A Contemporary Review of Operative Indications for Chest Wall Trauma

Chest wall trauma, including rib and sternal fractures, is prevalent and a source of morbidity and mortality in trauma patients. While many injuries are managed non-operatively, surgical stabilization of flail segment rib fractures has shown benefits in ventilator weaning, pneumonia reduction, and functional recovery. However, evidence for operative management in non-flail injuries remains inconsistent, with outcomes often influenced by patient selection, injury pattern, and institutional expertise. Minimally invasive and thoracoscopic techniques continue to evolve, but their adoption is limited by resource demands and technical complexity. Management of sternal fractures also remains controversial, though supporting data are derived from retrospective series.