Please assess the completion status of the following clinical trial:

Trial Title: Flail Chest - Rib Fixation Study

Study Design Characteristics:
- Allocation: RANDOMIZED
- Intervention Model: PARALLEL
- Observational Model: None
- Primary Purpose: None
- Time Perspective: None
- Masking: NONE
- Phase: None
- Number of Arms: 2.0

Eligibility Criteria:
Inclusion Criteria:~1. Adults \>21 years and \<75 years~2. Stove-in chest to encompass both~   1. Unilateral flail chest (\>3 ribs fractured at two places) or~  2. Contiguous rib fractures with at least 2 ribs pushed in \> the rib diameter of the pushed in rib~3. Mechanically ventilated~Exclusion Criteria:~1. Patient unlikely to survive due to the trauma or age or multiple co-morbidities~2. Stove-in chest patients that do not require early (less than or equal to 48 hours of injury) ventilatory support~3. Bilateral flail chest~4. Sternal flail~5. P/F ratio \< 200:1 over a period of greater than or equal to 6 hours while on the ventilator.~6. Other injuries that will likely prolong tracheal intubation and mechanical ventilation eg significant head injury resulting in low GCS (Glasgow Coma Score, a scale used to assess the central nervous system in patients who have undergone trauma), spinal cord injury resulting in paralysis of some or all of the respiratory muscles etc. These are merely examples. It is in the opinion of the investigator/surgeon what injuries would prolong tracheal intubation.~7. Any contra-indication to surgery including severe immunosuppression or severe chronic disease making elective surgery dangerous in the opinion of the surgeon~8. Inability to proceed with any aspect of critical care due to personal beliefs, living will etc eg non acceptance of blood products~9. Inability to obtain informed consent.~10. Subject's refusal for follow up~11. Pregnant women~12. Prisoners~13. Any other reason for which the potential subject is not a good candidate, in the opinion of the investigator.~If the site investigator believes that a patient is a good candidate for the study (i.e. requires ventilation primarily due to altered chest wall mechanics) but fails to meet all criteria, site may contact Dr Ajai Malhotra to see if a waiver will be granted.

- Gender: ALL
- Minimum Age: 21 Years
- Maximum Age: 75 Years
- Healthy Volunteers: f

Study Arms:
- Operative rib fixation (Type: ACTIVE_COMPARATOR): Randomized subjects will be operated upon within 72 hours of ventilation (early fixation) to stabilize the stove-in segment. Where all fractured ribs are accessible and the number of fractured ribs is few, stabilization of all fractured ribs would be the goal. However, where fractured ribs are in areas difficult to access, enough ribs, based on surgeon judgment, would be fixed to stabilize the stove-in segment. Post-operatively, the patients would receive the standard of care, similar to what is outlined for the non-operative arm.~Operative fixation will be accomplished utilizing the MatrixRIB Fixation System (Synthes CMF, West Chester, PA, USA) according to the device's instructions for use. Sites will obtain the product based on their medical center's normal purchasing practices.
- Non-operative arm (Type: NO_INTERVENTION): Randomized subjects to receive standard of care therapy for blunt thoracic trauma (as per each participating institution's own protocols):~a. Ventilatory support b.Timing of extubation (removal from ventilator): c.Analgesia: institution should provide adequate analgesia utilizing available resources including oral, parenteral, epidural, local nerve blocks etc., d.Chest physical therapy, e.Postural drainage, f.Incentive spirometry - after extubation.

Based on this trial design, predict the completion outcome and termination type (if applicable).

Answer: outcome: terminate
termination_type: enrollment issues