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Złamanie żebra – przyczyny, objawy, możliwe komplikacje

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Złamanie żebra wraz z urazami pokrewnymi, takimi jak pęknięcie żebra lub jego stłuczenie, to najczęściej występujący uraz klatki piersiowej. Według szacunków złamania żeber stanowią 10 proc. wszystkich złamań kości szkieletowych. Jakie są ich przyczyny i jakie mogą spowodować komplikacje?

Przyczyny i rodzaje złamań żeber

Złamania żeber są najczęściej wynikiem urazu klatki piersiowej, np. w wyniku wypadku komunikacyjnego, przygniecenia lub upadku z dużej wysokości. Inna grupa złamań żeber to tzw. złamania zmęczeniowe, występujące u osób uprawiających sport, zwłaszcza takie dyscypliny jak piłka ręczna i piłka siatkowa (złamania z obciążenia), pracujących fizycznie, a także zmagających się z silnym przewlekłym kaszlem. Do złamania żebra może dojść także na skutek masażu serca.

Wyróżnia się dwa podstawowe rodzaje złamania żebra: uraz bezpośredni oraz złamanie kompresyjne.

O urazie bezpośrednim można mówić w przypadku, kiedy do złamania dochodzi w wyniku działania siły na boczną stronę klatki piersiowej. Złamane żebro ulega wpukleniu do wewnątrz klatki piersiowej, co może prowadzić do poważnych powikłań.

Złamanie kompresyjne polega natomiast na ściśnięciu żebra przez siłę działającą na klatkę piersiową z przodu lub z tyłu. Żebro ulega nadmiernemu wygięciu na zewnątrz zgodnie z naturalną wypukłością.

Objawy złamania żebra

Podstawowym objawem złamania żebra jest ból w klatce piersiowej, który nasila się podczas wdechu, kaszlu, śmiechu i kichania. Z tego powodu dolegliwości bólowe mogą doprowadzić do duszności i spłycenia oddechu, a także do ograniczenia ruchomości klatki piersiowej.

Ból nasila się również przy dotyku oraz podczas ruchów kręgosłupa (zwłaszcza w przypadku skrętu i zgięcia bocznego), a także przy aktywności fizycznej. Może promieniować na inne części klatki piersiowej, obręcz barkową i szyję.

W okolicy złamania występuje obrzęk i zasinienie.

Powikłania złamania żebra

W większości przypadków złamania żeber zrastają się bez powikłań w ciągu 6-8 tygodni. Złamaniom żeber mogą jednak towarzyszyć poważne komplikacje pourazowe.

W wyniku złamania żebra może dojść do uszkodzenia innych struktur klatki piersiowej: opłucnej, płuca, śledziony, wątroby, serca i nerek, a także mięśni oddechowych. Uszkodzenie opłucnej może spowodować odmę opłucnową. Powikłaniem złamania żebra może być także zapalenie płuc.

Leczenie złamanego żebra

Farmakoterapia w przypadku złamania żebra polega na podawaniu leków przeciwbólowych i przeciwzapalnych. Pacjent, u którego doszło do urazu, powinien zostać poddany rehabilitacji oddechowej w celu utrzymania właściwego upowietrznienia płuc i zapobiegania zapalenia płuc.

Nie zaleca się natomiast stosowania ucisku za pomocą bandaży, plastrów lub tapingu, ponieważ może to skutkować ograniczeniem prawidłowej wentylacji płuc w obszarze urazu.

Źródła:

https://www.mp.pl/, https://swiatrehabilitacji.pl/

Przeczytaj także: Jak pandemia koronawirusa wpłynęła na opiekę nad pacjentami z cukrzycą?

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