Treatment of choice of flail chest is
.It is fracture of two or more consecutive ribs, with each rib having two or more fracture sites. Such segment is called as flail segment. Treatment  Intercostal tube drainage.  Applying clips to fracture ribs and fi xing above and below to normal ribs.  Antibiotics like penicillins, cefotaxime.  Blood transfusion, IV fluids.  Bronchodilators, steroids.  Ventilator suppo with IPPV--IPPV is treatment of choice. Assisted ventilation is required for several days until the chest wall stabilises. If ventilator suppo is required for more than 10 days, then tracheo stomy is done to prevent laryngeal stenosis which can occur due to prolonged endotracheal intubation.  Thoracotomy--when required only. Ref: SRB's Manual of Surgery, 4th Edition, pg. no. 1196
Ext. fixation of flail segment & mech ventilation
Strapping
O2 administration
Intrapleural local analgesia
Trauma