ISSN: 1305-3876
Dil: Türkçe
İçerik: Özel sayılar şeklinde yılda 3 sayı yayınlanır.
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Chest Wall Injuries And Flail Chest
Dr. Akın Eraslan BALCIa
aGöğüs Cerrahi ABD, Fırat Üniversitesi Tıp Fakültesi, ELAZIĞ
Flail chest is one of the worst subset of mutliple rib fractures and is likely the most common serious injury to the thorax seen by clinicians. A flail chest occurs when a segment of the thoracic wall becomes unattached from the rest of the chest wall. This typically occurs when ribs are fractured in two places, allowing that segment of the thoracic wall to "float" independently of the rest of the chest wall. Flail chest can also occur when ribs are fractured proximally in conjunction with disarticulation of costochondral cartilages distally. In very youngs in whom the costal cartilages are quite flexible, a flail chest can occur when several ribs are fractured proximally and the costal cartilages allow the segment to move independently of the rest of the chest wall. "Paradoxical chest wall motion" best describes a flail chest. Treatment of flail chest is dictated by the clinical condition and degree of respiratory distress. Pulmonary contusion is the basic pathology contribute clinical status. Thus supportive treatment for pulmonary healing is very important. Oxygen supplementation is often necessary depending on the underlying lung pathology. Mechanic ventiation is important treatment modality both alone and together with surgery. Improvements in noninvasive ventilation techniques like CPAP and pain control may also improve currently observed outcomes. Epidural analgesia is the effective method for pain relief. If the flail segment is impairing gas exchange or contributing to hypoxemia, the flail segment should be fixed operatively. This prevents the flail segment from moving out paradoxically during respiration.Keywords: Flail chest, Thoracic InjuriesTurkiye Klinikleri J Surg Med Sci 2007, 3(47):18-28
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