What is “Flail Chest”?
“Flail chest” is an injury that is associated with instability and asynchronous movement of the chest wall during respiration. The condition occurs due to fracture of multiple ribs.
Such injuries can occur due to trauma of any sort e.g. hit by car, playing at the park with larger dogs, dog bites etc. Younger intact males that roam tend to be at an increased risk. Breeds such as Yorkshire terriers and Chihuahuas also appear over represented due to their size.
Physical Examination FindingsFlail chest can be identified visually by the asynchronous movement of the chest during breathing. The patient will have an increase in respiratory rate and effort. Flail Chest segment moves inward during inspiration and outward during expiration. Due to this motion, an inability to oxygenate occurs. If the injury is caused by a bite or hit by car, other wounds or skin lacerations may be identified.
What to do?
A flail chest must be evaluated immediately. Chest xray are performed to investigate fractured ribs and to examine other concurrent conditions such as hernia in diaphragm, fluids in the lungs, and contusions.
Pain management is essential to prevent breathing disturbances. Supplementation of oxygen is also critical to help manage the patient's impaired ability to oxygenate.
Intensity of treatment and surgery depends on the degree of patient distress.