The degree of risk to the patient depends on the cause of injury, the site and extent of tenderness, the patient’s age and pre-existing cardiopulmonary reserve function, and the presence or absence of co-injury. The most frequent site of shackle chest is on the lateral side of the thorax, and a small percentage occurs in the anterior thorax. In cases of thoracic trauma with multiple rib fractures and shortness of breath combined with shock, the presence of hemopneumothorax with pulmonary contusion as the main pulmonary injury is considered first. With the help of X-ray chest film, B ultrasound, CT and other examinations to clarify the diagnosis. Differential diagnosis of shackle chest: 1, thoracic deformity: chicken chest is a wedge-shaped convexity of the anterior wall of the chest like the sternum of birds, so named. Funnel chest is a concave deformity of the anterior wall of the chest, like a funnel. These are two common thoracic deformities. 2, thoracic collapse: one side of the thoracic collapse can be caused by abscess chest or pleurisy, extensive pleural thickening adhesions and contraction, pulmonary atelectasis, pulmonary fibrosis, chronic fibrous tuberculosis, chronic pulmonary suppuration and other disorders. 3, rib and subpectoral inhalation depression: rib and subpectoral inhalation depression is a clinical manifestation caused by pediatric micromaxillary malformation syndrome. Micrognathiasyndrome is also known as cleft palate – micrognathiasyndrome – hypoglossal syndrome, micrognathiy-hypoglossal syndrome, micrognathiy-hypoglossal syndrome, inspiratory airway obstruction syndrome, Robin syndrome, Pierre-Robin syndrome and so on. This syndrome is characterized by congenital micromandibular malformation, tongue prolapse, cleft palate and inspiratory airway obstruction in neonates and infants, and the incidence of death due to airway obstruction caused by this syndrome is high.