Justice Ruth Bader Ginsburg Breaks Ribs After Fall. What Does That Mean?

By Jamie Wells, M.D. — Nov 08, 2018
Did you know all falls are not alike, and why that is the case? Or why every rib fracture is not the same? Here are a few factors that influence prognosis.
By Steve Petteway, Collection of the Supreme Court of the United States (Ruth B…

Supreme Court Justice Ruth Bader Ginsburg fell in her office, according to media reports via the court released statement, and broke multiple ribs. As per CNBC,

“She went home, but after experiencing discomfort overnight, went to George Washington University Hospital early this morning," the statement from the court said. "Tests showed that she fractured three ribs on her left side and she was admitted for observation and treatment."

What does it mean to break multiple ribs?

You may recall Senator Rand Paul was assaulted last year and sustained multiple rib fractures. I wrote extensively about the consequences and evolving complications such injuries can cause in these two pieces:

  • To learn about what causes rib fractures and the compounding problems that breaking multiple bones can create in terms of reduced lung capacity and ventilation and so on, read here.
  • To learn about the negative chain reaction multiple rib fractures can cause and the significant complication Senator Rand Paul experienced, review here.

The profound difference between individuals in terms of prognosis depends on the extent to which they endured the injury, whether they can avoid the secondary impact the fractures created, what caused the problem and how robust their underlying health status is at the time. The Senator was violently assaulted. As per early reports regarding the Supreme Court Justice, she fell.

Why does the mechanism of injury matter so much?

When sustaining a fall, the key issues surround the context of the fall. For example, did someone simply accidentally trip or did they experience lightheadedness or dizziness that incited the trauma? This can speak to more worrisome reasons that need to be addressed (e.g. arrhythmias, stroke, dehydration, infection).

To learn more about why preventable injury by falling is among the top 5 leading causes of death, read here. A crucial aspect of a fall is whether or not other areas are injured, like the head. These can make situations escalate quickly in terms of risks for complications. Real estate matters in the body when it gets hurt - location is critical to outcomes. 

Does the damage done match the force and manner of the fall?

For instance, bumping into a desk while walking should expectedly cause nothing or a minor bruise. A forceful hug, for example, should not break someone’s ribs and if it does then it is necessary to consider what are called pathological fractures (ones from disorders of bone itself like severe osteoporosis or cancer).

To sum up

After reviewing the prior articles on multiple rib fractures, it will become clear how they can be extremely painful and prompt a cascade of untoward events. Hopefully, in this high profile case the course will be uneventful with a swift recovery. It appears through public reports that she has broken ribs in the past and it is good news that it apparently did not impact her ability to return to her normal activities then. That said, as we age our resilience to bounce back after injury gets somewhat diminished.

Time will tell and clinical status, etiology and location, like most medical realities, will give the greatest insight about extent and the degree of evolving concern of secondary effects.