ACUTE Innovations® products are designed and built with the patient’s chest wall in mind to get the patient Back to health. Back to work. Back to life.  The following is an overview of widely used anatomical and medical terms as well as surgical procedure information related to chest wall injuries.  This may help you to understand your doctor’s terminology.  Statements about metal sensitivity and MRI compatibility can be found in the Reference section and our patient’s success stories can be found here.

The presented information is for educational and informational purposes only and is not a substitute for the professional judgment of a qualified health care professional.

Anatomical & Medical Terms

Chest Wall

Functions as a protective cage around the vital organs of the body and consists of muscles, skin, fat, and bones of the chest (thoracic skeleton).  The rib cage is part of this thoracic skeleton and consists of 24 ribs (two sets of 12), the sternum, and spine.  The top seven pairs of ribs are called “true” ribs and attach to the sternum (breast bone) in the front of the body.  The next three pairs, ribs 8, 9 and 10, are called “false” ribs.  These indirectly connect to the sternum by attaching to the cartilage of the 7th rib.  Rib pairs 11 and 12 are called “floating” ribs and do not attach to the sternum.  All ribs attach to the spine in the back.

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Thoracic

Relating to or affecting the thorax (chest), which is the part of the body between the neck and abdomen.

 

Traumatic Injury

A serious or life threatening injury.  Such an injury can be a result of a car accident, gunshot wound, or fall, for example.  Traumatic injuries can occur to any part of the body, e.g. brain, extremities, internal organs.

 

Acute Pain

Intense pain directly related to an injury and occurring at the site of injury.  It usually comes on fast after the injury occurs and becomes less intense as the injury heals.

 

Flail Chest

A flail chest occurs when at least three consecutive ribs are broken with a minimum of two breaks in each rib.  This creates a segment in the chest wall that moves separately from the other parts of the chest as breathing occurs.

 

Chest Wall Deformity

The most common structural abnormalities in the chest are Pectus Excavatum (also known as funnel chest), where the individual’s sternum is sunken in, and Pectus Carinatum (also known as pigeon chest), which is characterized by a protrusion of the sternum and ribs.  These deformities are caused naturally through birth and development.

Non-Union

A broken bone that fails to heal and does not make a new bone connection between the two broken ends is called a non-union.  It may occur as a result of a significant trauma and can cause a severe amount of pain with the continued movement.

Osteotomy

Surgical cutting of a bone.  In some surgeries one or more ribs need to be cut to provide access to the chest.  This intentional break avoids fracturing of the rib cage during a surgical procedure.

Successful Bone Healing

Requirements for successful bone healing

• Good blood supply
• Good bone to bone contact (gap smaller than 1cm and significant surface area of contact)
• Relative stability at the fracture site (minimal movement)

If these three main requirements for healing are jeopardized, a non-union can occur.

Factors that may contribute to poor bone healing

• Infection
• Malnutrition and vitamin deficiencies
• Diabetes
• Corticosteroid use
• Nicotine use, including the persistent cough related to smoking
• Entrapped soft tissue between the broken bone
• Older age
• Obesity
• Alcohol abuse
• Metabolic bone disease
• Osteoporosis

Rib Fracture Repair

Rib Fractures

A crack or break in the bone.  Rib fractures can come in a variety of shapes and sizes, all with their own varying degree of severity.  Also, a break in the costal cartilage may be called a fractured rib, even if the rib itself is not broken.  Rib Fractures can bring significant amounts of pain and disability.

There are four main fracture types:

COMMINUTED FRACTURE

Definition: A comminuted rib fracture is one in which the bone is broken, splintered or crushed into at least three separate pieces.  This type of fracture can be challenging to treat due to the complexity of the break.

OBLIQUE FRACTURE

Definition: An oblique frascture is a slanted or angled fracture of the shaft along the bone's long axis, typically resulting in a sharp angle to the fracture.

SEGMENTAL FRACTURE

Definition: A segmental fracture in a bone is one in which several large bone fragments separate from the main body of a fractured bone.  The ends of the fragments may pierce into the chest cavity.

