easy techniques is that, if they don't work the first time, the patient will be in further pain and the spasm would be even stronger. As for the technique being show, it's similar to the sandbag swing technique. Difference being, the sandbag technique with the patient lying prone and on the edge of the bed, the patient is in control and the relaxing of the muscles is gradual and caused by the weight of the sandbag. The doctor just need to facilitate the swing without any physical exertion.
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Re: Fractured Ribs

Postby CKinnard » Tue Jul 22, 2014 11:12 am

Yes he does say in his presentation his technique is not always first or most appropriate, and then he provides an excellent review of the lit to help guide selection. I was pretty impressed with the lack of analgesia and speed demonstrated. Amazing what one can find on utube these days :)

I've had a few mates over the years who were able to pop their shoulders back in, once they'd dislocated the 3rd time. Two got surgery because they'd pop with simple movement in bed, and the other gave footy away and seems to manage.

Is it roughly accurate 95% of dislocations are anterior, 5% posterior and a very small % frank inferior (as opposed to torn deltoids or cuff)?
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Re: Fractured Ribs

Postby Parker » Tue Jul 22, 2014 11:29 am

I can't keep any liquids down today, I went to work yesterday and was fine.

I have thrown up breakfast, coffee, but I did finally poo...

I'm starting to sip small amounts of water to see what happens, I'm keeping an eye on myself and will go to the doctor if the vomiting persists. So tired.
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Re: Fractured Ribs

Postby sogood » Tue Jul 22, 2014 11:36 am

CKinnard wrote:Is it roughly accurate 95% of dislocations are anterior, 5% posterior and a very small % frank inferior (as opposed to torn deltoids or cuff)?

It's in that ball park based on available statistics. To also note, shoulder joint is quite delicate. Once damaged, it's very hard to get it back to normal. Invariably it becomes a life-long issue. Health for longevity is not about how fast and how tough one is, but to keep fit whilst avoiding injuries.
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Re: Fractured Ribs

Postby ball bearing » Tue Jul 22, 2014 11:47 am

sogood wrote: Health for longevity is not about how fast and how tough one is, but to keep fit whilst avoiding injuries.

Just so. I had a gentle reminder of these facts yesterday when I came off on a gravel track.
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Re: Fractured Ribs

Postby Parker » Tue Jul 22, 2014 11:54 am

Topic is ribs
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Re: Fractured Ribs

Postby ball bearing » Tue Jul 22, 2014 11:58 am

Parker wrote:Topic is ribs

Haha! I didn't realise that you were monitoring the content so closely. I actually fell on my side and bruised my hip and a couple of ribs. Happy?
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Re: Fractured Ribs

Postby Parker » Tue Jul 22, 2014 11:59 am

ball bearing wrote:
Parker wrote:Topic is ribs

Haha! I didn't realise that you were monitoring the content so closely. I actually fell on my side and bruised my hip and a couple of ribs. Happy?

Yep
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Re: Fractured Ribs

Postby sogood » Tue Jul 22, 2014 12:14 pm

Parker wrote:Topic is ribs

Given that you've declared that your ribs weren't fractured and it was just muscle and soft tissue bruising, the initial topic has expired and thread drift followed naturally to related health issues.

If you care to bring it back to topic, here are two relevant images.
Image

Image
Last edited by sogood on Tue Jul 22, 2014 12:17 pm, edited 1 time in total.
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Re: Fractured Ribs

Postby ball bearing » Tue Jul 22, 2014 12:16 pm

I thought that the topic had become about constipation.
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Re: Fractured Ribs

Postby sogood » Tue Jul 22, 2014 12:21 pm

Here's another good one, and on topic.

Image
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Re: Fractured Ribs

Postby ball bearing » Tue Jul 22, 2014 12:24 pm

My wife makes me slather comfrey creme on my sore ribs. I do not know if comfrey helps with the healing process, but I have had very regular bowel movements.
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Chest wall bruising and respiratory muscles

Postby sogood » Tue Jul 22, 2014 12:28 pm

Also relevant for a bruised chest wall is the following schematic, showing how these muscles are used in breathing and other body movements.

Image

Ouch!

Image
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Re: Fractured Ribs

Postby Parker » Tue Jul 22, 2014 2:14 pm

ball bearing wrote:I thought that the topic had become about constipation.

Well, when your all blocked up and need to poo, it hurty the ribs when your straining.

Thanks So good, that helps explains the ribs better.... It was really helpful and I'm not just saying that
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Re: Fractured Ribs

Postby piledhigher » Tue Jul 22, 2014 2:18 pm

Parker wrote:Topic is ribs


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Re: Fractured Ribs

Postby Parker » Tue Jul 22, 2014 2:21 pm

:lol: Yummy
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Re: Chest wall bruising and respiratory muscles

Postby CKinnard » Tue Jul 22, 2014 2:57 pm

sogood wrote:Also relevant for a bruised chest wall is the following schematic, showing how these muscles are used in breathing and other body movements.


excellent schematics!
my physio said something about rib pain being associated more so with intercostal nerve insult/inflammation, rather than actual bone breakage, hence even if there isn't a break, it can still be as painful as if there was.

he massaged it firmly a couple of months after injury and it hurt like hell, but seemed fine and unrestricted after. he said it was necessary to loosen the scars in the muscle that might also tug at the nerves.

when you look at those diagrams, it seems the nerves travel closely to the bone, and may be stretched nastily if the bone breaks, or even torn.
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