elderly people. Treatment There is no specific treatment for rib fractures, but various supportive measures can be taken. In simple rib fractures, pain can lead to reduced movement and cough suppression; this can contribute to formation of secondary chest infection. Flail chest is a potentially life-threatening injury and will often require a period of assisted ventilation. Flail chest and first rib fractures are high-energy injuries and should prompt investigation of damage to underlying viscera (e.g., lung contusion) or remotely (e.g., cervical spine injury). Spontaneous fractures in athletes generally require a cessation of the cause, e.g., time off rowing, while maintaining cardiovascular fitness. Nerve blocks Nerve blocks that may be used to help with pain and reduce respiratory complications related to rib fractures. These include rhomboid intercostal block, epidural anesthesia, paravertebral block, erector spinae plane block and serratus anterior plane block. There is very little evidence to support the use of one nerve block over another on the basis of analgesia or safety. Surgery Treatment options for internal fixation/repair of rib fractures include: Judet and/or sanchez plates/struts are a metal plate with strips that bend around the rib and then is further secured with sutures. There are different specialist rib fixation systems on the market. They have two options: a precontoured metal plate that uses screws to secure the plate to the rib; and/or an intramedullary splint which is tunneled into the rib and secured with a set screw. Anterior locking plates are metal plates that have holes for screws throughout the plate. The plate is positioned over the rib and screwed into the bone at the desired position. The plates may be bent to match the contour of the section. U-plates can also be used as they clamp on to the superior aspect of the ribs using locking screws. See also Pulmonary hygiene References External links Chest trauma Bone fractures Injuries Wikipedia medicine articles ready to translate