Ribs and clavicles are necessary as part of the framework for normal breathing. When broken, the ribs and clavicles can no longer act as a scaffold for proper inspiration and respiration becomes diminished. With pneumothorax, the seal between the ribcage and lungs is further compromised leading to worsening respiratory condition. Without adequate respiration, carbon dioxide is not exhaled properly and builds up in the blood, causing the blood to be acidified. This can result in decompensation and acidosis necessitating intubation and transfer for a higher level of care at a trauma center.
The risk of death due to complications increases with every additional rib fractured, and an individual sustaining more than 6 rib fractures has a significant risk of death due to pneumonia, empyema, pneumothorax, or other complicating factors. Pneumothorax around may require major surgical intervention. Secondary pneumonia is a common complication. Another complication is gastritis with gastric bleeding. Prolonged ventilator support may lead to placement of a tracheostomy tube and/or a gastrostomy tube. Prolonged hospitalizations can lead to severe deconditioning, ongoing pain, significant internal adhesions, and external scarring.