Absorbable plates for rib fracture repair: preliminary experience.
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.


CONCLUSIONS
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.
Mayberry
John C
JC
Trauma/Critical Care Section, Oregon Health & Science University, 3181 S.W. Sam Jackson Park Road, L223A, Portland, OR 97239, USA. mayberrj@ohsu.edu
Terhes
John T
JT
Ellis
Thomas J
TJ
Wanek
Sandra
S
Mullins
Richard J
RJ
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001860:Bone Plates; D001863:Bone Screws; D005260:Female; D005592:Fracture Fixation / Q000379:methods*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008875:Middle Aged; D011184:Postoperative Period; D012253:Rib Fractures / Q000145:classification / Q000209:etiology / Q000601:surgery*