Abstract
An 83-year-old woman was admitted for multiple rib fractures from the left 3rd to the 11th ribs, a flail chest, pulmonary contusion, hemo-pneumothorax, and abdominal injuries. Immediately after admission, tracheal intubation was performed and positive-pressure ventilation was initiated ; however, such internal fixation was not successful for improving the pain or the paradoxical movement of the chest wall. We decided to perform early surgical stabilization of the rib fractures on day 5 after admission, for the purpose of early weaning from mechanical ventilation and for providing pain relief. Preoperatively, we identified which rib fractures mainly affected her respiration and caused chest pain, and then we performed minimal fixation of these fractured ribs. Soon after the operation, the patient could be weaned off from the ventilator. Thus, early fixation of rib fractures causing flail chest should be considered in aged patients. Furthermore, identification of the rib fractures mainly causing the symptoms is crucial to improve the pain and dyspnea with minimally invasive intervention.
