Percutaneous Rib Fixation Using Tether-Guided Bone Plate
Find Innovative SolutionsGenerate Solutions
Solution Overview
Problem
Current methods for repairing fractured ribs are invasive, leading to significant surgical trauma, lengthy recovery times, and complications such as muscle loss, blood loss, and damage to neurovascular bundles due to the difficulty in stabilizing rib fractures with existing fixation devices.
Innovation Solution
A minimally invasive system and method using percutaneous incisions and a trocar to deliver a bone plate and fastener assembly through the pleural space, with a tether guiding and securing the components to the rib, allowing for stabilization with minimal risk to neurovascular anatomy and reduced surgical time.
Engineering Contradictions & Design Principles
Engineering Contradiction Analysis
1Reliability
If traditional open surgical fixation methods are used to stabilize rib fractures, then reliable fixation can be achieved, but significant surgical trauma, blood loss, and damage to neurovascular bundles occur due to large incisions and extensive tissue dissection
Solution Approach 1:
The surgical approach is segmented into multiple small incisions rather than one large incision. Trocars are inserted through separate small incisions to access different aspects of the rib fracture site, allowing fixation to be performed through distributed minimal access points rather than extensive open exposure
Solution Approach 2:
Trocars serve as intermediary tools that facilitate access to the rib fracture site through small incisions. These intermediaries allow surgical instruments to reach the target area without requiring large direct exposures, thereby reducing surgical trauma while maintaining fixation capability
2Ease of operation
If large incisions are made to accommodate fixation devices and visualize rib segments, then adequate exposure for plate placement is achieved, but surgical time increases and muscle function is compromised
Solution Approach 1:
The surgical procedure is divided into discrete steps performed through separate small incisions with dedicated tools for each function (trocar insertion, rib exposure, plate placement). This segmentation allows efficient performance of each task through minimal access points, reducing overall surgical time compared to maintaining a large incision throughout the procedure
Solution Approach 2:
Trocars are inserted and positioned before rib exposure and plate placement. This preliminary action establishes the minimal access pathways needed for subsequent steps, allowing the surgery to proceed efficiently through pre-established small incisions rather than requiring large incisions for all operations
3Reliability
If conventional fixation devices are used to stabilize rib fractures, then bone segments can be secured, but the thin rib cortex and soft marrow make reliable fixation problematic under breathing cycles and coughing
Solution Approach 1:
The fixation approach is adapted to the local quality of rib anatomy. The thin cortex and soft marrow are accommodated by using fixation methods that distribute stress appropriately and do not require deep penetration or high mechanical strength that would compromise the fragile rib structure
Solution Approach 2:
The fixation strategy changes parameters to match rib characteristics. Instead of using high-strength rigid fixation that would damage thin cortex, the approach uses methods suitable for soft marrow and thin bone, accommodating the specific mechanical properties of ribs rather than imposing standard fixation parameters
Data Source
AI summary
A bone repair system and method for percutaneously fixing a first bone segment to a second bone segment, such as rib bone segments, in a body of a patient include drilling a first hole through the first bone segment and a second hole through the second bone segment, and feeding a first tether through the first hole and a second tether through the second hole, each tether having a proximal end and a distal end. The first and second tether distal ends are withdrawn from the body while the first and second tether proximal ends have not passed through the first and second bone segments, respectively. A reinforcing member, such as a bone plate, having first and second openings, is passed onto the first and second tether distal ends, and the reinforcing member is pulled into engagement with the first and second bone segments guided by the tethers. The reinforcing member is secured to the first bone segment with a first fastener assembly through the first hole and the first opening and to the second bone segment with a second fastener assembly through the second hole and the second opening to fix the first bone segment to the second bone segment.