Resumo

LLERA DOMINGUEZ, Gerardo; RABELL HERNANDEZ, Sergio; VALLS MARTIN, Arnaldo  e  MENENDEZ GUERRERO, Aurelio. Tórax inestable: Fisiopatología, tratamiento. Rev Cubana Cir [online]. 1996, vol.35, n.1. ISSN 0034-7493.

It is reported that thoracic traumas have a high mortality, and the flail chest, a modality, showed in Cuba, in a series from 1985 to 1988, the 25 %. The management of flail chest has been changing with the physiopathology accepted at each moment. When it was thought that the main problem was the thoracic instability, the methods were used just to immobilize. Later, the internal pneumatic stabilization was used, but at a long term it produced mortality due to respiratory infections and tracheal stenosis. It is highlighted that with today's concept, the main objective is the underlying lung contusion; the patients are selected and ventilation is indicated only for those who have a compromised respiratory function; the others are treated with physical therapy and blockade, or peridural anesthesia to fight pain. It is concluded that it is important to disconect early the ventilated patients from the mechanical respirator, and external fixators like Valls' are useful for this purpose. In patients submitted to thoracotomy, an osteosynthesis may be performed if necessary

Palavras-chave : THORACIC INJURIES [physiopathology]; THORACIC INJURIES [therapy]; FRACTURE FIXATION; INTERNAL; TRACTION; RESPIRATION ARTIFICIAL.