Emergency Central is a collection of disease, drug, and test information including 5-Minute Emergency Medicine Consult, Davis’s Drug, McGraw-Hill Medical’s Diagnosaurus®, Pocket Guide to Diagnostic Tests, and MEDLINE Journals created for emergency medicine professionals. Explore these free sample topics:
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- Free-floating segment of chest wall:
- 3 or more adjacent ribs are fractured in 2 or more places.
- Rib fractures in conjunction with sternal fractures or costochondral separations
- The free-floating segment of chest wall paradoxically moves inward during inspiration and outward during expiration.
- The principal pathology associated with flail chest is the associated pulmonary contusion:
- There is no alteration in ventilatory mechanics owing to the free-floating segment.
- Blunt thoracic trauma
- Fall from a height
- Motor vehicle accident
- Missile injury
- Ribs usually break at the point of impact or posterior angle:
- Ribs 4–9 most prone to fracture.
- Weakest point of ribs is 60° rotation from sternum.
- Transfer of kinetic energy to the lung parenchyma adjacent to the injury:
- Disruption of the alveolocapillary membrane and development of pulmonary contusion
- Arteriovenous shunting
- Ventilation/perfusion mismatch
- Respiratory failure may result.
- Relatively elastic chest wall makes rib fractures less common in children.
- Presence of rib fractures implies much higher energy absorption.
Much more susceptible to rib fractures:
- Described with low-energy mechanisms
- Complicated by osteoporosis