Chest wall trauma is rapidly evolving and now represents a multidisciplinary field with incredible growth in research and surgical intervention; however, even with more than 800 publications on chest wall trauma to date, surgical indications are not black and white. Injury patterns need to be better defined and outcome measurements need to evolve for accurate longer term functional assessment of patients if this field of surgery is to move beyond historical indications for operative intervention. This essay will communicate what is known about operative indications in a way that stratifies the need for surgery.
