Who's had broken ribs?

cmhbob

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My antagonist is a 60-or-so-year-old man. He just got into a fight with three other bad guys and ended up killing them. In the process, I want him to be injured, though not crippled. I'm giving him a broken wrist (from a fall during the fight) and a couple of cracked ribs (from punches and kicks during the fight). I don't want a punctured lung, and I've read that compression wraps are no longer used.

Nikolai was a Stasi officer for a while, then did a bunch of other criminal stuff, then was in prison for about three years. So he's probably in slightly better shape than most 60-year-old, but he's still 60 years old.

I'm assuming he'll be able to drive, though he'll be uncomfortable at least. How much bending and lifting would he probably be able to do? He's going to do some heavy work disposing of the bodies (dismembering hands and heads), then driving 9 or so hours, scattering the body parts along the way. Anyone who's had cracked or bruised ribs, can you recall any specific limitations or aches?
 

MaeZe

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You're worried about the ribs? If you fracture a wrist or any joint (looks down at finger that won't straighten or bend properly) it needs to be repaired within a couple days at most or the final outcome may not be a nicely functioning joint.

The main goal of rib fracture treatment (non-displaced) is to prevent secondary pneumonia. Pain control is used to keep the patient taking deep breaths and coughing to keep mucus moving out of the trachea. In the field, you might still use splinting to accomplish that goal.

Intermittent ice, pain meds and splinting to cough regularly would be enough for an uncomplicated rib fracture. But the guy needs to actively prevent pneumonia, so give him some knowledge.
 

Brickcommajason

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I broke ribs in a kickboxing match 20 years ago and still wince thinking about it.

Broken ribs = crippled. Every shift, even turning a steering wheel and pooping hurts so damn much. even a tough guy won't be moving bodies once the adrenaline fades. Plus, as a bonus goodie, if he gets hit in that broken rib it can be pushed inward and puncture an organ.

Cracked ribs are reasonable. They still hurt like an sob, but they don't just end you.
 

Pony.

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I’ve bruised ribs in a motorcycle wreck, that was bad enough. If what I did was only a bruise, I seriously don’t want to know what a cracked or broken rib feels like. Everything hurt. Every move, every breath, every jolt and bump. There’s no way to lie down, sit, or just exist comfortably. Damage those ribs and narcotics will be your best friend.
 

Rabe

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I’ve bruised ribs in a motorcycle wreck, that was bad enough. If what I did was only a bruise, I seriously don’t want to know what a cracked or broken rib feels like. Everything hurt. Every move, every breath, every jolt and bump. There’s no way to lie down, sit, or just exist comfortably. Damage those ribs and narcotics will be your best friend.


Ditto. Basically, I see or read any scene where a person with cracked ribs is doing what is described and I'm immediately through with that book and writer. It would have to be some extremely extraordinary circumstance to get around the incredulous factor presented. And with a 60 year old? Nope.

But I feel the same about non-seat belted people in vehicle rollovers just walking away from the crash as well.
 

Bacchus

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I fractured a couple of ribs on the rugby pitch (I lost a contact lens at the same time but I had a spare...)

The doctor jokingly said that she couldn't exactly put them in a sling and that I would have to wait for six weeks - which almost to the day - is how long it took.

The first week was agony, sleep was impossible but the worst bit was laughing which hurt like Hades.

I was back at work after a few days but very careful and it was a desk job so easy enough to sit still. In my experience you realise that every single muscle in the body is connected directly to the ribs and there is no way your character could do heavy work without extreme pain. It's doable, of course, humans are remarkably resilient, but he would probably rather not.

As for being sixty... I am in my fifties. I look after myself and reckon could still take the knocks that I took in my twenties but have learned not to (c: The biggest difference as you get older is that bits ache for no reason.
 

mtj0000

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A fractured wrist in the traditional sense means radius and/or ulnar, he wouldn't be able to move that. If you have something like a fractured scaphoid which is one of the carpal bones in the wrist he might be able to move that.
People's response to rib fractures is highly variable. Young people might stay overnight in hospital if they've got a high pain tolerance an older person is more likely to need a few days to a week with an IV drip. With older people the bones are more fragile and they are more likely to have damage to the tissues underlying the ribs. Pneumonia takes a minimum of 5-7 days to develop and is more likely without adequate pain relief because people can't overcome the pain to breath deeply. There are no movement limitations from fractured ribs.
Even bruising from being kicked or punched can be very painful. You can do an x-ray and tell someone there is no fracture and they will look at you with incredulity because they are in so much pain.
In terms of driving providing the car is automatic he should be able to drive even one handed, having said that with those sorts of injuries car insurance wouldn't cover him for 2-6 weeks. I assume though that with dead bodies in the car the insurance would be the last thing your character would be thinking about.
 

