Metal Plates Outperform Resorbable Plates in Study of Rib Fractures

Metal plates used in the stabilization of rib fractures resulted in better alignment with less displacement upon discharge and at three- to six-month follow-up, according to a study presented at the American Association for the Surgery of Trauma 2021 annual meeting (paper 59).

“Surgical options for the management of rib fractures have increased over the last decade,” said Dennis W. Ashley, MD, a professor of surgery at the Mercer University School of Medicine, in Macon, Ga. “There are many systems now available to the acute care surgeon who wishes to perform surgical stabilization.”

Although plates constructed of polymers—which are resorbed by the body over the course of 18 to 24 months—are frequently used in procedures such as chest wall reconstruction, there is limited experience using them for the surgical stabilization of rib fractures.

Dr. Ashley and his colleagues conducted a study among adult patients with rib fractures treated at a Level I trauma center who were randomized to receive either metal or resorbable plates. The study focused on whether the two types of plates would provide similar fracture alignment, pain control and quality-of-life scores. Assessment of rib displacement was conducted on the day of discharge, and outpatient follow-up was conducted between three and six months.

A total of 29 patients were included in the study: 14 in the titanium group and 15 in the resorbable plate group. Demographics and mechanism of injury were similar for both groups, and motor vehicle crash was the most common mechanism of injury for all patients.

Nine patients had displacement upon discharge, all of whom were in the resorbable group. Twenty-two specific ribs had displacement upon discharge, all of which were also in the resorbable group.

The trend continued.

During the follow-up period, three patients experienced additional displacement in the resorbable cohort. Similarly, 10 ribs with displacement at follow-up were found in the resorbable group.

Pain scores, opioid use and quality-of-life scores were similar in both groups at all periods.

Dr. Ashley noted that the study was limited by its single-center design. However, he said since chest radiography was used in place of CT for displacement, follow-up displacement rates were likely conservative.