Manubriosternal joint dislocation (MSD) is a rare traumatic injury, usually preceded by a high energy trauma. We report a case of a 40-year-old female who was involved in a motor vehicle accident and presented to a tertiary trauma centre. She suffered from severe chest wall injuries, including significantly displaced manubriosternal dislocation with lung herniation, bilateral rib fractures and hemopneumothoraxes. She underwent a chest wall reconstruction with open reduction and internal fixation with sternal and costal plates with good functional outcome. In this case report we discuss the management of these rare and unstable type I manubriosternal dislocation with associated rib fractures.