Rib Plating

Rib plating is a surgical procedure used to stabilize fractured or broken ribs. During the surgery, the surgeon uses plates and screws to hold the broken ribs in place, allowing them to heal properly. The surgery is typically performed on patients who have suffered severe chest injuries, such as those involved in car accidents or falls. By stabilizing the ribs, rib plating can help relieve pain and improve breathing function.

Step 1: Incision and Retraction

The surgeon will make an incision and use a knife and bovie to cut down. Your role as a surgical technologist is to use retractors to hold back the muscles and skin around the surgical site. This will provide a clear view of the ribs that need to be plated.

Step 2: Measuring the Ribs

The surgeon will use the caliper from the Synthes set to measure the thickness of the ribs. This measurement will determine the size of the drill bit needed for the procedure. Once the surgeon has determined the size, inform them so that they can instruct you to load the correct drill bit.

Step 3: Plate and Hole Measurement

The surgeon will use the reduction clamps from the Synthes set to measure how many holes are needed for the plate. Once they have determined the number of holes, they will use the plate cutter from the set to cut the plate to the correct size. You will then need to retrieve a drill guide from the pan for the next step.

Step 4: Drilling

Once the plate is ready, the surgeon will begin drilling holes in the ribs using the drill guide. Your role is to fill the holes with the corresponding size of screw to match the drill bit. The screws are used to hold the plate in place and stabilize the ribs.

Step 5: Chest Tube Insertion and Closing

Once all the ribs have been plated and the screws have been inserted, the surgeon will insert a chest tube. This will help drain any excess fluid or air from the surgical site. After that, the surgeon will begin the process of closing up the incision. Your role as a surgical technologist is to assist the surgeon in any way necessary during this process.

The Surgery Sparknotes

1. Retract muscle and skin with retractors as surgeon directs down with knife and bovie.
2. Measure rib thickness with caliper and load correct drill bit.
3. Use reduction clamps to measure number of holes needed, cut plate, and retrieve drill guide from pan.
4. Fill drilled holes with corresponding size screw and stabilize ribs.
5. Insert chest tube and begin closing incision.