clinical study of the u-plate fracture repair system to treat rib fractures

Conditions: Rib Fracture; Flail Chest

Summary: the purpose of this study is to gather information about a device used to help fix broken ribs. hypothesis: rib fracture repair with the u-plate system is clinically durable and safe for the indications of flail chest repair, acute pain control, chest wall defect repair, and rib fracture non-union.

rib fractures are a painful and disabling injury commonly found among trauma patients. according to the national center for health statistics, approximately 300,000 people with rib fractures were treated in emergency and ambulatory care departments in the united states in the year 2004. rib fracture patients are significantly more disabled at 30 days post-injury than patients with chronic medical illness and lose an average of 70 days of work or usual activity during their acute recovery. the rationale for conducting this study is to demonstrate in a prospective study that the u-plate repair system is durable and safe. although this clinical outcome data is not required by the fda to market and implant this prosthesis, the investigators believe that in order for the u-plate to be widely accepted, prospectively collected outcome data are necessary. with the goal of improving the durability of fixation of rib fractures over the techniques currently available and with the additional goal of developing a minimally invasive technique, a u-shaped plate was developed. the design of the u-plate theoretically overcomes the inherent softness of the human rib by grasping the rib over its superior margin and by securing the plate with anterior to posterior locking screws that do not rely on screw purchase in bone. thus much of the strength and durability of the fixation is transferred from the relatively soft rib to the plate itself.

Eligibility criteria:
inclusion criteria: * subjects must be at least 18 years of age * subjects must have one of the four clinical indications listed below: 1. flail chest with failure to wean from ventilator (\> 5 days post-injury) and paradoxical chest wall movement visualized; no significant pulmonary contusion and no significant brain injury 2. painful, displaced rib fractures (acute pain control) and failure of narcotics or epidural pain catheter to control pain; fracture movement exacerbates pain (after 7 - 10 days) and minimal associated injuries 3. chest wall defect/severely displaced fractures and non-repair defect may result in pulmonary hernia and severely displaced fractures are significantly impeding lung expansion in hemi-thorax 4. symptomatic rib fracture non-union and ct scan evidence of fracture non-union at least 2 months post-injury exclusion criteria: * subjects who are enrolled in another investigational treatment trial * subjects who have received an investigational drug or device within 30 days of enrollment * subjects who are unable to complete the follow-up questionnaires * subjects with severe head injuries or other severe associated injuries * subjects who are not expected to survive the follow-up period * female subjects who are pregnant * non-english or english as second language speakers

Keywords: rib fracture rib fracture repair rib fracture orif flail chest implant prosthesis rib fracture non-union chest wall deformity