Flail chest
Updates to Article Attributes
Flail chest or segment occurs when three or more contiguous ribs are fractured in two or more places. Clinically, a segment of only one or two ribs can act as a flail segment, hence there is some controversy between the clinical and radiological definitions.
Clinical presentation
Clinically, this is observed in a non-ventilated patient as paradoxical movement of the flail segment. It can often be clinically occult 4-5. Its significance lies in the fact it can lead to severe ventilation difficulties in ventilation, especially in the peri-intubated patient.
Pathology
A flail chest is predominantly regarded as a marker for chest trauma severity and is almost always associated with other thoracic injuries, which are also major contributors to respiratory insufficiency, such as 1, 2, 5:
Aetiology
Flail chest is most commonly associated with high-impact thoracic blunt trauma and results from severe anteroposterior compression found in motor vehicle collisions, blast or crush injuries 5.
Radiographic appearance
Chest x-ray is less sensitive than CT for the diagnosis of flail segments 4.
Treatment and prognosis
Flail chest can be treated with medically with 'internal splinting' using positive pressure ventilation or internal fixation is sometimes performed 3.
-<p><strong>Flail chest </strong>or <strong>segment</strong> occurs when three or more contiguous <a href="/articles/ribs">ribs</a> are <a href="/articles/rib-fractures">fractured</a> in two or more places. Clinically a segment of only one or two ribs can act as a flail segment, hence there is some controversy between the clinical and radiological definitions.</p><h4>Clinical presentation</h4><p>Clinically, this is observed in a non-ventilated patient as paradoxical movement of the flail segment. It can often be clinically occult <sup>4-5</sup>. Its significance lies in the fact it can lead to severe difficulties in ventilation, especially in the peri-intubated patient.</p><h4>Pathology</h4><p>A flail chest is predominantly regarded as a marker for chest trauma severity and is almost always associated with other thoracic injuries, which are also major contributors to respiratory insufficiency, such as <sup>1, 2, 5</sup>:</p><ul>- +<p><strong>Flail chest </strong>or <strong>segment</strong> occurs when three or more contiguous <a href="/articles/ribs">ribs</a> are <a href="/articles/rib-fractures">fractured</a> in two or more places. Clinically, a segment of only one or two ribs can act as a flail segment, hence there is some controversy between the clinical and radiological definitions.</p><h4>Clinical presentation</h4><p>Clinically, this is observed in a non-ventilated patient as paradoxical movement of the flail segment. It can often be clinically occult <sup>4-5</sup>. Its significance lies in it can lead to severe ventilation difficulties, especially in the peri-intubated patient.</p><h4>Pathology</h4><p>A flail chest is predominantly regarded as a marker for chest trauma severity and is almost always associated with other thoracic injuries, which are also major contributors to respiratory insufficiency, such as <sup>1, 2, 5</sup>:</p><ul>
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