Flail Chest

A complication of multiple rib fractures, rib and sternum fractures, or thoracic surgery. A portion of the chest wall becomes isolated from the thoracic cage and exhibits paradoxical respiration.

Also Known As:

Networked: 142 relevant articles (8 outcomes, 11 trials/studies)

Relationship Network

Disease Context: Research Results

Related Diseases

1.	Contusions
2.	Pain (Aches)
3.	Rib Fractures (Rib Fracture)
4.	Dislocations
5.	Brain Injuries (Brain Injury)

Experts

1.	Mayberry, John C: 3 articles (05/2009 - 11/2003)
2.	Jurkovich, Gregory J: 2 articles (01/2016 - 07/2013)
3.	Marasco, Silvana: 2 articles (05/2015 - 11/2009)
4.	Vyhnánek, F: 2 articles (01/2015 - 01/2011)
5.	Briccoli, Antonio: 2 articles (07/2013 - 01/2002)
6.	Cooper, Jamie: 2 articles (05/2013 - 11/2009)
7.	Athanassiadi, Kalliopi: 2 articles (10/2010 - 10/2002)
8.	Gerazounis, Michalis: 2 articles (10/2010 - 10/2002)
9.	Mullins, Richard J: 2 articles (05/2009 - 11/2003)
10.	Trunkey, Donald D: 2 articles (05/2009 - 01/2009)

Drugs and Biologics

Drugs and Important Biological Agents (IBA) related to Flail Chest:

1.	TitaniumIBA 01/01/2015 - "The goal of the study was to compare surgical rib fixation using claw-type titanium plate with conservative treatment in the management of patients with flail chest. " 01/01/2015 - "Surgical rib fixation with claw-type titanium plate is a reliable and efficient method in the management of patients with flail chest." 01/01/2015 - "Management of patients with flail chest by surgical fixation using claw-type titanium plate." 07/01/2013 - "Chest wall reconstruction with fascia lata, alone or in combination with titanium plates, allows the surgeon to perform a dynamic reconstruction without flail chest in extensive exeresis. " 03/01/2010 - "Titanium plate fixation is an effective method to stabilize complicated flail chest, with clinical utility in a cardiothoracic practice."
2.	glucuronyl glucosamine glycan sulfate (Vessel)IBA 05/01/1994 - "Flail chest does not seem to be a marker for great vessel, tracheobronchial, or diaphragmatic injuries. " 01/01/2014 - "Major thoracic vessel injuries (AIS ≥5), bilateral lung contusion, bilateral flail chest, structural heart injury (AIS ≥3) significantly influence mortality in study patients. "
3.	AlloysIBA 01/01/2010 - "The curative effect and long-term follow-up results were observed after internal fixation with a shape memory alloy embracing fixator in patients with multiple fractured ribs and flail chest from January 2006 to December 2009. " 01/01/2010 - "Memory alloy embracing fixator in treatment of multiple fractured ribs and flail chest." 01/01/2010 - "The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing fixator in patients with multiple fractured ribs and flail chest. "
4.	aldosterone secretion inhibitory factor (ASIF)IBA 01/01/2009 - "Here we present a case of traumatic flail chest in a patient with traumatic severe chest wall deformity treated by chest wall reconstruction with AO-ASIF [Arbeitsgemeindschaft fur Osteosynthesefragen (Association for the Study of Internal Fixation)] osteosynthesis plaque."
5.	titanium nickelide (Ni-Ti)IBA 01/01/2010 - "The present study was to explore curative effect and postoperative results of Ti-Ni shape memory alloy embracing fixator in patients with multiple fractured ribs and flail chest. "
6.	OxygenIBA 02/01/2007 - "Isolated flail chest may be successfully managed with aggressive pulmonary toilet including facemask oxygen, CPAP, and chest physiotherapy. " 12/01/2015 - "The management of flail chest includes early aggressive multimodal analgesia, adequate oxygen, and ventilatory support. " 10/01/1979 - "Effects of contusion and flail chest on pulmonary perfusion and oxygen exchange." 06/01/1996 - "The effect on ventilatory function of fixation of a flail segment in internal (FIP) and external (FEP) position and oxygen administration was studied in an experimental flail chest with pleural indemnity. "
7.	Polypropylenes (Polypropylene)IBA 01/01/2002 - "Reconstruction using Marlex mesh combined with moldable metal plates was carried out to prevent flail chest in nine patients, resection alone was performed in five patients, and a muscular flap was used in two patients. " 05/01/1997 - "An unusual case of flail chest: surgical repair using Marlex mesh." 01/01/2006 - "A second repair with Marlex and stainless-steel mesh was required in two patients; for flail chest after an autologous bone graft in one; and following re-recurrence of breast carcinoma in another patient who had undergone a musculocutaneous flap repair. "
8.	MethylprednisoloneFDA LinkGeneric 01/01/1985 - "Accordingly, we have since 1976 administered high doses of methylprednisolone already on admission in patients with multiple rib fractures and/or flail chest (30 mg/kg i.v. X 3 at 8 hr intervals). " 09/01/1987 - "Thus, on admission methylprednisolone 30 mg/kg body weight was given to 107 patients having at least four rib fractures or a flail chest. " 03/01/1992 - "Seven patients with varying degrees of paradoxical chest wall movement (flail chest) were managed conservatively at the University of Port Harcourt Teaching Hospital with frusemide, methylprednisolone, non administration of crystalloid fluids and limitation of fluid intake. "
9.	SilkFDA Link 12/01/2014 - "Silk fiber-reinforced polycaprolactone (SF/PCL) plates were developed for rib fracture stabilization and studied using a canine flail chest model. "
10.	Methylmethacrylate (Metaplex)IBA 06/01/2006 - "We describe a simple and practical method of operative stabilization of flail chest using a prosthetic mesh and methylmethacrylate anchored to the ribs and sternum. " 06/01/2006 - "Operative stabilization of flail chest using a prosthetic mesh and methylmethacrylate."

