53 polytraumatic patients were randomized to receive surgical rib fixation or conservative treatment for the treatment of flail chest. Outcomes of interest included length of stay outcomes, the incidence of adverse events, mechanical ventilation, and pain at rest, during coughing and during deep breathing. Study results revealed surgical treatment of flail chest to result in less time on mechanical ventilation and in the ICU, lower incidences of pneumonia, acute respiratory distress syndrome and thoracic deformity, and lower 1 week post-treatment pain scores during coughing and deep breathing compared to conservative treatment.