The novel use of Nuss bars for reconstruction of a massive flail chest.

We present the case of a patient who sustained a massive flail chest from a snowmobile accident. All ribs of the right side of the chest were fractured. Nonoperative management was unsuccessful. Previously reported methods of rib stabilization were precluded given the lack of stable chest wall elements to fixate or anchor the flail segments. We present a novel surgical treatment in which Nuss bars can be used for stabilization of the most severe flail chest injuries, when reconstruction of the chest is necessary and fixation of fractured segments is infeasible owing to adjacent chest wall instability.