Gamerman Melisa, Romero Manteola Enrique, Contreras Sofía, Patiño Celeste, Bonetto Germán, Salvadores Agustina
Sanatorio Allende, Córdoba, Argentina.
Arch Argent Pediatr. 2020 Feb;118(1):e57-e60. doi: 10.5546/aap.2020.e57.
Flail chest is defined by fracture of 3 or more adjacent ribs, at 2 or more sites, with paradoxical movement of the affected chest. It occurs in 2 to 4 % of blunt chest trauma, with a mortality of 10 to 15 %. Treatment is conservative, using analgesia and positive pressure ventilation, or surgical osteosynthesis of rib fractures. We present the case of a 9-year-old girl with blunt chest trauma and flail chest. Computed tomography showed rib fractures from 2 to 7 left ribs, in middle and anterior arches. Due to inadequate pain management, it was placed in mechanical ventilation. After 72 hours the surgical resolution was decided, osteosynthesis of the 3 to 7 ribs was performed. The patient evolved favorably. The surgical management allowed reducing days of mechanical ventilation and days of hospitalization.