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Absorbable Plates for Rib Fracture Repair: Preliminary Experience

Mayberry, John C. MD; Terhes, John T. MD; Ellis, Thomas J. MD; Wanek, Sandra MD; Mullins, Richard J. MD

The Journal of Trauma: Injury, Infection, and Critical Care: November 2003 - Volume 55 - Issue 5 - p 835-839
doi: 10.1097/01.TA.0000090037.72142.33
ORIGINAL ARTICLES
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Background  Absorbable prostheses are currently used in a variety of bone reconstructions and fixations.

Methods  This is a case series of rib fracture fixation using absorbable plates and screws consisting of 70:30 poly(l-lactide-co-d,l-lactide) from April 2001 through November 2002.

Results  Ten patients underwent rib fracture fixation with absorbable plates and screws. Indications included flail chest with failure to wean (five patients), acute pain with instability (four patients), and chest wall defect (one patient). All patients with flail chest weaned from mechanical ventilation successfully. All patients with pain and instability reported rapid subjective improvement or resolution. The patient with a chest wall defect repair returned to full athletic activity without limitations at 6 months. Thoracoscopic assistance was used in three cases and muscle-sparing incisions were used in eight cases. Two patients with screw fixation only developed loss of rib fracture reduction. One patient developed a wound infection requiring drainage. The period of follow-up ranged from 3 to 18 months.

Conclusion  Absorbable plates produce good clinical results and are an option for rib fracture repair. Two-point fixation (screw fixation plus suture cerclage) is required. Further refinements in technique should focus on minimally invasive methods.

From the Trauma/Critical Care Section (J.C.M., R.J.M.), Department of Surgery (J.M.T., S.W.), and Department of Orthopedics (T.J.E.), Oregon Health & Science University, Portland, Oregon.

Submitted for publication June 19, 2003.

Accepted for publication July 16, 2003.

Presented at the 33rd Annual Meeting of the Western Trauma Association, February 23–28, 2003, Snowbird, Utah.

Address for reprints: John C. Mayberry, MD, Department of Surgery, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, L223A, Portland, OR 97239; email: mayberrj@ohsu.edu.

© 2003 Lippincott Williams & Wilkins, Inc.