Abstract:
An apparatus ( 10 ) for the correction of chest deformities is provided and includes a rib implant ( 26 ) for mounting to a rib, a sternal implant ( 22 ) for mounting to a sternum, and a first elongate member ( 24 ). The rib implant includes a first aperture ( 44 ) having a first axis ( 45 ). The sternal implant includes a second aperture ( 140 ) having a second axis ( 143 ). The first elongate member has a first end ( 152 ) adjustably received in the first aperture and a second end ( 150 ) adjustably received in the second aperture.

Description:
FIELD 
       [0001]    The present disclosure relates to a rib reconstruction device or assembly, and more particularly to a system for correcting abnormalities in a thoracic cavity, including defects in rib cage. 
       BACKGROUND 
       [0002]    This section provides background information related to the present disclosure and is not necessarily prior art. 
         [0003]    Defects, injuries and abnormalities in the thoracic cavity, including defects associated with the rib cage, chest wall, and sternum, can cause several problems and lead to long term complications. For example, defects in the thoracic cavity can restrict lung capacity and lead to difficulty breathing. Moreover, thoracic cavity defects leave many of the body&#39;s vital organs (e.g., lungs, heart, liver, etc.) susceptible to traumatic injury. These defects can arise from congenital deformities (e.g., pectus excavatum or hollow chest, Poland syndrome, fused ribs, etc.) or disease (e.g., cancer). In some cases, surgery may be required to correct the defects in the thoracic cavity. Known surgical techniques often use metal reconstructive devices or implants. The reconstructive devices are often fixed to existing tissue or bone, and focus primarily on small, localized defects in the thoracic cavity. In this regard, it may be desirable to provide a surgical system and method that allows a user to repair variously sized defects in the thoracic cavity, and/or repair the defects when the amount of available tissue and/or bone is limited. 
       SUMMARY 
       [0004]    This section provides a general summary of the disclosure, and is not a comprehensive disclosure of its full scope or all of its features. 
         [0005]    In one configuration, the present disclosure provides an apparatus for the correction of chest deformities. The apparatus includes a rib implant for mounting to a rib, a sternal implant for mounting to a sternum, and a first elongate member. The rib implant includes a first aperture having a first axis. The sternal implant includes a second aperture having a second axis. The first elongate member has a first end adjustably received in the first aperture and a second end adjustably received in the second aperture. 
         [0006]    In some configurations, the first axis is generally parallel to the second axis. 
         [0007]    In some configurations, the first axis is generally aligned with the second axis. 
         [0008]    In some configurations, the rib implant includes a third aperture having a third axis, and the rib is adjustably received in the third aperture. 
         [0009]    In some configurations, the third axis intersects the first axis. 
         [0010]    In some configurations, the third axis is generally parallel to the first axis. 
         [0011]    In some configurations, the rib implant includes a first channel configured to receive a first rib, the first channel including a third axis intersecting the second axis. 
         [0012]    In some configurations, the apparatus includes a suture member operatively securing the first rib within the first channel. 
         [0013]    In some configurations, the apparatus includes a plate member for clamping the rib between the plate member and the rib implant. 
         [0014]    In some configurations, the apparatus includes a second rib implant for mounting to a rib. The second rib implant can include a third aperture having a third axis. The sternal implant can include a fourth aperture having a fourth axis. A second elongate member can include a first end adjustably received in the third aperture and a second end adjustably received in the fourth aperture. 
         [0015]    In some configurations, the third and fourth axes are generally parallel to the first and second axes. 
         [0016]    In some configurations, the first rib implant includes a fifth aperture having a fifth axis, and the second rib implant includes a sixth aperture having a sixth axis. 
         [0017]    In some configurations, the fifth axis is generally parallel to the sixth axis and generally perpendicular to the third and fourth axis. 
         [0018]    In some configurations, the support member is disposed in the fifth and sixth apertures. 
         [0019]    In some configurations, the first elongate member is flexible. 