Therapies and Procedures

1.	Artificial Respiration (Mechanical Ventilation) 01/01/1984 - "Patients with traumatic flail chest and paradoxical respiration need first of all immediate intubation and artificial respiration, afterwards operative stabilization is beneficial in selected patients. " 10/01/1990 - "We conclude that 40% of flail chest are controllable without mechanical ventilation and that the result of this conservative therapy is superior to any other treatments." 07/01/1978 - "Controlled mechanical ventilation has been the mainstay of treatment in the flail chest syndrome for more than 20 years, retrospective studies have recently suggested that the technique is unnecessary, and they infer that spontaneous ventilation or intermittent mandatory ventilation are equally effective. " 04/01/2002 - "Thirty-seven consecutive severe flail chest patients who required mechanical ventilation were enrolled in this study. " 03/01/1980 - "[Spirometric study of flail chest treated by artificial respiration]."
2.	Mechanical Ventilators (Ventilator) 09/01/2014 - "Increasing attention has been directed towards operative rib fixation of traumatic flail chest; reported benefits include more rapid weaning from the ventilator, decreased intensive care unit stays, decreased complications and improved functional results. " 01/01/2015 - "Likewise, in pediatric flail chest, the available evidence does not suggest that ventilator management protocols should be adopted routinely, and the treatment for pediatric flail chest was not established completely. " 01/01/2015 - "Flail chest in polytraumatized patients: surgical fixation using Stracos reduces ventilator time and hospital stay." 02/01/2014 - "Surgical rib fixation resulted in a significant decrease in ventilator days and may represent a novel approach to decreasing morbidity in flail chest patients when used as a rescue therapy in patients with declining pulmonary status. " 03/01/2013 - "A case of flail chest treated before availability of electrically driven respirators."
3.	Intensive Care (Surgical Intensive Care) 05/01/2013 - "Operative fixation of fractured ribs reduces ventilation requirement and intensive care stay in a cohort of multitrauma patients with severe flail chest injury." 05/01/2015 - "There is now adequate evidence in randomised controlled trials that rib fixation in flail chest patients reduces ventilator times, intensive care stay and costs of treatment in ventilator dependent patients [1-3]. " 12/01/2012 - "In this case report, we present 2 cases of flail chest in geriatric patients after severe blunt chest trauma, which were treated at the University Hospital Innsbruck (Level I Trauma Center and Tyrolean Geriatric Fracture Center) by a multidisciplinary team of physicians from anesthesia, intensive care, trauma surgery, and acute geriatrics. " 01/01/1993 - "In the ten survivors with flail chest, stability was achieved without secondary dislocation, giving good pain relief, improved respiratory mechanics and reduced duration of ventilatory support and intensive care requirements. " 05/01/1977 - "A patient with flail-chest injury, and associated abdominal and musculo-skeletal trauma, required several modes of mechanical ventilation in the Surgical Intensive Care Unit Ventilator modalities included mechanical ventilation with positive end-expiratory pressure (PEEP) and intermittent mandatory ventilation (IMV) with continuous positive airway pressure (CPAP) during 12 days of intensive respiratory care. "
4.	Intermittent Positive-Pressure Ventilation 12/01/1995 - "Among 64 cases of flail chest injury, 25 were managed by internal fixation of ribs, whereas the remaining 38 were managed by endotracheal intubation and intermittent positive-pressure ventilation alone. " 05/01/2005 - "A comparative study of continuous positive airway pressure (CPAP) and intermittent positive pressure ventilation (IPPV) in patients with flail chest." 03/01/2002 - "However, IPPV has not proven to be beneficial in traumatic brain injury and flail chest, in the absence of other indications." 05/01/2005 - "We conducted a prospective, randomised study of continuous positive airway pressure (CPAP) given via a face mask to spontaneously breathing patients compared with intermittent positive pressure ventilation (IPPV) with endotracheal intubation (ETI) in 52 patients with flail chest who required mechanical ventilation. " 05/01/1980 - "The authors measured antidiuretic hormone (ADH) excretion and renal and cardiovascular function in eight patients with flail chest during four ventilatory conditions: continuous positive-pressure ventilation (CPPV), intermittent positive pressure ventilation (IPPV), spontaneous breathing with continuous positive airway pressure (CPAP) and spontaneous breathing (SB). "
5.	Drug Therapy (Chemotherapy) 03/01/1980 - "On the other hand, prolonged stabilization of the chest wall in the second patient until a chemotherapy-induced remission occurred was associated with resolution of the flail chest."