Clinical Outcomes of Surgical Stabilization of Flail Chest Injury
Benjamin C Taylor1, T Ty Fowler, Bruce G French
1From the Grant Medical Center, Columbus, OH (Dr. Taylor, Dr. French, and Ms. Dominguez), and the Mount Carmel Medical Center, Columbus (Dr. Fowler).
Introduction:
Recent reported success in surgical stabilization of flail chest has been described in small series, but scant evidence exists for this procedure in the orthopaedic literature.
Methods:
We reviewed 88 consecutive patients who underwent surgical stabilization of flail chest, along with 88 consecutive patients with flail chest who underwent traditional closed management before initiation of our algorithm change to surgical management.
Results:
Surgical stabilization of flail chest injuries led to statistically significant decreases in hospital length of stay, ventilator-dependency time, pneumonia, tracheostomy, and mortality rate. In addition, the presence of pulmonary contusion did not eliminate the significant improvements in the aforementioned variables.
Discussion:
Surgical stabilization of flail chest with modern techniques and implants provides significant improvements in both mortality and short-term outcomes. Although pulmonary contusion decreased overall outcomes across both cohorts, this factor did not alter the ability of rib fixation to improve outcomes.
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