Introduction: Associated thoracic and spine injuries are one of the most severe lesions in the structure of polytrauma. Spine trauma occurs in more than 15% of polytrauma patients, but thoracic trauma – in 52% of cases [1, 2, 3]. The last one causes severe respiratory complications. The risc of lipidic embolism is too high in these cases [4, 5, 6]. Materials and methods: The author presents treatment outcomes of 152 patients with rib cage and thoracic organ lesions, and 29 patients with spine fractures associated with other lesions like abdomen and urinary tract injuries, fractures of the pelvis and extremities bones. The cause of trauma was: traffic accident (81,4%), fall from height (15,2%), habitual trauma (3,4%). A complex examination was performed according to elaborated algorithm which also included thoracic and spine X-ray with rib fractures marks, ultrasound of the pleural sinuses, spirography, CT, MNR. Rib fractures were in 152 cases, multiple - in 139 (91,4%) patients. Unilateral rib fractures were in 99 (65,1%) cases, bilateral – in 53 (34,9%). Fractures of the sternum were in 16 cases, clavicle – 34, scapula – 23, upper limbs – 69, pelvis – 107, lower limbs – 89. Pneumothorax was in 14 (9,2%), hemothorax - 43 (28,3%), hemopneumothorax 71 (46,7%). Complications were absent in 24 (15,8%) patients. . Spine fractures were in 29 patients, vertebral body lesions were in 11 cases. Unstable vertebral injuries were in 2 cases and were located in the thoracic segment. The success of treatment depends on quick restoration of the airways and lung excursion, elimination of blood and air from the pleural cavity, removal of paradox breath, “rib valve stabilization”, following by adequate anesthesia. Stabilization of the rib cage, osteosynthesis of sternum (n=14), clavicle (n=34), scapula (n=17) and ribs (n=12) were performed after hemodynamic optimization and removal of the respiratory insufficiency. Vertebral body fractures with compression gr.II-III were treated by reclinator with gradual increase of the reclination angle. Two patients with unstable vertebral injuries were transferred to the department of neurosurgery for specialized treatment. Results: we obtained positive results in 100% cases due to early diagnosis and correct treatment tactics. Conclusions: thoracic and spine injuries are usual for polytrauma patients and often burden their general condition, complicate the diagnostic process and increase the preoperative period by 13,31±1,2 days. Complex management of these patients gives satisfactory results in all cases.