When should patients be discharged from the hospital following treatment for a rib fracture?

Updated: Jun 13, 2017
  • Author: Sarah L Melendez, MD; Chief Editor: Trevor John Mills, MD, MPH  more...
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Answer

Routine follow-up chest x-rays days after the injury are not recommended. They add little besides cost to a careful clinical examination and should be performed only if indicated by clinical findings (eg, unilateral decreased breath sounds suggesting pneumothorax, persistent pain suggesting malunion or nonunion). [45]

Consider an incentive spirometer, especially with multiple fractures, as it may help avoid complications and remind the patient to avoid splinting and to take deep breaths.

One study of patients aged 65 years and older suggests that patients in this age group without risk factors may be safely discharged home. Risk factors are age ≥85 years, initial systolic blood pressure < 90 mm Hg, hemothorax, pneumothorax, 3 of more unilateral rib fractures, or pulmonary contusion. Patients without these risk factors, with isolated blunt chest trauma, did not have an adverse event in this preliminary study (100% sensitivity, 38.5% specificity). [20]


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