What Is Flail Chest?

Flail chest occurs usually as a result of blunt trauma, separating a portion of the rib cage from the chest wall. Diagnosis requires a minimum of three ribs in close proximity, broken in two or more places that is confirmed by an X-ray.

Significance

• A flail chest is suggestive of underlying injuries. Broken ribs have sharp edges that can cause cuts and bruising to the lungs when ribs are knocked out of place. Severe trauma can send a broken rib into the lung, puncturing it.

Function

• Drawing a breath requires the muscles around the ribcage to expand. This action creates a vacuum effect in which the lungs are able to draw air. A broken section of the ribcage, pulled away from the chest wall interferes with this normal chest movement.

Symptoms

• Paradoxical movement of the chest is a physical symptom of flail chest. Upon inspiration, the affected area will draw inward as the rest of the chest expands. During expiration, the affected area will expand when the rest of the chest contracts.

Other Symptoms

• Indicators of a flail chest may also include bruising or discoloration of the chest, chest pain and difficulty breathing. If the injuries are a result of a motor vehicle accident, chest bruising from a seat belt may also be an indicator.

Treatment

• Managing chest wall injuries is geared to protecting the lungs. Patients are immediately placed on 100 percent oxygen and may be intubated or have a chest tube inserted. Mechanical ventilation, corrective surgery and pain management may also be employed in treatment.