Multidirectional thoracic wall stabilization: a new device on the scene.

PURPOSE Stabilization and replacement of ribs is still a challenge, because most available systems for intramedullary and extramedullary fixation are less than perfect. We present our experience with a modified device, which compensates for several disadvantages in other methods. DESCRIPTION Originating from the Strasbourg Thoracic Osteosyntheses System (STRATOS [MedXpert GmbH, Heitersheim, Germany]), the multidirectional thoracic wall stabilization system uses tripodal clips with sharp clasping legs. They can be placed without dissecting the ribs, and bridge fractures or defects with titanium bars can be avoided. A rotating lug provides multidirectional stabilization. EVALUATION We used the multidirectional thoracic wall stabilization system in 4 patients (thoracic deformity, Poland syndrome, flail chest, and thoracic wall hernia). Placement of the devices met with expectations on simplified handling. The long-term follow-up showed no displacement or fracture of the implants and an uncomplicated clinical course. CONCLUSIONS The newly designed multidirectional thoracic wall stabilization system provides multidirectional use and reduces surgical trauma. In the long term, this device could help to lower the threshold for surgical stabilization of flail chest, for example, and widens the spectrum of less-invasive reconstruction of chest wall deformities.