Flail chest

Introduction Multiple rib fractures, especially the anterior partial chest wall, can be softened by the loss of support of the intact ribs, resulting in abnormal breathing movement: when inhaling, the chest wall of the softened area is invaginated. When exhaling, the chest wall of the area bulges outward. This type of chest wall is called the chest. Even the chest is a serious type of chest injury. The stability of the chest mechanical movement caused by the floating of the chest wall and the concomitant pulmonary contusion often cause severe respiratory and circulatory dysfunction. Untimely treatment or improper treatment can cause serious consequences.

Cause

Repeated chest pain is a severe blunt injury of the chest, resulting in multiple rib fractures, because the anterior and posterior ribs lose bone connection, the affected chest wall is unstable due to loss of support and the chest wall is softened, and the pleural cavity is negative during inhalation. The pressure is increased and the softened chest wall is more inwardly recessed. When the exhalation, the negative pressure of the chest cavity is reduced, so that the chest wall is convex outward. This is opposite to the movement of the chest wall in other parts, which is called abnormal breathing, which is called chest wall floating.

Most of the causes of injuries are traffic accidents, crush injuries, pressure and bruises. In males and young adults, the ratio of male to female is 4.5:1. Even the chest is often complicated by pulmonary contusion or lung contusion. The incidence of pulmonary contusion and pulmonary contusion in this group is 84%. The chest wall floating caused by the thoracic chest destroys the stability of the thoracic mechanical movement. The increase of respiratory resistance reduces the respiratory performance. Impaired ventilatory function combined with concurrent lung injury is more serious of respiratory dysfunction, causing severe hypoxemia.

an examination

Related inspection

Chest MRI chest flat chest perspective

Physical examination and imaging examination can be diagnosed.

The degree of damage to the patient from the chest is determined by the cause of the injury, the softening site and extent, the age of the patient and the original cardiopulmonary reserve function, and whether there is a combined injury. The multiple sites of the thoracic chest are on the outside of the thorax, and a small part occurs in the chest. For patients with multiple rib fractures of thoracic trauma, those with shortness of breath and shock, first consider the presence of hemorrhage in the lungs with lung injury and lung contusion. Diagnosis by X-ray chest X-ray, B-ultrasound, CT and other examinations.

Differential diagnosis

The differential diagnosis of the chest:

1. Thoracic deformity: The chicken breast is a sternum with a wedge-like convex shape on the chest wall, hence the name. The funnel chest is a concave deformity of the chest wall, shaped like a funnel. These are two common thoracic deformities.

2, thoracic collapse: one side of the thoracic collapse can be caused by empyema or pleurisy, extensive pleural thickening adhesion and contraction, atelectasis, pulmonary fibrosis, chronic fibrotic tuberculosis, chronic lung suppuration and other diseases.

3, ribs and sub-sternal inhalation depression: ribs and sub-sternal inhalation depression is a clinical manifestation caused by pediatric small jaw deformity syndrome. Micrognathia syndrome (also known as cleft palate - small jaw deformity - hypoglossal syndrome, small mandibular - hypoglossal syndrome, small jaw and big tongue deformity syndrome, inspiratory airway obstruction syndrome, Robin syndrome) Pierre-Robin syndrome. The symptoms are characterized by congenital small jaw deformity, lingual palpebral, cleft palate and inspiratory airway obstruction in neonates and infants. The respiratory tract obstruction caused by this symptom causes death and the incidence is high.

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