Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Portable supine view the chest provided . Interval placement of a left chest tube noted . A pigtail chest tube is also seen . Left chest wall emphysema is new from prior . There is small residual left pneumothorax . Left rib fractures are now seen which appear acute . Left humeral shaft fracture again noted .
    OUTPUT:
    
1 . Left chest tube in place . Small residual left pneumothorax . 2 . New left chest wall emphysema . 3 . Left - sided rib fractures appear acute . 4 . Left humeral shaft fracture again noted .