A male patient aged 30 years following a road traffic accident presents with fracture

A male patient aged 30 years following a road traffic accident presents with fracture of 4^th to 10^th ribs and respiratory distress. He is diagnosed to have flail chest and PaO₂ is < 60%. The treatment of choice is


a) fixation of ribs 
b) strapping of the chest  
c) IPPV with oral intubation  
d) tracheostomy


Ans (c)