Archive for Tuesday, October 23, 2012

New ‘rib-plating’ procedure can spare lives, pain

Shawnee resident Patrick Hamilton and Dr. Adam Kaye look over imaging of the titanium plates that Kaye used to fuse eight of Hamilton's ribs back together with at Overland Park Regional Medical Center following a dirt bike accident last year.

Shawnee resident Patrick Hamilton and Dr. Adam Kaye look over imaging of the titanium plates that Kaye used to fuse eight of Hamilton's ribs back together with at Overland Park Regional Medical Center following a dirt bike accident last year.

October 23, 2012

Had Patrick Hamilton crashed his dirt bike and broken eight ribs in another time or place, he might have died or wished he had due to the long, painful recovery generally associated with such injuries.

But thanks to a new surgical procedure called rib plating, the 52-year-old Shawnee resident was back to work at his Lenexa law firm in November 2011 — the month after undergoing the innovative procedure at Overland Park Regional Medical Center.

Overland Park Regional and the University of Kansas Hospital are the only two facilities in the region where surgeons perform rib plating, which fuses broken ribs back together with bendable titanium plates.

“It was a godsend that I was hurt in an area that offered it,” said Hamilton, who added that his only symptoms a year later are some numbness on his left side and a little soreness after doing a lot of yard work.

“But he’s doing yard work,” noted Dr. Adam Kaye, the general and trauma surgeon who put Hamilton’s ribs back together during a two-and-a-hour procedure on Oct. 4, 2011.

On Sept. 21, 2011, Hamilton had taken his new dirt bike to the Valley MX motorocross track in Grain Valley, Mo., to break in the engine. He doesn’t remember the crash that left him face down in the mud that day. But after he was transported to Centerpoint Medical Center in Independence, Mo., emergency room personnel quickly determined it was serious enough to leave Hamilton with eight broken ribs on his left side, a collarbone shattered in four places, and a punctured and collapsed left lung.

Five days later, Hamilton was transferred to Overland Park Regional Medical Center, which like Centerpoint is part of the HCA Midwest Health System. It is also home to Johnson County’s only trauma center and Dr. Kaye’s surgical practice.

Kaye, who has performed 18 rib-plating operations since May 2010, said the new procedure is currently reserved for patients who have sustained at least three broken ribs with “displacement,” meaning separation as opposed to mere cracking of the bone. Hamilton easily met that criteria.

“His fractures were so extensive that the bones were overlapping each other, reducing the volume of his lung field,” Kaye said. “Patrick had more broken ribs than I’ve ever treated at one time. And essentially, his respiratory system was failing.”

Typically, Kaye said, patients with broken ribs are given pain medication and kept as immobilized as possible during the several weeks it takes the ribs to heal on their own. But in cases like Hamilton’s, such an approach can produce several downsides.

“Rather than having to cope with the sometimes lifelong effects of broken ribs such as trapped nerves, breathing issues, malunion or misalignment of healed bone, and relying on medications to relieve chronic pain,” Kaye said, “trauma patients like Patrick Hamilton can breathe easier with this surgery.

“Rib plating offers enhanced pain control, helps decrease a patient’s hospital stay and chance of infection, and increases the patient’s quality of life.”

Hamilton doesn’t remember any pain associated with his rib injuries, likely due to the sedation that was required by their severity.

But Kaye said another patient he recently operated on exemplifies the difference rib plating can make for those in pain. The patient, a woman from Maine who had broken six ribs in an accident, initially declined the rib-plating procedure. But after two days of intense pain, she reconsidered, then walked out of the hospital pain-free three days later.

“I talked to her after she returned home, and her only complaint is that her golf game is off,” Kaye said. “But she’s playing golf.”

Due to rib plating’s ability to minimize pain and maximize recovery, Kaye said, he believes its use will expand to include less-serious rib injuries in the future.

The procedure itself is not expensive, he said, noting that the surgeon and hospital receive only about $200 and $250 per rib, respectively.

All the bills associated with Hamilton’s care, however, totaled $1.2 million, the attorney said.

“We paid less than five grand,” said Hamilton, a husband and father of two. “If we had had a capped (health insurance) policy, we’d have been in trouble.”

As it stands, Hamilton said he was extremely thankful his wife opted for rib-plating procedure for him while he was out of it in the Overland Park Regional ICU.

“I feel normal, have returned to work and resumed normal activities with my wife and kids — except riding my bike,” he said. “I’ve promised my wife that it can wait.”

Instead, Hamilton has settled for shuttling patients around the Overland Park Regional campus in a golf car.

“I wanted to volunteer here, to give back to this amazing place and the people like Dr. Kaye, who truly saved my life,” he said.

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