Nuss procedure for multiple rib fractures combined with sternal fracture: a case report and literature review

To describe the use of the Nuss procedure in a patient with multiple rib fractures combined with a sternal fracture and to review the relevant literature. The clinical data of a 60-year-old woman who sustained multiple segmental rib fractures and a sternal fracture in a traffic accident in August 2025 were retrospectively reviewed. The patient presented with flail chest and cardiac compression secondary to chest wall depression. A single Nuss bar was implanted to stabilize the thoracic cage. A narrative literature review identified 12 relevant publications comprising 23 cases. Including the present case, a total of 24 cases were reviewed to summarize the indications, technical considerations, and precautions associated with this procedure. The patient recovered well after surgery. The literature review suggested that the Nuss procedure may offer advantages in selected patients with complex chest wall trauma, although the available clinical experience remains limited. The Nuss procedure is technically feasible for the treatment of selected patients with multiple rib fractures and may provide an alternative surgical option for complex chest wall trauma.