Blunt chest trauma is usually caused by traffic accidents, strenuous sports activities, impacts, or falls from height, and the mortality rate can be as high as 25%, while the leading cause of death is cardiac contusion. In contrast, tricuspid valve insufficiency is relatively rare in cardiac contusions, which are caused by closed chest injuries resulting in tricuspid valve leaflet tears, tendon rupture or papillary muscle rupture due to blunt chest trauma, and acute right heart failure can occur, and surgery for tricuspid papillary muscle ectopic fixation and repair of tricuspid valve insufficiency or valve replacement is the best option. We have performed 3 such procedures with satisfactory results. Simple tricuspid valve insufficiency due to trauma is less common in clinical practice and is mainly due to closed chest injury caused by chest impact injury. This is due to blunt chest impact resulting in a sharp increase in right intraventricular pressure, resulting in tricuspid valve damage, and its pathological changes are mainly leaflet tears, tendon rupture, papillary muscle rupture, etc. Since the anterior tricuspid valve is the leaflet that plays a major role in tricuspid valve closure, damage to the tricuspid valve occurs mainly in the anterior leaflet, followed by blunt trauma causing posterior papillary muscle rupture. In this group, one case was a rupture of the anterior and posterior papillary muscles of the tricuspid valve, and two cases were ruptures of the anterior papillary muscles of the tricuspid valve. Traumatic injuries caused by traffic accidents are usually compound injuries, and clinical attention is highly focused on injuries to the head, extremities, and thoracic and abdominal organs, and emergency care is given, and injuries to the heart are easily missed. Electrocardiogram and echocardiogram can provide a clear diagnosis. Even if the diagnosis of tricuspid valve insufficiency due to tricuspid papillary muscle rupture is made, it is recommended to treat other internal organ injuries or extremity fractures first, because the tricuspid papillary muscle rupture edge has significant edema and fragile tissues in the acute phase, which is not conducive to trimming and local fixation, and to treat surgically only after 3-4 weeks or longer when the papillary muscle rupture edge is fibrotic and the tissues are more rigid. During this period, targeted treatment can be performed if there are clinical manifestations of right heart insufficiency. Surgery is the only effective treatment for traumatic tricuspid valve insufficiency. Tricuspid valve repair and shaping under extracorporeal circulation is the preferred method, and in most cases good results can be achieved with the valve shaping ring implantation technique. Simple tricuspid leaflet tears due to trauma are rare and are mainly due to tearing of the anterior papillary muscle from its fixation, followed by tearing of the posterior papillary muscle from its fixation and resulting in tricuspid valve insufficiency. We attempted to fix the avulsed anterior papillary muscle in situ in case 1, but the anterior tricuspid leaflet was difficult to completely align with the posterior tricuspid leaflet and the septal leaflet after in situ fixation, and satisfactory results could not be achieved even with the implantation of a tricuspid shaped ring. After repeated comparisons, we found that if the anterior tricuspid papillary muscle is fixed in the upper septum and the posterior papillary muscle is fixed in the lower septum, the anterior and posterior tricuspid leaflets can be fully expanded to achieve complete closure. If the tricuspid annulus is found to be significantly enlarged, the tricuspid Carpentier ring is also used to fix the annulus for more satisfactory long-term results. In our group, two cases were placed with tricuspid carpenter rings and one child was not placed with a tricuspid carpenter ring because of a normal tricuspid annulus, and intraoperative esophageal ultrasound indicated satisfactory hemodynamics.