When rib fractures do not affect respiratory movements, surgical treatment is usually not required, but further surgical fixation is needed for unilateral multiple rib fractures causing kyphosis leading to respiratory dysfunction. The main role of the rib cage is to support the chest paralysis to maintain the stability of the thorax and to assist respiratory movement to maintain the negative pressure in the thoracic cavity. After a rib fracture with localized collapse, without affecting the normal respiratory function, even if the fracture is displaced significantly, it is sufficient to let the fracture heal abnormally, without affecting the normal function, due to the presence of respiratory movement and the undulation of the chest wall, the fracture will always be mildly active with the respiratory movement, resulting in a slow healing of the fracture. The fracture will heal slowly and will heal completely in about half a year. For unilateral multiple rib fractures, the chest wall collapses with paradoxical respiratory activity, requiring surgical internal fixation to maintain the stability of the chest wall and improve respiratory function. Therefore, most rib fractures do not require surgical treatment, but only this particular type of unilateral multiple rib fracture with chest wall collapse that causes paradoxical respiratory activity requires surgical treatment.