Raindrop

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Bruised/squashed my floating ribs and my false ribs. I was fine as long as I didn't breathe. :Wha:

I couldn't sleep properly, and I certainly couldn't lie down (I was propped up in bed). I remember coughing a lot, which was as fun as you can imagine. I could walk and even carry stuff with my left arm, but I couldn't really move my right arm -- just no strength, because it was all bruised and swollen in there. I had trouble tying up my shoelaces, LOL!

It probably varies; although my injury wasn't bad (no actual fracture, just misplaced bits), the bruise itself was rather large. I don't want to know what *fractured* ribs feel like. I can still feel the main impact as a permanently sore spot at the bottom of the sternum, about 15 years after the fact.
 

bombergirl69

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Fractured two ribs when kicked by a horse. Hurt like a mofo--yes to pain while driving (I drive a pickup and remember slumping over on the console) and to never finding a comfortable position sitting or lying down, or standing, for that matter.) But, I still waited a week or so to get checked, then found out about the ribs. actually left after the X-ray and they had to call me with the results. But other than offering pain meds (nope) wasn't much they could do anyway. No restrictions (I didn't need any!) I used a rice pack heated in the microwave, then belted around my waist. I did go to work and was able to toss horses hay and lead them (I had one colic.) I was able to (gingerly) sight in a rifle. I could not carry stuff like a water bucket or a stack of files. I could not lift things (except that rifle!) so definitely could not have chopped wood, and could not have hauled anything on that side. I don't remember how long it took to heal but more than a month anyway!
 

talktidy

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I gave one of my characters bruised ribs -- I had intended broken, but that wasn't doable -- in my WIP and was thrown off track when my google-fu revealed what I thought I knew about the subject was utter tosh. None of that binding of the ribs malarkey.

Apparently, cold packs to reduce pain and inflammation is the way to go. Heat pads are not recommended. Although I can imagine if they help with the pain, there is a tendency to say to hell with it.
 

cmhbob

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Thanks all. Good info to sift through.

As part of the fight, he's going to fall hard on an outstretched hand, then get kicked several times while he's down. I have in mind that after the fight, he's basically going to decapitate the three dead men, then remove their hands. I was already planning on the wrist injury being a scaphoid fracture, and have written it so far that his hand and wrist are basically numb after several hours on the road. It's a big Class C RV, but it's newer, so all automatic and power everything. I've got him asking for help getting the rig set up at the RV park though (sewer and power).

I may come back to this thread when the draft is finished in a few months and ask a couple of you to beta-read.
 

WeaselFire

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He's going to need serious medication if he's lifting a body with broken, or even bruised, ribs. Any use of the diaphragm muscle, such as breathing, talking, lifting, straining, etc. will be very painful to downright debilitating. The wrist is a walk in the park compared to the ribs, though he won't be able to handle much of anything with that hand/arm.

Jeff
 

MaeZe

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Thanks all. Good info to sift through.

As part of the fight, he's going to fall hard on an outstretched hand, then get kicked several times while he's down. I have in mind that after the fight, he's basically going to decapitate the three dead men, then remove their hands. I was already planning on the wrist injury being a scaphoid fracture, and have written it so far that his hand and wrist are basically numb after several hours on the road. It's a big Class C RV, but it's newer, so all automatic and power everything. I've got him asking for help getting the rig set up at the RV park though (sewer and power).

I may come back to this thread when the draft is finished in a few months and ask a couple of you to beta-read.
Oh dear, I've always thought of a navicular fracture as a hand fracture, definitely not the wrist 'joint'. Well, guess it's clear ortho is not my specialty. But I am familiar with it as infamously not showing up on the initial x-ray. You have to look for it later as healing calcification then shows up on the X-ray.

Blaaap! Sorry MaeZe, 50%, you fail the exam. :tongue
 

ap123

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*raises hand* A few years ago I fell and fractured two ribs, wrist, and 3 fractures in my pelvis. Compared to the wrist and pelvis, the pain/limited mobility from the ribs was quite manageable. Shock and adrenaline could get your character through driving a few hours, sheer stubbornness a couple more, but I cannot see how he'd be able to dismember a body/do heavy lifting. Is he able to completely immobilize his wrist quickly? How? Thinking about driving, sitting was excruciating for me, but likely due more to the pelvic fractures.
 

