We often receive patients who have fractured ribs after a car accident, and some doctors advocate conservative treatment (taking it slow), while others advocate surgery. The patient is at a loss as to which is the better way to proceed. The ribs and sternum are the main bony components of our thoracic cavity, mainly serving to protect the internal organs of the chest and to assist in breathing. There are 24 ribs, (the same for men and women) half on each side. When the rib fracture is heavily misaligned, the pain is severe, the fracture is usually greater than 3 or more, the chest wall is floating, and it affects breathing and coughing, it is time for surgery, with the benefit of significantly reducing the bony pain, facilitating the patient’s breathing and phlegm, reducing the incidence of respiratory failure, and allowing the patient to recover quickly. The best time to operate is 24-48 hours after the injury. The surgical procedure is an incision and internal fixation of the rib fracture, which is simple and has few complications.