nmpЖурнал им. Н.В. Склифосовского «Неотложная медицинская помощь»Russian Sklifosovsky Journal "Emergency Medical Care"2223-90222541-8017“N.V. Sklifosovsky Research Institute for Emergency Medicine”10.23934/2223-9022-2023-12-1-110-121nmp-1576Research ArticleОБЗОР ЛИТЕРАТУРЫREVIEWSХирургические методы стабилизации грудной клетки при множественных переломах реберSurgical Methods of Chest Stabilization in Multiple Rib Fractureshttps://orcid.org/0000-0002-1847-711XТарабринЕ. А.TarabrinE. A.

Тарабрин Евгений Александрович, доктор медицинских наук, заведующий кафедрой; главный научный сотрудник отделения неотложной хирургии, эндоскопии и интенсивной терапии

119991, Москва, ул. Большая Пироговская, д. 2, стр. 4

129090, Москва, Б. Сухаревская пл., д. 3

Evgeny A. Tarabrin, Doctor of Medical Sciences, Health Department, Head of the Department

2, bldg. 4, Bolshaya Pirogovskaya Str., Moscow, 119991

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

t_evg_a@mail.ruhttps://orcid.org/0000-0001-7838-4890КотанджянВ. Г.KotanjyanV. G.

Котанджян Вазген Гагикович, заведующий хирургическим торакальным отделением

129090, Москва, Б. Сухаревская пл., д. 3

Vazgen G. Kotanjyan, Head of the Surgical Thoracic Department

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

dr.kotanjan@yandex.ruhttps://orcid.org/0000-0003-2170-0009ОфицеровА. А.OfitserovA. A.

Офицеров Андрей Аркадьевич, научный сотрудник отделения биотехнологий и трансфузиологии

129090, Москва, Б. Сухаревская пл., д. 3

Andrey A. Ofitserov, Researcher

3, Bolshaya Sukharevskaya Sq., Moscow, 129090

3930590@mail.ruТоракальное хирургическое отделение, ФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» МЗ РФ; ГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияSurgical Thoracic Department, I.M. Sechenov First Moscow State Medical University of the Ministry; N.V. Sklifosovsky Research Institute for Emergency MedicineRussian FederationГБУЗ «Научно-исследовательский институт скорой помощи им. Н.В. Склифосовского ДЗМ»РоссияN.V. Sklifosovsky Research Institute for Emergency MedicineRussian Federation202316042023121110121Copyright © Тарабрин Е.А., Котанджян В.Г., Офицеров А.А., 20232023Тарабрин Е.А., Котанджян В.Г., Офицеров А.А.Tarabrin E.A., Kotanjyan V.G., Ofitserov A.A.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.jnmp.ru/jour/article/view/1576

Закрытая травма груди занимает одно из лидирующих мест среди всех повреждений. Переломы ребер могут приводить к формированию флотирующих фрагментов грудной стенки — «реберному клапану». При множественных переломах ребер с начала ХХ века использовались хирургические методы стабилизации грудной клетки, которые в последние десятилетия стали более популярными.  

Хирургическое лечение позволяет значительно уменьшить болевой синдром, ускорить восстановление респираторной функции и тем самым снизить частоту развития пневмонии, потребность в искусственной вентиляции легких и трахео­стомии и сократить период нахождения в стационаре. Различают четыре основные хирургические методики лечения, использующие: 1) тракцию грудной клетки; 2) аппараты внешней фиксации; 3) постоянную внутреннюю фиксацию; 4) накостный остеосинтез пластинами. В данном исследовании были дополнительно выделены методика, осуществляемая через торакоскопический доступ, и методика, использующая биоразлагаемые материалы. Хирургические возможности в лечении пациентов со множественными переломами ребер не исчерпаны и, вероятно, будут совершенствоваться по мере достижений в технологической сфере. 

Closed chest injury occupies one of the leading places among all injuries. Rib fractures can lead to the formation of floating fragments of the chest wall, the “costal valve”. With multiple rib fractures, surgical methods of chest stabilization have been used since the beginning of the 20th century, which have become more popular in recent decades.  

Surgical treatment can significantly reduce pain, accelerate the recovery of respiratory function. In turn, a decrease in pain reduces the incidence of pneumonia, the need for mechanical ventilation and tracheostomy, and the period of hospitalization. There are four main surgical methods of treatment: 1) chest traction methods; 2) external fixation devices; 3) methods of permanent internal fixation; 4) plate osteosynthesis. We also separated the group of techniques performed via thoracoscopic access and the technique using biodegradable materials. Surgical options in the treatment of patients with multiple rib fractures have not been exhausted and are likely to improve with advances in technology. 

