A new technique of fixing a costal coaptation pin after resection of rib segment.

The Poly-L-lactide costal coaptation pin is an effective device in chest wall reconstruction. However, fixation is sometimes incomplete, despite the use of the costal coaptation pin. We report here the use of two suture techniques for the fixation of the incised ribs with costal coaptation and discuss the effectiveness of these procedures. We used the Poly-L-lactide costal coaptation pin in 174 cases of posterolateral thoracotomies with two suture methods. In one method the rib was generally fixed with suture only (L-method, n = 30), and in the H-method pairs of holes were made at the end of the incised ribs for ligating with sutures (H-method, n = 144). The effectiveness of each method was evaluated based on the degree of fixation and lateral shift 24 months postoperatively. Lateral shift was none in 114 (79.2%) cases using the H-method and 18 (60.0%) cases using the L-method. Fixation was good in 131 (91.0%) cases using the H-method but in only 20 (66.7%) cases using the L-method. H-method was significantly more effective than the L-method of costal coaptation. The H-method was very effective for fixing incised ribs and is convenient for use by thoracic surgeons.