LONG-TERM FOLLOW-UP OF PATIENTS WITH OPERATIVE STABILIZATION OF A FLAIL CHEST

The outcome is reported of patients after external chest wall stabilis ation for respiratory insufficiency due to a traumatic flail chest. Si nce 1990, all patients with a flail chest causing respiratory insuffic iency despite peridural analgesia and without further reason for prolo nged mechanical ventilation underwent osteosynthesis of the chest wall using the AO-technique with 3.5 mm thick reconstruction plates, and w ere prospectively followed-up by use of clinical and radiological eval uation. 23 patients underwent external chest wall fixation between 199 0 and 1996 and were followed for a mean time of 28 months. 2 patients died after the operation, giving a 30-day-survial Fate of 91.3 %. 21 p atients survived and were extubated and transferred to the ward after a mean time interval of 3.9 and 7.8 days, respectively. 95 % of the su rvivors revealed a 100 % working capacity at assessment and 86 % retur ned to preoperative sports activities without complaining of chest wal l or shoulder girdle pain or dysfunction. External chest wall fixation appears to be an attractive alternative to prolonged intubation and m echanical ventilation for selected patients with flail-chest respirato ry insufficiency despite peridural analgesia, providing they do not re quire prolonged intubation for other reasons.