Category: General

  • 16
  • Oct
Broken (Fractured) Ribs
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Brief Outline of Broken (Fractured) Ribs

Contact sports such as football and hockey, or sports that may result in falls or blunt trauma to the chest have a higher incidence of rib fractures than other sports. Pain and tenderness over the rib cage after blunt trauma or a fall, especially with difficulty breathing, should always be treated as potentially broken ribs, and medical help sought.

Anatomy and physiology of Broken Ribs

There are twelve pairs of ribs, comprising true, false, and floating ribs. The first seven pairs are known as true ribs, and attach by costal cartilage directly to the sternum. The next three pairs are known as the false ribs, and attach to costal cartilage but not directly to the sternum. The final two pairs of ribs are known as floating ribs, and lack attachment either to costal cartilage or to the sternum.

Ribs

The ribs protect the organs inside the chest (thoracic) cavity, and are also essential in the breathing mechanism. The muscles responsible for opening up the chest cavity, to allow air to enter the lungs, attach to the ribs. The ribs are more flexible than many other bones due to their cartilaginous attachments. When the ribs or the cartilage attachments fracture or break, they weaken the support and protection of the chest cavity. This also interferes with the muscles’ ability to open the chest cavity effectively to allow for adequate ventilation, which results in poor air intake and oxygen exchange. Any of the ribs may fracture, and often more than one ribs is involved in the injury.

Cause of Broken Ribs

Hard blow to the chest, side or back. Fall, landing on the chest, back or side. Forceful coughing – most common in people with impaired bone health e.g. osteoporosis.

Signs and symptoms of Broken Ribs

Pain and tenderness over the fracture site, which may be noted also when pressing on the sternum or compressing the rib cage. Pain and difficulty breathing, especially on inhalation. Depending on the number of ribs involved, irregular movement of the chest during respiration may be noted, as well as some swelling.

Complications if left broken ribs unattended

Fractured ribs that are left unattended will be painful and could lead to infections in the lungs due to shallow breathing. Reduce oxygen levels may result from the lower volume of air taken in. The bone ends may separate and cause damage to the delicate lung tissue underneath, causing a punctured lung or other damage; possibly even to the heart. Overall stability of the chest cavity will be affected also.

Treatment for Broken Ribs

If a rib fracture is suspected, seek medical attention. Anti-inflammatory injection can be administered to reduce the inflammation to the painful area.

Rehabilitation and prevention for Broken Ribs

Rest is essential for recovery and repair of fractured ribs. It is important to take at least one deep, lung expanding breath each hour to ensure adequate lung tissue involvement and avoid infections in the lungs. Protecting the injured area until it is completely healed is important. Due to the inability to totally rest this area because of its constant movement during respirations, it takes longer to heal, usually 6-8 weeks.

Building muscle mass in the chest and back will help protect the ribs from injury. Avoiding trauma to the rib cage is the most important step in preventing rib fractures.

Orthopaedic Specialist Treating Broken Ribs

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

Book Appointment Online for Broken Ribs Treatment

  • 14
  • Oct
Pectoral Muscle Insertion Inflammation
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Brief Outline of Pectoral Muscle Insertion Inflammation

The pectoralis major or pectoral muscle is used in many sports when the arms act to push away a weight (as during weight lifting) or another athlete (during various contact sports). Repetitive activity, particularly bench pressing, can cause irritation to the muscle or tendon’s insertion point, leading to discomfort and loss of mobility.

Anatomy and physiology

The large pectoralis major muscle forms the anterior wall of the axilla, and has its origin in the clavicle, sternum, and first six costal cartilages, inserting in the greater tubicle of the humerus bone. The muscle adducts and medially rotates the humerus. The clavicular portion flexes and medially rotates the shoulder joint, and horizontally adducts the humerus towards the opposite hip. It is one of the main climbing muscles, pulling the body up to the fixed arm.

Cause of Pectoral Muscle Insertion Injury

Excessive load on the pectoralis major muscle, especially when bench-pressing. Excessive force against the pectoral from pushing activities in contact sports. A fall on to one or both outstretched arms.

Signs and symptoms of Pectoral Muscle Insertion Inflammation

Pain and weakness in the shoulder. Difficulty raising the arm. Pain or stiffness during lifting.

