Traumatic rib fracture: Conservative therapy or surgical fixation?

Rib fractures are a common problem affecting injured patients, and the vast majority of patients heal their rib fractures without surgical intervention. Patients with severe rib fracture syndromes such as flail chest, traumatic chest wall defects, or pulmonary hernias are selectively recommended for rib fracture fixation, but the practice is not uniform and is controversial. Proponents of operative intervention contend rib fracture fixation in select patients will diminish the risk of respiratory complications and improve long-term pain and disability. Skeptics argue that operative intervention is applicable to a very small subset of injured patients with severe chest wall injuries and unnecessary or meddlesome in the rest.