Abstract
The outcome is reported of patients after external chest wall stabilisation for respiratory
insufficiency due to a traumatic flail chest. Since 1990, all patients with a flail
chest causing respiratory insufficiency despite peridural analgesia and without further
reason for prolonged mechanical Ventilation underwent osteosynthesis of the chest
wall using the AO-technique with 3.5 mm thick reconstruction plates, and were prospectively
followed-up by use of clinical and radiological evaluation. 23 patients underwent
external chest wall fixation between 1990 and 1996 and were followed for a mean time
of 28 months. 2 patients died after the Operation, giving a 30-day-survial rate of
91.3%. 21 patients survived and were extubated and transferred to the ward after a
mean time interval of 3.9 and 7.8 days, respectively. 95 % of the survivors revealed
a 100 % working capacity at assessment and 86% returned to preoperative sports activities
without complaining of chest wall or Shoulder girdle pain or dysfunction External
chest wall fixation appears to be an attractive alternative to prolonged intubation
and mechanical Ventilation for selected patients with flail-chest respiratory insufficiency
despite peridural analgesia, providing they do not require prolonged intubation for
other reasons.
Key words
Flail chest - Stabilisation
