Flail Chest - Everything You Need To Know - Dr. Nabil Ebraheim
285.9 هزار بار بازدید -
8 سال پیش
-
Dr. Ebraheim’s educational animated video
Dr. Ebraheim’s educational animated video describes the condition of Flail Chest, signs and symptoms, the pathophysiology of it, hoe to diagnose it, and the treatment options.
Flail chest could be a life threatening condition.
A segment of the rib cage breaks and becomes separated or detached from the chest wall.
It usually requires significant violent force in order to break the ribs in this war.
The fractured segment will sink into the chest with inspiration and expand out of the chest wall with expiration opposite to the normal chest wall mechanism.
The segmented rib fractures works independently.
If the segmented section moves right, then the rest of the ribs move left, and vice versa.
The flail chest moves in the opposite direction to the rest of the chest wall.
This is called paradoxical breathing.
There may be a pulmonary contusion associated with the flail chest fracture segment.
There also may be a noticeable chest wall deformity with presence of air in the subcutaneous tissue (crepitus).
The trauma usually causes scapular fractures or clavicle fracture.
Symptoms:
- Chest pain and shortness of breath.
- Paradoxical movement of the flail segment.
- The constant movement of the ribs is really painful.
- The broken rib may puncture the lung and cause pneumothorax.
X-ray: it is difficult to see if the fractures are displaced or nondisplaced.
CT scan is probably better for visualizing these fractures.
The prognosis varies and it depends on the severity of the condition, however the death rate ranges between 10%-25% usually depending on the pulmonary injury.
About 8% of patients who are admitted to the hospital with fractured ribs will have a flail chest.
Treatment:
• Observation:
- If there is no respiratory compromise.
- No flail chest segment.
Follow advanced life trauma support (ATLS) principles:
- Airway
- Breathing
- Circulation
• Give the patient pain control, usually with intercostal block
• Avoid suppression of breathing
• Give the patient positive pressure ventilation, chest tube if needed.
• Surgery:
- May help in reducing the duration of ventilator support and aid in the pulmonary function.
- Patient will need aggressive pulmonary toilet and physiotherapy.
- You do open reduction and internal fixation when there is severe pain and displaced ribs.
- When there is flail chest segment, three or more consecutive fractured ribs with segmental injury.
- When the rib fractures are associated with failure to wean the patient off of ventilation.
- When there are rib fractures.
- Open reduction and internal fixation
- Usually a plate and screw system is used.
Become a friend on facebook:
Facebook: drebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati...
Flail chest could be a life threatening condition.
A segment of the rib cage breaks and becomes separated or detached from the chest wall.
It usually requires significant violent force in order to break the ribs in this war.
The fractured segment will sink into the chest with inspiration and expand out of the chest wall with expiration opposite to the normal chest wall mechanism.
The segmented rib fractures works independently.
If the segmented section moves right, then the rest of the ribs move left, and vice versa.
The flail chest moves in the opposite direction to the rest of the chest wall.
This is called paradoxical breathing.
There may be a pulmonary contusion associated with the flail chest fracture segment.
There also may be a noticeable chest wall deformity with presence of air in the subcutaneous tissue (crepitus).
The trauma usually causes scapular fractures or clavicle fracture.
Symptoms:
- Chest pain and shortness of breath.
- Paradoxical movement of the flail segment.
- The constant movement of the ribs is really painful.
- The broken rib may puncture the lung and cause pneumothorax.
X-ray: it is difficult to see if the fractures are displaced or nondisplaced.
CT scan is probably better for visualizing these fractures.
The prognosis varies and it depends on the severity of the condition, however the death rate ranges between 10%-25% usually depending on the pulmonary injury.
About 8% of patients who are admitted to the hospital with fractured ribs will have a flail chest.
Treatment:
• Observation:
- If there is no respiratory compromise.
- No flail chest segment.
Follow advanced life trauma support (ATLS) principles:
- Airway
- Breathing
- Circulation
• Give the patient pain control, usually with intercostal block
• Avoid suppression of breathing
• Give the patient positive pressure ventilation, chest tube if needed.
• Surgery:
- May help in reducing the duration of ventilator support and aid in the pulmonary function.
- Patient will need aggressive pulmonary toilet and physiotherapy.
- You do open reduction and internal fixation when there is severe pain and displaced ribs.
- When there is flail chest segment, three or more consecutive fractured ribs with segmental injury.
- When the rib fractures are associated with failure to wean the patient off of ventilation.
- When there are rib fractures.
- Open reduction and internal fixation
- Usually a plate and screw system is used.
Become a friend on facebook:
Facebook: drebraheim
Follow me on twitter:
https://twitter.com/#!/DrEbraheim_UTMC
Donate to the University of Toledo Foundation Department of Orthopaedic Surgery Endowed Chair Fund:
https://www.utfoundation.org/foundati...
8 سال پیش
در تاریخ 1395/04/23 منتشر شده
است.
285,946
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