Experience with titanium devices for rib fixation and coverage of chest wall defects

OBJECTIVES: To describe our experience with two new titanium-based devices for chest wall reconstruction and stabilization. METHODS: A retrospective analysis of 18 consecutive patients (multiple rib fractures n = 9, iatrogenic rib fracture n = 2, lung herniation n = 2, chest wall tumour n = 5) who underwent surgery for rib fractures or chest wall tumours requiring chest wall resection and reconstruction between October 2010 and March 2012 was conducted. Chest wall defects and rib fractures were fixed with titanium clips and bars or titanium plates and screws through a posterolateral thoracotomy. RESULTS: There were 12 males, and the median age was 61 years. There were no postoperative deaths. The only postoperative complication observed was a pleural effusion requiring drainage in one patient who had titanium clips for the fixation of multiple traumatic rib fractures. Median length of stay of the drain and median length of hospital stay were 3 days (range 1-6) and 4 days (range 2-42 days), respectively. The average follow-up period of operatively managed patients was 6 months, (range 2-14 months). Two cases of hardware failure occurred in two patients treated for a lung hernia with large chest wall defects involving the anterior costal margin with either devices. CONCLUSIONS: Titanium devices (clips and bars; screws and plates) are effective and safe for repair of rib fractures and large chest wall defect reconstruction with minimal complications and good long-term results.