Introduction: From the beginning of the twentieth century till the current time, an overview is presented of the surgical treatment for rib fractures and flail chest.
Methods: Many techniques have been used to stabilize the thorax wall. There has been no follow-up for the most described techniques and the evidence provided is at its best at L3-4. This, together with the noninvasiveness of mechanical ventilation, has made the latter the golden standard.
Conclusion: However, the recent introduction of better and fully dedicated materials provides the possibility of exploring the surgical treatment of chest injuries. The authors make a case for operative treatment of rib fractures and flail chest.