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.