Surgical Fixation of Flail Chest Injuries: Reduction and Fixation Options, Tips and Tricks

Summary: Modern techniques of rib fracture fixation surgery follow the AO principles of fracture reduction, fixation, and appropriate soft tissue handling. Fixation techniques can be performed using anatomic reduction and rigid fixation, or bridge plate fixation for comminuted fractures. Anatomic and nonanatomic plates can be used, although titanium precontoured locking plates are the most commonly used. Other contemporary intra- and extramedullary fixation strategies have also been developed. Intrathoracic fixation is a novel technique, however, limited literature on clinical outcomes currently exists. This article discusses techniques of reduction, fixation, and tips and tricks for surgical fixation of rib fractures.