Edges

Edges – the arc-shaped pair flat bones which, connecting a backbone and a chest bone, form a thorax. On the thickness the edge seldom exceeds 5 millimeters.

Structure of edges

Edges represent the curved narrow plates consisting from:

• Bones (long spongy bones with a head, a neck and a hillock) – in the longest (back) part;
• Cartilage – in shorter (front) part.

The body of an edge has internal (concave) and outside (convex) the surfaces limited rounded off and acute to edges. Vessels and nerves are located in the furrow passing on an internal surface of bottom edge.

At the person up to twelve edges on each party which are connected to bodies of chest vertebrae the back ends. Edges on a way of fastening divide into three groups:

• Seven upper edges (true edges) the front ends connect directly to a breast;
• Three following, false edges, are connected by the cartilages to a cartilage of the previous edge;
• Two lower edges (the fluctuating edges) the front ends lie freely.

Connect to a breast and vertebras of an edge by means of all types of connections:

• Synarthroses (syndesmoses and synchondroses);
• Symphyses;
• Diarthrosis.

The thorax is covered by a connective tissue cover from within, at once under which the pleura consisting of two smooth leaves is located. Freely allows to slide between leaves at breath a thin layer of lubricant.

Function of edges

Treat the main functions of edges:

• Protective function. Edges, forming a thorax, close heart, easy and large vessels from injuries and external influences;
• Frame function. The thorax promoting deduction of bodies in a chest cavity in the necessary situation does not allow heart to be displaced in the parties and to be fallen down by a lung.

Fracture of edges

It is possible to allocate three main groups of the reasons because of which edges hurt:

• Damage of the internals located directly in a thorax;
• Defeat of vessels and nerves;
• Disturbance of a framework of a chest wall.

The fracture of edges belongs to one of the most widespread injuries of a thorax and, as a rule, meets at elderly people more often that is connected with age change of elasticity of bone structures of a thorax.

Most often injuries as a result are the reasons of a fracture of edges:

• Falling;
• Direct stroke to the area of edges;
• Thorax prelums.

Edges break more often on the side surfaces of a thorax (in places of the greatest bend) that causes pain in this area. In many cases of an edge hurt not right after an injury, and a bit later when bone fragments begin to rub at breath (especially at a breath) and the movement.

The partial disturbance of integrity of an edge without the shift of bone fragments arising because of an injury or pathological process in an organism is called an incomplete change.

The incomplete change can arise both because of an injury, and because of defeat of an inert part of an edge the pathological process leading to reduction of durability of a bone tissue, for example:

• At osteoporosis (states at which salts of calcium are washed away from a bone tissue);
• At development of tumors in a thorax;
• At tuberculosis of edges;
• At a chronic inflammation of a bone tissue of an edge;
• At diseases of blood (multiple myeloma).

Uncomplicated fractures of one or several edges usually do not represent threat for health and human life. The main danger at this injury is:

• Internal injury;
• Breath disturbance;
• Development of the accompanying complications.

More serious danger is constituted by multiple fractures of edges that is connected with increase of risk of development of plevropulmonalny shock and life-threatening complications (for example, pheumothorax and a hemothorax). Besides, at a multiple fracture it is often observed by the shift of fragments which pose a threat for a pleura, easy and intercostal vessels because of the acute ends.

Also the change can bring:

• To development of the hypodermic emphysema caused by penetration of air into hypodermic cellulose at injury of a lung;
• To plentiful bleeding in soft tissues or a pleural cavity at damage of intercostal vessels.

At multiple fractures edges strongly hurt, at the same time pain amplifies at the movements, breath, cough, a conversation and decreases at rest and in a sitting position. Also at multiple fractures of edges shallow breathing and lag of a thorax on the party of defeat is observed.

The broken rib comes to light at a palpation as the most healthy place, and also on a peculiar crunch of bone fragments (bone crepitation). The diagnosis can usually be confirmed by means of a thorax X-ray analysis, and in suspicion cases on pneumo - and a hemothorax it is necessary to carry out in addition ultrasonography of a pleural cavity, a roentgenoscopic research and a pleurocentesis.

To thicket front and side fractures of edges which are, as a rule, transferred more hard are followed by disturbance of breath. Damage of back departments of edges causes disturbance of lung ventilation less often.

Treatment of a fracture of edges

At a fracture of edges in most cases fixing is not required, except for the complicated and multiple fractures which treatment has to take place only in hospital conditions.

Fixing of a thorax without indications can lead to a bigger restriction of breath that in turn promotes development of developments of stagnation, including congestive pneumonia.

The average term of treatment of uncomplicated fractures of edges – about one month, and term of treatment of the multiple and complicated changes depends on the general state and weight of the arisen complications.