SPIRAL FRACTURE

Definition: A spiral rib fracture is helical, caused by a twisting force.  You may also hear spiral fractures referred to as torsion fractures, in references to the forces involved.  In a spiral fracture, the bone has been twisted apart along the bone's long axis.

We recommend you consult a doctor after a rib injury.  A blow that is hard enough to fracture a rib could also injure other parts of your body, e.g. your lungs, spleen, and blood vessels.  A common injury associated with a fractured rib is a punctured or collapsed lung, called a pneumothorax.

Most rib fractures are treated conservatively using pain management.  Depending on the severity and location of the fracture, along with review of any other physical ailments (e.g. a flail chest can significantly affect the mechanics of breathing), a surgeon may recommend repairing the ribs – commonly referred to as fixation or stabilization.

ACUTE Innovations offers three products for rib fracture fixation and stabilization:

• RibLoc® Rib Fracture Plating System
• RibLoc® U Plus Chest Wall Plating System
• BioBridge® Resorbable Chest Wall Stabilization Plate

Speak with your doctor to find out if one of our rib fracture implants is right for you.

To find a surgeon near you please contact ACUTE Innovations today.

Chest Wall Reconstruction

The chest wall is comprised of skin, fat, muscles, and the thoracic skeleton.  It functions as a protective cage around the vital organs of the body.  A substantial disruption of its structure can have severe consequences.

Common indications (symptoms) for a chest wall reconstruction may include multiple rib fractures, flail chest, tumor removal, and radiation injury, just to name a few.  Depending on the severity of these symptoms, surgery might be needed to re-gain structure and functionality of the chest wall.

The goals of such a surgery include restoring the shape of the rib cage, protecting internal organs, and optimizing respiratory functions.  Whenever possible, the chest wall reconstruction should not only result in a functional outcome, but also an aesthetic one.

ACUTE Innovations offers two products for chest wall reconstruction:

• BioBridge® Resorbable Chest Wall Stabilization Plate
• RibLoc® U Plus Chest Wall Plating System

BioBridge is a resorbable plate which disappears over time through the body’s natural metabolism.  It offers appropriate strength and resorption time that outlasts typical bone healing duration.  Chest wall reconstruction with this product provides long-term chest wall stability through bone healing and/or soft tissue scarring.

The design of RibLoc U Plus combines technology, experience, patient needs, and surgeon feedback.  These titanium plates are customizable for each patient and situation.

Speak with your doctor to find out if one of our chest wall reconstruction implants is right for you.

To find a surgeon near you please contact ACUTE Innovations today.

Pectus Repair

A pectus repair might be needed if a deformity of the chest is present.  The most common structural abnormalities in the chest are Pectus Excavatum and Pectus Carinatum.  Traditionally, these defects, if severe enough, are repaired by removing the deformed cartilage and placing a bar (strut, brace) across the sternum to hold it into proper positioning during healing.

ACUTE Innovations’ BioBridge® Resorbable Chest Wall Stabilization Plate was designed to help stabilize the sternum at the time of an open pectus repair.  BioBridge maintains full strength for 180 days while new cartilage or scar tissue develops.  The plate dissolves in 18-24 months through the body’s natural metabolism.

Speak with your doctor to find out if BioBridge is right for you.

To find a surgeon near you please contact ACUTE Innovations today.

Sternotomy

A sternotomy is a cut to the chest in the middle of the sternum which gives a wide view of the inside of the patient’s thoracic organs.  A sternotomy is mainly done to access the heart for a cardiac or bypass type procedure.  Traditionally, the sternum is closed after such a procedure with a simple wire closure.  However, the forces on a healing sternum are multi-dimensional and complex12 and pull on the sternum in three directions:

Such forces on the sternum occur during normal daily activities like picking up a package, turning the steering wheel in a car, etc.  A wire closure alone might not be sufficient to withstand these movements.  The design of ACUTE Innovations AcuTie® II Sternum Closure System has been optimized to resist these forces, providing more complete stability in all dimensions.

