Progress and controversy in management of traumatic flail chest

Flail chest is mostly associated by pulmonary contusion.Synthetic therapy consists of the fixation of floating chest wall and treatment of pulmonary contusion.Surgical fixation has recently been suggested as a method to correct floating chest wall.However,the indication and technique of open internal fixation should be stressed.Mechanical ventilation is used to deal with ALI and ARDS due to severe pulmonary contusion instead of internal pneumatic stabilization with positive pressure for paradoxical respiration.