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Absorbable plates for rib fracture repair: preliminary experience
John C Mayberry1, John T Terhes, Thomas J Ellis
1Trauma/Critical Care Section, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, L223A, Portland, OR 97239, USA. mayberrj@ohsu.edu
The Journal of Trauma
|November 11, 2003
Summary
Absorbable plates offer a viable option for rib fracture repair, showing good clinical results in patients with flail chest and instability. Two-point fixation is recommended for optimal outcomes.
Area of Science:
- Biomaterials Science
- Orthopedic Surgery
- Regenerative Medicine
Background:
- Absorbable prostheses are utilized in various bone reconstructions and fixation procedures.
- Poly(L-lactide-co-D,L-lactide) is a key material in developing these biodegradable implants.
Purpose of the Study:
- To evaluate the clinical efficacy of absorbable plates and screws for rib fracture fixation.
- To assess outcomes in patients with complex thoracic injuries requiring surgical intervention.
Main Methods:
- A case series involving ten patients undergoing rib fracture fixation with 70:30 poly(L-lactide-co-D,L-lactide) plates and screws.
- Techniques included thoracoscopic assistance and muscle-sparing incisions.
Main Results:
- Successful weaning from mechanical ventilation in all flail chest patients.
- Rapid subjective improvement or resolution of pain and instability in most patients.
- One patient with a chest wall defect returned to full athletic activity within 6 months.
- Two cases of lost reduction with screw-only fixation and one wound infection were noted.
Conclusions:
- Absorbable plates demonstrate good clinical results and serve as a viable option for rib fracture repair.
- A two-point fixation technique (screw fixation with suture cerclage) is crucial for stability.
- Future developments should emphasize minimally invasive surgical approaches.