Tips and Tricks relating to the Depuy Synthes MatrixRIB Fixation System | Which Medical Device

The following tips and tricks were provided by Mr Sion Barnard, Consultant Cardiothoracic Surgeon.

As with many practical techniques, preparation is the key and this includes:-

1) Close review of the scans and careful placement of the incision.

2) Making sure there is enough equipment. If there is a lot of fractures the ribs tend to be the same size and it would be quite easy to run out of the commonly used screws (8-12mm) if there is not a sufficient stock.

3) Spending a few minutes making sure the plate is bent to the right shape and aligned on the rib in the cranio caudal direction-a fine forceps to palpate the rib edges is useful here. However, if the plate does not sit properly or one of the screws does not engage in the rib, it is best to take all of the screws out and start again.

4) We find the use of crocodile clamps to clamp the plate onto the rib very useful, these obviously can be removed once two or three screws have been placed. It causes minimal damage to the intercostal muscle.

5) In the case of very posterior screws under the muscle layer, it is possible to make a small stab incision and there is equipment to keep the muscle fibers separated and place a very posterior screw or a very anterior screw for that matter, in a more minimally invasive fashion, without enlarging the incision and doing more muscle dissection.