Treatment of traumatic flail chest in 54 cases

Objective To evaluate the therapy of traumatic flail chest and its effects.Methods The clinical data of 54 cases with flail chest in our unit from Sep.1998 to Ma.2004 were studied retrospectively.Results Forty-nine cases were cured(90.7%),there was not obvious pulmonary dysfunction during the followed-up,5 cases died(9.3%).Suspended traction of ribs were performed in 16 cases,internal fixation of ribs in 2 cases,4 cases were treated with respirator.Pulmonary atelectasis were found in 11 cases.Eight cases underwent tracheotomy,and fibroptic bronchoscopy for diagnosis and treatment were performed in 8 cases.Conclusion Integrative therapy should be taken for traumatic flail chest.Beside treatment of pulmonary contusion,traction or internal fixation of ribs for severe floating chest is necessary.The main indication of respirator is severe hypoxemia uncorrected by fixed chest and foreboding of ARDS.Early tracheotomy contribute a lot to a higher survival rate.