Chest Wall Bruise (Contusion) (Child)

The chest wall runs from the shoulders to the diaphragm or bottom of the ribs. It includes the front and back of the rib cage. It also includes the breastbone, shoulders, and collarbones. A blunt trauma such as during a car accident or fall can injure the chest wall. This injury is called a chest wall bruise (contusion).

Injury to the chest wall may result in bruising and swelling. It may also result in broken ribs and injured muscles. These cause pain, often during breathing. If one or more ribs are broken in several areas, the chest wall may become unstable and painful. This may cause serious breathing trouble.

In the emergency room or urgent care center, any broken bones or other injuries will be assessed. Your child will likely be given medicine for pain. Broken ribs usually heal without further treatment. A broken shoulder or collarbone may be taped or supported with a sling.

Home care

  • The child’s provider may prescribe medicines for pain or swelling. Follow the provider’s instructions for giving these medicines to your child. Don't use additional or other pain medicines without first talking with your healthcare provider.

  • Allow your child to rest as needed. Give pain medicine before an activity or sleeping at night.

  • Change a sling, tape, or dressings as advised by the healthcare provider.

  • Position your child so that he or she is as comfortable as possible.

  • Follow the healthcare provider’s instructions for putting ice or heat on the injury.

  • Have your child hold a pillow against the chest to ease pain when breathing and coughing.

Follow-up care

Follow up with your child’s healthcare provider, or as advised.

Special notes to parents

  • A child’s chest wall is very flexible. During an injury, more force may be placed on the internal organs, such as the lungs and heart, than on the chest wall bones. As a result, a child’s chest wall may look fine even if there are serious internal injuries. So always get your child medical attention for a serious blow to the chest wall.

  • After being injured in a car accident or by a fall, your child may have fears and nightmares about the injury. This can last for several months to many years. If the fear affects your child’s ability to function, talk to the child’s provider. Therapy or other help may be needed.

When to seek medical advice

Call your child's healthcare provider if your child has any of the following:

  • Continuing or worsening pain not relieved by pain medicine

  • Trouble breathing, shortness of breath, or fast breathing

  • Swelling or bruising that doesn’t go away or gets worse

  • Signs of infection such as increased redness or swelling, worsening pain, or foul-smelling drainage from a wound

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