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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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Last updated: July 22, 2026