         [0020]    In another configuration, the present disclosure provides an apparatus for the correction of chest deformities. The apparatus includes a first bracket for mounting to a first rib, a second bracket for mounting to a second rib, a plate, and a sternal implant. The first bracket mounts to a first rib and includes a first rib-receiving aperture, a first rod-receiving aperture, and a first support member-receiving aperture. The first rib-receiving aperture includes a first rib-receiving axis. The first rod-receiving aperture includes a first rod-receiving axis generally perpendicular to the first rib-receiving axis. The first support member-receiving aperture includes a first support member-receiving aperture axis generally parallel to the first rod-receiving axis. The second bracket mounts to a second rib and includes a second rib-receiving aperture, a second rod-receiving aperture, and a second support member-receiving aperture. The second rib-receiving aperture includes a second rib-receiving axis. The second rod-receiving aperture includes a second rod-receiving axis generally perpendicular to the second rib-receiving axis. The second support member-receiving aperture includes a second support member-receiving aperture axis generally parallel to the second rod-receiving axis. The plate includes first and second channels and is operable to clamp the first rib in the first channel and in the first rib-receiving aperture, and clamp the second rib in the second channel and in the second rib-receiving aperture. The sternal implant is mounted to a sternum and includes a third rod-receiving aperture having a third rod-receiving axis. 
         [0021]    In yet another configuration, the present disclosure provides an apparatus for the correction of chest deformities. The apparatus includes a rib implant for mounting to a rib, a sternal implant for mounting to a sternum, and a rod member. The rib implant includes a rib-receiving aperture having a rib-receiving axis, a first rod-receiving aperture having a first rod-receiving axis, and a support member-receiving aperture having a support member-receiving axis extending in a direction substantially perpendicular to the rib-receiving axis and the first rod-receiving axis. The sternal implant includes a second rod-receiving aperture having a second rod-receiving axis extending in a direction substantially parallel to the rib-receiving axis and the first rod-receiving axis. The rod member includes a first end adjustably disposed in the first rod-receiving aperture and a second end adjustably disposed in the second rod receiving aperture. 
         [0022]    Further areas of applicability will become apparent from the description provided herein. The description and specific examples in this summary are intended for purposes of illustration only and are not intended to limit the scope of the present disclosure. 
     
    
     
       DRAWINGS 
         [0023]    The drawings described herein are for illustrative purposes only of selected embodiments and not all possible implementations, and are not intended to limit the scope of the present disclosure. 
           [0024]      FIG. 1  is a perspective view of a rib reconstruction assembly in accordance with the principles of the present disclosure; 
           [0025]      FIG. 2  is an exploded view of the rib reconstruction assembly of  FIG. 1 ; 
           [0026]      FIG. 3  is an end view of a plate of the rib reconstruction assembly of  FIG. 1 ; 
           [0027]      FIG. 4  is perspective view of a rib coupler or bracket for use with the rib reconstruction assembly of  FIG. 1 ; 
           [0028]      FIG. 5  is perspective view of another rib coupler or bracket for use with the rib reconstruction assembly of  FIG. 1 ; 
           [0029]      FIG. 6  is an exploded view of a plate subassembly for use with the rib reconstruction assembly of  FIG. 1 ; 
           [0030]      FIG. 7  is a perspective view of another plate subassembly for use with the rib reconstruction assembly of  FIG. 1 ; 
           [0031]      FIG. 8  is an end view of the plate subassembly of  FIG. 7 ; 
           [0032]      FIG. 9  is a perspective view of another rib reconstruction assembly in accordance with the principles of the present disclosure; and 
           [0033]      FIG. 10  is an exploded view of the rib reconstruction assembly of  FIG. 9 . 
       
    
    
       [0034]    Corresponding reference numerals indicate corresponding parts throughout the several views of the drawings. 
       DETAILED DESCRIPTION 
       [0035]    Example embodiments will now be described more fully with reference to the accompanying drawings. The terminology used herein is for the purpose of describing particular example embodiments only and is not intended to be limiting. As used herein, the singular forms “a,” “an,” and “the” may be intended to include the plural forms as well, unless the context clearly indicates otherwise. The terms “comprises,” “comprising,” “including,” and “having,” are inclusive and therefore specify the presence of stated features, integers, steps, operations, elements, and/or components, but do not preclude the presence or addition of one or more other features, integers, steps, operations, elements, components, and/or groups thereof. The method steps, processes, and operations described herein are not to be construed as necessarily requiring their performance in the particular order discussed or illustrated, unless specifically identified as an order of performance. It is also to be understood that additional or alternative steps may be employed. 
         [0036]    When an element or layer is referred to as being “on,” “engaged to,” “connected to,” or “coupled to” another element or layer, it may be directly on, engaged, connected or coupled to the other element or layer, or intervening elements or layers may be present. In contrast, when an element is referred to as being “directly on,” “directly engaged to,” “directly connected to,” or “directly coupled to” another element or layer, there may be no intervening elements or layers present. Other words used to describe the relationship between elements should be interpreted in a like fashion (e.g., “between” versus “directly between,” “adjacent” versus “directly adjacent,” etc.). As used herein, the term “and/or” includes any and all combinations of one or more of the associated listed items. 
