To investigate the classification of costal arch fractures (CAFs), the internal fixation methods and its outcomes.

We retrospectively analyzed 71 patients with CAF admitted to Central Hospital Affiliated to Shenyang Medical College for internal fixation from May 2017 to May 2022, including 59 males and 12 females, with a mean age of 49±4.3 years (age range, 17–86 years). According to the clinical manifestations and fracture characteristics, we classified CAFs as either simple or compound. The simple type refers to CAF alone or costal cartilage fractures with ribs attached to the costal arch; the compound type means CAF combined with fractures of 8–10 ribs of the adjacent costal arch. According to the severity of CAFs, and adjacent costal cartilage and rib fractures, the simple type is further divided into CAF Ⅰ and CAF Ⅱ, and the compound type into CAF Ⅲ and CAF Ⅳ. All 71 patients underwent internal fixation surgery using MatrixRIB under a small local incision, with some subjected to additional wire strapping.

The patients were followed up for 6 months to 2 years post operation. Until the last follow up, all patients had experienced no pain, without malunion, displacement of the titanium plate, and slipping of the titanium nail.

The classification of CAFs has clinical significance for the development of surgical plans, injury assessment and case statistics. Internal fixation is an effective treatment, avoiding long-term pain, failure of healing, and malunion.