Flail chest refers to
(B) Fracture of multiple ribs > A flail chest occurs when a segment of the chest wall does not have bony continuity with the rest of the thoracic cage .> Flail chest usually results from blunt trauma associated with multiple rib fractures i.e. 3 or more ribs fractured in 2 or more places.# Major chest wall trauma (Flail chest)> This occurs when several adjacent ribs are fractured in two places either on one side of the chest or either side of the sternum.> The flail segment moves paradoxically, i.e.-inwards during inspiration and outwards during expiration, thereby reducing effective gas exchange.> The net result is poor oxygenation from injury to the underlying lung parenchyma and paradoxical movement of the flail segment.> The underlying lung injury with loss of alveolar function may result in deoxygenated blood passing into the systemic circulation> This creates a right-to-left shunt and prevents full saturation of arterial blood.> In the absence of any other injuries and, if the segment is small and not embarrassing respiration, the patient may be nursed on a high-dependency unit, with regular blood gas analysis and good analgesia until the flail segment stabilizes.> In the more severe case, endotracheal intubation is required with positive-pressure ventilation for up to 3 weeks, until the fractures become less mobile.> Thoracotomy with fracture fixation is occasionally appropriate if there is an underlying lung injury to be treated at the same time.> An anterior flail segment with the sternum moving paradoxically with respiration can be stabilized by internal fixation but operative management is not usually for either.
Fracture of Sternum
Fracture of multiple ribs
Open pneumothorax
Tension pneumothorax
Miscellaneous