Open pneumothorax is a life-threatening chest wall injury governed by fluid-flow physics: when a chest wall defect approaches two-thirds the diameter of the trachea, its shorter tube length causes air to preferentially flow through the wound rather than down the airway during inspiration, impairing ventilation and causing hypoxia. Flail chest arises from multiple, multi-level rib fractures that create a segment of thoracic cage discontinuous from the rest of the chest wall, causing paradoxical inward movement of that segment during inspiration, which directly impairs ventilation and is strongly associated with underlying pulmonary contusion.
Open pneumothorax is a life-threatening chest wall injury governed by fluid-flow physics: when a chest wall defect approaches two-thirds the diameter of the trachea, its shorter tube length causes ai…