title: Contemporary management of flail chest.
abstract: Thoracic injury is currently the second leading cause of trauma-related death and rib fractures are the most common of these injuries. Flail chest, as defined by fracture of three or more ribs in two or more places, continues to be a clinically challenging problem. The underlying pulmonary contusion with subsequent inflammatory reaction and right-to-left shunting leading to hypoxia continues to result in high mortality for these patients. Surgical stabilization of the fractured ribs remains controversial. We review the history of management for flail chest alone and when combined with pulmonary contusion. Finally, we propose an algorithm for nonoperative and surgical management.
authors.affiliation: Department of Surgery, Loyola University of Chicago, Maywood, Illinois, USA.
authors.forename: P Geoff
authors.initials: PG
authors.lastname: Vana
authors.forename: Daniel C
authors.initials: DC
authors.lastname: Neubauer
authors.forename: Fred A
authors.initials: FA
authors.lastname: Luchette
mesh_terms: D019468:Disease Management; D005409:Flail Chest / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D005593:Fracture Fixation, Internal / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D012253:Rib Fractures / Q000150:complications / Q000175:diagnosis / Q000601:surgery; D014057:Tomography, X-Ray Computed