Effects of Surgical Fixation of Flail Chest on Patients with or without Pulmonary Contusion

Objective To analyze and discuss indications,contraindications and outcomes of surgical fixation for flail chest in patients with and without pulmonary contusion and to clarify the impact of pulmonary contusion.Methods The average age of 42 patients with flail chest,including 34 males and 8 females,was 50.9±12.3 years.These patients were operated by chest wall stabilization.According to pulmonary contusion or not,patients were separated into two groups: flail chest without pulmonary contusion(Group A,n=11) and flail chest with pulmonary contusion(Group B,n=31).Factors of sex,age,number of rib fracture,preoperative tube thoracotomy,number of rib fixation,hospital stay,timing of operative chest wall stabilization,incidence of ICU,incidence of ventilator,and complication between two groups were compared respectively.Results After operations,characteristics of flail chest in all patients disappeared and both sides of thoracic skeleton were symmetric.Meanwhile,paradoxical movement of the chest wall segment and collapsed chest wall were not found.There was no significant difference in sex,age,number of rib fracture,preoperative tube thoracotomy,number of rib fixation,hospital stay,timing of operative chest wall stabilization,incidence of ICU,incidence of ventilator and complication between two groups.There wers higher incidences of ICU and ventilator in Group B compared with Group A.Two of eldly male patients died of shock and multiple organ dysfunction syndrome in Group B.Conclusion Although having higher incidences of ICU and ventilator,patients with flail chest and pulmonary contusion still have indications to perform operative chest wall stabilization because of its satisfactory outcome.