остеосинтез реберзакрытая травма грудипереломы реберrib osteosynthesisclosed chest injuryrib fracturesReferencesLoCicero J, Mattox KL. Epidemiology of chest trauma. Surg Clin. 1989;69:15–19. PMID: 2911786 https://doi.org/10.1016/S0039- 6109(16)44730-4LoCicero J, Mattox KL. Epidemiology of chest trauma. Surg Clin. 1989;69:15–19. PMID: 2911786 https://doi.org/10.1016/S0039- 6109(16)44730-4Harrison M. Traumatic pneumothorax: a review of current practices. Br J Hosp Med. 2014;75:132–135. PMID: 24621627 https://doi.org/10.12968/ hmed.2014.75.3.132Harrison M. Traumatic pneumothorax: a review of current practices. Br J Hosp Med. 2014;75:132–135. PMID: 24621627 https://doi.org/10.12968/ hmed.2014.75.3.132Vana PG, Neubauer DC, Luchette FA. Contemporary management of flail chest. Am Surg. 2014;80:527–535. PMID: 24887787 https://doi. org/10.1177/000313481408000613Vana PG, Neubauer DC, Luchette FA. Contemporary management of flail chest. Am Surg. 2014;80:527–535. PMID: 24887787 https://doi. org/10.1177/000313481408000613Martin TJ, Eltorai AS, Dunn R, Varone А, Joyce MF, Kheirbeket T, al. Clinical management of rib fractures and methods for prevention of pulmonary complications: a review. Injury. 2019;50:1159–1165. PMID: 31047683 https://doi.org/10.1016/j.injury.2019.04.020Martin TJ, Eltorai AS, Dunn R, Varone А, Joyce MF, Kheirbeket T, al. Clinical management of rib fractures and methods for prevention of pulmonary complications: a review. Injury. 2019;50:1159–1165. PMID: 31047683 https://doi.org/10.1016/j.injury.2019.04.020He WW, Yang Y, Wu WM, Zhao T, Guo X, Li Y, et al. Chest wall stabilization (CWS) in China: current situation and prospect. J Thorac Dis. 2019;11(Suppl 8):S1104–S1148. PMID: 31205761 https://doi. org/10.21037/jtd.2019.03.31He WW, Yang Y, Wu WM, Zhao T, Guo X, Li Y, et al. Chest wall stabilization (CWS) in China: current situation and prospect. J Thorac Dis. 2019;11(Suppl 8):S1104–S1148. PMID: 31205761 https://doi. org/10.21037/jtd.2019.03.31Познанский С.В. Евтихов Р.М., Кутырев Е.А., Колбашова Ю.Н., Кукушкин А.В. Видеоторакоскопическая стабилизация каркаса грудной клетки. Современные технологии в медицине. 2010;(1– 2):72–73.Poznanskiy SV, Evtikhov RM, Kutyrev EA, Kolbashova YuN, Kukushkin AV. Videotorakoskopicheskaya stabilizatsiya karkasa grudnoy kletki. Sovremennye tehnologii v medicine. 2010;(1–2):72–73 (In Russ.).Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040–1047. PMID: 10866248 https://doi. org/10.1097/00005373-200006000-00007Bulger EM, Arneson MA, Mock CN, Jurkovich GJ. Rib fractures in the elderly. J Trauma. 2000;48:1040–1047. PMID: 10866248 https://doi. org/10.1097/00005373-200006000-00007Bemelman M, Poeze M, Blokhuis TJ, Leenen LPH. Historic overview of treatment techniques for rib fractures and flail chest. Eur J Trauma Emerg Surg. 2010;36:407–415. PMID: 21841952 https://doi.org/10.1007/ s00068-010-0046-5Bemelman M, Poeze M, Blokhuis TJ, Leenen LPH. Historic overview of treatment techniques for rib fractures and flail chest. Eur J Trauma Emerg Surg. 2010;36:407–415. PMID: 21841952 https://doi.org/10.1007/ s00068-010-0046-5Flagel BT, Luchette FA, Reed RL, Esposito TJ, Davis KA, Santaniello JM, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138:717–725. PMID: 16269301 https://doi.org/10.1016/ j.surg.2005.07.022Flagel BT, Luchette FA, Reed RL, Esposito TJ, Davis KA, Santaniello JM, et al. Half-a-dozen ribs: the breakpoint for mortality. Surgery. 2005;138:717–725. PMID: 16269301 https://doi.org/10.1016/ j.surg.2005.07.022Кукушкин М.Л., Табеева Г.Р., Подчуфарова Е.В. Болевой синдром: патофизиология, клиника, лечение. Москва: ИМАпресс; 2011.Kukushkin ML, Tabeeva GR, Podchufarova EV. Bolevoy sindrom: patofiziologiya, klinika, lechenie. Moscow: IMApress; 2011.(In Russ.) 11. May L, Hillermann C, Patil S. Rib fracture management. BJA Educ. 2016;16:26–32. https://doi.org/10.1093/bjaceaccp/mkv011May L, Hillermann C, Patil S. Rib fracture management. BJA Educ. 2016;16:26–32. https://doi.org/10.1093/bjaceaccp/mkv011Van Lieshout EMM, Verhofstad MHJ, Van Silfhout DJT, Dubois EA. Diagnostic approach for myocardial contusion: a retrospective evaluation of patient data and review of the literature. Eur J Trauma Emerg Surg. 2021;47(4):1259–1272. PMID: 31982920 https://doi. org/10.1007/s00068-020-01305-4Van Lieshout EMM, Verhofstad MHJ, Van Silfhout DJT, Dubois EA. Diagnostic approach for myocardial contusion: a retrospective evaluation of patient data and review of the literature. Eur J Trauma Emerg Surg. 2021;47(4):1259–1272. PMID: 31982920 https://doi. org/10.1007/s00068-020-01305-4Bagnenko SF, Tulupov AN. Current Problems In Diagnostics and Treatment of Closed Chest Trauma. Emergency Medical Care. 2009;10(2):4–10. (In Russ.).Багненко С.Ф., Тулупов А.Н. Актуальные проблемы диагностики и лечения тяжелой закрытой травмы груди. Скорая медицинская помощь. 2009;10(2):4–10.Vagner EA, Rogatskiy VA, Chereshnev VA. Patologicheskaya fiziologiya travmy grudi. Perm’, 1990. (In Russ.).Вагнер Е.А., Рогацкий В.А., Черешнев В.