Re-building a ribcage… with plates and screws: Surgery that can mend fractured ribs



21:36 GMT, 29 September 2012

A pioneering technique for repairing broken ribs is dramatically reducing recovery times – so that patients can return to normal life within days.

Thousands of people suffer broken ribs every year as a result of falls, road and horse-riding accidents, and sports injuries.

Until recently, the only treatment option was to strap up the ribs and take painkillers while they healed.

Pioneering: The new rib-fracture treatment takes just two hours and means patients can be fully recovered within days

Pioneering: The new rib-fracture treatment takes just two hours and means patients can be fully recovered within days

This process can take weeks or even months, cause debilitating complications such as breathing difficulties and pneumonia, and often leave the patient with a chest deformity because the ribs never heal properly.

However, a new two-hour surgical procedure called the Synthes Rib Matrix, now available on the NHS and privately from £12,000, can transform recovery time.

Instead of leaving the ribs to heal by themselves, tailor-made metal plates are pinned to the broken bones to speed up the healing process and alleviate pain.

Tom Routledge, a consultant thoracic surgeon who works at London hospitals Guy’s and London Bridge, offers the technique.

He says: ‘Ribs are like dry twigs and they can break very easily – in some cases just by coughing. This also makes them very difficult to repair.

‘We now have the technology to stabilise the fracture, pulling the ribs back into place, which relieves the pain straight away.’

Rebuilding a ribcage with plates and screws

During the two-hour operation, the surgeon makes a small incision and inserts a titanium metal plate shaped to fit the anatomical contours of the rib.

Each ready-made plate is about half an inch wide and varies in length from 2in to 5in, depending on which rib it is being used for.

The plate and the rib are then attached together with screws to hold the bone in place. The plates are left in the body for ever.

Routledge says: ‘Within two days, patients are in much better shape and are normally out of hospital.

‘Pain tends to last days rather than the weeks or months associated with traditional treatment and there are fewer complications such as pneumonia, so it makes a tremendous difference.

'For footballers and rugby players, a broken rib can be career-limiting and this can get them playing again dramatically quicker.’

However, although this procedure is approved by the National Institute for Health and Clinical Excellence (NICE), many doctors do not know about it. ‘Patients are still being told by local A&E departments that nothing can be done for broken ribs,’ says Routledge.

'The best time to have this operation is as soon after the break as possible as it speeds up recovery'

‘But there is no need for patients to suffer at home in pain any more. The best time to have this operation is as soon after the break as possible as it speeds up recovery.’

Angela Whittington, 57, who lives near Tunbridge Wells, Kent, was left in excruciating pain when she was kicked in the back by a horse in April last year, which broke four ribs and punctured her lung.

Even though the ribs on the right side of her upper back had shattered in several places, her GP and local hospital said there was nothing they could do to help her and they would mend on their own.

However, eight weeks after the accident, she suddenly found she couldn’t breathe and was taken to hospital again.

‘When they took X-rays of my ribs, nothing had mended,’ Angela says. ‘When I moved my right arm backwards, I could feel the bones grating – it was very painful.’

She heard about the new operation through a friend who had suffered a similar accident.

At the beginning of this year, she arranged to have the surgery privately using health insurance.

As soon as she came round from the operation – during which three metal plates were inserted – she noticed a difference, and within five days she was home.

‘When I came to, I was amazed. I could lift my right arm right up without any restriction to the movement,’ she says.

Although she has been left with a 6in scar down her right shoulder blade, the surgery has transformed her life.

‘I took painkillers as I needed them for about a month, and I was driving my car within four weeks and a heavy goods vehicle horse box after six weeks.

‘Now there is no pain.

‘It aches sometimes, but nothing significant.’