Rib fixation with a plate for radius and overlapping technique in comminuted fractures

Abstract

A 49-year-old male with sustained multiple comminuted right rib (3rd–9th) fractures, right pneumothorax, and a flail chest was referred to our hospital with complaints of severe pain. He previously underwent closed thoracostomy in the right thoracic cavity. Rib fixation was performed after 4 days. On evaluation, comminuted fractures of the 4–8th right ribs were detected. We followed a conventional method of using an 8or 6-hole-plate (MatrixRIB; DepuySynthes, USA) and an 8or 4-hole-plate (RibFix BluTM; DepuySynthes) for his rib fixation. The fourth rib was fixed using an 8-hole-plate (MatrixRIB). However, the distance of the intact portion on the 5–7th ribs was too long to be successfully managed using a conventionally used plate. Therefore, 8-hole-plates (Small Fragment Locking Compression Plate; DepuySynthes), which are usually employed for radius fixation, were used on these ribs. The 8 rib was fixed with an overlapping method with two flexible 4-hole-plates (RibFix BluTM) and a longer screw, considering the anatomy of the comminuted fractures (Fig. 1.). The patient was extubated the day after the operation and was transferred to the general ward on the second day after the operation. The plates were intact even on 40th postoperative day.