Sternal Closure | FAQ
The midline sternotomy is the most commonly used incision in cardiac surgery and is often referred to as “cracking the chest.” This term refers to the breastbone (sternum) being cut down the middle to allow for access to the heart. Once the heart surgery has been completed, the cut halves of the breastbone need to be put back together. This may be done using several different methods, one of which is using plates and screws, a method known as rigid fixation.
Osteoporosis is a disease of the bones. It happens when too much bone is lost, too little is made or both. As a result, bones become weak and may break from a minor fall or, in serious cases, even from simple actions such as sneezing or bumping into furniture. Osteoporosis means “porous bone.” When looking at healthy bone under a microscope, parts of it look like a honeycomb. In those who have osteoporosis, the holes and spaces in the honeycomb are much bigger than they are in healthy bone. This means bones have lost density or mass and that the structure of the bone tissue has become abnormal. As bones become less dense, they also become weaker and more likely to break.
(Source: National Osteoporosis Foundation, http://nof.org/articles/7)
Yes, Sternalock 360 offers one system to approximate, compress and rigidly fixate the sternum. SternaLock 360 is indicated for patients with normal or poor bone quality, such as osteoporosis.
(Source: Zimmer Biomet Form No. BMF00-3285)
SternaLock® Blu is a rigid fixation system of plates and screws—along with specifically-designed instruments—for use following sternotomy or sternal reconstructive procedures. The thin, uniquely designed SternaLock® Blu plates offer an anatomical fit with cuttable cross sections for emergent re-entry. The benefits of rigid fixation include increased stability, greater strength, superior bone healing and reduced pain.
(Source: Zimmer Biomet Form No. BMF00-3260)
Rib Fixation | FAQ
A fractured rib is a common injury that occurs when one of the bones in the rib cage breaks or cracks. The most common cause is chest trauma, such as from a fall, motor vehicle accident or impact during contact sports. Many broken ribs are merely cracked. While still painful, cracked ribs aren’t as potentially dangerous as ribs that have been broken into separate pieces. A jagged edge of broken bone can damage major blood vessels or internal organs, such as the lung.
(Source: Mayo Clinic: http://www.mayoclinic.org/diseases-conditions/broken-ribs/home/ovc-20169623)
RibFix Blu is an implant system of plates and screws that is indicted for use in the stabilization and fixation of fractures in the chest wall, including sternal reconstructive surgical procedures, trauma or planned osteotomies. The system may be used in normal and poor bone to promote union.
(Source: Zimmer Biomet RibFix Blu brochure, Form No. BMF00-7430)
Pectus Repair | FAQ
Pectus Excavatum is a chest disorder occurring in approximately one out of every 1,000 children. This congenital deformity is characterized by a concave, funnel-shaped chest. The inward-facing sternum can apply pressure to vital organs of the chest, resulting in restricted organ growth and shortness of breath. Mildly present at birth, Pectus Excavatum usually becomes more serious throughout childhood, often magnifying considerably during the teenage years.
(Source: Zimmer Biomet Pectus Excavatum brochure, Form No. BMF00-2500)
There are two types of surgical correction: open repair (Ravitch procedure) and minimally-invasive repair with a metal bar (Nuss procedure). Both are done with general anesthesia and require an inpatient hospital stay of five to seven days. The majority of patients with Pectus Excavatum are candidates for the Nuss procedure. However, the decision to undergo a Ravitch or Nuss procedure will depend on the degree of the pectus deformity and the age of the patient. The procedure that’s performed will ultimately be determined by the surgeon.
Open repair—the Ravitch procedure—is done through a horizontal incision across the mid-chest. The abnormal costal cartilages are removed, preserving the lining of cartilage, thus allowing the sternum to move forward in a more normal position. In certain patients, an osteotomy (a cut) in the sternum is done to allow the sternum to be positioned forward. In addition, to keep the sternum elevated in the desired position after the removal of the cartilages and the osteotomy, a temporary metal chest strut (bar) may need to be placed.
Repair with a metal pectus bar—the Nuss Procedure—is achieved by bending a stainless bar to fit the chest wall. The bar is then inserted and secured through a small incision under each arm, using the aid of an endoscope to monitor and avoid injury to the heart during insertion. The bar goes over the ribs and under the sternum, to push the sternum forward into the new position. The ends of the bar are secured to the chest wall.
(Source: University of California San Francisco, http://www.pedsurg.ucsf.edu/conditions–procedures/pectus-excavatum.aspx)