User:Mr. Ibrahem/Flail chest
| Flail chest | |
|---|---|
 | |
| A 3D reconstruction from a CT scan showing a flail chest. Arrows mark the rib fractures. | |
| Specialty | Emergency medicine |
| Symptoms | Chest pain, trouble beathing[1] |
| Complications | Pulmonary contusion, pneumothorax[2] |
| Causes | Blunt chest wall trauma[2] |
| Risk factors | Old age, osteogenesis imperfecta[2] |
| Diagnostic method | Based on symptoms, supported by medical imaging[2] |
| Differential diagnosis | Aortic dissection, pulmonary embolism, sternal fracture, esophagitis[2] |
| Treatment | Oxygen therapy, non-invasive ventilation, mechanical ventilation, pain management, surgery[2] |
| Frequency | 7% of major chest trauma[2] |
| Deaths | 15% risk[2] |
Flail chest is when a segment of the rib cage becomes detached from the rest of the chest wall, due to trauma.[2] Symptoms may include chest pain and trouble beathing.[1] Complications may include pulmonary contusion (bruise of lung tissue), and pneumothorax.[2]
The cause is typically significant blunt chest wall trauma, such as may occur during a motor vehicle collision.[2] Risk factors include old age and osteogenesis imperfecta.[2] The underlying mechanism involves at least three adjacent broken ribs in at least two places, such that part of the chest wall moves independently.[2][3] This results in the flail segment moving in the opposite direction as the rest of the chest wall.[2] Diagnosis is based on symptoms, which may be supported by medical imaging.[2]
Initial management may include oxygen therapy, non-invasive ventilation, or mechanical ventilation.[2] Pain management including nerve blocks may be required.[2] Surgery, to fix the fractures, appears to result in better outcomes.[4][3] Some people following recovery have chronic pain or remain disabled.[3]
A flail chest occurs in about 7% of major chest trauma.[2] Males are more commonly affected than females.[2] The risk of death is about 15%; though is often due to associated injuries.[2] The condition was first clearly described in 1955.[3]
References[edit]
- ^ a b "Flail Chest - Trauma - Orthobullets". www.orthobullets.com. Archived from the original on 8 November 2021. Retrieved 6 July 2022.
- ^ a b c d e f g h i j k l m n o p q r s t Perera, TB; King, KC (January 2022). "Flail Chest". PMID 30475563.
{{cite journal}}: Cite journal requires|journal=(help) - ^ a b c d Majercik, Sarah; Pieracci, Fredric M. (May 2017). "Chest Wall Trauma". Thoracic Surgery Clinics. 27 (2): 113–121. doi:10.1016/j.thorsurg.2017.01.004.
- ^ Coughlin, TA; Ng, JW; Rollins, KE; Forward, DP; Ollivere, BJ (August 2016). "Management of rib fractures in traumatic flail chest: a meta-analysis of randomised controlled trials". The Bone & Joint Journal. 98-B (8): 1119–25. doi:10.1302/0301-620x.98b8.37282. PMID 27482027.