[Diagnosis and treatment of complex closed chest injuries]

The results of treatment of 256 patients with complicated closed chest injury are discussed. Multiple fractures of the ribs were found in 178, closed pneumothorax in 127, pneumohemothorax in 71, isolated hemothorax in 55, and rupture of the diaphragm in 3 patients. Most patients received nonoperative treatment, 5 patients (6.1%) needed emergency thoracotomy. Early drainage of the pleural cavity, endoscopic (thoracoscopy, bronchoscopy) methods of treatment, mechanical stabilization of floating rib fractures made it possible to improve the results and reduce the terms of treatment. Two (0.8%) persons died from shock and cardiopulmonary insufficiency.