FLAIL CHEST: Epidemiology, exploration, management, and prognostic factors

Thoracic traumas are frequent in emergency rooms and constitute a major public health problem. Flail chest, defined by multiple fractures on ¿3 levels, are serious injuries with high morbidity and mortality (5-36%). Their incidence varies from 6 to 15%. Life-threatening emergencies are dominated by respiratory and hemodynamic distress. Diagnosis is based on radiography and especially on thoracic CT scans.Management is multidisciplinary. Treatment is most often conservative, based on oxygen therapy, monitoring, and above all, effective analgesia. Epidural analgesia is the reference technique, improving ventilation and reducing pulmonary complications.Surgery is reserved for selected cases. Complications include pneumonia and those related to drainage. Major prognostic factors are age ¿55 years, high ISS (¿25), associated lesions, and length of hospitalization. ISS and TRISS are the reference scores for assessing severity and predicting mortality.

Pagina's: 72, Paperback, Our Knowledge Publishing