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A flail chests occurs when a segment of the thoracic wall breaks under extreme stress and becomes detached from the rest of the chest wall.
Additional recommended knowledge
It is a serious, life-threatening chest injury often associated with underlying pulmonary injury and is most commonly seen in cases of significant blunt trauma.
This typically occurs when three or more ribs are fractured in two or more places, allowing that segment of the thoracic wall to displace and move independently of the rest of the chest wall. Flail chest can also occur when ribs are fractured proximally in conjunction with disarticulation of costochondral cartilages distally. For the condition to occur, generally there must be a significant force applied over a large surface of the thorax to create the multiple anterior and posterior rib fractures. Rollover and crushing injuries most commonly break ribs at only one point– for flail chest to occur a significant impact is required, breaking the ribs in two or more places.
The characteristic paradoxical motion of the flail segment occurs due to pressure changes associated with respiration that the rib cage normally resists:
The constant motion of the ribs in the flail segment at the site of the fracture is exquisitely painful, and, untreated, the sharp broken edges of the ribs are likely to eventually puncture the pleural sac and lung, which may be fatal.
Treatment of the flail chest initially follows the principles of Advanced Trauma Life Support. Further treatment includes:
Surgical fixation is usually not required.
|This article is licensed under the GNU Free Documentation License. It uses material from the Wikipedia article "Flail_chest". A list of authors is available in Wikipedia.|