Management of flail chest

Abstract

Thoracic injuries are directly responsible for 25% of trauma deaths in the United Kingdom, and a significant contributory factor to another 25%. The majority of these injuries are due to blunt thoracic trauma and flail chest can be a significant component in these injuries. Flail chest is a condition that is managed by a range of specialties, including cardiothoracic and orthopaedic surgeons, as well as anaesthetists and intensivists. Simple cases can be easily managed by analgesia and supplemental oxygen therapy. However, the literature available supports a number of practices including elective ventilation and possibly surgical fixation for more complex cases. This article sets out to review the literature on the pathophysiology, investigation, and management of this potentially life-threatening condition with particular regard to the additional management of underlying pulmonary contusion.