Pulmonary function has been measured at intervals after direct chest injuries of mild and moderate severity in 46 patients. Ventilatory capacity (e.g. FEV1) and vital capacity were reduced and the residual volume was increased. Total lung capacity and alveolar volume were also reduced and as a result total pulmonary diffusing capacity (transfer factor) was decreased, however, the remaining lung had a normal diffusion coefficient. Intercostal nerve block at the fracture site did not improve ventilatory capacity although marked pain relief was achieved. Recovery was slower in those patients not admitted to hospital than in the more seriously injured patients who were admitted. It is suggested that more attention should be paid to the outpatient follow-up of such patients, perhaps paying particular attention to physiotherapy.
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