الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Thoracic trauma accounts for about 10-15% of all trauma and considered the second leading cause of death after head injuries among the trauma population accounting for about 25% of trauma-related deaths. Blunt thoracic traumas accounts for over 90%, commonly secondary to motor vehicle accidents (RTA), falls and crush or blast injuries with flail chest (FC) injuries occur in approximately 10-15% of patients with blunt thoracic trauma. About 35% of all blunt trauma patients and two thirds of thoracic trauma patients sustain one or more rib fractures, with flail chest (FC) injuries occur in approximately 10-15% of patients with blunt thoracic trauma. Flail chest injuries are associated with high rates of short-term and long-term morbidity, with mortality rates that may reaches up to 42 %. Complications associated with flail chest injuries are due to chest wall instability, pulmonary contusions and hemorrhage with resultant de- creased lung volume and pulmonary function, causing respiratory distress, respiratory failure and subsequent development of pneumonia and ARDS. Pulmonary complications due to flail chest include pneumothorax, hemothorax, pulmonary contusion, pneumonia, atelectasis, predisposes to acute respiratory distress syndrome (ARDS), prolonging mechanical ventilation requirements and increasing the injury burden of the traumatized patient. Management of a flail chest should include these areas of concern; maintaining adequate ventilation, fluid restriction, pain relief and fixation of the unstable chest wall. Ventilation should be maintained with oxygen mask; mechanical ventilation should be used only when other methods fail and extubation should be attempted as early as possible. Pain management should be addressed early and aggressively. This may include nerve blocks or epidural anesthesia.