Rib fracture is most common serious injury to chest

Fractured ribs are commonly associated with collisions, falls or other forms of trauma. These injuries can lead to extended periods of disability in athletes.

The human rib cage consists of 24 ribs (12 on each side) connected to a bone in the center of the chest called the sternum and attached in the back to the thoracic vertebrae. There are muscles, nerves and connective tissue located between the ribs.

The rib cage is designed to protect vital organs including the heart, lungs and major blood vessels. It is also an important functional component as part of the respiratory system. The rib cage will expand and contract with each breath.

Fractured ribs in adults are most commonly the result of falls and motor vehicle accidents. In young people these injuries result from blunt trauma associated with athletic injuries. The middle and lower ribs are most often injured. The involved trauma is often a sudden, high impact to a small focal area such as that inflicted by an elbow or a baseball.

Rib fractures are the most common serious injury to the chest. Severe fractures can result in a punctured lung. Multiple fractures can cause a condition called flail chest that will diminish the ability to effectively exchange air. Intense pain is the most common initial symptom. The pain intensifies with breathing, coughing or any activity that requires movement of the chest wall.

Treatment involves the use of rest, ice and pain medication. Pain medication can range from non-steroidal anti-inflammatory medications to narcotics.

An ongoing study at St. Francis Hospital and Medical Center in Hartford involves the comparison of current medical treatment including narcotics versus marijuana administered in a fixed-dose pill form.

"Rib fractures are an excellent condition for this trial since it fairly predictably results in pain that improves in six weeks and resolves in eight weeks," reports Dr. James Feeney, associate director of trauma and principal investigator for the study.

Returning to sports after a rib fracture can be expedited with early recognition and effective treatment.

Dr. Alessi is a neurologist in Norwich and serves as an on-air contributor for ESPN. He is director of UConn NeuroSport and can be reached at agalessi@uchc.edu