Rib fractures are the most common of thoracic injuries, accounting for approximately 85% of closed chest injuries. Initially, conservative methods such as binding of the entire thorax and external fixation of the chest wall were used to treat rib fractures; more severely injured rib fracture ends may be further misaligned, resulting in chest wall deformity, reduced pulmonary ventilation capacity, and impaired respiratory function. Sequelae such as bone discontinuity or deformed healing arise due to continued activity of the fractured break end. Patients may be left with long-term chest pain and chest discomfort, which seriously affects their quality of life and may lead to a series of complications if not treated properly, especially in elderly patients where pulmonary infections resulting from failure to expel sputum are often fatal. With the deepening understanding of the pathophysiology of rib fracture, the changing concept of treatment and the rapid progress of material science, the treatment method has gradually developed from the initial conservative treatment to the active surgical treatment now. We have accumulated considerable experience in treating more than 4,500 patients with chest trauma each year. Through surgical treatment of some patients with severe multiple rib fractures, we have used a controlled study to compare the differences in treatment time, complication rates, post-injury pain and chest function in patients with roughly similar degrees of conservative treatment. In particular, in patients with multiple rib fractures combined with severe pulmonary contusions, early surgical fixation can shorten the duration of ventilator application, reduce complications, and significantly reduce costs. Foreign studies have also confirmed that surgical treatment is emerging as a new, aggressive approach to the treatment of multiple rib fractures, which can significantly benefit some patients with multiple rib fractures. The rib is only a scaffold to maintain the shape and stability of the thorax, so not all rib fractures require surgical fixation; for most patients, conservative treatment can basically achieve therapeutic results, and there is no definite conclusion as to which part of patients with multiple rib fractures require surgical treatment, and there are no clear and uniform indications for surgical treatment currently carried out in China, which inevitably leads to waste of resources and overmedication, as well as This inevitably leads to waste of resources, over-medication, and also deprives some patients of the best treatment measures. We have made a preliminary correlation analysis of fractures and related complications and sequelae such as chest pain in patients with multiple rib fractures, and found that there is a correlation between the location, number and degree of dislocation of the broken ends of rib fractures and the severity of pulmonary contusion, hemothorax, pneumothorax and the degree of chest pain in patients, according to which, we have developed six hospital criteria: Indications for surgical fixation of rib fractures: 1. Shackled chest, including paradoxical chest wall movement, persistent chest wall instability resulting in respiratory distress or inability to disengage ventilator supporters; 2, multiple rib fractures resulting in thoracic collapse, obvious deformity of the thorax, resulting in restricted ventilatory function or patients needing to restore the thoracic shape due to aesthetic requirements; 3, multiple rib fractures with obvious misalignment of more than three broken ends (including three); 4, rib fractures with misalignment of less than three, but combined with hemopneumothorax, etc. requiring thoracotomy or requiring orthopedic surgery can 5.Simple rib fracture of more than 5 (including), only 1-2 dislocated ends, pain is obvious and cannot be relieved by conservative treatment, surgery can be recommended. Contraindications to surgical fixation of rib fractures: 1. advanced age (over 75 years old), poor cardiopulmonary function or combined with other entrapment cannot tolerate surgery; 2. combined with other parts of the injury, which may be life-threatening; 3. rejection or allergy to the fixation material; 4. open injury with severe contamination of the wound. Rib fixation materials are roughly divided into two categories: intramedullary fixation and extramedullary fixation, and metal and absorbable materials according to the nature of the materials. Common fixation devices include Kirschner steel pins, metal splints (including various plates, special fixators), titanium-nickel alloy memory ring huggers, etc., each with its own advantages and disadvantages. In addition, it should be noted that it is not necessary to fix all the fractured ribs, but only the so-called pillar ribs and fractures that may affect the stability of the chest wall can be repositioned and fixed, if too much is fixed, it will increase unnecessary surgical trauma and cause postoperative stiffness and restriction of the chest wall.