SternaLock Blu

FEA

FINITE ELEMENT ANALYSIS computerized method for predicting how a product reacts to real-world forces, vibration, heat, fluid flow, and other physical affects

what are sterna lock blu plates made of

IV titanium

Emergency screws

Magenta 2.7mm self-tapping

what cut is the MICS for?

T cuts ONLY

design for screws to increase pull-out strength

accomplished by having larger threads at an angle and depth to maximize purchase into cancellous bone

at what months in the restore study did the patients receive ct scan

at 3 OR 6 months, NOT both

greater thread pitch?

bigger gap between threads

what study said wire pull through with the force of coughing?

cadaver study

in what study was there a plated sternum fail?

cadaver study, due to rib fracture or intercostal tearing

why can't the wires or plates touch?

corrosion, two metals interacting

objective of "sternal closure with rigid plate fixation versus wire closure: a randomized controlled multi center trial"

evaluate sternal bone healing and pain in patients with multiple risk factors undergoing open heart surgery via a median sternotomy

restore study objective

evaluate sternal bone healing and pain in patients with multiple risk factors undergoing open heart surgery vis. a median sternotomy

what does FEA show

finite element analysis shows whether a product will break, wear out or work the way it was designed

SternaLock Blu indication

intended for us in the stabilization and fixation of fractures of the anterior chest wall including -sternal fixation following sternotomy and reconstructive surgical procedure to promote fusion 1. sternal closure following variety of open heart surgeries 2.sternal revisions 3.Primary/Secondary traverse fracture fixation 4. Rib fixation

cadaver study looked at lateral...

lateral distraction, rostro-caudal shear, and anterior/posterior ahead using a pneumatic test

how do you measure sternum during MICS?

measuring caliper

rigid fixation results in superior...what study talks about animals

mechanical stability and fixation compared to wire circlage ...important of sternal approximation and mechanical stability in bone healing

MICS

minimally invasive closure system

how to ensure full approiximaiton of transverse sternotomy?

rostra-caudal alignment of superior sternotomy

up down alignments

rostro/caudal

what does grater threw distance in a screw accomplish?

slows for less bone displacement

chamfered edges

smooth

what pattern to insert screws

star or cross pattern

main points of restore

sternal healing was superior in rigid plate fixation patients at both 3 and 6 month -complication rates similar between groups -25% reductio in pain and narcotic usage

science behind rigid sternal fixation purpose

tell the story of rigid fixation FEA talks about RESTORE study-sternalock resulted in superior bone healing compared to wire cerclage in a prospective randomized trial.

the science behind rigid sternal fixation

the purpose of the paper is to tell the story of rigid sternal fixation

sternal closure with rigid plate: randomized controlled multi center trial" .. did they have more complications or less than wire cerclage?

the same complication rates, BUT plates had a 25% reduction in pain, narcotic use and 70% of rigid fixation patient achieve stern union vs 24% at 6 months

FEA study

the science behind rigid sternal fixation

paper with FEA

the science behind rigid sternal fixation

locking mechanism screw head

the smaller threads under the screw head are the locking mechanism

what are sterna lock blu screws made of

titanium alloy

A cadaveric, biomechanics analysis of sternal fixation systems objective

to compare the mechanical performance of rigid fixation vs- wire cerclage in cadavers sternum

cadaveric study details

using rigid plate fixation in two different configuration compared to writing using 3 trans-sternal and 5 peri-sternal wires.

main talking points of "sterna approximation and mechanical stability in bone healing"

wire work at approximating but do not provide mechanical stability. wire technique makes no difference plates provide enhanced mechanical strength and stiffness, which supports bone healing

can sternalock be used with osteoporosis?

yes

gold screws sternalock

-2.4mm -self-drilling lengths: 8, 10, 12, 14, 16, 18, 20

sterna lock blu screw design

-designed for cancellous bone to increase pull-out strength

"The Importance of Sternal Approximation and Mechanical Stability in Bone Healing' objective

-establish the role that approximation and rigid fixation play in bone healing -introduce CT scans to demonstrate the differences in bone healing seen between plates and wires. talks about animals

12 steps technique for plating

1. Expose sternum 2. Completed Mid-Line Sternotomy 3. Complete surgical procedure 4. assess bone and mark transverse fractures 5. Measure sternal depth where plate placement will occur and record measurements 6. wire the manubrium and zypohoid to reduce the top and bottom of the sternum 7. compete the full approximation by placing reduction forceps at the mid-boy 8. direct soft tissue from surface of sternum 9. select plate/screw configuration 10. contour partes as needed to ensure they lay flat on the sternum 11. fixate plate, inserting screws in a star pattern 12. seat screws and complete chest closure

4 step MICS procedure

1. approximate superior stern atomy with wires, and then use hexagon plate and appropriate length screws to stabilize the manubrium 2. The assemble device: lay the MICS plate on flat surface and position the instrument footplate int eh center of the plate. Turn the locking set screw clockwise with the manual driver to secure the plate to the instrument. 3. Postion plate inferior of the transverse sternotomy and implant screws. Pull the instrument superior to approximate transverse and implant remaining screws. 4. Continue pulling on the instrument until all screws have been implanting.

SternaLock Blu vs. wires

1. increased strength and stiffness 2. increased mechanical stability 3. reduced sternal separation 4. superior bone healing 5. reduced pain and narcotic usage

Plates profile

1.6mm

how many patients in the restore study

146

profile plate with screw

2.4

if a doctor is using a ruler to measure sternum how many mm do you add

2mm

separation of more than ..... can lead to non-union

2mm

plate for mini-thoracotomatie

4/8 hole straight plate

plate to use in mini-sternotomies

8 hole JL plate