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Related Concept Videos

Flail Chest-II01:26

Flail Chest-II

Managing flail chest, a condition characterized by a segment of the chest wall moving independently from the rest of the thoracic cage, requires a comprehensive approach. It includes a thorough assessment of the patient's condition, a diagnostic evaluation to determine the extent of the injury, and the implementation of appropriate medical interventions tailored to the individual's needs.
Assessment:
1. Clinical Evaluation:
History:
Flail Chest-I01:24

Flail Chest-I

Overview of Flail Chest
Flail chest is a severe and potentially life-threatening condition characterized by the fracture of three or more adjacent ribs in multiple places. It is most commonly caused by direct impacts and trauma, such as motor vehicle accidents or injuries from a steering wheel impact. It can also occur due to falls in elderly individuals with osteoporosis, or assaults involving sharp objects.
Pathophysiology
The pathophysiology of flail chest is complex, involving fractures of...
Pneumothorax-II01:27

Pneumothorax-II

Pneumothorax is a medical condition defined by the buildup of air in the pleural space between the lungs and the chest wall. This accumulation of air can lead to partial or complete lung collapse, resulting in a range of clinical manifestations. Understanding the clinical presentation and effective management strategies is crucial for healthcare professionals in providing timely and appropriate care to individuals with pneumothorax.
Clinical Manifestations:
Pneumothorax II: Pathophysiology01:08

Pneumothorax II: Pathophysiology

Pneumothorax means the presence of air in the pleural space — the thin potential gap between the visceral and parietal pleura. This condition disrupts the normal pressure balance that keeps the lungs inflated, leading to partial or complete collapse of the affected lung.Normal physiologyUnder normal conditions, the pleural space maintains a slightly negative intrapleural pressure, which keeps the lungs expanded against the chest wall. This negative pressure creates a delicate balance between...
Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care01:29

Pulmonary Embolism II: Diagnostic Studies and Interprofessional Care

Diagnosing Pulmonary EmbolismDiagnosing pulmonary embolism (PE) involves clinical assessment and advanced imaging tests. The preferred diagnostic tool is the spiral (helical) CT scan or CT angiography (CTA), which uses intravenous contrast media to visualize the pulmonary vasculature and identify emboli.A ventilation-perfusion (V/Q) scan is an alternative for patients unable to receive contrast media. This scan includes both perfusion and ventilation scanning. Perfusion scanning involves...
Pulmonary Embolism I: Introduction01:29

Pulmonary Embolism I: Introduction

Pulmonary embolism (PE) occurs when a thrombus, fat or air embolus, amniotic fluid, or tumor tissue blocks one or more pulmonary arteries. These blockages originate in the venous system or the right side of the heart.EtiologyPE primarily arises from deep vein thrombosis (DVT) and other hypercoagulable states, such as inherited thrombophilias. Additional etiological factors include venous stasis, commonly seen in obesity, and endothelial injury from surgery and trauma. Less common causes include...

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Related Experiment Video

Updated: May 23, 2026

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling
15:11

Surgical Fixation of Sternal Fractures: Preoperative Planning and a Safe Surgical Technique Using Locked Titanium Plates and Depth Limited Drilling

Published on: January 5, 2015

Flail chest injury: are we making any progress?

Robert M Cannon1, Jason W Smith, Glen A Franklin

  • 1Department of Surgery, University of Louisville, Louisville, Kentucky, USA. rmcann03@louisville.edu

The American Surgeon
|April 5, 2012
PubMed
Summary

Flail chest mortality has improved, but pneumonia remains a significant risk. Early deaths are common, highlighting the need for better pneumonia prevention strategies in severe chest trauma patients.

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Area of Science:

  • Trauma Surgery
  • Critical Care Medicine
  • Thoracic Surgery

Background:

  • Flail chest is a severe thoracic injury with historically high mortality rates.
  • Recent large-scale studies on flail chest management and outcomes are limited.
  • Understanding current trends in flail chest patient demographics and mortality is crucial.

Purpose of the Study:

  • To analyze patient demographics, outcomes, and causes of death in a recent cohort of flail chest patients.
  • To identify factors influencing mortality and length of stay in intensive care units.
  • To evaluate the current impact of flail chest injuries and associated complications.

Main Methods:

  • Retrospective review of 164 patients with flail chest admitted between January 2001 and May 2010.
  • Analysis of patient demographics, comorbidities (head injury, pulmonary contusion), and outcomes.
  • Univariate and multivariate analyses to determine predictors of mortality and ventilator dependency.

Main Results:

  • The study included 164 patients with a median age of 51.4 years; 40.8% had head injuries and 77% had pulmonary contusions.
  • Pneumonia developed in 43.9% of patients, and overall mortality was 25% (9.1% attributed to flail chest).
  • Pneumonia was a significant predictor of overall mortality and ICU length of stay; most flail chest deaths occurred within 48 hours.

Conclusions:

  • Mortality associated with flail chest has significantly improved compared to historical data.
  • Pneumonia remains a major complication and predictor of poor outcomes in flail chest patients.
  • Enhanced strategies for pneumonia prevention are essential for improving patient outcomes in severe chest trauma.