Product Overview
Acute Innovations has developed U-shaped plate technology to provide 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.
Indications for Use
The Acute Innovations 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.
Related Documents
Note: RibLoc U Plus 90 Instrumentation Amadeo Surgical Technique not intended for US domestic use.
Videos
RibLoc U Plus Cadaver Lab with Lawrence Lottenberg, MD
In this video, Dr. Lawrence Lottenberg demonstrates his approaches and installation of the RibLoc U Plus product in chest wall injuries.
RibLoc U Plus Voice of Customer Interview with Lawrence Lottenberg, MD
In this video, Dr. Lawrence Lottenberg highlights his usage of the RibLoc U Plus product in his practice.
The Evolution of Rib Plating with Francis Ali-Osman, MD
In this video, trauma surgeon Dr. Ali-Osman briefly outlines the challenges and opportunities around rib plating as a treatment.
Product Training Series: RibLoc U+ and U+ 90 Key Features with Elya Henry
Chest Wall Portfolio Product Manager Elya Henry goes through the key features of the system.
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
Custom Fit to the Rib
The RibLoc U Plus plate was designed to be customizable to the individual patient. The plates range in length from 50 mm - 215 mm, which allows the surgeon to address a broad range of fracture patterns.
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
Plate Variety
The RibLoc U Plus system offers U-shaped plates for rib fixation as well as a straight plate to stabilize sternum fractures.
The U-shaped plates are available in 50mm, 75mm, 115mm, 155mm, and 215mm. The straight plate has a length of 126mm. All plates have been designed to work with existing RibLoc U Plus and U Plus Instrumentation.
Sternum Fracture Fixation
The straight plate offers fixation for transverse sternal fractures while using U Plus instrumentation.
Image courtesy of Bruce Hamm, MD, Associate Professor of Surgery, Division of Trauma, Critical Care and Acute Care Surgery, School of Medicine.
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
U Plus 90 Adds Power for Efficiency
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 U Plus 90 degree 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.
- 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
- Sarani B, et al. Pitfalls associated with open reduction and internal fixation of fractured ribs. Injury 2015; 46(12):2335-2340.