An innovative procedure adopted by a thoracic surgeon and his team at Surrey Memorial Hospital (SMH) to treat severe rib fractures is sparing patients lengthy hospital stays, months of pain and suffering, and extended absences from work – including a hockey player who otherwise would not be spending the holidays at home.
The MATRIX program procedure – which involves an incision with strategic application of specialized titanium plates to the worst fractures – has been routinely performed by Dr. James Bond, chief of thoracic surgery for both SMH and Fraser Health, since July 2010. Dr. Bond has advanced the surgical use of these plates and created a comprehensive program of care that is the only one of its kind in Canada.
Designed in Oregon using cadaveric modelling, the titanium plates are configured for not only each rib but for the left and right side, conforming to the curvature of all the ribs with little bending or reshaping. Until the advent of the plates and surgical procedure, the standard of practice was to treat patients with rib fractures non-operatively. As a result, patients died or had poor outcomes such as fractures that never correctly bonded and remained painful. Matrix surgery has changed that.
“The benefits of this procedure are twofold: there is an immediate survival and pain benefit, and a delayed benefit favouring earlier return to work and mitigation of chronic pain and breathlessness,” said Dr. Bond.
According to Dr. Bond, patients with severe fractures are normally treated with multiple pain medications and often placed on a ventilator until they can breathe on their own.
“Thanks to the procedure, patients can be off ventilator support in one-to-two days and are at reduced risk for the kind of complications that cause death (pneumonia, blood clots etc.). Patients can be discharged earlier because of better pain control and no breathing issues, resulting in shorter hospital and ICU stays which translate to cost-effectiveness for the health care system,” added Dr. Bond.
Paul Gruber is one of Dr. Bond’s grateful patients who, as a result of this treatment, won’t have to spend Christmas in the hospital. Gruber suffered multiple fractures on seven ribs on his left side when he slammed into the boards while playing hockey shortly before Thanksgiving. He underwent the procedure within a few days and is at home recovering and regaining his mobility with plans to return to work in January.