title: Delayed fracture of MatrixRIB precontoured plate system.
abstract: OBJECTIVE
  Use of titanium prostheses for reconstructing chest wall defects following major chest wall resections is rapidly increasing in popularity. Previously, complications including prosthesis fracture have been reported for the system secured to the rib ends using clips following chest wall reconstruction and pectus excavatum repair. By contrast, fracture failure in titanium systems fastening the plate to the rib with locking screws through predrilled holes has not been previously reported, possibly owing to differences in the design and material of the system.
  
  
  METHODS
  We report an index case of plate fracture in the latter design following rib reconstruction and discuss the pathophysiology and relative risks behind such fractures.
  
  
  RESULTS
  Fracture of titanium plate occurred after chest impact during sport at 25 months following initial plate implantation. Surgical excision was performed because of persistent pain and cough.
  
  
  CONCLUSIONS
  Fracture failure can occur in those systems fastening the plate to the rib with locking-screws, and patients, particularly those engaged in contact sports or occupations with chest impact risks, should be informed of this possibility during consent, as surgical removal is most likely required following implant fracture failur.
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China calvinng@surgery.cuhk.edu.hk.
authors.forename: Calvin S H
authors.initials: CS
authors.lastname: Ng
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Randolph H L
authors.initials: RH
authors.lastname: Wong
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Micky W T
authors.initials: MW
authors.lastname: Kwok
authors.affiliation: Department of Surgery, Prince of Wales Hospital, The Chinese University of Hong Kong, Hong Kong SAR, China.
authors.forename: Anthony P C
authors.initials: AP
authors.lastname: Yim
mesh_terms: D017824:Bone Cysts, Aneurysmal / Q000175:diagnosis / Q000601:surgery*; D001860:Bone Plates; D020878:Device Removal; D006801:Humans; D008297:Male; D010027:Osteotomy; D011474:Prosthesis Design; D011475:Prosthesis Failure; D019919:Prosthesis Implantation / Q000009:adverse effects / Q000295:instrumentation*; D011859:Radiography; D019651:Plastic Surgery Procedures / Q000009:adverse effects / Q000295:instrumentation*; D012086:Reoperation; D012272:Ribs / Q000000981:diagnostic imaging / Q000601:surgery*; D013997:Time Factors; D014025:Titanium; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D014025:Titanium
keywords: Chest wall; Fracture; MatrixRIB; Reconstruction; Titanium plate