Complications if left Pectoral Muscle Insertion Inflammation unattended

Irritation of the pectoral muscle insertion will become further aggravated if it is neglected. Tears in the muscle or tendon can develop, leading to increased pain and weakness and the danger of long-term degeneration of muscle and tendon. Should tearing at the insertion point become serious, surgery may be required to repair it.

Treatment for Pectoral Muscle Insertion Inflammation

Rehabilitation and prevention

Thorough healing time must be allowed for the pectoral muscle and associated tendons. Strength training of the pectorals through weights will generally help restore the athlete to prior condition, providing that no serious tearing of the muscle has resulted. Attention to proper weight training technique and a gradual, rather than sudden increase in stress on the pectoral muscle, can help prevent this injury.

Long-term prognosis for Pectoral Muscle Insertion Inflammation

Given proper care and healing time, combined with gradual strength training of the pectoral muscles and complex of shoulder muscles, the athlete may generally expect a full return to normal activity.

Orthopaedic Specialist Treating Pectoral Muscle Insertion Inflammation

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

Dr Kevin Yip

  • 11
  • Oct
Muscle Strain (Biceps Brachii, Chest)
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Brief Outline of Muscle Strain (Biceps Brachii, Chest)

Muscle strains are among the most common sports injuries and often result from the sudden extension of a joint beyond its normal range of function. This causes damage to muscle and other soft tissue. The chest muscles (pectoralis major and minor) joint the biceps brachii muscle at the shoulder joint. Weight training, sudden, violent torsion of the shoulder during throwing sports, or a sudden force applied to the nexus of the pectorals and biceps brachii (as when warding off a check in hockey with the arm extended), can produce such injuries.

Anatomy and physiology

The biceps brachii muscle is located on the front of the upper arm, and operates over three joints. Its function is to allow bending of the arm and to support loads placed on the arm. This muscle has two parts, known as the long head and short head, both connected to bone via the biceps brachii tendon.

Along with the pectoralis minor, the large pectoralis major muscle forms the anterior wall of the axilla, and has its origin in the clavicle, sternum, and first six costal cartilages, inserting in the greater tubecule of the humerus bone. The muscle is used for flexion, adduction, and medial rotation. It joins the biceps brachii muscle, meeting at the shoulder joint.

Cause of Muscle Strain (Biceps Brachii, Chest)

Sudden movement leading to a muscle tear. Large physical demand placed on the muscle. Warding off a check in hockey or tackle in football.

Signs and symptoms of Muscle Strain

Tenderness and pain over the affected muscle. Stiffness. Pain during muscle use.

Complications if left Muscle Strain unattended

Muscle strains are usually self-limiting  and repair themselves given proper time off from exertion and allowing time for healing. Insufficient recovery time however can lead to further tearing, increasing the risk of re-injury and lead to degenerative changes in the muscles over time.

Treatment for Muscle Strain

  • Anti-inflammatory medication
  • Injection
  • Physiotherapy

Rehabilitation and prevention for Muscle Strain

Stretching exercises follow healing can help restore full mobility in the affected area while strengthening exercises can help prevent re-injury. Stretching and warm-ups, as well as attention to proper athletic technique (particularly in weight training) may help prevent this type of injury.

Long-term prognosis for Muscle Strain

Muscle strains involving the pectoral muscles of the chest and/or the biceps brachii are common and – given adequate time for proper healing – generally not a serious threat to the athlete, although severe or repeated muscle strains can cause chronic pain and lead to impairment of muscle function.

Muscle Strain Specialist

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore

  • 10
  • Oct
Sternoclavicular Separation
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Brief Outline of Sternoclavicular Separation

Sternoclavicular separation occurs when a ligament connecting the collar bone or clavicle to the breastbone or sternum is torn. Rotation at the joint is affected by this injury, which may occur during contact sports when the shoulder forcefully strikes the ground or is landed upon by another player. The separation may occur anteriorly or posteriorly (in front of or behind the breastbone). Sternoclavicular Separation

Anatomy and physiology

The sternoclavicular (SC) joint is functionally a ball-and-socket joint, but unlike most articular surfaces, the articular cartilage is fibrocartilage rather than hyaline cartilage. The SC joint is surrounded by a joint capsule, thickened anteriorly and posteriorly by: the posterior sternoclavicular ligament, the anterior sternoclavicular ligament, the costoclavicular ligament, and the interclavicular ligament. The sternoclavicular joint is strong and generally resistant to dislocation, and has a wide range of movement. Sternoclavicular Anatomy

Cause of Sternoclavicular Separation

Direct blow to the sternum. Fall onto the shoulder or outstretched hands. Shoulder striking the ground, or another athlete landing on top of the shoulder.