А. Патологическая физиология травмы груди. Пермь; 1990.Velmahos GC, Vassiliu P, Chan LS, Murray JA, Berne TV, Demetriades D. Influence of flail chest on outcome among patients with severe thoracic cage trauma. Int Surg. 2002;87(4):240–244. PMID: 12575808Velmahos GC, Vassiliu P, Chan LS, Murray JA, Berne TV, Demetriades D. Influence of flail chest on outcome among patients with severe thoracic cage trauma. Int Surg. 2002;87(4):240–244. PMID: 12575808Dehghan N, De Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg. 2014;76(2):462– 468. PMID: 24458051 https://doi.org/10.1097/TA.0000000000000086Dehghan N, De Mestral C, McKee MD, Schemitsch EH, Nathens A. Flail chest injuries: a review of outcomes and treatment practices from the National Trauma Data Bank. J Trauma Acute Care Surg. 2014;76(2):462– 468. PMID: 24458051 https://doi.org/10.1097/TA.0000000000000086Moreno De La Santa P, Magdalena P, Polo Otero MD, Delgado C, Leal S, Trinidad C, et al. Rib fractures: mortality risk factors. Interact Cardiovasc Thorac Surg. 2013;17(Is suppl 1):19–20, abs 0-074. https:// doi.org/10.1093/icvts/ivt288.74Moreno De La Santa, Magdalena P, Polo Otero MD, Delgado C, Leal S, Trinidad C, et al. Rib fractures: mortality risk factors. Interact Cardiovasc Thorac Surg. 2013;17(Is suppl 1):19–20, abs 0–074. https:// doi.org/10.1093/icvts/ivt288.74Rendeki S, Molnár TF. Pulmonary contusion. J Thorac Dis. 2019;11(Suppl 2):S141–S151. PMID: 30906578 https://doi.org/10.21037/ jtd.2018.11.53Rendeki S, Molnár TF. Pulmonary contusion. J Thorac Dis. 2019;11(Suppl 2): S141–S151. PMID: 30906578 https://doi. org/10.21037/jtd.2018.11.53Boyd AD. Lung injuries. In: Hood RM, Boyd AD, Culliford AT. (ed.) Thoracic Trauma. Philadelphia: Saunders; 1989:153–155.Boyd AD. Lung injuries. In: Hood RM, Boyd AD, Culliford AT. (ed.) Thoracic Trauma. Philadelphia: Saunders; 1989. p. 153–155.Allen GS, Coates NE. Pulmonary contusion: A collective review. Am Surg. 1996;62:895–900. PMID: 8895709Allen GS, Coates NE. Pulmonary contusion: A collective review. Am Surg. 1996;62:895–900. PMID: 8895709Allen GS, Cox CS. Pulmonary contusion in children: Diagnosis and management. South Med J. 1998;91:1099–1106. PMID: 9853720 https:// doi.org/10.1097/00007611-199812000-00002Allen GS, Cox CS. Pulmonary contusion in children: Diagnosis and management. South Med J. 1998;91:1099–1106. PMID: 9853720 https:// doi.org/10.1097/00007611-199812000-00002Ganie FA, Lone H, Lone GN, Wani ML, Singh S, Dar AM, et al. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course. Bull Emerg Trauma. 2013;1:7–16. PMID: 27162815Ganie FA, Lone H, Lone GN, Wani ML, Singh S, Dar AM, et al. Lung Contusion: A Clinico-Pathological Entity with Unpredictable Clinical Course. Bull Emerg Trauma. 2013;1:7–16. PMID: 27162815Cohn SM. Pulmonary contusion: Review of the clinical entity. J Trauma. 1997;42:973–979. PMID: 9191684 https://doi.org/10.1097/00005373- 199705000-00033Cohn SM. Pulmonary contusion: Review of the clinical entity. J Trauma. 1997;42:973–979. PMID: 9191684 https://doi.org/10.1097/00005373- 199705000-00033Livingston DH, Hauser CJ. Trauma to the chest wall and lung. McGrawHill Professional, 2003. In: Moore EE, Feliciano DV, Mattox KL. (eds.) Trauma. 5th ed. New York, McGraw-Hill Professional; 2004:507–538.Livingston DH, Hauser CJ. Trauma to the chest wall and lung. McGrawHill Professional, 2003. In: Moore EE, Feliciano DV, Mattox KL. (eds.) Trauma. 5th ed. New York, McGraw-Hill Professional; 2004. p. 507– 538.Bader A, Rahman U, Morris M, McCormack JE, Huang EC, Zawin M, et al. Pulmonary contusions in the elderly after blunt trauma: incidence and outcomes. J Surg Res. 2018;230:110–116. PMID: 30100025 https://doi. org/10.1016/j.jss.2018.04.049Bader A, Rahman U, Morris M, McCormack JE, Huang EC, Zawin M, et al. Pulmonary contusions in the elderly after blunt trauma: incidence and outcomes. J Surg Res. 2018;230:110–116. PMID: 30100025 https://doi. org/10.1016/j.jss.2018.04.049Haynes D, Baumann M. Management of pneumothorax. Semin Respir Crit Care Med. 2010;31:769–780. PMID: 21213209 https://doi.org/10.1055/ s-0030-1269837Haynes D, Baumann M. Management of pneumothorax. Semin Respir Crit Care Med. 2010;31:769–780. PMID: 21213209 https://doi.org/10.1055/ s-0030-1269837Ramanathan R, Wolfe LG, Duane TM. Initial suction evacuation of traumatic hemothoraces: a novel approach to decreasing chest tube duration and complications. Am Surg. 2012;78:883–887. PMID: 22856496Ramanathan R, Wolfe LG, Duane TM. Initial suction evacuation of traumatic hemothoraces: a novel approach to decreasing chest tube duration and complications. Am Surg. 2012;78:883–887. PMID: 22856496Athanassiadi K, Gerazounis M, Theakos N. Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg. 2004;26:373–376. PMID: 15296899 https://doi. org/10.1016/j.ejcts.2004.04.011Athanassiadi K, Gerazounis M, Theakos N. Management of 150 flail chest injuries: analysis of risk factors affecting outcome. Eur J Cardiothorac Surg. 2004;26:373–376. PMID: 15296899 https://doi. org/10.1016/j.ejcts.2004.04.011Karmy-Jones R, Jurkovich G. Management of Blunt Chest and Diaphragm Injuries. In: Patterson GA, Pearson FG, Cooper JD, Deslauriers J, Luketich JD, Lerut AEMR. (eds.) Pearson’s Thoracic and Esophageal Surgery. 3rd ed. Phiadelphia, PA: Churchill Livingston Elsevier; 2008:1768–1776.Karmy-Jones R, Jurkovich G. Management of Blunt Chest and Diaphragm Injuries. In: Patterson GA, Pearson FG, Cooper JD, Deslauriers J, Luketich JD, Lerut AEMR. (eds.) Pearson’s Thoracic and Esophageal Surgery. 