         [0037]    Although the terms first, second, third, etc. may be used herein to describe various elements, components, regions, layers and/or sections, these elements, components, regions, layers and/or sections should not be limited by these terms. These terms may be only used to distinguish one element, component, region, layer or section from another region, layer or section. Terms such as “first,” “second,” and other numerical terms when used herein do not imply a sequence or order unless clearly indicated by the context. Thus, a first element, component, region, layer or section discussed below could be termed a second element, component, region, layer or section without departing from the teachings of the example embodiments. 
         [0038]    Spatially relative terms, such as “inner,” “outer,” “beneath,” “below,” “lower,” “above,” “upper,” and the like, may be used herein for ease of description to describe one element or feature&#39;s relationship to another element(s) or feature(s) as illustrated in the figures. Spatially relative terms may be intended to encompass different orientations of the device in use or operation in addition to the orientation depicted in the figures. For example, if the device in the figures is turned over, elements described as “below” or “beneath” other elements or features would then be oriented “above” the other elements or features. Thus, the example term “below” can encompass both an orientation of above and below. The device may be otherwise oriented (rotated  90  degrees or at other orientations) and the spatially relative descriptors used herein interpreted accordingly. 
         [0039]    With reference to  FIGS. 1 and 2 , a rib reconstruction assembly  10  is provided in accordance with the principles of the present disclosure. The rib reconstruction assembly  10  is shown operatively associated with a thoracic cavity  12 , including a plurality of ribs  14 , and a sternum  16 . The thoracic cavity  12  may include a first radius of curvature R 1  extending along, and at least partially defined by, one of the ribs  14 , and a second radius of curvature R 2  extending from and between at least two of the ribs  14 . As will be explained in more detail below, the rib reconstruction assembly  10  may be used to treat and repair defects and abnormalities in the thoracic cavity  12 , including abnormalities in the first and second radii of curvature R 1 , R 2 . By way of example only, the rib reconstruction assembly  10  may be used to treat such conditions as pectus excavatum, fractured or fused ribs, Poland syndrome, and oncological cases. 
         [0040]    The rib reconstruction assembly  10  may include a plate subassembly  20 , a sternal implant  22 , and an elongate member or rod  24 . The plate subassembly  20  may include a first rib implant or bracket  26 , a second rib implant or plate  28 , and a support member  30 . As will be explained in more detail below, in an assembled configuration, the plate subassembly  20  may be coupled to the sternal implant  22  and to at least one of the ribs  14 , while the sternal implant  22  may be coupled to the sternum  16 . 
         [0041]    The bracket  26  may include a body portion  32  and a flange portion  34 . The body portion  32  may extend from a proximal or lateral end  36  to a distal or medial end  38  along a first axis  40 . As illustrated, in some configurations, the body portion  32  may include a generally cylindrical construct. It will be appreciated, however, that the body portion  32  may include other shapes and configurations within the scope of the present disclosure. With reference to  FIG. 2 , the body portion  32  may further include a first aperture  42 , a second aperture  44 , and a slot or window  46 . The first aperture  42  may be formed in the lateral end  36  and may extend along the first axis  40  within the body portion  32 . As illustrated, in some configurations, the first aperture  42  may be a through-hole extending from and between the lateral and medial ends  36 ,  38  of the body portion  32 . In other configurations, the first aperture  42  may include a rib-receiving portion  42   a  extending along the first axis  40  from the lateral end  36 , and a fastener-receiving portion  42   b  extending along the first axis  40  from the medial end  38 . In this regard, the rib-receiving portion  42   a  and the fastener-receiving portion  42   b  may each extend partially through the body portion  32 . As will be explained in more detail below, the rib-receiving portion  42   a  of the first aperture  42  may be sized and shaped to receive one of the ribs  14 . The fastener-receiving portion  42   b  may be sized and shaped to receive a set screw  47  or other suitable fastener for securing the rod  24  within the second aperture  44 . In this regard, the fastener-receiving portion  42   b  may be internally threaded. 
         [0042]    The body portion  32  may further include a porous plasma layer or coating  49  formed within the rib-receiving aperture  42 . The porous plasma coating  49  can help to promote bone ingrowth between the bracket  26  and the rib  14 , and thus help to secure the bracket  26  to the rib  14 . 
