Rib Fracture Plating System
ACUTE Innovations® RibLoc Rib Fracture Plating System was the first system developed in the United States for rib fracture repair. It was intuitively designed to provide greater stability over an anterior rib plate while avoiding the neurovascular bundle. The color-coded implants and instruments allow a minimally-invasive and straight-forward approach that aids in reducing OR time.
Using cadaver ribs plated with a small gap, a 4.6cm long RibLoc plate with 4 screws was statistically superior in durability to an anterior plate of over twice the length and 6 screws after only 50,000 breathing cycles.4 This was evaluated based on stiffness loss, as shown. Additionally, the reduced length of the RibLoc plate may facilitate a less invasive technique.3
The 46mm plate is the shortest plate on the market and only requires four screws for fixation. An incision as little as 7cm has been used for installation which can allow access to up to three ribs in the field of fractures.
The longer 61mm and 76mm plates can address oblique or complicated fracture patterns while still allowing a small incision size.
Indications for Use
The Acute Innovations® RibLoc® Rib Fracture Plating System, including plates, screws and accessories, is designed for rib fractures, fusions or osteotomies.
Color-coded plates, screws and instruments correlate to the anterior-posterior thickness of the rib. The four colors ensure that the correct size of screws and plates are being used on the rib while avoiding the neurovascular bundle.
There are three available plate lengths in each color to address a variety of fracture patterns. This straight forward system is efficient and effective in the OR.
Step 1: Measure Rib
- Measure the anterior/posterior rib thickness near fracture using the thickness gauge. Read the size from back or top center of red sleeve. If between sizes select the larger size.
- Select plate size based on rib thickness.
Step 2: Prepare the Plate
1. Assemble both targeting guides to plate.
2. Contour the plate, if necessary, by leveraging off the target guides. If more than minor adjustment is needed for a long plate (61mm or 76mm) then insert the intermediate screws into the threaded holes of the plate prior to bending.
Step 3: Drill Bone for Screw Insertion
- Place plate onto rib, centered over fracture.
- Use drill or drill guide that matches the color of the plate.
- Insert drill bit into targeting guide barrel and advance until drill bottoms out on the guide.
- Use one drill bit per case and discard when finished.
Step 4: Insert Screws
- Remove drill.
- Insert screw through guide & tighten until groove on driver shaft is flush with entrance of targeting guide barrel.
- Repeat drilling and screw insertion for all four holes.
Step 5: Tighten Screws
- Remove targeting guides.
- Sequentially tighten each set of screws until snug, do not over tighten.
Long Plate Application
Drilling for 2.3mm screws
- Thread corresponding colored drill guide into one of the center holes.
- Use the 2.0mm drill bit. Insert drill through drill guide, advance until drill bottoms out on the guide.
- Use one drill bit per case.
- Remove drill guide.
- Insert screws using the 1.5mm hex driver for the 2.3mm screws.
- Tighten screw until snug. Caution not to over tighten.
Long Plate Extreme Bending
- If more than minor contouring of long plate (61mm or 76mm) is needed then insert the screws into the threaded holes prior to bending to preserve the integrity of the threads in the plate.
- Remove the screws after bending. Install the plate onto the rib and follow steps above.
Keys to Success
- Select the correct thickness of plate for the rib
- Firmly attach both targeting guides to plate
- Use the correct drill and screw size by matching colors
- Tighten screws in pairs until snug, over tightening may cause stripping
- Use one drill per case