Pieracci FM, Leasia K, Bauman Z, et al. - Researchers sought to ascertain the efficacy of surgical stabilization of rib fracture (SSRF) in patients without flail chest. They hypothesized that in patients with displaced rib fractures, SSRF could improve outcomes in the absence of a flail chest. They conducted a multicenter, prospective, controlled, clinical trial (12 centers) comparing SSRF within 72 hours vs medical management. Among 110 individuals enrolled, 23 were included in the randomization arm and 87 were included in the observational arm. SSRF was performed on 51 (46.4%) patients. At a 2-week follow-up, the operative group exhibited significantly lower numeric pain score, as compared with the nonoperative group (2.9 vs 4.5), and further, there was a significant improvement in respiratory disability-related quality of life (disability score, 21 vs 25). The operative vs the nonoperative group trended toward lower narcotic consumption. Outcomes here suggest that patients with three or more displaced fractures in the absence of flail chest exhibit improvement in the primary outcome of numeric pain score at a 2-week follow-up in correlation to undergoing SSRF within 72 hours. Data thus support undertaking SSRF in patients without a flail chest.