Successful management of severe flail chest via early operative intervention.

A review on the role of open reduction and internal fixation of flail chest injuries is presented. A 37-year-old woman involved in a motorcycle crash sustained comminuted rib fractures on her right 3rd through 12th ribs. On postinjury day 2, the patient's fifth through ninth ribs were surgically reduced and plated. Later that same day, the patient was successfully weaned from mechanical ventilation and experienced a rapid improvement in incentive spirometry volumes. Further studies are needed to definitively determine the benefits of rib plating versus conventional treatment. Through our case, we are able to demonstrate successful management of pain and chest wall instability associated with flail chest through the use of rib plating.