Operative Chest Wall Fixation with Osteosynthesis Plates

Blunt chest wall trauma is a major cause of morbidity andmortality, especially in the presence of a flail chestwhere paradoxical inward movement of the flail seg-ment in inspiration is found.1–3 Patients with a flail chest require aggressive pain con-trol, pulmonary toilet, and often intubation and mechanical ventilation to establish an internal pneumatic stabilization of the flail segment. This may result in a prolonged ICU stay and pulmonary complications including pneumonia, septicemia and barotrauma.3–9 The high mortality rate of up to 10 –36%3,10 –12 is partly due to the high prevalence of associated life-threatening extra-thoracic injuries. How-ever, one principle cause of death consists of pneumonia and sepsis with prolonged intubation.3,13,14 Several potential advantages of operative chest wall sta-bilizations have been reported. These include reduced dura-tion of mechanical ventilation,4,7,8,13,15–17 shortened ICU sta