Surgery for Unstable Chest Wall Injuries - How Many Fractures Should be Fixed?

The goal of this prospective, randomized study is to learn about the effects of two different surgical techniques for treating unstable chest wall injuries in adults. The main questions it aims to answer are: Does fixing two fractures per rib lead to better healing than fixing one fracture per rib in patients with unstable chest injuries? Does the choice of surgical method affect lung function, pain, other symptoms, risk of pneumonia, or the risk of complications? Participants will: * Undergo surgery using either the standard method (fixing one fracture per rib) or an alternative method (fixing two fractures per rib), both using a muscle-sparing technique. * Be followed up at 1, 3, and 12 months after surgery. * Have CT scans at 3 months (and at 12 months if healing is incomplete) to assess bone healing. * Be evaluated for lung function, pain, symptoms, and complications. This study aims to provide new knowledge about which surgical method is best for unstable chest wall injuries, helping to improve treatment and recovery for these patients.

NCT Number	NCT07338656
Lead Sponsor	Sahlgrenska University Hospital
Conditions	Rib Fracture Multiple, Flail Chest
Enrollment	100 participants
Start Date	2026-05-05
Primary Completion	2027-12 (estimated)
Study Completion	2028-12 (estimated)
Updated on ClinicalTrials.gov	2026-04-28