Tórax inestable, evolución sin osteosíntesis: presentación de un caso.

Blunt thoracic trauma is usually the result to direct impact to high velocity or falls being responsible of rib fractures. Flail chest is defined as fractures to three or four ribs in more than two segments of his length, causing a paradoxical phenomenon at thoracic box during respiration, collapsing during inhalation and expanding at exhalation. The anterior or lateral location is the most serious given their physiopathological impact; the diagnosis is established by physical examination, radiographs, chest CT and studies of respiratory physiology. Treatment is based on the internal pneumatic stabilization through mechanical ventilation and osteosynthesis. We present the case a female patient 18 years old who is admitted at General of South Hospital, because of complicated closed thoraco-abdominal trauma with right pneumothorax, left hemopneumothorax who needed chest tube placement and intubation, liver injury grade IV at the segments II and III and splenic flexure injury, entering UCI where she remained for twelve days under mechanical ventilation. It stresses the strengthening rib at absence of osteosynthesis or fixation with developments observable at imaging studies of periodic control.