Flail Chest


When a portion of the bone in the chest wall breaks due to stress and detaches itself, it is known as a flail chest. This condition is life threatening. It can occur when ribs are broken in multiple spots and causes a separation in the segment so that the chest wall moves on its own. Two or more ribs have to be broken for this condition to happen and must be broken in two places. In most cases, pulmonary contusions or bruises of the lung are suffered along with this condition and can interfere with the oxygen in the blood. As the ribs able to move constantly, the place where the fracture is located is very painful and if not treated, the fragments of broken bone can puncture the lung or pleural sac and runs the risk of causing pneumothorax.

The most commonly seen cause of this condition is blunt trauma. For it to occur, significant physical force has to be applied to a large area of the thorax for it to cause multiple fractures. Car accidents are a common cause of trauma. A genetic connective tissue disorder that causes fragile bones is also a cause. Three different types associated to the condition known as osteogenesis imperfecta causes bones to be fragile and easier to break. Even the smallest amount of pressure can cause the ribs to break in multiple places causing the flailing condition. Bone deterioration is most common in older persons and puts them at a higher risk for development as well.

Flail chest symptoms include chest pain and difficulty breathing. When flailing occurs, the bones that are broke move in the opposite direction of the main chest wall and causes breathing to become difficult. The most telling sign is the movement of the chest wall. As the affected area draws inward during breath, the rest of the chest expands. In the opposite direction, the chest contracts as the affected area moves out. Other flail chest symptoms include bruising or discoloration of the chest area. In the case of a car accident where seat belts are worn, the strap can cause extreme bruising.

Chest x-ray is used to diagnose the location of fractures. Flail chest treatment is centered on protecting the lungs and by neutralizing the risk of injuries on them. Mechanical ventilation is used to stabilize the chest cavity. Corrective surgery is performed in severe cases where prolonged ventilation is necessary. Ribs can be set and the pressure can be relieved from the lungs in this procedure. Pain medication are also used as part of flail chest treatment. Opioids can be prescribed to slow down breathing and reduce pain.

This condition is life threatening. It can cause significant damage to the lungs or surrounding organs and should be treated immediately. Movement of a person that was injured should only be performed by medical personnel to reduce the risk of further injury. Any type of blunt trauma to the chest should be examined to determine a diagnosis of flail chest.