Sternum Plating System

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Sternum Plating System

Fig 1: Sternal Fixation System titanium plates

A small percentage of surgical procedures that involve splitting the sternum to enter the thoracic cavity. develop serious complications that require sternal repair and/or reconstruction.

The new Sternal Fixation System is intended as a solution to encourage bony union in these cases. It serves as a solution for surgeons looking to rigidly fixate these patients with the added safety of emergent re-entry.

While many surgeons currently remove the sternum the new system allows for a procedure that involves reducing the sternal halves and implanting plates, which span the sternum and are fixed to the ribs and/or sternum of the patient. The chest wall is then reinforced through advancement of the pectoral muscles.

The Sternal Fixation System consists of titanium locking plates that function with 3.0 mm titanium locking screws, similar to those used in the mandible area. The straight plates are actually an assembly of two single plates, which are connected by a U shaped pin. In case of emergency removing the pin allows re-entry into the thoracic cavity. Long and straight plates are fixed to the ribs; additional smaller plates are available for fixation of the manubrium.

Details
Instruments
Clinical Cases
Disclaimer

The Sternal Fixation System is available with 12-hole Titanium Locking Plates (Fig 2) as well as Titanium Locking H plates small/large and Titanium Locking Star Plates with 6 and 12 holes (Fig 3). The set contains Locking Screws (3.0 mm) from 8 mm to 18 mm and the Titanium Emergency Release Pin to connect and disconnect the plates at the fixation site,

A Titanium Sternal Locking Plate with 30 holes is available additionally (Fig 2).

Fig 2: 12-, 20 and 30-hole Titanium Locking Plates

Fig 3: Titanium Locking H plates small/large and Titanium Locking Star Plates with 6 and 12 holes

Instruments

The Sternal Fixation System Set contains a 2.4/3.0 mm Screwdriver with Holding Sleeve, a combination Bending Pliers for 2.0 mm/2.4 mm plates, a Bending Template with 37 holes as well as a Plate Cutter. For effective reduction of the sternotomy there are special Sternal Reduction Forceps and additional large Bone Reduction Forceps available.

The set also comes with respective threaded drill guides and drill bits with stops from 8 mm to 18 mm (J-Latch).

Caliper

The new universal caliper is designed for easy readability, durability, and compact size. In comparison with the currently available flat caliper this device also offers improved handling capabilities yet is easier to clean. The calibrated markings are etched in black on an off-white arm extension, which has a square shape and is etched on all four sides. The extensions arm is made of radel (polyphenylsulfone (PPSU) for better durability. It is intended for various areas of thoracic surgery, ie, with the sternal fixation system and the matrix rib system.

Fig 4: New caliper (top) and old caliper (bottom)

Sternal closure with Ti Plate system

Cases provided by J Thornton, UT Southwestern Medical Center, Dallas, TX

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