Functional Outcomes After Muscle-Sparing Fixation of Flail Chest Injuries.

To present outcomes in a multicenter review of a large number of flail chest patients. Retrospective case series. One urban Level I and 1 urban Level II trauma center. Fifty-two adult patients who underwent treatment of their flail chest injury with locking plate and screw constructs through muscle-sparing approaches, followed for a minimum of 1 year postoperatively. All patients went on to successful union, with complication rates in line with recent published norms. Periscapular strength returned to greater than 90% of the noninjured side by 3 months postoperatively and to within a mean of 95% of the noninjured side by 6 months postoperatively. Glenohumeral range of motion similarly improved over this same interval. Use of anatomically designed modern locking plate and screw fixation constructs with muscle-sparing approaches results in efficient return to function and restoration of shoulder function and strength as compared with the noninjured shoulder. Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.