Speak with your doctor to find out if AcuTie II is right for you.

To find a surgeon near you please contact ACUTE Innovations today.

The information presented is for educational and informational purposes only, and is not a substitute for the professional judgment, of a qualified health care professional. Your reliance upon this information is solely at your own risk. By accessing this information, you assume full responsibility for the use of the information and agree that ACUTE Innovations is not responsible or liable for any claim, loss, or damage arising from the use of the information. Speak to your doctor to decide if one of ACUTE Innovations’ implants is appropriate for your type of injury. Individual results vary and not all patients will return to the same activity level. There is the possibility of the device or treatment failing as a result of loose fixation and/or loosening, stress, excessive activity, or weight bearing or load bearing, particularly if the implant experiences increased loads due to delayed union, nonunion, or incomplete healing, and the possibility of nerve or soft tissue damage related to either surgical trauma or the presence of the implant. The failure to follow postoperative care instructions can cause the implant and/or treatment to fail.


IMPORTANT INFORMATION ABOUT AcuTie® II STERNAL CLOSURE SYSTEM

ACUTE Innovations AcuTie® II Sternal Closure System is intended for use in the stabilization and fixation of fractures of the anterior chest wall, including sternal fixation following sternotomy and sternal reconstructive surgical procedures.

Contraindication can be costal cartilage repair, active or latent infection, sepsis, osteoporosis, insufficient quantity or quality of bone/soft tissue, and material sensitivity. If sensitivity is suspected, tests are performed prior to implantation. Patients who are unwilling or incapable of following postoperative care instructions are contraindicated for this device.
Possible adverse effects can be pain, discomfort, or abnormal sensations due to the presence of an implant. Implant fracture, migration and/or loosening may occur due to excessive activity, prolonged loading upon the device, incomplete healing, or excessive force exerted on the implant during insertion. These type of adverse effects could lead to additional surgery and device removal. Metal sensitivity or histological or allergic reaction resulting from implantation of a foreign material may occur. Nerve or soft tissue damage, necrosis of bone or bone resorption, necrosis of the tissue or inadequate healing may result from the presence of an implant or due to surgical trauma. Implant contains nickel. Not to be used by or for people with a known nickel allergy, or with an allergy or sensitivity to one of the other components.


IMPORTANT INFORMATION ABOUT BioBridge® RESORBABLE CHEST WALL STABILIZATION PLATE

ACUTE Innovations BioBridge® Resorbable Chest Wall Stabilization Plate is intended for use in the presence of appropriate additional immobilization or fixation, indicated for maintaining the alignment and fixation of bone fractures, osteotomies, arthrodeses or bone grafts, and, maintenance of relative position of weak bony tissue (e.g., bone grafts, bone graft substitutes, or bone fragments from comminuted fractures), in trauma and reconstructive procedures, but can also be used for metacarpus, proximal and middle phalangeal bones, as well as long bones, flat bones, short bones, irregular bones, appendicular skeleton, and thorax.

Contraindication can be active or latent infection, sepsis, osteoporosis, insufficient quantity or quality of bone/soft tissue, and material sensitivity. If sensitivity is suspected, tests should be performed prior to implantation. Patients who are unwilling or incapable of following postoperative care instructions are contraindicated for this device. This device is not intended for attachment or fixation to the posterior elements (pedicles) of the cervical, or lumbar spine.

Possible adverse effects can be sterile inflammation as a result of a body reaction to the degradation products of the absorbable material; pain, discomfort, or abnormal sensations due to the presence of an implant. Implant fracture, migration and/or loosening may occur due to excessive activity, prolonged loading upon the device, incomplete healing, or excessive force exerted on the implant during insertion. Histological or allergic reaction resulting from implantation of a foreign material may occur. Nerve or soft tissue damage, necrosis of bone or bone resorption, necrosis of the tissue or inadequate healing may result from the presence of an implant or due to surgical trauma.