3rd ed. Phiadelphia, PA: Churchill Livingston Elsevier; 2008. p. 1768–1776.Liu Q, Luan L, Zhang G, Li B. Treatment of Chronic Traumatic Diaphragmatic Hernia Based on Laparoscopic Repair: Experiences From 23 Cases. Front Surg. 2021;8:706824. PMID: 34336921 https://doi. org/10.3389/fsurg.2021.706824Liu Q, Luan L, Zhang G, Li B. Treatment of Chronic Traumatic Diaphragmatic Hernia Based on Laparoscopic Repair: Experiences From 23 Cases. Front Surg. 2021;8:706824. PMID: 34336921 https://doi. org/10.3389/fsurg.2021.706824Tessely H, Journé S, Therasse A, Hossey D., Lemaitre J. A case of colon necrosis resulting from a delayed traumatic diaphragmatic hernia. J Surg Case Rep. 2020;2020:rjaa101. PMID: 32582428 https://doi. org/10.1093/jscr/rjaa101Tessely H, Journé S, Therasse A, Hossey D., Lemaitre J. A case of colon necrosis resulting from a delayed traumatic diaphragmatic hernia. J Surg Case Rep. 2020;2020:rjaa101. PMID: 32582428 https://doi. org/10.1093/jscr/rjaa101Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005;4(6):583–587. PMID: 17670487 https://doi.org/10.1510/icvts.2005.111807Granetzny A, Abd El-Aal M, Emam E, Shalaby A, Boseila A. Surgical versus conservative treatment of flail chest. Evaluation of the pulmonary status. Interact Cardiovasc Thorac Surg. 2005;4(6):583–587. PMID: 17670487 https://doi.org/10.1510/icvts.2005.111807Richter T, Ragaller M. Ventilation in chest trauma. J Emerg Trauma.Shock. 2011;4(2):251–259. PMID: 21769213 https://doi.org/10.4103/0974- 2700.82215Richter T, Ragaller M. Ventilation in chest trauma. J Emerg Trauma. Shock. 2011;4(2):251–259. PMID: 21769213 https://doi.org/10.4103/0974- 2700.82215Duggal A, Perez P, Golan E, Tremblay L, Sinuff T. Safety and efficacy of noninvasive ventilation in patients with blunt chest trauma: a systematic review. Crit Care. 2013;17(4):R142. PMID: 23876230 https:// doi.org/10.1186/cc12821Duggal A, Perez P, Golan E, Tremblay L, Sinuff T. Safety and efficacy of noninvasive ventilation in patients with blunt chest trauma: a systematic review. Crit Care. 2013;17(4):R142. PMID: 23876230 https:// doi.org/10.1186/cc12821Benyan AS. Vnutrennyaya pnevmaticheskaya stabilizatsiya v lechenii perednego rebernogo klapana. Messenger of Anesthesiology and Resuscitation. 2014;(6):66–68. (In Russ.).Бенян А.С. Внутренняя пневматическая стабилизация в лечении переднего реберного клапана. Вестник анестезиологии и реаниматологии. 2014;(6):66–68.Cullen P, Modell JH, Kirby RR, Klein Jr EF, Long W. Treatment of flail chest. Arch Surg. 1975;110:1099–1103. PMID: 1098616 https://doi. org/10.1001/archsurg.1975.01360150043008Cullen P, Modell JH, Kirby RR, Klein Jr EF, Long W. Treatment of flail chest. Arch Surg. 1975;110:1099–1103. PMID: 1098616 https://doi. org/10.1001/archsurg.1975.01360150043008Fowler TT, Taylor BC, Bellino MJ, Althausen PL. Surgical Treatment of Flail Chest and Rib Fractures. J Am Acad Orthop Surg. 2014;22(12):751– 760. PMID: 25425610 https://doi.org/10.5435/JAAOS-22-12-751Fowler TT, Taylor BC, Bellino MJ, Althausen PL. Surgical Treatment of Flail Chest and Rib Fractures. J Am Acad Orthop Surg. 2014;22(12):751– 760. PMID: 25425610 https://doi.org/10.5435/JAAOS-22-12-751Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative Management of Rib Fractures in the Setting of Flail Chest: A Systematic Review and Meta-Analysis. Ann Surg. 2013; 258(6):914–921. PMID: 23511840 https://doi.org/10.1097/SLA.0b013e3182895bb0Leinicke JA, Elmore L, Freeman BD, Colditz GA. Operative Management of Rib Fractures in the Setting of Flail Chest: A Systematic Review and Meta-Analysis. Ann Surg. 2013; 258(6):914–921. PMID: 23511840 https://doi.org/10.1097/SLA.0b013e3182895bb0Benyan AS. Surgical Stabilization of the Chest in Multiple and Floating Rib Fractures. N.N. Priorov Journal of Traumatology and Orthopedics. 2015;22(3):86–92. (In Russ.) https://doi.org/10.17816/vto201522386-92.Бенян А.С. Хирургическая стабилизация грудной клетки при множественных и флотирующих переломах ребер. Вестник травматологии и ортопедии им.Н.Н. Приорова. 2015;(3):86–92.Jones T, Richardson E. Traction on the sternum in the treatment of multiple fractured ribs. Surg Gynec Obstet. 1926;42:283.Jones T, Richardson E. Traction on the sternum in the treatment of multiple fractured ribs. Surg Gynec Obstet. 1926;42:283.Jasloiv I. Skeletal traction in the treatment of multiple fractures of the thoracic cage. Am J Surg. 1946;72(5):753–755. PMID: 21003141 https:// doi.org/10.1016/0002-9610(46)90358-3Jasloiv I. Skeletal traction in the treatment of multiple fractures of the thoracic cage. Am J Surg. 1946;72(5):753–755. PMID: 21003141 https:// doi.org/10.1016/0002-9610(46)90358-3Heroy WW, Eggleston FC. A method of skeletal traction applied through the sternum in «steering wheel» injury of the chest. Ann Surg. 1951;133(1):135–138. PMID: 14800268 https://doi. org/10.1097/00000658-195101000-00016Heroy WW, Eggleston FC. A method of skeletal traction applied through the sternum in «steering wheel» injury of the chest. Ann Surg. 1951;133(1):135–138. PMID: 14800268 https://doi. org/10.1097/00000658-195101000-00016Constantinescu O. A new method of treating the flaii chest wall. Am J Surg. 1965;109:604–610. PMID: 14281884 https://doi.org/10.1016/ s0002-9610(65)80014-9Constantinescu O. A new method of treating the flaii chest wall. Am J Surg. 1965;109:604–610. PMID: 14281884 https://doi.org/10.1016/ s0002-9610(65)80014-9Kornilov NV, Gryaznukhin EG. Travmatologiya i ortopediya. Saint Petersburg, 2004. (In Russ.).Корнилов Н.В., Грязнухин Э.Г. Травматология и ортопедия. Санкт-Петербург; 2004.Balci AE, Eren S, Cakir О, Eren MN. