Successful Surgical Fixation Using Bio-Absorbable Plates for Frail Chest in a Severe Osteoporotic Octogenarian

Ann Thorac Cardiovasc Surg. 2019 Dec 20;25(6):336-339. doi: 10.5761/atcs.cr.17-00223. Epub 2018 Mar 22.

Abstract

We present a case of a severe osteoporotic octogenarian who sustained serious flail chest from a traffic accident. The 3rd-9th ribs of the right chest wall were fractured. Non-operative management was unsuccessful. We performed a surgical fixation using a bio-absorbable and bio-active mini-plating set. This plating set is unsintered hydroxyapatite (u-HA) particles/poly-L-lactide (PLLA) composite osteosynthesis device commonly used for cranial, oral, and maxillofacial surgeries. The use of the u-HA/PLLA device for chest wall reconstruction has previously been reported, but no long-term results have been included. This case showed several advantages of the procedure with 4-year follow-up over other reported methods, especially in an osteoporotic elderly patient.

Keywords: absorbable plate; flail chest; rib fracture; surgical fixation.

Publication types

  • Case Reports

MeSH terms

  • Absorbable Implants*
  • Accidents, Traffic
  • Aged, 80 and over
  • Bone Plates*
  • Durapatite / chemistry
  • Female
  • Flail Chest / diagnostic imaging
  • Flail Chest / etiology
  • Flail Chest / surgery*
  • Fracture Fixation / instrumentation*
  • Fracture Healing
  • Humans
  • Osteoporosis / complications*
  • Osteoporosis / diagnostic imaging
  • Polyesters / chemistry
  • Prosthesis Design
  • Rib Fractures / diagnostic imaging
  • Rib Fractures / etiology
  • Rib Fractures / surgery*
  • Severity of Illness Index
  • Treatment Outcome

Substances

  • Polyesters
  • poly(lactide)
  • Durapatite