chest wall injury

Flail Chest

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flail chest
chest wall stabilization

Multiple rib fractures with a flail chest segment

The upper image is a 3-D reconstruction of the chest of the patient who was involved in a motor vehicle accident. The arrows are pointing to the rib fracture sites. Several ribs were broken in two or more places creating a flail chest segment with a paradoxical chest movement. Considering the extent of the ribs fractures, the patient was taken to OR for a chest wall stabilization (image below).

Chest wall stabilization

I am a big proponent of the chest wall stabilization for patients with severe chest trauma and flail chest. In my experience, it facilitates weaning from the ventilator, pain control and improves activity. Should it become the standard of care?

Chest wall stabilization for flail chest - is it ready for the prime time?

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Severe chest wall injury and flail chest – those are very difficult injuries to treat. The greatest challenge is to wean those patients off mechanical ventilation and keep them off the ventilator. Pain control is a problem as well – often patients end up having epidural catheter for analgesia. The recovery is long and painful for the patients with severe chest wall injury. Not surprising, the functional capacity is diminished for many months after the discharge from the Hospital. There is a lot of literature out there about the treatment options of these injuries. In my practice, I have seen great benefits from a chest wall stabilization procedure (click on image above). In my experience it was easier to wean the patients off the ventilator, pain was better controlled and the patients, in general, did better from activity standpoint. Those are the observations from my practice. I do believe in this treatment modality and I hope to see it becoming the standard of care.

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