This document discusses rib fractures in elderly patients and makes a case for rib plating surgery. It finds that patients over age 45 with more than 4 rib fractures are at increased risk for poor outcomes like longer ventilation, ICU stays, and hospital stays. The document presents two case studies of elderly men who underwent rib plating surgery after injuries resulting in multiple rib fractures. Both patients showed improved pulmonary function after surgery and were discharged to rehabilitation. The document concludes that rib fixation should be considered for elderly patients with flail chest, significant fracture displacement, or respiratory issues in order to reduce complications compared to nonsurgical management.