What it is
Rib fixation surgery uses plates and screws to stabilise multiple rib fractures, flail chest, or painful non‑union. Stabilising the chest wall improves breathing mechanics, reduces pain, and shortens recovery from thoracic trauma.
Rehabilitation focuses on pulmonary care, safe mobility, shoulder and scapular mechanics, and a paced return to work or sport.
What happens when it occurs
Stabilised ribs move more normally with breathing. Pain reduces, allowing deeper breaths and coughing. Early goals are pulmonary hygiene, walking, and gentle shoulder motion. Strength and endurance progress as comfort improves.
Common indications and pre‑operative factors
- Flail chest with respiratory compromise
- Displaced rib fractures causing severe pain or failing conservative care
- Symptomatic non‑union affecting breathing or function
Who is most affected
Adults after road or workplace incidents in Australia. Men are over‑represented in high‑energy chest trauma.
Typical symptoms before surgery
- Severe chest wall pain, shallow breathing, difficulty coughing
- Crepitus or chest wall instability after trauma
- Reduced shoulder motion due to guarding
When to seek care
Immediately after chest trauma, especially with shortness of breath or reduced oxygen levels.
How we diagnose
Clinical and respiratory assessment, X‑ray and CT to define fractures, pain and function review. Decision‑making includes pulmonary status and associated injuries.
Management
- Breathing exercises, incentive spirometry, and supported coughing
- Early walking and posture for lung expansion
- Gentle shoulder and scapular mobility progressing to strength
- Pain control plan and sleep support; return‑to‑work planning
Rehabilitation milestones
Phase 1 days 0–7: pulmonary hygiene, short frequent walks, gentle shoulder motion within comfort.
Phase 2 weeks 1–4: posture and breathing retraining, scapular endurance, light aerobic work.
Phase 3 weeks 4–8: progressive strength and work‑ or sport‑specific tasks.
Phase 4 months 2–3+: full duty when criteria and comfort allow.
Readiness to progress
- Adequate deep breathing and an effective cough
- Shoulder range returns without chest wall pain
- Walking distance and strength targets met
Long-term care
- Maintain aerobic fitness and thoracic mobility
- Scapular and trunk strength twice weekly
- Risk reduction for future trauma; smoking cessation for lung health
Australia snapshot
- Performed in major trauma centres across Australia
- Men feature more often in high‑energy trauma; older adults with falls also present
- Structured pulmonary and musculoskeletal rehabilitation improves outcomes
Latest insights
Breathing drives recovery. Stabilise, expand, and walk.
Shoulder mechanics matter—restore scapular control as pain allows.
