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Potentially life-threatening emergency
Flail chest
Other Resources UpToDate PubMed
Potentially life-threatening emergency

Flail chest

Contributors: Casey Silver MD, Mary Anne Morgan MD, Michael W. Winter MD
Other Resources UpToDate PubMed

Synopsis

Flail chest is a chest wall injury of 3 or more adjacent ribs with fractures that cause that section of rib cage to separate from the chest wall and move independently of the rest of the rib cage. Flail chest is usually caused by blunt trauma but may occur during thoracic surgery. It is considered a medical emergency.

Flail chest is characterized by pleuritic chest pain, ecchymosis, and dyspnea. A more difficult to detect symptom is abnormal chest motion.

Commonly associated injuries include pneumothorax, hemothorax, and pulmonary contusion. Intraabdominal, upper extremity, and head injuries are also often seen due to the severe mechanism of injury needed to cause flail chest.

Management begins with oxygen administration, monitoring for signs of respiratory failure, noninvasive positive airway pressure administration by mask, and analgesia. More severe conditions may require endotracheal intubation and mechanical ventilation.

Codes

ICD10CM:
S22.5XXA – Flail chest, initial encounter for closed fracture
S22.5XXB – Flail chest, initial encounter for open fracture

SNOMEDCT:
78011002 – Flail Chest

Look For

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Diagnostic Pearls

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Differential Diagnosis & Pitfalls

To perform a comparison, select diagnoses from the classic differential

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Best Tests

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Management Pearls

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Therapy

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References

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Last Reviewed:04/23/2019
Last Updated:05/13/2019
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Potentially life-threatening emergency
Flail chest
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A medical illustration showing key findings of Flail chest : Pleuritic chest pain, Ecchymosis, Dyspnea, Hypoxia
Copyright © 2024 VisualDx®. All rights reserved.