The authors present a pilot study in which 20 patients with simple rib fractures were randomized prospectively into two treatment groups. One group received ibuprofen and the other group ibuprofen plus a rib belt for analgesia. There were no statistically significant differences observed in pulmonary function testing between the groups at initial visit, 48 hours, or 5 days. Atelectasis developed in four patients, two in each treatment group; there were no cases of pneumonitis. Patients with displaced rib fractures experienced a higher rate of hemo- or pneumothorax than did those with nondisplaced fractures (5/10 versus 1/10). Patients with displaced fractures who used rib belts experienced a higher rate of hemothorax than those using oral analgesia alone (4/6 versus 1/4). Patients using rib belts uniformly reported a significant amount of additional pain relief. The clinician can use a rib belt to provide additional comfort to the patient with fractured ribs without apparent additional compromise to respiratory parameters. A further study stratifying displaced and nondisplaced fractures has been initiated to clarify the possible contributing roles of displaced rib fractures and the rib belt in patients with displaced fractures.
Copyright by WB Saunders Company.

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