Delayed fracture of MatrixRIB precontoured plate system.

OBJECTIVES Use of titanium prostheses for reconstructing chest wall defects following major chest wall resections is rapidly increasing in popularity. Previously, complications including prosthesis fracture have been reported for the system secured to the rib ends using clips following chest wall reconstruction and pectus excavatum repair. By contrast, fracture failure in titanium systems fastening the plate to the rib with locking screws through predrilled holes has not been previously reported, possibly owing to differences in the design and material of the system. METHODS We report an index case of plate fracture in the latter design following rib reconstruction and discuss the pathophysiology and relative risks behind such fractures. RESULTS Fracture of titanium plate occurred after chest impact during sport at 25 months following initial plate implantation. Surgical excision was performed because of persistent pain and cough. CONCLUSIONS Fracture failure can occur in those systems fastening the plate to the rib with locking-screws, and patients, particularly those engaged in contact sports or occupations with chest impact risks, should be informed of this possibility during consent, as surgical removal is most likely required following implant fracture failur.