Analysis of clinical management of 91 patients with traumatic flail chest.

Objective To compare the treatments and clinical outcomes and summarize the experience in the treatment of traumatic flail chest.Methods A retrospective study was carried out on 91 patients with traumatic flail chest hospitalized in our hospital from January 1995 to June 2008.Results Although there was no significant difference in the severity of injury between group Ⅰand group Ⅱ,the death rate of patients in groupⅠin which patients underwent less invasive treatment was higher(7 deaths,25%) than that in group Ⅱ(4 deaths,6.3%)(P0.05).The condition of the patients in invasive treatment group was more severe than that in conservative treatment group,however,there was no significant mortality difference between invasive treatment group and conservative treatment group(P0.05).The ratio of the chest wall deformation and the incidence of pulmonary atelectasis in invasive treatment group were less than those in conservative group.Conclusion The therapeutic effect of invasive treatment was better than that of conservative treatment.The key treatment measures are to restore stability of the chest wall at an early stage,effectively treat pulmonary contusion,and ensure non-obstruction of the airway plus effective pain relief,prevent and treat the insufficiency of respiration and pulmonary infection.Mechanical ventilation should be administered to patients when necessary.