         [0043]    The second aperture  44  may be formed near the medial end  38  of the body portion  32  and extend along a second axis  45 . The second aperture  44  may be sized and shaped to receive the rod  24 . Accordingly, references herein to the rod-receiving aperture  44  will be understood to mean the second aperture  44 . The second aperture  44  may be formed between the medial end  38  and the window  46 , and may extend from an upper side  48  (relative to the view in  FIG. 1 ) of the body portion  32  to a lower side  50  of the body portion  32 . As illustrated, the second aperture  44  may be a through-hole, such that the second aperture  44  may intersect, or otherwise be in communication with, the first aperture  42 . In this regard, in some configurations the second axis  45  may extend in a direction substantially perpendicular to the first axis  40 . As illustrated in  FIG. 2 , the second aperture  44  may include a serrated portion  54  for gripping or otherwise helping to secure the rod  24  within the second aperture  44 . 
         [0044]    The window  46  may be formed in the body portion  32  between the lateral end  36  and the second aperture  44 . In this regard, the window  46  may be formed in a front or anterior side  60  (relative to the view in  FIG. 1 ) of the body portion  32 , and may be at least partially defined by a first sidewall  62  and a second sidewall  64  opposing the first sidewall  62 . The first and second sidewalls  62 ,  64  may be substantially planar and spaced such that the plate  28  can be disposed within the window  46 , as will be explained in more detail below. The window  46  may open into, or otherwise be in communication with, the first aperture  42 . 
         [0045]    As illustrated in  FIG. 2 , the flange portion  34  of the bracket  26  may be coupled to the body portion  32 . In some configurations, the flange portion  34  may be integrally and monolithically formed with the body portion  32 . In this regard, the flange portion  34  may be coupled to, and/or extend from, a rear or posterior side  68  (relative to the view in  FIG. 1 ) of the body portion  32 , in a direction substantially perpendicular to the first axis  40 . The flange portion  34  may include a third aperture  70 . The third aperture  70  may be a through-hole extending in a direction substantially perpendicular to the first aperture  42  and substantially parallel to the second aperture  44 . The third aperture  70  may be sized and shaped to receive the support member  30 . Accordingly, references herein to the support member-receiving aperture  70  will be understood to mean the third aperture  70 . 
         [0046]    The plate  28  may extend from a proximal end  76  to a distal end  78 , and may include a first lateral side  82 , a second lateral side  84 , an anterior side  86 , and a posterior side  88 . The second lateral side  84  may oppose the first lateral side  82 , such that a distance between the first and second lateral sides  82 ,  84  is substantially equal to, or slightly less than, a distance between the first and second sidewalls  62 ,  64  of the window  46 . In this regard, in the assembled configuration, the plate  28  may be disposed within the window  46 , as illustrated in  FIG. 1 . 
         [0047]    The anterior side  86  of the plate  28  may include a convex curvature extending from the proximal end  76  to the distal end  78 , such that in the assembled configuration the anterior side extends at least partially about the first axis  40 . In this regard, it will be appreciated that the anterior side  86  may define a radius of curvature R 3 . The radius of curvature R 3  may be substantially equal to the second radius of curvature R 2  of the thoracic cavity  12 . 
         [0048]    The posterior side  88  of the plate  28  may include at least one groove or channel  92  formed therein. As illustrated in  FIG. 2 , in some configurations the posterior side  88  may include three channels  92 . It will be appreciated, however, that the posterior side  88  may include more or fewer than three channels  92  within the scope of the present disclosure. The channel  92  may extend from and between the first and second lateral sides  82 ,  84 , and may be sized and shaped to receive one of the ribs  14 . 
         [0049]    The plate  28  may further include at least one through-hole or aperture  96  extending from and between the anterior and posterior sides  86 ,  88 . As illustrated, the aperture  96  may extend between adjacent channels  92 , such that the aperture  96  does not intersect the channel  92 . In some configurations, the aperture  96  may include a counterbore portion  98  to receive a head portion  100  of a fastener  102  (e.g., screw or bolt). 
