Bioabsorbable poly-L-lactide costal coaptation pins and their clinical application in thoracotomy Akitoshi Tatsumi, MD, Naoki Kanemitsu, MD, Tatsuo Nakamura,

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Bioabsorbable poly-L-lactide costal coaptation pins and their clinical application in thoracotomy Akitoshi Tatsumi, MD, Naoki Kanemitsu, MD, Tatsuo Nakamura, MD, Yasuhiko Shimizu, MD The Annals of Thoracic Surgery Volume 67, Issue 3, Pages 765-768 (March 1999) DOI: 10.1016/S0003-4975(98)01264-8

Fig 1 Two types of P-L-LA costal coaptation pins with dimensions of 3 × 3 × 27 mm and 3 × 4 × 27 mm were used. The Annals of Thoracic Surgery 1999 67, 765-768DOI: (10.1016/S0003-4975(98)01264-8)

Fig 2 The rib is cut at the costal angle (top) and a thoracotomy is performed. In closure, the coaptation pin is inserted into the bone marrow (center) and the rib is ligated with an absorbable suture (bottom). The Annals of Thoracic Surgery 1999 67, 765-768DOI: (10.1016/S0003-4975(98)01264-8)

Fig 2 The rib is cut at the costal angle (top) and a thoracotomy is performed. In closure, the coaptation pin is inserted into the bone marrow (center) and the rib is ligated with an absorbable suture (bottom). The Annals of Thoracic Surgery 1999 67, 765-768DOI: (10.1016/S0003-4975(98)01264-8)

Fig 3 Ten months after operation, the rib showed no side displacement and was firmly fixed, and an anchoring callus was visible. Immature fiber bone was buried in the crevice at the edge of the fracture. The Annals of Thoracic Surgery 1999 67, 765-768DOI: (10.1016/S0003-4975(98)01264-8)

Fig 4 “Nail-headed” swelling in the coapted area (top). On pathohistologic evaluation, fragments of material (arrow) remained in the central section of the rib and were surrounded by a fibrin-like substance (bottom). (Hematoxylin and eosin; original magnification ×20 then 52.2% reduction.) The Annals of Thoracic Surgery 1999 67, 765-768DOI: (10.1016/S0003-4975(98)01264-8)