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann. 2004;12(1):11–15. PMID: 14977734 https://doi.org/10.1177/021849230401200104Balci AE, Eren S, Cakir О, Eren MN. Open fixation in flail chest: review of 64 patients. Asian Cardiovasc Thorac Ann. 2004;12(1):11–15. PMID: 14977734 https://doi.org/10.1177/021849230401200104Ushakov NG. The algorithm of diagnostics and tactics of treatment of victims with the multiple ribs fracture at the closed chest injury. Aspirantskiy Vestnik Povolzhiya. 2010;10(3–4):116–119. (In Russ.) https://doi.org/10.17816/2072-2354.2010.0.3-4.116-119Ушаков Н.Г. Алгоритм диагностики и тактики лечения пострадавших с множественными клапанными переломами ребер при закрытой травме груди. Аспирантский вестник Поволжья. 2010;(3– 4):116–119.Goloboro’dko NK, Bulaga VV. General principles of the activities of a specialized center of polytrauma and shock. Grekov’s Bulletin of Surgery. 1989;142(6):139–141. PMID: 2815465. (In Russ.).Голобородько H.K., Булага В.В. Общие принципы работы специализированного центра политравмы и шока. Вестник хирургии им. И.И. Грекова. 1989;(6):139–141.Gredzhev AF, Paniotov AP. Panel’naya fiksatsiya pri mnozhestvennykh perelomakh reber. Klinicheskaia khirurgiia. 1977;(8):69–78. (In Russ.).Греджев А.Ф., Паниотов А.П. Панельная фиксация при множественных переломах ребер. Клиническая хирургия. 1977;(8):69–78.Glavas M, Altarac S, Vukas D, Ivancic A, Drazinic I, Gusic N, et al. Flail chest stabilization with palacos prosthesis. Acta Med Croatica. 2001;55(2):91–95. PMID: 11505635Glavas M, Altarac S, Vukas D, Ivancic A, Drazinic I, Gusic N, et al. Flail chest stabilization with palacos prosthesis. Acta Med Croatica. 2001;55(2):91–95. PMID: 11505635Vishnevskiy DA, Rudakov CC, Milanov NO. Khirurgiya grudnoy stenki. Moscow: Vidar-M Publ.; 2005. (In Russ.).Вишневский Д.А., Рудаков C.C., Миланов Н.O. Хирургия грудной стенки. Москва: Видар-М; 2005. 51. Шатохин В.Д., Пушкин С.Ю., Дьячкова Г.В., Губа А.Д., Шатохин Д.В., Камеев И.Р. Результаты оперативного лечения флотирующих переломов грудинно-реберного комплекса. Гений ортопедии. 2018;24(3):290–295.Shatokhin VD, Pushkin SYu, Diachkova GV, Guba AD, Shatokhin DV, Kameev IR. Outcomes of operative treatment of floating sternocostal fractures. Genij Ortopedii. 2018;24(3):290–295. https://doi. org/10.18019/1028-4427-2018-24-3-290-295Dor V, Paoli J, Noirclerc M, Malmejac C, Chauvin G, Pons R. Lysteosynthese des volets thoraciques technique, resultants et indications apropos de 19 observations. Ann Chir. 1967;2(15):983–996. PMID: 5619289Dor V, Paoli J, Noirclerc M, Malmejac C, Chauvin G, Pons R. Lysteosynthese des volets thoraciques technique, resultants et indications apropos de 19 observations. Ann Chir. 1967;2(15):983–996. PMID: 5619289Guernelli N, Bragaglia RB, Briccoli A, Mastrorilli M, Vecchi R. Technique for the management of anterior flail chest. Thorax. 1979;34(2):247–248. PMID: 483193 https://doi.org/10.1136/thx.34.2.247Guernelli N, Bragaglia RB, Briccoli A, Mastrorilli M, Vecchi R. Technique for the management of anterior flail chest. Thorax. 1979;34(2):247–248. PMID: 483193 https://doi.org/10.1136/thx.34.2.247Landreneau RS, Hinson JM, Hazerlrigg SR, Johnson JA, Boley TB, Curtis JJ. Strut fixation of an extensive flail chest. Ann Thorac Surg. 1991;51(3):473–475. PMID: 1998429 https://doi.org/10.1016/0003- 4975(91)90871-mLandreneau RS, Hinson JM, Hazerlrigg SR, Johnson JA, Boley TB, Curtis JJ. Strut fixation of an extensive flail chest. Ann Thorac Surg. 1991;51(3):473–475. PMID: 1998429 https://doi.org/10.1016/0003- 4975(91)90871-mШaпoт Ю.Б., Бесаев Г.М., Кашанский Ю.Б., Зайцев E.H. Техника остеосинтеза при переломах ребер, грудины и ключицы. Вестник хирургии им. И.И. Грекова. 1985;(11):83–87.Шaпoт Ю.Б., Бесаев Г.М., Кашанский Ю.Б., Зайцев E.H. Техника остеосинтеза при переломах ребер, грудины и ключицы. Вестник хирургии им. И.И. Грекова. 1985;(11):83–87.Forward DP, Ollivere BJ, Ng JWG, Coughlin TA, Rollins KE. Current concepts in rib fracture fixation. Bone Jt. 360. 2016;5(5):2–7. https://doi. org/10.1302/2048-0105.55.360464Forward DP, Ollivere BJ, Ng JWG, Coughlin TA, Rollins KE. Current concepts in rib fracture fixation. Bone Jt. 360. 2016;5(5):2–7. https://doi. org/10.1302/2048-0105.55.360464Bottlang M, Helzel I, Long W, Fitzpatrick D, Madey S. Less-Invasive Stabilization of Rib Fractures by Intramedullary Fixation: A Biomechanical Evaluation. J Trauma. 2010;68(5):1218–1224. PMID: 20068479 https://doi.org/10.1097/TA.0b013e3181bb9df1Bottlang M, Helzel I, Long W, Fitzpatrick D, Madey S. Less-Invasive Stabilization of Rib Fractures by Intramedullary Fixation: A Biomechanical Evaluation. J Trauma. 2010;68(5):1218–1224. PMID: 20068479 https://doi.org/10.1097/TA.0b013e3181bb9df1Bottlang M, Walleser S, Noll M, Honold S, Madey SM, Fitzpatrick D, et al. Biomechanical rationale and evaluation of an implant system for rib fracture fixation. Eur J Trauma Emerg Surg. 2010;36(5):417–426. PMID: 21841953 https://doi.org/10.1007/s00068-010-0047-4Bottlang M, Walleser S, Noll M, Honold S, Madey SM, Fitzpatrick D, et al. Biomechanical rationale and evaluation of an implant system for rib fracture fixation. Eur J Trauma Emerg Surg. 2010;36(5):417–426. PMID: 21841953 https://doi.org/10.1007/s00068-010-0047-4Zaidenberg EE, Rossi LA, Bongiovanni SL, Tanoira I, Maignon G, Ranalletta M. Snapping scapular syndrome secondary to rib intramedullary fixation device. Int J Surg Case Rep. 2015;17:158–160. PMID: 26629853 https://doi.org/10.1016/j.ijscr.2015.11.010Zaidenberg EE, Rossi LA, Bongiovanni SL, Tanoira I, Maignon G, Ranalletta M. Snapping scapular syndrome secondary to rib intramedullary fixation device. Int J Surg Case Rep. 2015;17:158–160. PMID: 26629853 https://doi.org/10.1016/j.ijscr.2015.11.010Akil A, Ziegeler S, Reichelt J, Semik M, Müller MC, Fischer S. Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain. Eur J Trauma Emerg Surg. PMID: 30989244 https://doi.org/10.1007/s00068-018-01062-5Akil A, Ziegeler S, Reichelt J, Semik M, Müller MC, Fischer S. Rib osteosynthesis is a safe and effective treatment and leads to a significant reduction of trauma associated pain. Eur J Trauma Emerg Surg. PMID: 30989244 https://doi.org/10.1007/s00068-018-01062-5Redwan B, Reichelt J, Freermann S, Semik M, Fischer S. Video-assisted minimally invasive rib osteosynthesis using intramedullary titanium splints in patients with unstable rib fractures: treatment algorithm and first clinical results. Interact Cardiovasc Thorac Surg. 2015;21(Suppl 1): S60. https://doi.org/10.1093/icvts/ivv204.220Redwan B, Reichelt J, Freermann S, Semik M, Fischer S. Video-assisted minimally invasive rib osteosynthesis using intramedullary titanium splints in patients with unstable rib fractures: treatment algorithm and first clinical results. Interact Cardiovasc Thorac Surg. 2015;21(Suppl 1): S60. https://doi.org/10.1093/icvts/ivv204.220De Jong MB, Kokke MC, Hietbrink F, Leenen LPH. Surgical Management of Rib Fractures: Strategies and Literature Review. Scand J Surg. 2014;103(2):120–125. PMID: 24782038 https://doi.org/10.1177/145749 6914531928De Jong MB, Kokke MC, Hietbrink F, Leenen LPH. Surgical Management of Rib Fractures: Strategies and Literature Review. Scand J Surg. 2014;103(2):120–125. PMID: 24782038 https://doi.org/10.1177/145749 6914531928Marasco S, Quayle M, Summerhayes R, Šutalo ID, Liovic P. An assessment of outcomes with intramedullary fixation of fractured ribs. J Cardiothorac Surg. 2016;11(1):126. PMID: 27495253 https://doi. org/10.1186/s13019-016-0510-3Marasco S, Quayle M, Summerhayes R, Šutalo ID, Liovic P. An assessment of outcomes with intramedullary fixation of fractured ribs. J Cardiothorac Surg. 2016;11(1):126. PMID: 27495253 https://doi. org/10.1186/s13019-016-0510-3Pharaon KS, Marasco S, Mayberry J. Rib Fractures, Flail Chest, and Pulmonary Contusion. Curr Trauma Rep. 2015;1:237–242. https://doi. org/10.1007/s40719-015-0026-7Pharaon KS, Marasco S, Mayberry J. Rib Fractures, Flail Chest, and Pulmonary Contusion. Curr Trauma Rep. 2015;1:237–242. https://doi. org/10.1007/s40719-015-0026-7Бенян А.С., Пушкин С.Ю., Сызранцев Ю.В., Камеев И.Р. Остеосинтез ребер с применением технологии «MATRIX RIB» в лечении пострадавшего с множественными флотирующими переломами ребер. Вестник хирургии им.И.И. Грекова. 2013;172(6):78–79.Бенян А.С., Пушкин С.Ю., Сызранцев Ю.В., Камеев И.Р. Остеосинтез ребер с применением технологии «MATRIX RIB» в лечении пострадавшего с множественными флотирующими переломами ребер. Вестник хирургии им.И.И. Грекова. 2013;172(6):78–79.Pushkin S, Benyan A. Our first steps in osteosynthesis of fractured ribs using Matrix Rib technologies. Eur Respir J. 2012;40(Suppl 56): Annual Congress 2012: Chest wall, thoracic trauma and complications in thoracic surgery. Thematic Poster Session, #2421. URL: https://www. ers-education.org/lr/show-details/?idP=120960 [Дата обращения 13 мая 2022 г.]Pushkin S, Benyan A. Our first steps in osteosynthesis of fractured ribs using Matrix Rib technologies. Eur Respir J. 2012;40(Suppl 56): Annual Congress 2012: Chest wall, thoracic trauma and complications in thoracic surgery. Thematic Poster Session, #2421. URL: https://www. ers-education.org/lr/show-details/?idP=120960 [Дата обращения 13 мая 2022 г.]Bottlang M, Long WB, Phelan D, Fielder D, Madey SM. Surgical stabilization of flail chest injuries with MatrixRIB implants: A prospective observational study. Injury. 2013;44(2):232–238. PMID: 22910817 https://doi.org/10.1016/j.injury.2012.08.011Bottlang M, Long WB, Phelan D, Fielder D, Madey SM. Surgical stabilization of flail chest injuries with MatrixRIB implants: A prospective observational study. Injury. 2013;44(2):232–238. PMID: 22910817 https://doi.org/10.1016/j.injury.2012.08.011Wu W-M, Yang Y, Gao Z-L, Zhao T-C, He W-W. Which is better to multiple rib fractures, surgical treatment or conservative treatment? Int J Clin Exp Med. 2015;8(5):7930–7936. PMID: 26221350Wu W-M, Yang Y, Gao Z-L, Zhao T-C, He W-W. Which is better to multiple rib fractures, surgical treatment or conservative treatment? Int J Clin Exp Med. 2015;8(5):7930–7936. PMID: 26221350Jermin PJ, Perry J, Kalra S, Flockton E, Rourke HK. The Use of Novel Adopters for Acute Rib Fixation in Critical Chest Trauma, Undertaken by Orthopaedic Surgeons: an Observational Cohort Study. J Crit Care Med. 2015;1(3):96–101. https://doi.org/10.1515/jccm-2015-0016Jermin PJ, Perry J, Kalra S, Flockton E, Rourke HK. The Use of Novel Adopters for Acute Rib Fixation in Critical Chest Trauma, Undertaken by Orthopaedic Surgeons: an Observational Cohort Study. J Crit Care Med. 2015;1(3):96–101. https://doi.org/10.1515/jccm-2015-0016Pieracci FM, Lin Y, Rodil M, Synder M, Herbert B, Kha Tran D, et al. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures. J Trauma Acute Care Surg. 2016;80(2):187–194. PMID: 26595710 https://doi.org/10.1097/TA.0000000000000925Pieracci FM, Lin Y, Rodil M, Synder M, Herbert B, Kha Tran D, et al. A prospective, controlled clinical evaluation of surgical stabilization of severe rib fractures. J Trauma Acute Care Surg. 2016;80(2):187–194. PMID: 26595710 https://doi.org/10.1097/TA.0000000000000925Xu JQ, Qiu PL, Yu RG, Gong SR, Ye Y, Shang XL. Better short-term efficacy of treating severe flail chest with internal fixation surgery compared with conservative treatments. Eur J Med Res. 2015;20(1):55. PMID: 26003405 https://doi.org/10.1186/s40001-015-0146-0Xu JQ, Qiu PL, Yu RG, Gong SR, Ye Y, Shang XL. Better short-term efficacy of treating severe flail chest with internal fixation surgery compared with conservative treatments. Eur J Med Res. 2015;20(1):55. PMID: 26003405 https://doi.org/10.1186/s40001-015-0146-0Qiu M, Shi Z, Xiao J, Zhang X, Ling S, Ling H. Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures. Indian J Surg. 2016;78(6):458–463. PMID: 28100942 https:// doi.org/10.1007/s12262-015-1409-2Qiu M, Shi Z, Xiao J, Zhang X, Ling S, Ling H. Potential Benefits of Rib Fracture Fixation in Patients with Flail Chest and Multiple Non-flail Rib Fractures. Indian J Surg. 2016;78(6):458–463. PMID: 28100942 https:// doi.org/10.1007/s12262-015-1409-2Althausen PL, Shannon S, Watts C, Thomas K, Bain MA, Coll D, et al. Early surgical stabilization of flail chest with locked plate fixation. J Orthop Trauma. 2011;25(11):641–647 PMID: 22008858 https://doi. org/10.1097/BOT.0b013e318234d479Althausen PL, Shannon S, Watts C, Thomas K, Bain MA, Coll D, et al. Early surgical stabilization of flail chest with locked plate fixation. J Orthop Trauma. 2011;25(11):641–647 PMID: 22008858 https://doi. org/10.1097/BOT.0b013e318234d479Beks RB, Reetz D, de Jong MB, Groenwold RHH, Hietbrink F, Edwards MJR, et al. Rib fixation versus non-operative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: a multicenter cohort study. Eur J Trauma Emerg Surg. 2019;45(4):655–663. PMID: 30341561 https://doi.org/10.1007/s00068-018-1037-1Beks RB, Reetz D, de Jong MB, Groenwold RHH, Hietbrink F, Edwards MJR, et al. Rib fixation versus non-operative treatment for flail chest and multiple rib fractures after blunt thoracic trauma: a multicenter cohort study. Eur J Trauma Emerg Surg. 2019;45(4):655–663. PMID: 30341561 https://doi.org/10.1007/s00068-018-1037-1Ng CSH, Wong RHL, Kwok MWT, Yim APC. Delayed fracture of MatrixRIB precontoured plate system. Interact Cardiovasc Thorac Surg. 2014;19(3):512–514. PMID: 24876218 https://doi.org/10.1093/icvts/ ivu175Ng CSH, Wong RHL, Kwok MWT, Yim APC. Delayed fracture of MatrixRIB precontoured plate system. Interact Cardiovasc Thorac Surg. 2014;19(3):512–514. PMID: 24876218 https://doi.org/10.1093/icvts/ ivu175De Palma A, Sollitto F, Loizzi D, Di Gennaro F, Scarascia D, Carlucci A, et al. Chest wall stabilization and reconstruction: short and longterm results 5 years after the introduction of a new titanium plates system. J Thorac Dis. 2016;8(3):490–498. PMID: 27076945 https://doi. org/10.21037/jtd.2016.02.64De Palma A, Sollitto F, Loizzi D, Di Gennaro F, Scarascia D, Carlucci A, et al. Chest wall stabilization and reconstruction: short and longterm results 5 years after the introduction of a new titanium plates system. J Thorac Dis. 2016;8(3):490–498. PMID: 27076945 https://doi. org/10.21037/jtd.2016.02.64Sales JR, Ellis TJ, Gillard J, Liu Q, Chen JC, Ham B, Mayberry JC. Biomechanical Testing of a Novel, Minimally Invasive Rib Fracture Plating System. J Trauma Inj Infect Crit Care. 2008;64(5):1270–1274. PMID: 18469649 https://doi.org/10.1097/TA.0b013e31804a7fd5Sales JR, Ellis TJ, Gillard J, Liu Q, Chen JC, Ham B, Mayberry JC. Biomechanical Testing of a Novel, Minimally Invasive Rib Fracture Plating System. J Trauma Inj Infect Crit Care. 2008;64(5):1270–1274. PMID: 18469649 https://doi.org/10.1097/TA.0b013e31804a7fd5Deb SJ. Rib Fracture Stabilization Reduces Chest Wall Pain following Blunt Thoracic Trauma. J Trauma Treat. 2014;S2:1–4. https://doi. org/10.4172/2167-1222.S2-004Deb SJ. Rib Fracture Stabilization Reduces Chest Wall Pain following Blunt Thoracic Trauma. J Trauma Treat. 2014;S2:1–4. https://doi. org/10.4172/2167-1222.S2-004Said SM, Goussous N, Zielinski MD, Schiller HJ, Kim BD. Surgical stabilization of flail chest: the impact on postoperative pulmonary function. Eur J Trauma Emerg Surg. 2014;40(4):501–505. PMID: 26816247 https://doi.org/10.1007/s00068-013-0344-9Said SM, Goussous N, Zielinski MD, Schiller HJ, Kim BD. Surgical stabilization of flail chest: the impact on postoperative pulmonary function. Eur J Trauma Emerg Surg. 2014;40(4):501–505. PMID: 26816247 https://doi.org/10.1007/s00068-013-0344-9Petscavage JM, Ha AS, Khorashadi L, Perrich K, Chew FS. New and Improved Orthopedic Hardware for the 21st Century: Part 2, Lower Extremity and Axial Skeleton. Am J Roentgenol. 2011;197(3):W434–444. PMID: 21862770 https://doi.org/ 10.2214/AJR.10.5354Petscavage JM, Ha AS, Khorashadi L, Perrich K, Chew FS. New and Improved Orthopedic Hardware for the 21st Century: Part 2, Lower Extremity and Axial Skeleton. Am J Roentgenol. 