         [0050]    The bracket  26  and/or the plate  28  may be manufactured using an additive manufacturing process, such as three-dimensional printing. In this regard, the bracket  26  and/or the plate  28  may be constructed from a suitable biocompatible material, such as a biocompatible polymer. A method of manufacturing the bracket  26  and/or the plate  28  may include obtaining an image of a patient&#39;s thoracic cavity  12 , including the sternum  16  and the ribs  14 . The image may be produced from an X-ray, an MRI, an ultrasound, or other suitable image capturing technique. The image may include data representing certain characteristics of the thoracic cavity  12  (e.g., radius R 1 , radius R 2 , etc.) and/or data representing certain characteristics of the ribs  14  (e.g., shapes, sizes, location, etc.). In some configurations, the data may include a fourth radius of curvature of one or more of the ribs  14 . The image, and/or the data representing the image, may be communicated to an additive manufacturing machine (e.g., a three-dimensional printer). The additive manufacturing machine may manipulate or otherwise use the data in order to produce a bracket  26  and/or a plate  28  having characteristics (e.g., shape, size, etc.) that match, or are otherwise compatible with, the certain characteristics of the thoracic cavity  12  and/or the ribs  14  of the patient. In this way, the bracket  26  and/or the plate  28  can be manufactured or otherwise customized for a specific patient, such that the rib-receiving portion  42   a  of the bracket  26  and/or the channels  92  of the plate  28  match, or are otherwise compatible with, the characteristics of the patient&#39;s ribs  14 . For example, as illustrated in  FIG. 3 , a fourth radius of curvature R 4  of at least one of the channels  92  may be substantially equal to a fifth radius of curvature R 5  of a least one of the ribs  14 . While the manufacturing process is described herein as being an additive manufacturing process, it will also be appreciated that the bracket  26  and/or the plate  28  may be manufactured, or otherwise customized, using other suitable manufacturing processes, such as injection molding, machining, and casting. 
         [0051]    The support member  30  may extend from a proximal end  110  to a distal end  112 . While the support member  30  is illustrated as having a generally cylindrical construct, it will be appreciated that the support member  30  may include other shapes within the scope of the present disclosure. In this regard, the support member  30  may be sized and shaped such that the support member  30  can be received by and through the third aperture  70  of the bracket  26 . In this regard, in the assembled configuration, the support member  30  may be disposed within the third aperture  70  such that the support member  30  extends substantially perpendicular to the first axis  40 . The support member  30  may further include at least one through hole or aperture  116 . The number of apertures  116  may equal the number of apertures  96  formed in the plate  28 , such that the fasteners  102  extend through the apertures  96  and through the apertures  116  to secure the plate  28  to the support member  30 . In this regard, the aperture  116  may include a threaded portion  118  to threadingly engage a threaded portion  119  of the fastener  102 . 
         [0052]    The sternal implant  22  may include a sternum-receiving portion  120  and a rod-receiving portion  122 . The sternum-receiving portion  120  may include a first or anterior arm  124  and a second or posterior arm  126 . The first and second arms  124 ,  126  may define a channel or cavity  128  therebetween. As illustrated, the cavity  128  may define a U-, C- or J-shaped cross section. In this regard, the cavity  128  may be sized and shaped to receive the sternum  16  between the first and second arms  124 ,  126 . In the assembled configuration, the first arm  124  may be disposed on an anterior side of the sternum  16 , and the second arm  126  may be disposed on the posterior side of the sternum  16 . 
         [0053]    The first arm  124  may include at least one through-hole or aperture  130 . As illustrated, in some configurations, the first arm  124  may include eight apertures  130 . It will be appreciated, however, that the first arm  124  may include more or fewer than eight apertures  130  within the scope of the present disclosure. In this regard, the apertures  130  may be arranged in a series of rows and/or columns. The apertures  130  may be sized and shaped to receive a suture  132  or other suitable fastener (e.g., screw or bolt) for securing the sternal implant  22  to the sternum  16 . 
         [0054]    The second arm  126  may include at least one through-hole or aperture  134 . As illustrated, in some configurations, the second arm  126  may include eight apertures  134 . It will be appreciated, however, that the second arm  126  may include more or fewer than eight apertures  134  within the scope of the present disclosure. In this regard, the apertures  134  may be arranged in a series of rows and/or columns. The apertures  134  may be sized and shaped to receive the suture  132  or other suitable fastener (e.g., screw or bolt) for securing the sternal implant  22  to the sternum  16 . As will be explained more detail, below, the suture  132  may extend from the apertures  130  of the first arm  124  to the apertures  134  of the second arm  126  to secure the sternal implant to the sternum  16 . 
