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Updated: Feb 24, 2026

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Rib Fractures: To Fix or Not to Fix? An Evidence-Based Algorithm
Michael Bemelman1, M W de Kruijf1, Mark van Baal1
1Department of Surgery, St. Elisabeth Hospital.
Abstract:
Rib fractures are a common injury resulting from blunt chest trauma. The most important complications associated with rib fractures include death, pneumonia, and the need for mechanical ventilation. The development of new osteosynthesis materials has stimulated increased interest in the surgical treatment of rib fractures. Surgical stabilisation, however, is not needed for every patient with rib fractures or for every patient with flail chest. This paper presents an easy-to-use evidence-based algorithm, developed by the authors, for the treatment of patients with flail chest and isolated rib fractures.
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