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Rib fractures are the most common injury sustained following blunt chest trauma.Since it is a procedure that has been recently introduced, many researchers have beenstudying and reporting on the advantages of rib fixation for the treatment of rib fractures.The authors of this study developed a guideline for rib fracture fixation in patients whohave flail chest or multiple rib fracture injuries. Therefore, this study aimed to report theadvantages of conducting rib fracture fixation with osteosynthesis plates at BangkokHospital Headquarters. The study consists of three cases who received rib fracture fixationfollowing the suggested guidelines. All three cases demonstrated improvement of ventilationafter rib fixation, a short intubation period, and no post-operative pulmonary infection. Inconclusion, rib fracture fixation is a treatment option for flail chest patients that reduceindications of mechanical rib cage failure.