Plate Osteosynthesis Technology Modernizes Rib Fracture Surgery

The potential benefits of surgical stabilization (osteosynthesis) of severe rib fractures include reduced mechanical ventilation support, shortened intensive care unit (ICU) stays and hospitalization, better secretion management through efficient cough, and minimized chest wall deformities resulting from trauma. The system consists of locking plates pre-contoured to fit an average rib shape; intramedullary splints for fixation and stabilization of the ribs; and locking screws designed to be used without removing the periosteum.

The MatrixRIB Fixation System is designed to be optimally used with a series of minimally invasive plate osteosynthesis (MIPO) instruments designed to provide surgeons with improved, minimally invasive access to the rib fractures, including difficult to reach sub-scapula fractures. The instruments include a trocar, a threaded reduction tool (TRT) with a self-drilling tip, and a 90° screwdriver with drilling capability. The MatrixRIB Fixation System and MIPO instrumentation are products of DePuy Synthes (West Chester, PA, USA).

“MatrixRib actually uses technology which was originally designed for neurosurgery and has been modified to allow us to implant locking plates and screws to perform rib stabilizations and fixations with significantly increased accuracy and precision,” said consultant cardiothoracic surgeon Alan Kirk, of Golden Jubilee National Hospital (Dunbartonshire, UK). “Not only does this have the potential to improve patient outcomes, but it allows us to carry out complex procedures which are simply not available with traditional methods.”

Rib fractures are common in blunt chest wall trauma, and usually heal on their own without specific treatment, but a subset of patients have fractures that produce overlaying bone fragments that may produce severe pain, respiratory compromise, and chest wall deformity. About 10% of chest wall trauma cases, however, result in flail chest, fracture of at least three consecutive ribs in at least two locations each. Flail chest injuries are associated with a mortality rate of up to 36%, since patients develop paradoxical inward movement of the flail segment which prevents effective inspiration, requiring prolonged mechanical ventilation.

Related Links:
DePuy Synthes
Golden Jubilee National Hospital