This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: Trauma, Subject name: Surgery
Treatment of choice of flail chest is 
Select and explain. 
A. Ext. fixation of flail segment & mech ventilation, B. Strapping, C. O2 administration, D. Intrapleural local analgesia
A: Ext. fixation of flail segment & mech ventilation
Answer: A: Ext. fixation of flail segment & mech ventilation 
Explanation: .It is fracture of two or more consecutive ribs, with each rib having two or more fracture sites. Such segment is called as flail segment. Treatment  Intercostal tube drainage.  Applying clips to fracture ribs and fi xing above and below to normal ribs.  Antibiotics like penicillins, cefotaxime.  Blood transfusion, IV fluids.  Bronchodilators, steroids.  Ventilator suppo with IPPV--IPPV is treatment of choice. Assisted ventilation is required for several days until the chest wall stabilises. If ventilator suppo is required for more than 10 days, then tracheo stomy is done to prevent laryngeal stenosis which can occur due to prolonged endotracheal intubation.  Thoracotomy--when required only. Ref: SRB's Manual of Surgery, 4th Edition, pg. no. 1196