|Individuals over age 45 with more than four rib fractures are at increased risk for pulmonary complications or spleen or liver lacerations sustained in conjunction with traumatic rib fracture. Pulmonary complications may include laceration of the lung tissue (parenchyma) by fracture fragments, introduction of air into the pleural cavity surrounding the lungs (pneumothorax), and bleeding into the pleural cavity surrounding the lungs (hemothorax), often from a lacerated artery. These types of complications may require chest surgery (thoracotomy). Although rare, penetration of the heart has been reported, resulting in pericardial or aortic hemorrhage. Individuals with chronic underlying respiratory illnesses such as COPD, emphysema, or asthma may need to be hospitalized for respiratory support and management.|
Other complications of severe rib fractures with multiple trauma include damage to organs such as the spleen, liver, heart, major blood vessels, or bones in the chest cavity. Pulmonary contusions occurs in 20% to 40% of individuals with rib fractures, and the incidence of liver injury associated with rib fracture is 10.7%, and spleen injury is 11.3% (Nadalo). Though rare, nonunion (failed union) of the fracture may occur.
Source: Medical Disability Advisor