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Hmong broken, bruised, cracked, and otherwise screwed my ribs up many many times I can say it's probably the second most painful injury I've had. (Tailbone being the first and damn does that hurt). Don't forget if he's on the ground he's likely going to curl in on himself both for protection and from pain.

I'll divide it between the top ribs (ribs 1-7, also have heard then referred to as the 'true ribs') and bottom ribs (ribs 8-12, also heard them referred to as the 'false ribs'. You know you spend to much time in the tender care of the emergency department when you start picking up on the medical terminology), though I'll sometimes refer to the floating ribs separately (those would be ribs 11/12) and in some cases distinguish between left and right sides of the rib cage. Keep in mind my medical knowledge is limited to listening to the docs grumble and experience watching them put me back together again. I don't know technical terms beyond some of the injuries I get which happen a little to often. Now I'm assuming this is an injury caused by blunt force trauma via a fist or foot rather then say some of the more creative ways of trying to murder your ribs cage. Also assuming you've missed damage to the actual organs. Keep in mind I have an incredible amount of pain tolerance. Put it this way, the nurses are no longer allowed to ask how much on a scale of 1-10 in order to figure out if I really need pain meds because my 3-4 is about other people's 12-'I'm in too much pain to count any higher' levels.

bruised ribs:
Top left- every movement is going to be painful. Breathing is painful, thinking about breathing is painful, muscle swelling and surrounding tissue swelling can really screw with internal organs. Best treatment I've found is a hot compress while laying on my non injuries side and wishing I was dead so I didn't have to feel pain anymore.
top right- pretty much the same deal, slightly less painful I find because you don't have to worry about that annoying muscle called the heart beating.
Either side you aren't going to be doing much heavy anything for a while without everything being painful. You probably could lift heavy objects but you would be in so much pain the next day after your body slept that you wouldn't be getting out of bed without assistance.
bottom ribs- hurt like hell but I could mostly ignore them. Was still able to ride, lift hay bales and buckets. Couldn't carry my backpack on my back though, stretched things that didn't need stretching.

fractured:
top- depending on how bad the fracture is, continuing to work especially if you do any kind of lifting or swinging creates a much higher chance of further damaging the ribs. If they are badly fractured it could cause them to go snap crackle pop in ways the body is never meant to do. In this case, (at least the two times I did it) rather then the ribs snapping in from the force of a blow, mine snapped outwards and not very much (in actual movement wise.) but I most certainly felt it (although that could have been the internal bleeding as my rib clipping some blood carrying vessel which was apparently important enough to warrant interesting reactions. Maybe because I was breathing out as I lowered one end of a trough of water in one case and the other dropping a sack of grain they snapped in weird ways. I would suppose if you were bent over to lift something it would snap inward as you generally inhale when lifting so your rib cage would be constricting.
bottom ribs- painful, you won't be doing much of anything. Kinda like being kicked in the balls I imagine but without the pain fading after awhile.
floating ribs- if it requires movement it's going to feel like someone forgot a sharp surgical instrument inside you after try cracked your rib cage like an egg. Just saying. Honestly fractured floaters hurt not then some of the breaks I've had.

broken:
now everytime I've broken my ribs I seem to get some kind of infection in the lungs. Though that could be my body loosing all faith in my ability to keep out of trouble.

Top (1-3)- honestly not that bad, at least for me. Most of the time I can get through the pain easily enough if the break isn't really that bad as breaks go. I usually show up in emerge either because of my lungs being infected (pneumonia sucks) or because of bleeding.
Top (4-7)- New levels of pain. Basically reached curl up in a ball and hope to die levels of pain. You are not doing anything else other then maybe reflexively trying to punch the wall (as opposed to the doctor) when they play poke and prod. You can work through it if you have a high pain tolerance but you risk further damage that would then have to be surgically corrected. On one memorable (and by memorable I mean mildly horrifying) occasion I had clipped a blood vessel that was apparently important in some way and blood started filling up between the ribs and lungs compressing them. I was fine for a while before I realized that breathing should be painful not increasingly difficult.
Bottom (8-10)- meh, not that bad unless you're still breathing. Yeah that breathing thing? Every time your rib cage expands and contracts it's going to send shooting pain through your body like a little kid jabbing a bad bruise with their finger as you get tased.
Floating ribs (11/12)- can't honestly say, mine were surgically removed after is broke them in such a way that they decided to migrate to other places. Mind this was after I had broken them a few times previously and so they weren't in the best of shape to begin with.