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Long-term disability associated with flail chest injury.
Influence of flail chest on outcome among patients with severe thoracic cage trauma.
When patients were classified by thoracic injury type, rib fracture was the most common, followed by hemothorax, pneumothorax, subcutaneous emphysema, flail chest, pneumomediastinum, and mediastinal hematoma.
Thirty nine patients out of 216(18%) had a hemothorax probably due to chest wall injury with a tear of vessel, sternal fracture (5), flail chest (4), cardiac injury (2) and diaphragmatic injuries were uncommon.
A flail chest was defined as two or more rib fractures at two or more places; patients classified as having sustained a flail chest were not included in the rib fracture group.
Positive pressure ventilation was just coming into its own, owing to its widespread use during anesthesia, and was being selected over the iron lung because fear of prolonged tracheal cannulation had abated and patients with flail chest, obesity, COPD and other lung pathology were much more difficult to ventilate than the polio patients who generally had no pulmonary disease.
The result was a totally flail chest, with huge effort required to move very little air in and out of his lungs.