2011;197(3):W434–444. PMID: 21862770 https://doi.org/ 10.2214/AJR.10.5354Judet R. Costal osteosynthesis. Rev Chir Orthop Reparatrice Appar Mot. 1973;59(Suppl 1):334–335. PMID: 4268839Judet R. Costal osteosynthesis. Rev Chir Orthop Reparatrice Appar Mot. 1973;59(Suppl 1):334–335. PMID: 4268839Jayle CP, Allain G, Ingrand P, Laksiri L, Bonnin E, Hajj-Chahine J, et al. Flail Chest in Polytraumatized Patients: Surgical Fixation Using Stracos Reduces Ventilator Time and Hospital Stay. Biomed Res Int. 2015;2015: 624723. PMID: 25710011 https://doi.org/10.1155/2015/624723Jayle CP, Allain G, Ingrand P, Laksiri L, Bonnin E, Hajj-Chahine J, et al. Flail Chest in Polytraumatized Patients: Surgical Fixation Using Stracos Reduces Ventilator Time and Hospital Stay. Biomed Res Int. 2015;2015: 624723. PMID: 25710011 https://doi.org/10.1155/2015/624723Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52(4):727–732. PMID: 11956391 https://doi. org/10.1097/00005373-200204000-00020Tanaka H, Yukioka T, Yamaguti Y, Shimizu S, Goto H, Matsuda H, et al. Surgical stabilization of internal pneumatic stabilization? A prospective randomized study of management of severe flail chest patients. J Trauma. 2002;52(4):727–732. PMID: 11956391 https://doi. org/10.1097/00005373-200204000-00020Berthet J-P, Caro AG, Solovei L, Gilbert M, Bommart S, Gaudard P, et al. Titanium Implant Failure After Chest Wall Osteosynthesis. Ann Thorac Surg. 2015;99(6):1945–1952. PMID: 25916874 https://doi.org/10.1016/ j.athoracsur.2015.02.040Berthet J-P, Caro AG, Solovei L, Gilbert M, Bommart S, Gaudard P, et al. Titanium Implant Failure After Chest Wall Osteosynthesis. Ann Thorac Surg. 2015;99(6):1945–1952. PMID: 25916874 https://doi.org/10.1016/ j.athoracsur.2015.02.040Жестков К.Г., Барский Б.В., Воскресенский О.В. Мини-инвазивная хирургия в лечении флотирующих переломов ребер. Тихоокеанский медицинский журнал. 2006;1(23):62–66.Жестков К.Г., Барский Б.В., Воскресенский О.В. Мини-инвазивная хирургия в лечении флотирующих переломов ребер. Тихоокеанский медицинский журнал. 2006;1(23):62–66.Ke S, Duan H, Cai Y, Kang J, Feng Z. Thoracoscopy-Assisted Minimally Invasive Surgical Stabilization of the Anterolateral Flail Chest Using Nuss Bars. Ann Thorac Surg. 2014;97(6):2179–2182. PMID: 24882301 https://doi.org/10.1016/j.athoracsur.2013.08.066Ke S, Duan H, Cai Y, Kang J, Feng Z. Thoracoscopy-Assisted Minimally Invasive Surgical Stabilization of the Anterolateral Flail Chest Using Nuss Bars. Ann Thorac Surg. 2014;97(6):2179–2182. PMID: 24882301 https://doi.org/10.1016/j.athoracsur.2013.08.066Schots JP, Vissers YL, Hulsewé KW, Meesters B, Hustinx PA, Pijnenburg A, et al. Addition of video-assisted thoracoscopic surgery to the treatment of flail chest. Ann Thorac Surg. 2017;103(3):940–944. PMID: 27939010 https://doi.org/10.1016/j.athoracsur.2016.09.036Schots JP, Vissers YL, Hulsewé KW, Meesters B, Hustinx PA, Pijnenburg A, et al. Addition of video-assisted thoracoscopic surgery to the treatment of flail chest. Ann Thorac Surg. 2017;103(3):940–944. PMID: 27939010 https://doi.org/10.1016/j.athoracsur.2016.09.036Xia H, Zhu P, Li J, Zhu D, Sun Z, Deng L, et al. Thoracoscope combined with internal support system of chest wall in open reduction and internal fixation for multiple rib fractures. Exp Ther Med. 2018;16(6):4650–4654. PMID: 30542416 https://doi.org/10.3892/etm.2018.6817Xia H, Zhu P, Li J, Zhu D, Sun Z, Deng L, et al. Thoracoscope combined with internal support system of chest wall in open reduction and internal fixation for multiple rib fractures. Exp Ther Med. 2018;16(6):4650–4654. PMID: 30542416 https://doi.org/10.3892/etm.2018.6817Pieracci FM. Completely thoracoscopic surgical stabilization of rib fractures: can it be done and is it worth it? J Thorac Dis. 2019;11(Suppl 8): S1061–S1069. PMID: 31205763 https://doi.org/10.21037/jtd.2019.01.70Pieracci FM. Completely thoracoscopic surgical stabilization of rib fractures: can it be done and is it worth it? J Thorac Dis. 2019;11(Suppl 8): S1061–S1069. PMID: 31205763 https://doi.org/10.21037/jtd.2019.01.70Bauman ZM, Beard R, Cemaj S. When less is more: A minimally invasive, intrathoracic approach to surgical stabilization of rib fractures. Trauma Case Rep. 2021;32:100452. PMID: 33778146 https://doi.org/10.1016/ j.tcr.2021.100452Bauman ZM, Beard R, Cemaj S. When less is more: A minimally invasive, intrathoracic approach to surgical stabilization of rib fractures. Trauma Case Rep. 2021;32:100452. PMID: 33778146 https://doi.org/10.1016/ j.tcr.2021.100452Mayberry JC, Terhes JT, Ellis TJ, Wanek S, Mullins RJ. Absorbable plates for rib fracture repair: preliminary experience. J Trauma. 2003;55(5):835-839. PMID: 14608152 https://doi.org/10.1097/01. TA.0000090037.72142.33Mayberry JC, Terhes JT, Ellis TJ, Wanek S, Mullins RJ. Absorbable plates for rib fracture repair: preliminary experience. J Trauma. 2003;55(5):835-839. PMID: 14608152 https://doi.org/10.1097/01. TA.0000090037.72142.33Lafferty PM, Anavian J, Will RE, Cole PA. Operative treatment of chest wall injuries: indications, Technique,and outcomes. J Bone Joint Surg Am. 2011;93(1):97–110. PMID: 21209274 https://doi.org/10.2106/JBJS. I.00696Lafferty PM, Anavian J, Will RE, Cole PA. Operative treatment of chest wall injuries: indications, Technique,and outcomes. J Bone Joint Surg Am. 2011;93(1):97–110. PMID: 21209274 https://doi.org/10.2106/JBJS. I.00696Hollinger JO, Battistone GC. Biodegradable bone repair materials. Synthetic polymers and ceramics. Clin Orthop Relat Res. 1986;(207):290– 305. PMID: 3522015Hollinger JO, Battistone GC. Biodegradable bone repair materials. Synthetic polymers and ceramics. Clin Orthop Relat Res. 1986;(207):290– 305. PMID: 3522015

The authors declare that there are no conflicts of interest present.