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Case Reports
. 2024 Apr 1;49(4):268-271.
doi: 10.30476/ijms.2023.97060.2873. eCollection 2024 Apr.

The World's First Implantation of a Personalized Microporous Titanium Sternum with Motile Costal Clip Connections: A Case Report

Ilya V Kolobaev  1 , Denis Baranovskii  1   2 , Vladimir Usachev  1 , Grigoriy Afonin  1 , Oleg Aleksandrov  3 , Anna Usacheva  1 , Ilya D Klabukov  2   4 , Peter Shegay  4 , Sergei Ivanov  1 , Andrey Kaprin  2   4
Affiliations
Case Reports

The World's First Implantation of a Personalized Microporous Titanium Sternum with Motile Costal Clip Connections: A Case Report

Ilya V Kolobaev et al. Iran J Med Sci. .

Abstract

Extensive chest wall defects occur in 28% of all sternal resection cases and are a major challenge in thoracic surgery. These cases are generally considered "critical defects" requiring primary or secondary reconstruction using various types of flaps, mesh repairs, bone autografts, or endoprosthesis. The past decade witnessed rapid advances in the application of personalized endoprostheses in thoracic surgery. Surgeons began to use carbon or titanium grafts for personalized sternum replacement. The main advantages of these implants are superior cosmetic effect, biocompatibility, and low risk of infection. Herein, we present a case of a 55-year-old patient with an indication for extended sternum resection due to metastatic thyroid cancer. The patient underwent extended sternum resection, followed by the implantation of a personalized microporous titanium sternum equipped with graspers for atraumatic rib fixation.

Keywords: Bone replacement; Sternum; Thoracic surgery; Titanium.

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Conflict of interest statement

None declared.

Figures

Figure 1
Figure 1
CT scan of the patient before surgery is illustrated. (a): Axial view of the anterior chest wall deformed by a massive tumor located in the manubrium sternum. (b): Sagittal view of the tumor soft tissue mass involving the jugular notch and expanding to the retrosternal.
Figure 2
Figure 2
The personalized microporous titanium sternum designed for sternum replacement of the patient. (a): General view of the crab-shaped prosthesis with two perforated pincers on each side. (b): The lower part of each pincer is fixed to the prosthesis, while the upper part pivoted from a fixed rivet, allowing easy clip on the rib end after implantation.
Figure 3
Figure 3
Three-dimensional simulation of the implant and the chest CT scan of the patient two years after surgery. (a): The model (green color) marks the exact resection area of the ribs and sternum (red color). (b): Overall appearance of the implant shows no evidence of deformation. (c) An axial view of the rib ends shows that the implant has remained fully fixed.
See this image and copyright information in PMC

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