The purpose of this study is to determine whether operative fixation of unilateral flail chest provides greater benefit than non-operative treatment.
Who can participate
Age range21 Years – 75 Years
SexALL
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AI-rewrites the medical criteria so a patient or caregiver can understand them. Always confirm with the trial site.
Inclusion criteria
✓. Adults \>21 years and \<75 years
✓. "Stove-in chest" to encompass both
✓. Unilateral flail chest (\>3 ribs fractured at two places) or
✓. Contiguous rib fractures with at least 2 ribs pushed in \> the rib diameter of the pushed in rib
✓. Mechanically ventilated
Exclusion criteria
✕. Patient unlikely to survive due to the trauma or age or multiple co-morbidities
✕. Stove-in chest patients that do not require early (less than or equal to 48 hours of injury) ventilatory support
✕. Bilateral flail chest
✕. Sternal flail
✕. P/F ratio \< 200:1 over a period of greater than or equal to 6 hours while on the ventilator.
✕. Other injuries that will likely prolong tracheal intubation and mechanical ventilation eg significant head injury resulting in low GCS (Glasgow Coma Score, a scale used to assess the central nervous system in patients who have undergone trauma), spinal cord injury resulting in paralysis of some or all of the respiratory muscles etc. These are merely examples. It is in the opinion of the investigator/surgeon what injuries would prolong tracheal intubation.
✕. Any contra-indication to surgery including severe immunosuppression or severe chronic disease making elective surgery dangerous in the opinion of the surgeon
What they're measuring
1
Morbidity
Timeframe: Measured daily during hospitalization (approx 1 month)
2
Mortality
Timeframe: Measured any time during hospital stay (approx 30 days)