Severe pain at the site of injury and breathing problems are the common symptoms experienced by individuals suffering from flail chest. In addition to these, the following are the signs and symptoms of flail chest:
A chest x-ray is done to analyze the condition of flail chest. The x-ray would also give information about fractures in the neighboring regions. However, x-rays are not competent enough to diagnose all rib fractures. Some of the fractures may not be spotted properly. But, when conditions such as pneumothorax, pulmonary contusion or hemothorax are diagnosed through x-ray examination it indicates that rib fractures are bound to be present.
In addition to x-ray, CT scan is also necessary to be carried out. A thoracic multi-slice computed tomography scan can identify rib fractures quite well compared to plain radiograph . However, such an examination gives little information regarding chest injuries and its use in diagnosing flail chest is limited.
Arterial blood gas measurement is also done to analyze the severity of the condition and also assess the need for mechanical ventilation. Such a kind of test helps in providing useful information during the management phase.
Management of the condition and putting the patient on 100% oxygen forms the basis of treatment of flail chest. Methods to protect lungs from further damage due to injury should also be employed. It is also necessary to prevent pneumonia which is one of the grave complications of this condition. The following are the several methods employed to treat flail chest.
Prognosis of the condition largely depends on the extent of injury to the rib cage, age of patient, and volume of blood loss . After discharge from the hospital, the patient is generally called for a 12 week outpatient program. In such a program, the patient is taught physiotherapy to improve mobility. After few weeks, the patient will be made to practice walking and posture correction exercises will also be taught.
If the condition of the patient is not stabilized on time, then it can give rise to various life threatening conditions. Problem in breathing followed by severe chest pain and respiratory failure are some of the major complications faced by affected individuals . The sharp edges of the broken ribs can even puncture the pleural sac as well as the lungs leading to pneumothorax. In serious conditions, if prompt treatment is not initiated it can even cause death.
Serious accidents and trauma continue to be the major causative factors. It has been estimated that about 76% of vehicle accidents contribute to flail chest. The elderly population is severely affected due to their weak bones which are frequently prone to fractures.
Children can even fall prey to flail chest either due to trauma or metabolic bone diseases such as osteogenesis imperfecta. Flail chest continues to be a leading cause of mortality and morbidity among trauma patients in both young and old .
It has been estimated that about 1 in every 13 patients who are admitted to hospital for trauma related cases suffer flail chest. Between the periods 1998 – 2003 as high as 262 cases of flail chest has been recorded. The actual numbers can be much higher that what is reported. The diagnosis of flail chest in neonates is suggestive of child abuse in most cases .
For the process of breathing to take place under normal conditions, it is required that muscle surrounding the rib cage and diaphragm move in order to expand the chest cavity. Such an activity creates vacuum which gets filled when air is inhaled. In conditions of flail chest these sequence of events do not occur as a result of which air is not drawn inside the lungs causing difficulty in breathing.
Flail chest is a condition wherein sections of broken rib cage interfere with normal movements of the chest. Therefore, it is important to immediately stabilize the condition of patients who have suffered blunt trauma. Blunt trauma not only causes flail chest but also is responsible for serious damage to the lungs.
Flail chest cannot be prevented; however, early initiation of treatment and proper management can prevent development of complications.
Flail chest is a serious condition wherein a segment of the rib cage separates from the chest wall as a result of severe injury. Due to this, the affected area is not able to contribute to lung expansion. Such a condition can be life threatening and can pose serious health risks for the individual. If prompt treatment is not initiated it can cause lifelong disability.
Flail chest is a condition caused due to blunt trauma wherein a segment of the rib cage gets separated from the chest wall. It is a life threatening condition that can lead to complications if treatment is not initiated on time.
Vehicle accidents and trauma are the major cause of chest injuries that can lead to flail chest.
An x- ray of the chest is helpful in diagnosing the condition of flail chest. In addition to x-rays, a test known as arterial gas measurement is done which is helpful in analyzing the need for mechanical ventilation. Such a test is also helpful during the management of the disease condition.
The patient is put on mechanical ventilator for stabilization of the chest cavity. Surgical procedures may be required depending upon the condition of the patients. It is often a treatment of choice when patients continue to depend on mechanical ventilator even when the wounds begin to heal. Medications to relieve pain are administered to reduce the discomfort caused due to injuries.