Bioabsorbable poly-L-lactide costal coaptation pins and their clinical application in thoracotomy.

Abstract

To gain a wider operation field, ribs often are fractured as the intercostal retractor is expanded. Thoracotomy through the periosteal bed and other procedures have been performed to prevent rib fractures, and rib resections occasionally have been required. We designed a poly-L-lactide costal coaptation pin. We used this pin in 184 thoracotomies and carried out long-term observation after insertion to evaluate its clinical efficacy and safety. Postoperative observation periods ranged from 1 to 58 months (mean +/-standard error, 21.6+/-1.2 months). We evaluated the costal pin according to its degree of fixation, categorizing it as "good," "fair," or "poor" in this respect. We also judged its lateral shift. We judged fixation as "good" in 130 cases (70.7%), and found no lateral shift in 103 cases (56%). Our overall evaluation indicated satisfactory results in 172 cases (93.5%). Rib fixation was secured in nearly all cases, and no side effects were encountered. We can confirm that the poly-L-lactide costal coaptation pin is a highly effective and safe device.