Vertical rib plating for the treatment of slipping rib syndrome

Abstract

Background: Slipping rib syndrome (SRS) is a painful condition of hypermobile, detached lower costal cartilages impinging the intercostal nerves. While surgical resection of the cartilaginous rib is reported as definitive treatment, recurrent symptoms are common. We describe the addition of vertical bioabsorbable rib plating to decrease recurrence.

Methods: An IRB-approved (#17-098), single institution, retrospective chart review was performed for patients who presented with SRS from 2009 to 2019 at a single institution. Descriptive statistics were used to compare patients with and without bioabsorbable vertical plating.

Results: A total of 85 patients (71.8% female, mean age 17.7 years) underwent evaluation for SRS. Of the 70 who underwent surgery solely for SRS, 29 (41%) underwent vertical rib plating at initial surgery while 41 (58.6%) did not. Recurrent symptoms developed in 7 (17.1%) unplated patients, while only 1 (3.4%) plated patient had recurrent SRS (which occurred after a motor vehicle crash) (p = 0.0116). Of the 8 with recurrent symptoms, 3 underwent vertical plating at a subsequent operation.

Conclusion: Rate of recurrent symptoms after cartilage resection alone for SRS was 17.1%. The addition of vertical rib plating with bioabsorbable plates decreased recurrent symptoms and improved outcomes.

Level of evidence: II.

Keywords: Bioabsorbable plating; Rib hypermobility; Slipping rib syndrome; Slipping rib syndrome recurrence; Slipping ribs; Vertical rib plating.