Surgical Stabilization of the Chest Wall: Patient Selection and Timing

Purpose of Review: Surgical stabilization of rib fractures (SSRF) is being used with increasing frequency, with broadened indications and proven therapeutic benefit. The following will focus on appropriate patient selection and ideal timing of repair, highlighting patients and injury patterns most likely to benefit from SSRF. Recent Findings: Recent enthusiasm for SSRF has occurred due to expansion beyond the traditionally accepted indication of flail chest, including many other injury patterns, radiographic findings, and physiologic variables. This has led to increased data for analysis of outcomes in SSRF, allowing creation of society guidelines around indications and timing of repair. Additionally, more critical analysis of timing of repair and patient-reported outcomes suggest further benefit following early repair. Summary: Review of the currently available literature supports broadened indications and earlier intervention for SSRF, now supported by society guidelines with enhanced outcomes. Further prospective study is necessary for ongoing analysis and further delineation of indications, outcomes and risk assessment to guide decision making in the repair of chest wall injury.