Backgrounds: To avoid malunion, dyspnea, persistent pain and respiratory function lost in patients with posterolateral multiple ribs fractures.

Methods: Of 39 patients with ribs fractures, six (15.4%) were underwent operative fixation. Indications were organized hematoma (3, 50%), pain and postural defect (2, 33%), and post-traumatic drainage (1, 16.7%). Fractured tips were approximated in the manner of end-to-end and pierced with perforator. Titanium plates were screwed down by titanium screw.

Results: Rate of fixated ribs to all fractured ribs was 0.57 (3.6/6.3), extrathoracic injuries were 83.3% (5/6); intrathoracic injuries were 50% (organized hematoma, 3/6). Postural defect improved and ribs were in their anatomical position in all patients in the immediate postoperative period. Pain and dyspnea dissappeared. Postoperative hospital stay was 6 ± 2 days. Titanium materials no interfered with postoperative computed tomography and magnetic resonance imaging. A 15% increase in FEV1 and 19% in FVC occurred.

Conclusions: In patients with posterolateral multiple ribs fractures who had thoracotomy for another reason, surgical stabilization is an effective method, which removes the pain and postural defect and increases the patient comfort. Titanium material has radiological advantage.

Keywords : rib fixation, titanium plates, rib fracture, flail chest