FRACTURE OF RIBS

Treatment Reduction Generally, in most cases of fracture of rib there is no marked displacement. So, no reduction is needed. In the cases there is displacement, according to different conditions, the patient may be asked to take standing, sitting or lying positions and throw his chest out, thus the fracture ends can be reduced generally. If reduction does not work, the pushing and pressing manipulations should be taken to press the eminent part fiat. Fixation Fixation with adhesive plaster: The patient sits erectly, taking deep respiration to draw the thorax into the minimum. Then he keeps shallow respiration while the operator uses a long adhesive plaster 7 to 10 cm in width to wrap from midcapular line of the normal side, passing the fracture region closely to the midclavicular line of the normal side. Then the second adhesive plaster is used in the same way, with the lower part covering the upper part of the first and the two plasters overlapping each other by half. In this way, the operator does the same from the lower to the upper for fixation until the fracture region with its nearby normal ribs superiorly and inferiorly have been fixed. The course for fixation is 3 to 4 weeks. Fixation with broad bandage: The Patient sits erectly, taking deep respiration to draw the thorax into the minimum. Then he keeps shallow respiration while the operator uses broad bandage to wrap in cycle until many rounds have been done for fixation or uses a SPecial multiple headed bandage to wrap for fixation. The fixation duration is 3 to 4 weeks. This fixation is used for patients who are allergic to adhesive plaster. Functional exercise The patient with mild fracture of rib should be allowed to walk freely. The severe patient who needs bed rest may take semireclining position and practice abdominal respiration. He can not walk freely until the condition gets better. Herbal therapy Internal treatment based on syndrome differentiation In the early stage Main symptoms and signs: Chest pain and cough aggravated by deep respiration. Therapeutic methods: Promoting blood flow to remove the stasis, and regulating qi to stop pain. Recipe and herbs: Modified Fu Yuan Huo Xue Tang. Specifically, Chaihu (Radix Bupleuri) 12 g, Tianhuafen (Radix Trichosanthis) 12 g, Jiudahuang ( Radix et Rhizoma Rhei Praeparata ) 6 g, Taoren (Semen Persicae ) 6 g, Dangguwei ( Extremitas Radix Angelicae Sinensis) 15 g, Honghua ( Flos Carthmi ) 9 g, Chuanshanjia ( Squama Manitis Pentadactytae ) 9 g, Chenpi (Pericarpium Citri Reticutatae) 9 g, Yanhusuo (Rhizoma Corydalis Yanhusuo ) 15 g and Gancao (Radix Glycyrrhizae) 3 g. Modification: For the case of severe pain, add Ruxiang ( Gummi Olibanum ) 9g and Moyao ( Myrrha ) 9 g; for the case of cough and asthma, add Gualoupi (Pericarpium Trichosanthis ) 10 g, Xingren ( Semen Pruni Armeniacae ) 10 g and Zhike ( Fructus Citri Aurantii) 10 g.

In the middle stage Main symptoms and signs: Alleviated pain in the chest and hypochondrium, limited turning-about. Therapeutic method: Reuniting the bones, muscles and ligaments. Recipe and herbs: Modified Xin Shang Xu Duan Tang. Specifically, Dangguiwei ( Extremitas Radix Angelicae Sinensis ) 12 g, Zhechong ( Eupolyphaga seu Steleophaga ) 10g, Ruxiang ( Gummi Olibanum ) 5 g, Moyao (Myrrha ) 5 g, Danshen (Radix Salviae Miltiorrhizae) 10 g, Xuduan (Radix Dipsaci) 12 g, Duanzirantong (Pyritum Carcinatum ) (to be decocted first) 20 g, Gusuibu ( Rhizoma Drynarii) 12 g, Zhixiangfu (Rhizoma Cyperi Rotundi Praeparata ) 10 g, Yanhusuo (Rhizoma Corydalis ) 15 g, Sumu ( Lignum Sappan ) 10 g and Gancao (Radix Glycyrrhizae ) 5 g. In the late stage Main symptoms and signs: Vague pain in the chest and hypochondrium, shortness of breath and lassitude. Therapeutic method: Replenishing qi and blood. Recipe and herbs: Modified Ba Zhen Tang. Specifically, Dangshen (Radix Codonopsitis Pilosulae ) 10 g, Baizhi ( Rhizoma Atractylodis Macrocephalae ) 10g, Fuling (Poriae) 10g, Danggui (RadixAngelicae Sinensis) 10 g, Baishaoyao ( Radix Paeoniae Alba ) 10 g, Shudihuang ( Radix Rehmanniae Praeparata ) 10 g, Chuanxiong ( Rhizoma Ligustici Chuanxiong) 6 g, Chenpi (Pericarpium Citri Reticulatae ) 10 g, Gancao (Radix Glycyrrhizae ) 3 g, Shengjiang ( Rhizoma Zingiberis Recens) 3 pieces and Dazao (Fructus Ziziphi Jujubae) 2 pieces. Modification: For the case of severe pain, add Sanleng ( Rhizoma Sparganii Stoloniferi ) 10 g, Ezhu (Rhizoma Curcumae ) 10 g and Zhike ( Fructus Citri Aurantii) 10 g. Chinese patent medicines: In the early stage, Tishang Shunqi Pill is orally taken, 5 g each time and twice daily; or Yunnan Baiyao is orally taken, 0.5 g each time and twice daily. In the middle stage, Jiegu Pellet is orally taken, 5 g each time and twice daily. In the late stage, Danzhi Xiaoyao Powder is orally taken, 6 g each time and twice daily. External therapy: In the early stage, Shuangbai Powder or Dingtong Paste is externally applied.In the middle stage, Jiegu Plaster is externally applied; in the late stage, Shexiang Zhuifeng Plaster or Zheng Honghua Oil is externally applied.