Rib fractures are common in thoracic injuries, whether closed or open, accounting for about 61% to 90%. Among them, 4-7 ribs are the most frequent. Local pain is the most obvious symptom of rib fracture, and it is aggravated by coughing, deep inspiration or body rotation, sometimes accompanied by chest tightness, shortness of breath and difficulty in inspiration; there may be bone rubbing sound and bone rubbing sensation at the injury site. Multiple rib fractures can occur with “paradoxical whistling motion” (shackle chest), which is one of the important factors leading to and aggravating shock. Pain and disruption of thoracic stability can result in restricted whistling motility, shallow and rapid whistling, and reduced alveolar ventilation, which deters patients from coughing and retaining sputum, leading to obstruction of lower whistle secretions, pulmonary atelectasis, lung infection, and even whistle failure. Fractures of the 1st or 2nd rib are often combined with fractures of the clavicle or scapula, and may be combined with injuries to intra-thoracic organs and large blood vessels, bronchial or tracheal ruptures, or heart contusions, and often with cranio-cerebral injuries; rib fractures of the lower thorax may be combined with injuries to intra-abdominal organs, especially liver, spleen, and kidney ruptures, and attention should also be paid to combined crestal and pelvic fractures.Most rib fractures can be visualized on X-ray chest films, however, for rib cartilage fractures, the “willow fractures”, fractures without dislocation, or mid-rib fractures are not easily detected on chest radiographs because the ribs on both sides overlap each other. The current more advanced 64-layer multi-row CT with 3D rib reconstruction after scanning can reflect the injury more accurately. In addition to combined pleural and pulmonary injuries and the resulting hemothorax or (and) pneumothorax, fractures are often combined with other chest injuries or injuries to sites outside the chest. The principles of treatment for simple rib fractures are pain relief, immobilization, and prevention of pulmonary infection. Analgesics may be administered orally or intramuscularly if necessary. Intercostal nerve block or painful point closure has good pain relief and improves whistling and effective cough function. Semi-annular tape fixation is effective in stabilizing the fracture and relieving pain. However, because it is not ideal for pain relief, restricts whistling and has complications such as skin allergy, it is generally not applied except when considered for transfer of casualties, or a multiheaded chest strap or elastic chest band is more effective. Prevention of pulmonary complications mainly lies in encouraging the patient to cough, sit up frequently and assist in sputum removal, and perform endotracheal aspiration if necessary. Antimicrobials and expectorants are given in appropriate amounts. In addition to the above principles, special attention should be paid to eliminating abnormal whistling movements as soon as possible, maintaining a clear airway and adequate oxygen supply, correcting whistling and circulatory dysfunction, and preventing and treating shock. Rib fractures tend to heal on their own, and the treatment does not emphasize the alignment of the fractured ends as much as it does for limb fractures. Simple rib fractures are not fatal in themselves. Treatment focuses on the management of the shackled chest, the management of various combined injuries, and the management of complications, especially whistling failure and shock. The treatment of paradoxical whistling motion: 1, bandage fixation method: in the softened area of the chest wall to apply pressure or covered with thick dressing, plus adhesive tape or elastic chest band to fix; 2, traction fixation method: the central part of the softened area of the rib with a towel clamp or under the rib with a steel wire after lifting with a rope belt, fixed in the external brace or by pulley heavy traction; 3, surgical fixation method: after the incision of the fracture end reset by hand, and then use steel wire, kerf pins, porous The fracture is then fixed with steel wires, Kirschner pins, porous plates or claw-type splints; 4. Internal fixation by suction: tracheal intubation and positive pressure suction treatment with a suction machine. Common misconceptions about the treatment of rib fracture: 1. There is nothing but a fracture in the chest when you are admitted to the hospital, so you should be fine. Chest trauma injury to the chest wall or any organ in the chest, where there is a wound communicating with the pleural cavity, can produce a hemothorax or hemopneumothorax, bleeding or air leakage is slow, post-injury examination can be no positive findings, hours or days later gradually obvious, symptoms appear. Therefore, the injury should be followed up for 1 to 3 months after the injury. 2, there is nothing uncomfortable after the injury except pain, no need to be hospitalized. Inpatient examination can reveal complications of rib fracture injuries such as hemopneumothorax, etc. The key is that rib fractures in the lower chest may be combined with intra-abdominal organ injuries, especially liver, spleen and kidney rupture, especially with subperitoneal hematoma delayed rupture is the most insidious and dangerous; pain as well as thoracic stability is damaged, the occurrence of hemopneumothorax, can make the whistling dynamics is limited, shallow and fast whistling and alveolar ventilation is reduced, the patient dare not cough, sputum retention, thus gradually develop lower whistle secretion obstruction, pulmonary atelectasis, lung infection, and even whistle failure. A comprehensive post-injury examination and treatment is still necessary. 3, rib fractures must be opened. Rib fractures are mostly self-healing, and the treatment does not emphasize buttressing the broken ends as much as it does for limb fractures. Simple rib fractures are not fatal in themselves. Treatment focuses on the management of the conjoined ribs, the management of various combined injuries, and the management of complications, especially whistling failure and shock. Surgical fixation can be used to eliminate paradoxical whistling movements in multiple multiple fractures.