Titanium plates prove life-saver for farmer trampled by bull

Surgeons James McVie and Joel Dunnin
Surgeons James McVie and Joel Dunnin
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A FARMER who was left fighting for his life after he was trampled by a bull is on the road to recovery after life-saving rib plating surgery.

Derek Thompson, 69, from Northallerton, spent three months in intensive care after suffering 22 fractured ribs when he was hit by the animal while rounding up his cattle.

His operation was the first of its kind performed by surgeons at the James Cook University Hospital in Middlesbrough.

Titanium plates, which Mr Thompson has compared with the model construction toy Meccano, were pinned to his broken bones to speed up the healing process, relieve pain and reduce the risk of complications such as breathing difficulties.

“I would think I was one of the most difficult cases they have ever had to save,” said Mr Thompson, who is now back at home with his family at their farm in Welbury.

“Nearly all my ribs were broken, there was not much left.

“They are now held in place with plates that look like bits of Meccano.

“They are doing a marvellous job, there’s no doubt about that.”

The operation was carried out by cardiothoracic surgeon Joel Dunning and orthopaedic surgeon James McVie.

Mr Dunning said: “We now offer rib plating for major fractures and are one of only eight centres nationally doing this.

“This procedure will be a major help to our most critically injured patients and as a major regional trauma centre we estimate that this will help a lot of patients from the whole region, increasing survival rates and reducing their days on the intensive care unit.”

Mr McVie added: “I’m really pleased that Mr Thompson is recovering well from his major chest injury and surgery. It’s great that we can now offer this surgery here at James Cook as it will help future trauma patients.”

Until recently, the only treatment for rib fractures was to strap them up and take painkillers while they heal naturally – a process which can take months.

They cannot be immobilised with splints in the same way as other broken bones are, as the ribcage needs to be able to expand and contract for a patient to breathe.

But the pain – which can make taking deep breaths and coughing excruciating – can lead to complications such as an increased risk of pneumonia, because phlegm can build up in the lungs and become infected.

Rib plating was first attempted in the 1970s and 1980s using metal plates and screws designed for other bones, such as forearms, but they were not flexible enough.

Newer techniques, such as the Synthes MatrixRIB system, developed in Switzerland five years ago, use curved plates sculpted to fit the contours of a ribcage.

Cuts are made to expose the affected ribs, which are repaired by attaching the plates with screws or wires.

The operation typically takes around two hours and patients can be home within days depending on their condition and other injuries.

The fractures then usually heal within six to eight weeks.

The procedure, which costs around £6,000 to the NHS, was approved by the National Institute for Clinical Excellence in 2010.

It is recommended for the treatment of patients with flail chest wall – a condition in which fractures have caused part of the rib cage to break away.

In severe cases this can prevent patients from breathing unaided and they may need to be put on a ventilator.

In a study, fewer patients who had the surgery developed pneumonia than those whose ribs were left to heal naturally, and those who did not have the operation stayed an average of 10 days longer in intensive care.