Treatment of traumatic flail chest and pulmonary contusion

Objective To evaluate the characteristics and comprehensive treatment of traumatic flail chest.Methods The medical records of 103 patients with flail chest in our unit from Jan.2000 to Dec.2007 were analyzed retrospectively.Patients' clinical characteristics,diagnosis and therapeutic measures were reviewed.Of all these patients,25(24.3%) had tracheotomy,30(29.1%) rib traction,28(27.8%) internal fixations of the sternum and rib,30(29.1%) mechanical ventilation,and 45(43.7%) non-operated fixation.Results Ninety-three patients(90.3%) were cured(9.7%),80 of whom recovered with normal pulmonary function.Ten patients died.Conclusion Pulmonary contusion and paradoxical respiratory movement are the main reasons for acute respiratory distress syndrome(ARDS) and respiratory failure of traumatic flail chest.The key measures involve easing pain,restoring the stability of the chest wall,assistant treatment with mechanical ventilation,and treatment of combined injuries,especially,pulmonary contusion.