Chest Wall Stabilization: Indications and Surgical Techniques

Alison H. Mungo, MD, Marcelo C. DaSilva, MD, FACS, Robert A. Meguid, MD, MPH, FACS

Key Points

To review the indications for stabilization of rib fracture, including flail chest, non-united rib fractures refractory to conventional pain management, chest wall deformity or defect, and trauma-associated rib fracture and respiratory failure. To review timing of repair in the acute phase. The presence of other injuries requiring trips to the operating room might dictate time restrictions. To review the proposed classification for flail chest to determine which patient would benefit the most from Surgical Stabilization of Rib Fractures (SSRF). To review the goals of rib fracture repair targeting unstable fractures and flail chest segments, improving respiratory function, and promoting early separation from mechanical ventilator support. To review selection of rib fractures for repair considering rib number as well as the number of ribs.

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