5.4 : 连枷箱 I：介绍

Flail chest is a traumatic condition that occurs when three or more adjacent ribs fracture in multiple places, causing a section of the chest wall to move independently from the rest of the thoracic cage.

The common causes of this condition include blunt chest trauma, often from motor vehicle accidents or injury from a steering wheel, falls in elderly individuals with osteoporosis, and assault with a sharp object.

Next, the pathophysiology involves fractures of the ribs, costal cartilage, or sternum, resulting in an unstable chest wall.

This causes paradoxical movement during breathing, impairing respiratory function.

The detached rib segment, known as the flail segment, moves inward during inspiration, limiting air intake, and outward during expiration, hindering exhalation.

The flail segment's paradoxical movement causes chest pain, dyspnea, hypoxemia, tachypnea, compromised gas exchange, increased dead space, and cyanosis.

Severe cases can cause crepitus, pneumothorax, poor tissue perfusion, metabolic acidosis from reduced cardiac output, and atelectasis.