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 breathing or body rotation, sometimes accompanied by chest tightness, shortness of breath and difficulty in breathing; there may be bone rubbing sound and bone rubbing sensation at the injury site. Multiple rib fractures can result in “paradoxical respiratory movements” (shackle chest), which is one of the most important factors leading to and aggravating shock. Pain and disruption of thoracic stability can result in restricted respiratory motion, shallow and rapid breathing, and reduced alveolar ventilation, which prevents the patient from coughing and retaining sputum, leading to obstruction of lower respiratory secretions, pulmonary atelectasis, lung infection, and even respiratory failure. The 1st or 2nd rib fracture is often combined with clavicle or scapula fracture, and may be combined with intra-thoracic organ and large blood vessel injury, bronchial or tracheal rupture, or heart contusion, and often combined with cranial injury; lower thoracic rib fracture may be combined with intra-abdominal organ injury, especially liver, spleen and kidney rupture, and should also be noted combined with spine and pelvis fracture. Most of the X-rays can show rib fractures, but it is not easy to detect rib cartilage fractures, “willow fractures”, fractures without dislocation, or mid-rib fractures on chest films because the ribs on both sides overlap each other. At present, the more advanced 64-layer multi-row CT with 3D rib reconstruction after scanning can reflect the injury situation 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. Treatment of rib fractures: The principles of treatment for simple rib fractures are pain relief, immobilization, and prevention of pulmonary infection. Pain relievers may be given orally or intramuscularly if necessary. Intercostal nerve block or painful point closure has good pain relief and improves respiratory 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 breathing and has complications such as skin allergy, it is generally not applied except when considered only 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. Treatment of paradoxical respiratory movements: 1. bandage fixation method: apply pressure to the softened area of the chest wall or cover it with thick dressing, plus adhesive tape or elastic chest belt fixation; 2. traction fixation method: clamp the ribs at the central part of the softened area with scarf clamp or wear steel wire under the ribs and then lift them with a rope belt, fix them in an external brace or traction by pulley weights; 3. surgical fixation method: reset the fracture end by hand after incision, and then use steel wire, Kirschner needle, porous The fracture is then fixed with steel wire, Kirschner’s pin, porous plate or claw-type bone plate; 4. Endotracheal fixation method: tracheal intubation and positive pressure breathing treatment with ventilator. 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 hemothorax or hemopneumothorax. When bleeding or air leakage is slow, there may be no positive finding in the post-injury examination, and gradually become obvious and symptomatic after a few hours or days. 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. Hospitalization examination can reveal the complications of rib fracture injuries such as hemopneumothorax, etc. The key is that rib fracture 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 respiratory motility limited, shallow and fast breathing and alveolar ventilation reduced, the patient dare not cough, sputum retention, thus gradually develop lower respiratory secretion obstruction, pulmonary atelectasis, lung infection, and even respiratory 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 on buttressing the broken ends as much as it does for limb fractures. Simple rib fractures are not fatal in themselves. Treatment focuses on management of the conjoined ribs, management of various combined injuries, and prevention of complications, especially respiratory failure and shock. Surgical fixation can be used to eliminate paradoxical respiratory movements in the case of multiple multiple fractures.