Related Experiment Video
Updated: Feb 10, 2026
Operant Sensation Seeking in the Mouse
Published on: November 10, 2010
Early results after operatively versus non-operatively treated flail chest: a retrospective study focusing on outcome
Mathieu M E Wijffels1, Tjebbe Hagenaars2, Diba Latifi2
1Trauma Research Unit, Department of Surgery, Erasmus MC, University Medical Center Rotterdam, P.O. Box 2040, 3000 CA, Rotterdam, The Netherlands. m.wijffels@erasmusmc.nl.
Purpose:
Flail chest was traditionally treated non-operatively using mechanical ventilation and pain control. In order to reduce the occurrence of ventilation-associated complications and long-term disability, operative rib fixation is becoming a proven standard therapy for these patients. However, the consequences of the surgical complications may influence success rates negatively. The aim of this study was to compare the outcome of flail chest treatment by surgical rib fixation with non-operative treatment, with special focus on the impact of surgical complications.
Methods:
A retrospective case series of operatively treated flail chest patients was compared with non-operatively treated patients. Patients' injury and treatment characteristics and outcome parameters (e.g., duration of mechanical ventilation, length of Intensive Care stay (ICLOS) and hospital length of stay (HLOS), mortality, surgery-related complications and pneumonia) were collected from the patients' medical files. Crude and matched-pairs analyses were performed in SPSS.
Results:
Twenty-three operatively and 47 non-operatively treated patients were enrolled. Operatively treated patients required significantly shorter mechanical ventilation; median 4 days versus 12 days for the non-operative group (p = 0.011). The matched-pairs analysis also showed a lower pneumonia rate (35% versus 80%; p = 0.035) and a shorter HLOS (median 21 versus 23 days; p = 0.028) in the operative group. No significant differences in duration of ICLOS, and occurrence of other injury-related adverse events were found between both groups. Seven surgery-related complications occurred, of which three required invasive solutions.
Conclusions:
Operative fixation of a flail chest in trauma patients results in a lower rate of pneumonia, less mechanical ventilation days and shorter hospital stay, compared with non-operative treatment, but at the cost of surgery-related complications requiring invasive solutions in some cases.
Related Concept Videos
01:24Flail Chest-I
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...
01:26Flail Chest-II
Assessment:
1. Clinical Evaluation:
History:
01:27Real Number Operations
01:17Operational Amplifiers
01:20Vector Operations
A vector multiplied by a scalar value is called scalar multiplication. The result obtained is a new vector with a different magnitude. If the scalar is positive, the direction of the vector remains the same, but if it is negative, the direction of the vector is reversed. For example, the product of the mass and velocity yields the momentum.
01:21Operant Conditioning
Reinforcement in operant conditioning can be positive or negative, both of which serve to increase the likelihood of a behavior. Positive...