Rib Reconstruction with Screws and Bone Cement

Summary

Rib reconstruction is often mandatory after chest wall resection. This video shows how to use orthopedic screws and bone cement molded in a latex drain for a very strong rib reconstruction. The procedure is easy to implement and versatile. It can be used even if the posterior end of the rib has been resected (a screw may then be inserted into the transverse process of the vertebra). It is also economical, and needs no special ancillary device.

Video Description

Three ribs were resected in continuity with the superior lobe for carcinoma. Only one rib reconstruction was required. Using a screwdriver, two 3.5 mm diameter orthopedic screws were inserted into the cut ribs. 15 mm of the screws passed through the rib. It was not necessary to use a drill. A 20 mm diameter latex Penrose drain was put over the anterior end of the cut rib, and a ligature was tied over it. A small hole was made in the drain with a scalpel to allow the escape of air. The drain was cut at the appropriate length. Bone cement was prepared, put in a 60 cc syringe, and injected into the posterior end of the drain. The posterior end, with the cement, was then molded onto the posterior screw. The neo-rib was kept in a good configuration until the cement hardened. The drain was split and withdrawn.