Procedure speeds healing in multiple rib fracture

Daniel Reilly doesn't remember the collision that broke his ribs.

In fact, he says he doesn't remember most of his 28 days in the hospital after a deer collided with his motorcycle on Mount Vernon Road on Oct. 18.

The 63-year-old Mount Vernon resident suffered 10 broken ribs, a broken clavicle and scapula as well as internal damage in the collision, including a perforated stomach.

Reilly said he was 'touch and go” for a period of time, but his recovery process was boosted with a new procedure brought to Mercy Medical Center by cardiothoracic surgeon Dr. C.C. Lee meant to help patients healing from multiple rib fractures.

'I'm really glad I had that done because I just haven't had that much pain,” Reilly said. 'Some, yes, and it's stiff and the shoulder's been really sore - but pain upon (a) deep breath, pain to cough, pain to sneeze is gradually less and less. So that's progress.”

To address Reilly's 10 broken ribs - many of which were broken multiple times along his back and side - Lee performed a procedure called rib plating.

In rib plating, a surgeon realigns broken ribs and the break using contoured titanium plates and screws. The operation typically takes about two hours.

According to an article in the medical journal 'BMJ,” rib fractures are the most common traumatic injury found in about 20 percent of patients.

'The mainstay of treatment has been pain control and respiratory support with positive pressure ventilation,” according to the 'BMJ.” 'However, over the past two decades, there has been mounting evidence to suggest that open reduction and internal fixation of ribs benefits patients.”

In most cases, the treatment for broken ribs involved letting them heal on their own.

But for patients who have broken three or more ribs, the long-healing process is often very painful and uncomfortable.

Before this procedure, 'there was no option,” Lee said. 'Just multiple days in the intensive-care unit and pain medication.”

Lee said these trauma patients often have mobility issues and find it difficult to breath, leading to further complications such as pneumonia or pulmonary embolisms.

'It's because your rib cage is sort of your stability to your lungs,” Lee said. 'It needs to work in synchrony with your lungs to be able to allow you to breathe on your own.”

In Reilly's case, this led to flail chest - a life-threatening condition in which a segment of a broken rib cage becomes detached from the chest wall.

Lee said Reilly was slow to recover after abdominal surgery to address his perforated stomach, which was performed before the rib surgery. At one point in his stay, Reilly went into respiratory arrest and had to be placed on a ventilator.

'It was hard for him to get out of bed and mobilize, mainly because he had multiple rib fractures,” he said.

Reilly then opted to have the rib plating operation.

Lee had 'said if I didn't have it done, the risk would be a lot more chronic pain than what I would otherwise have ...

,” Reilly recalled.

Reilly, a retired psychiatrist, is a motorcycle enthusiast and has been riding since he was a teenager.

He credits the helmet and the gear he was wearing while riding that day for 'saving his hide, literally.” He's always been aware of the risks while riding, but said he has learned his lesson about riding at night.

When he picked up his motorcycle from the shop after his hospital stay, Reilly said he 'was already getting the itch to ride again.”

Before the collision, Reilly said he was planning a road trip out West for this summer. Now, he's not sure of his future riding career.

'Whether I continue riding is going to depend on my confidence level when I do get back on one,” he said.

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