Signs and symptoms of Sternoclavicular Separation

Pain, swelling, and tenderness over the sternoclavicular joint. Abnormal movement between the breastbone and the collar bone. Possible displacement of the collar bone in front of or behind the breastbone.

Complications if left Sternoclavicular Separation unattended

Untreated sternoclavicular separation can lead to loss of motion and ongoing pain, stiffness, and weakness. Furthermore, in cases where the collar bone is forced behind the breastbone, a risk exists for damage to the underlying blood vessels in the chest or the heart, requiring surgical intervention.

Treatment for Sternoclavicular Separation

  • Reduction of the joint is needed
  • Immobilisation

Rehabilitation and prevention for Sternoclavicular Separation

As the injury is generally caused in a sports accident, prevention is usually not possible. In the case of anterior injury to the sternoclavicular joint (the most common), the condition is generally resolved without permanent complication, following adequate healing time. In more severe cases, surgery may be required. Range of motion exercises should help restore movement and rotational ability.

Long-term prognosis for Sternoclavicular Separation

With adequate time for healing, the injured athlete typically makes a full recovery. If the injury is serious (particularly in the case of posterior dislocation) instability of the joint may persist, in some case requiring surgery.

Sternoclavicular Separation Shoulder Orthoapedic Specialist, Dr Kevin Yip

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore
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  • 09
  • Oct
Fracture (Collar Bone, Humerus)
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Brief Outline of Fracture (Collar Bone, Humerus)

Fractures of the shoulder usually involve a break in either the clavicle (collar bone) or the neck of humerus (arm bone), or both. Impact injuries involving a sudden blow to the shoulder or a fall are usually responsible. Contact sports including football and rugby can result in shoulder fractures following a violent collision of two players.

Anatomy and physiology

The clavicle (collar bone) is a slender, doubly curved bone that attaches to the manubrium of the sternum medially (the sternoclavicular joint) and to the acromion of the scapula laterally (the acromioclavicular joint). The clavicle protects the underlying brachial plexus, pleural cap, and great vessels of the upper extremity. Clavicle fractures are common, often resulting from a fall on the lateral shoulder or on an outstretched arm. The humerus (arm bone) is the longest and largest bone of the upper limb. It articulates proximally with the scapula (at the glenoid fossa). Fractures to the humerus are generally the result of a fall on an outstretched arm. Broken Collarbone

Cause of Fracture (Collar Bone, Humerus)

Fall on an outstretched arm. Sudden blow to the clavicle. Collision of two athletes in sports, e.g. football.

Signs and symptoms of Fracture Collar Bone

Severe pain. Redness and bruising around the site of the injury. Inability to raise the arm.

Complications if left Fracture Collar Bone unattended

Complications are uncommon, although pneumothorax, haemothorax, and injuries to the brachial plexus or subclavian vessels are possible, requiring medical intervention. Chronic pain due to osteoarthritis may result should the injury be given insufficient time to heal.

Treatment for Fracture Collar Bone

  • Immobilisation using an arm sling if the fracture is undisplaced
  • Surgery if the bones are displaced

Rehabilitation and prevention for Fracture Collar Bone

Bones of the clavicle and humerus must first be realigned following fracture, so that proper healing may ensue. Healing occurs while the clavicle and arm bones are held in place with a strap or sling. After healing, physical therapy, including range of motion and strengthening exercises should be undertaken to restore full movement and flexibility.

Long-term prognosis for Fracture Collar Bone

Most shoulder fractures are successfully treated without resort to surgery, although this is occasionally required for fractures of the clavicle. For less severe fractures, full recovery and restoration of mobility may be expected. In the case of more severe fractures and particularly in older patients, some loss of motion and possibility of osteoarthritis exist.

Bone Fracture Orthoapedic Specialist, Dr Kevin Yip

Dr Kevin Yip Orthopaedic Surgeon Gleneagles Singapore
Book Appointment Online for Fracture Collar Bone Treatment
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