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NEW CRANIOMAXILLOFACIAL (CMF) PRODUCTS
William Long
NEW CRANIOMAXILLOFACIAL (CMF) PRODUCTS The Matrix Rib Fixation System The new matrix rib fixation system is indicated for the fixation and stabilization of rib fractures, fusions, and osteotomies of normal and osteoporotic bone. It was developed under the guidance of the Sternal Surgery WG, an international group of cardiothoracic and plastic surgeons within the CMF branch of the AOTK System. This new system is based on the matrix platform of plates and screws that have been developed for all areas in CMF surgery. It consists of precontoured locking plates, locking screws, and intramedullary splints for the fixation and stabilization of ribs and is indicated for the fixation and stabilization of rib fractures, fusions and osteotomies of normal and osteoporotic bone. The need to improve rib fracture care has been recognized for many years. To this end a number of surgeons have been using operative approaches including plates, intramedullary devices, vertical bridging, wire, sutures, and struts to repair the chest wall. Next is the attempt to achieve improvements in pain control, the goal for this system has been to reduce the duration of mechanical ventilation, ICU time, as well as the risk for chest wall deformities. Precontoured plates and splints
Although the majority of cases with fractured ribs can adequately be treated nonoperatively, the remaining number particularly severe chest wall trauma cases can be a cause of morbidity and mortality, especially in the presence of a flail chest where paradoxical inward movement of the flail segment in inspiration is found. About 10% of chest wall trauma cases result in a flail chest. Flail chest injuries, defined as fracture of at least three consecutive ribs in at least two locations each [1], are associated with a mortality rate of up to 33% [2]. Implants and screws The matrix rib precontoured plates are available in sets of four (four left plates and four right plates) with designs that correspond to a specific rib or rib pair. The plates, which cover fractures in all ribs suitable for plating, were designed to accommodate anatomical similarities between specific ribs.
Intramedullary splint The matrix rib fixation system is used with 2.9 mm self-tapping, locking cortex screws ranging from 6 to 14 mm in length (in increments of 2 mm). These screws are designed to be used with both the Synthes rib plates and IM rib splints. The screws are made of titanium alloy (ti-6Al- 7Nb). A 6 mm nonlocking screw is also available to temporarily secure the plate during insertion of the locking screws. This nonlocking