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In some cases, lots of forceful coughing -- like from a bout of pneumonia -- can cause rib fractures. Most of the time, the broken rib is only broken in one place, and is an incomplete fracture, meaning not all the way through the bone. Completely broken ribs may or may not move out of place. If they do move, they're called displaced rib fractures and are more likely to puncture lungs or damage other tissues and organs. Ribs that stay in place -- usually ribs that are not completely broken in half -- are called nondisplaced rib fractures.
A puncture wound through the chest wall. If a knife or stick or the like punctures the chest wall, air comes pouring in from the outside. A weak spot in the lung that starts leaking. Emphysema or other smoking damage to the lungs can do this, as can asthma, pneumonia, or lung cancer.