RibLoc U Plus Chest Wall Plating System
December 10, 2020
Product Overview Acumed’s U-shaped plate technology provides stability with anterior and posterior locking screws. The RibLoc U Plus Chest Wall Plating System offers straightforward, color-coded instrumentation for ease of use. The RibLoc U Plus 90 Instrumentation, a low-profile system, provides power for limited access areas to ensure efficiency in the operating room. It may be used with both the Implantmed …
Product Overview
Acumed’s U-shaped plate technology provides stability with anterior and posterior locking screws. The RibLoc U Plus Chest Wall Plating System offers straightforward, color-coded instrumentation for ease of use. The RibLoc U Plus 90 Instrumentation, a low-profile system, provides power for limited access areas to ensure efficiency in the operating room. It may be used with both the Implantmed and Amadeo Power Systems in the United States, and internationally only with the Amadeo Power System.
Indications for Use
Acumed’s RibLoc U Plus Chest Wall Plating System is intended to stabilize and provide fixation for fractures, fusions, and osteotomies of the ribs, and for reconstructions of the chest wall and sternum.
U Plus Chest Wall Plating System
The U Plus system provides a solution for rib fracture repair that is stable, efficient, versatile, and customizable to each patient and situation.
- U-clips compress to match the rib thickness
- Plates address diverse fracture patterns
- Custom bending instruments
- Multipurpose instrumentation
A Variety of Plates, Custom Fit to the Rib
The RibLoc U Plus plate was designed to be customizable to the individual patient. The U shaped plates range in lengths from 50 mm – 215 mm, with a 126 mm straight plate, allowing the surgeon to address a broad range of fracture patterns. All plates have been designed to work with existing RibLoc U Plus and U Plus 90 Instrumentation. The advanced design of the plate offers a compressible U-clip to fit to a broad range of rib thicknesses (6 mm – 14 mm).
U Plus Placement on Rib
The U-shape design of the U Plus plate aids in consistent and straightforward placement through the thickest portion of the rib while avoiding the neurovascular bundle.1 A biomechanical study was performed using cadaver ribs plated with a 4.6cm long RibLoc plate and 4 screws. It was superior in durability to an anterior plate of over twice the length and 6 screws after only 50,000 breathing cycles (typically two days of breathing).2 This was evaluated based on stiffness loss, as shown in the graph. Additionally, the reduced length of the RibLoc plate may facilitate a less invasive technique.2
Anterior and Posterior Locking
The U-clips are designed to minimize stress on the rib by distributing physiologic loads over a greater surface area. Once the screws are engaged and fixed to the cortices of the bone, the plate locks both anteriorly and posteriorly. An additional benefit to the U-clip design is that fewer screws are needed to provide an anchor to the bone, reducing the degree of dissection needed on the rib itself.3
Sternum Fracture Fixation
The straight plate offers fixation for transverse sternal fractures while using U Plus instrumentation.
Straightforward Installation
With the use of a hex driver and drill bit, a rib plate installation may be completed in as few as three steps for a simple fracture using the U Plus plate, Primary Guide, and screws.
Dual-Locking Screws
The 2.7 mm dual-threaded screws are provided in lengths from 6 mm to 14 mm in 2 mm increments, and are color-coded for accurate and efficient installation.
Custom Instrumentation
- Primary Guide: The Primary Guide aids in fracture reduction once compressed onto the rib. This innovative instrument indicates the correct screw and has a built in drill guide and stop.
- Intermediate Gauge: The Intermediate Gauge acts as a clamp for securing segmental fractures, maintaining fracture reduction, and as a sizing tool for intermediate screw placement.
- Hand Bender: The two-sided Hand Bender is specifically designed to contour the U Plus plate to match the curvature of the rib. The teardrop features (1) are used for in-plane bending. The unique design allows for bending the plate without deforming the screw holes, as well as an angle approach to bend the plates in-situ. The roller features (2) are used for out-of-plane bending.
- Joystick Bender: The Joystick Benders can be used to apply a twist or out-of-plane bend to the plate. They can be used in situ and can also be useful in holding and manipulating the plate during installation.
- Rib Forceps: The Rib Forceps are designed specifically to maintain proper plate placement on the bone and assist with fracture reduction.
U Plus 90 Instrumentation System
- The U Plus 90 System provides a comprehensive solution to plating ribs in limited access locations. The low-profile and 90° instrumentation facilitates fixation of subscapular, posterior, and anterolateral fractures through minimally invasive approaches. The newest addition to the U 90 instrumentation is the Amadeo Control Unit, which features a wireless foot pedal. The U Plus 90 System is designed for low-profile access while allowing the use of power to compress, drill, and install screws – all with efficiency.
- U Plus 90 Primary Guides: The U Plus 90 low-profile Primary Guides compress the plate to the rib while aiding in fracture reduction through minimally invasive procedures. This innovative guide provides straight-forward color-coded measurements for screw length.
- U Plus 90 Ratchets: The 90 Degree Ratchets are designed to tighten screws with little force in hard to access locations.
Citations
- Nirula R, Mayberry JC. Rib fracture fixation: controversies and technical challenges. Am Surg. 2010 Aug;76(8):793-802.
- 2. Sales JR, Ellis TJ, Gillard J, Liu Q. Chen JC, Ham B, Mayberry JC. Biomechanical testing of a novel, minimally invasive rib fracture plating system. J Trauma 2008; 64:1270-1274
- 3. Sarani B, et al. Pitfalls associated with open reduction and internal fixation of fractured ribs. Injury 2015; 46(12):2335-2340.