A 45-year-old man after blunt chest trauma has CT showing fractures of ribs 4 to 8 on the left with segmental fractures of three adjacent ribs. He is breathing spontaneously with paradoxical movement of a left chest wall segment. What is the key imaging correlate of his clinical finding?
- A Displaced sternal fracture with retrosternal haematoma
- B Haemothorax occupying more than one third of the hemithorax
- C Flail chest defined by two or more ribs fractured in two or more places ✓
- D First and second rib fractures with subclavian vessel injury
Correct answer: C. Flail chest defined by two or more ribs fractured in two or more places
Explanation
Paradoxical segmental chest wall movement defines flail chest, which radiologically requires fracture of two or more contiguous ribs at two or more sites each, producing a free-floating segment. The other options describe separate injuries: haemothorax causes dullness and reduced sounds, sternal fracture relates to direct impact, and upper rib fractures suggest great vessel injury rather than flail mechanics.
Reference: Bailey and Love's Short Practice of Surgery, 27th ed.
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Written and medically reviewed by the StethoPrep medical team.