IMPORTANT INFORMATION ABOUT RibLoc® RIB FRACTURE PLATING SYSTEM

ACUTE Innovations RibLoc® Rib Fracture Plating System, including plates, screws and accessories, is designed for use in rib fractures, fusions or osteotomies.

Contraindication can be costal cartilage repair, active or latent infection, sepsis, osteoporosis, insufficient quantity or quality of bone/soft tissue, and material sensitivity. If sensitivity is suspected, tests are performed prior to implantation. Patients who are unwilling or incapable of following postoperative care instructions are contraindicated for this device. This device is not intended for screw attachment or fixation to the posterior elements (pedicles) of the cervical or lumbar spine.

Possible adverse effects can be pain, discomfort, or abnormal sensations due to the presence of an implant. Implant fracture, migration and/or loosening may occur due to excessive activity, prolonged loading upon the device, incomplete healing, or excessive force exerted on the implant during insertion. Metal sensitivity or histological or allergic reaction resulting from implantation of a foreign material may occur. Nerve or soft tissue damage, necrosis of bone or bone resorption, necrosis of the tissue or inadequate healing may result from the presence of an implant or due to surgical trauma.


IMPORTANT INFORMATION ABOUT RibLoc® U Plus CHEST WALL PLATING SYSTEM

ACUTE Innovations RibLoc® U Plus Chest Wall Plating System is intended to stabilize and provide fixation for fractures, fusions, and osteotomies of the ribs, and for reconstructions of the chest wall.

Contraindication can be active or latent infection, sepsis, insufficient quantity or quality of bone/soft tissue, and material sensitivity. If metal sensitivity is suspected, tests should be performed prior to implantation. Patients who are unwilling or incapable of following postoperative care instructions are contraindicated for this device. This device is not intended for screw attachment or fixation to the posterior elements (pedicles) of the cervical or lumbar spine.

Possible adverse effects can be pain, discomfort, or abnormal sensations due to the presence of an implant. Implant fracture, migration and/or loosening may occur due to excessive activity, prolonged loading upon the device, incomplete healing, or excessive force exerted on the implant during insertion. These types of adverse effects could lead to additional surgery and device removal. Nerve or soft tissue damage, necrosis of bone or bone resorption, necrosis of the tissue or inadequate healing may result from the presence of an implant or due to surgical trauma. A histological or allergic reaction resulting from the implantation of a foreign material in the body may occur. The implant contains metal that may induce an allergic reaction in patients with an allergy or sensitivity to metallic components.
Medical Disclaimers

The “Find a Surgeon” portion of this website is solely designed to assist you in identifying physicians who have completed formal training relating to the use of one or more of ACUTE Innovation’s products. These physician profiles provided are for informational purposes only. Your reliance upon any information in the physician profiles is solely at your own risk. By accessing such information, you assume full responsibility for the use of the information and agree that ACUTE Innovations is not responsible or liable for any claim, loss, or damage arising from the use of the information. The physicians listed in the “Find a Surgeon” portion of this website are in no way affiliated with or endorsed by ACUTE Innovations, nor can ACUTE Innovations speak to their abilities, qualifications or reputation. Moreover, ACUTE Innovations cannot be held liable for the accuracy of any the information contained in their profiles, or for your reliance on any such information. In light of the above, ACUTE Innovations expressly disclaims all liability or warranties of any kind related to your choice of physician should you choose to undergo surgery carried out by one of the physicians listed.

@ 2016 ACUTE Innovations LLC, Hillsboro, OR 97122. All product names, logos, brands, company names and other trademarks featured or referred to within the acuteinnovations.com website are trademarks™ or registered® trademarks of their respective holders. ACUTE Innovations®, AcuTie®, BioBridge® and RibLoc® are registered trademarks of ACUTE Innovations LLC. All rights reserved. This website and its information is intended for United States residents only. Countries outside the United States may have regulatory requirements that differ from the United States and, therefore, this information may be inappropriate for use outside the United States.