Bilateral multiple ribs and sternum fracture causing central flail chest with respiratory failure

Kailash Charokar; Dileep K. S. Rathor; Siddhabrata Besra; Arvind Rathore

doi:10.18203/2349-2902.isj20243263

Authors

Kailash Charokar Department of General Surgery, People's Hospital, People’s College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
Dileep K. S. Rathor Department of Cardiothoracic and Vascular Surgery, Bansal Hospital, Bhopal, Madhya Pradesh, India
Siddhabrata Besra Department of General Surgery, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India
Arvind Rathore Department of General Surgery, People's College of Medical Sciences and Research Centre, Bhopal, Madhya Pradesh, India

DOI:

https://doi.org/10.18203/2349-2902.isj20243263

Keywords:

Bilateral chest trauma, Flail chest, Acute respiratory failure, Osteosynthesis

Abstract

Bilateral thoracic blunt injuries in a patient may present with central Flail chest, and acute respiratory failure which is one of the life-threatening complications. We present a case of central flail chest caused by blunt trauma, successfully managed with operative rib and sternum fixation. A 35-year male with a central flail chest with acute respiratory failure caused by road-traffic accident who was managed initially with bilateral intercostal chest-tube drainage for significant bilateral hemopneumothorax and lung contusions. The patient was intubated and connected to mechanical ventilatory support with positive pressure ventilation for the internal pneumatic stabilization. There were multiple rib fractures anteriorly (first to seventh rib bilaterally) and fracture of the sternum - the flail chest, for which he underwent bilateral rib fixation and fixation of sternum with titanium reconstruction plate and screws on the 9th postinjury day. Tracheostomy was done along with fixation in the same sitting. Post-operatively, after 48 hours of positive pressure mechanical ventilation, the weaning was started and by the 4-5th day, the patient was on room air with a tracheostomy tube. The patient recovered uneventfully and was discharged on the eighth postoperative day.

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