[Injuries of the wall of the thorax]

The mortality rate of chest injuries sustained in road accidents stands now at 15-20 per cent. The considerable force of the impact in road accident is, in 60-80 per cent of the cases responsible for chest injuries which involve other organs. Fractures of a single rib needs only analgetica or intercostal blockade. If a rib is broken in several places or if several rib are fractured instability of the chest wall is act to develop in 15-20 per cent of the cases. It manifest itself in paradoxical breathing and ensuing increase in dead space. In these cases required "internal pneumatic splitting" in form of positive pressure surgical stabilisation of the chest wall has regained favour. Wire or plate osteosynthesis screw-less rib plates and steel splints are being used. Primary stabilisation of the thoracis wall is indicated in the cases: with paradoxical breathing, with respiratory insufficiency or in the cases there are other reasons for thoracotomy. In these circumstances surgical intervention ensure that prolonged artificial ventilation and its attendant risks and complications and the demands made on the nursing staff are reduced to a minimum.