Astrid Carolina Álvarez-Ortega, Jose Alejandro Posso-Nuñez, Nicolás Felipe Torres-España, Carlos Alejandro García-González, Álvaro I. Sánchez-Ortiz, Mauricio Velásquez-Galvis.2025-07-242025-07-242025-03-05Álvarez-Ortega AC, Posso-Nuñez JA, Torres-España NF, García-González CA, Sánchez-Ortiz AI, Velásquez-Galvis M. Surgical stabilization of posterior rib fractures involving the costotransverse joint. Eur J Trauma Emerg Surg. 2025;51:127. doi:10.1007/s00068-025-02797-8.https://doi.org/10.1007/s00068-025-02797-8https://hdl.handle.net/20.500.14595/865This article presents a descriptive observational study on the surgical stabilization of posterior rib fractures involving the costotransverse joint, conducted at a tertiary care center in Colombia between 2020 and 2024. Eleven patients underwent surgical intervention using a multidirectional clip fixation system, with outcomes assessed through pulmonary function tests and quality of life measures. The study reports favorable results, including low complication rates, preserved pulmonary function, and acceptable postoperative quality of life. The findings suggest that surgical stabilization in these anatomically challenging fractures is feasible and beneficial, advocating for further research to establish standardized management guidelines.Purpose Surgical stabilization of posterior rib fractures involving the costotransverse joint is debated, with most patients managed non-operatively. However, surgery may be indicated for respiratory failure due to altered mechanics or severe pain leading to functional limitations. Long-term outcomes related to quality of life and pulmonary function in these patients are underreported. This study aimed to describe our unique experience with the surgical stabilization of posterior rib fractures involving the costotransverse joint and to report the associated outpatient clinical outcomes. Methods An observational descriptive study was conducted at a tertiary care institution in Colombia during 2020–2024. Patients with posterior rib fractures involving the costotransverse joint who underwent surgery were included. Data collected included demographics, trauma severity, and complication rates. Primary outcomeswere mortality, postoperative complications, and implant failure. Results Eleven patients were included, with a median age of 42 years (interquartile range [IQR] 35–53). The median Injury Severity Score was 26 [IQR 21–35]. The median hospital length of stay was 13 days [IQR 10–17], Intensive care unit stay was 7 days [IQR 4–10], and invasive mechanical ventilation duration was 4 days [IQR 3–4]. One patient (9.1%) experienced a postoperative surgical site infection. Pulmonary function tests revealed a median forced vital capacity at 66% of the predicted value [IQR: 63–73%] and a median forced expiratory volume in the first second at 65% of the predicted value [IQR: 64–70%]. Quality of life assessments indicated acceptable outcomes, with a median score of 60 points [IQR 50–75]. Conclusion Surgical stabilization of posterior rib fractures involving the costotransverse joint is feasible and yields favorable outcomes, overcoming many technical hurdles. Larger studies with standardized follow-up are needed to validate these findings and establish definitive management guidelines.en-USPosterior rib fracturesCostotransverse fracturesCostotransverse jointThoracic surgeryArticle