What is a 'flail segment'?
When there are three of more contiguous ribs with fractures in two or more places.
Chest
- Slightly displaced right posterior first rib fracture with an adjacent small extra pleural haematoma. This is away from the right subclavian vessels which enhance normally.
- Right 3rd-7th rib fractures laterally (3rd - 5th are 'flail segments’).
- Right extrapleural gas (+/- tiny right pneumothorax).
- Tiny left pneumothorax.
Thoracic spine
- Unstable 3 column fracture through the T9 vertebral body (Chance fracture). Surrounding haematoma.
- Left T1 transverse process fracture.
Abdomen/Pelvis
- Slit like IVC – hypovolaemia.
Incidental findings
- Right lung calcified granulomas.
- Small hiatus hernia.