BACKGROUND: Surgical rib fixation [SRF] is being used increasingly in trauma centres for stabilization of chest wall injuries, in line with new and evolving surgical techniques. Our institution has developed a pathway for the management of chest wall injuries and SRF, which includes a follow up low volume, non-contrast Computed Tomography (CT) scan at 12 months. METHODS: This study was a single centre retrospective study was conducted on 25 consecutive patients who underwent SRF between February 2019 to February 2020. All CT measurements were done by a CT radiographer under the supervision of a board-certified radiologist and included the use of 3DVR images. RESULTS: There were no patients with SRF who experienced hardware failure at 12 months in either flail or non-flail groups. For fractured ribs treated with SRF, complete or partial union occurred in 75/76 [98.7%] of ribs plated. The median ratio for improvement in lung volumes was 1.71 for flail SRF and 1.69 for non-flail SRF in our study. CONCLUSION: 3DVR CT at 12 months post SRF showed good alignment [no hardware failure] and fracture healing of fixed ribs in both flail and non-flail groups. Lung volumes also improved pre and post SRF for both flail and non-flail patients. More studies are needed to define how the pattern of rib fracture healing of fixed and non-fixed ribs affects lung volumes. LEVEL OF EVIDENCE: Level IIIStudy TypePrognostic Original Study.