Flail chest and pulmonary contusion.
Flail chest is most often accompanied by a significant underlying pulmonary parenchymal injury and can be a life-threatening thoracic injury. Its management is often complicated by the other injuries it is frequently associated with. Similarly, mortality and morbidity are dictated most often by the associated injuries and findings. Its treatment is complex and should first be one of pain management, judicious fluid resuscitation, and excellent pulmonary toilet. In those patients requiring mechanical ventilatory support, or who require ipsilateral thoracocotomy, rib stabilization may be considered depending on a host of potentially conflicting indications and contraindications. At the end of this section are listed the current major recommendations and their levels of evidence.
Bastos
Renata
R
Division of Cardiothoracic Surgery, University of Texas Health Science Center at San Antonio, San Antonio, TX 78229-3900, USA. bastos@uthscsa.edu
Calhoon
John H
JH
Baisden
Clinton E
CE
D003288:Contusions / Q000150:complications* / Q000000981:diagnostic imaging; D005409:Flail Chest / Q000150:complications / Q000000981:diagnostic imaging / Q000601:surgery*; D005440:Fluid Therapy / Q000009:adverse effects / Q000379:methods; D005592:Fracture Fixation / Q000379:methods; D006801:Humans; D008168:Lung / Q000000981:diagnostic imaging; D055370:Lung Injury; D011663:Pulmonary Surfactants / Q000627:therapeutic use; D011859:Radiography; D012121:Respiration, Artificial / Q000379:methods; D012253:Rib Fractures / Q000601:surgery; D019616:Thoracic Surgical Procedures; D016896:Treatment Outcome
D011663:Pulmonary Surfactants