         [0055]    The rod receiving portion  122  may be integrally formed with the sternum receiving portion  120 . In this regard, the rod receiving portion  122  and the sternum receiving portion  120  may define a monolithic construct. The rod receiving portion  122  may include first through-hole or aperture  140  and a second through-hole or aperture  142 . The first aperture  140  may extend along a third axis  143 . As will be explained in more detail, below, the first aperture  140  may be sized and shaped to receive the rod  24 . Accordingly, references herein to the rod-receiving aperture  140  will be understood to mean the first aperture  140 . In this regard, in some configurations, the first aperture  140  may include a substantially cylindrical construct. The second aperture  142  may extend in a direction substantially perpendicular to the third axis  143 , and may intersect or otherwise communicate with the first aperture  142 . The second aperture  142  may include a threaded portion  144  for threadingly receiving the set screw  47  to help secure the rod  24  within the first aperture  140 . 
         [0056]    The sternal implant  22  may be manufactured using an additive manufacturing process, such as three-dimensional printing. In this regard, the sternal implant  22  may be constructed from a suitable biocompatible material, such as a biocompatible polymer. A method of manufacturing the sternal implant  22  may include obtaining an image of a patient&#39;s thoracic cavity  12 , including the sternum  16 . The image may be produced from an X-ray, an MRI, an ultrasound, or other suitable image capturing technique. The image may include data representing certain characteristics of the thoracic cavity  12  (e.g., radius R 1 , radius R 2 , etc.) and/or data representing certain characteristics of the sternum  16  (e.g., shape, size, location, etc.). The image, and/or data representing the image, may be communicated to an additive manufacturing machine (e.g., a three-dimensional printer). The additive manufacturing machine may manipulate or otherwise use the data in order to produce or construct a sternal implant  22  having characteristics (e.g., shape, size, etc.) that match, or are otherwise compatible with, the certain characteristics of the thoracic cavity  12  and/or the sternum  16 . In this way, the sternal implant  22  can be manufactured or otherwise customized for a specific patient. For example, the characteristics of the first arm  124  and/or the second arm  126  can be customized such that the cavity  128  of the sternal implant  22  matches, or is otherwise compatible with, the characteristics of the patient&#39;s sternum  16 . While the manufacturing process is described herein as being an additive manufacturing process, it will also be appreciated that the sternal implant  22  may be manufactured, or otherwise customized, using other suitable manufacturing processes, such as injection molding, machining, and casting. 
         [0057]    The rod  24  may be an elongate, flexible member having a lateral or proximal end  150  and a medial or distal end  152 . In this regard, the rod  24  may define a length L between the proximal and distal ends  150 ,  152 . The rod  24  may be formed from a flexible metallic material, such as steel, for example. It will also be appreciated that the rod  24  may be formed from other flexible materials within the scope of the present disclosure. In some configurations, the rod  24  may be the “connecting rod  18 ” disclosed in commonly owned U.S. patent application Ser. No. 14/253,917, the disclosure of which is incorporated herein by reference in its entirety. As will be explained in more detail below, in the assembled configuration, the rod  24  may be disposed and secured to the plate subassembly  20  and the sternal implant  22 . 
         [0058]    As illustrated in  FIG. 1 , in the assembled configuration, the plate subassembly  20  may be secured to the rib  14 , and the sternal implant  22  may be secured to the sternum  16 . The rod  24  may be secured to the plate subassembly  20  and to the sternal implant  22  in the manner described above. Specifically, the rib  14  may be disposed within the rib-receiving aperture  42  of the bracket  26 . The plate  28  may be disposed within the window  46 , such that the rib  14  is secured between the plate  28  and the bracket  26 . In this regard, the fastener  102  may be placed within the aperture  96  of the plate  28  and within the aperture  116  of the support member  30  to secure the plate  28  to the support member  30 , and to clamp the rib  14  between the plate  28  and the bracket  26 . The sternum  16  may be disposed and secured within the cavity  128  of the sternal implant  22 . The suture  132  may be disposed within the apertures  130  of the first arm  124  and the apertures  134  of the second arm  126 , and wrapped around the sternum  16 , to secure the sternal implant  22  to the sternum  16 . 
         [0059]    The rod  24  may be bent or otherwise configured to have a pre-determined or desired shape. In this regard, the rod  24  may be bent to have a radius of curvature substantially equal to the desired radii of curvature R 1  and/or R 2  of the thoracic cavity  12 . Thereafter, the proximal end  150  of the rod  24  may be placed within the first aperture  140  of the sternal implant  22 , and the distal end  152  of the rod  24  may be placed within the second aperture  44  of the bracket  26 . The set screws  47  may be assembled within the second aperture  142  and the second portion  42   b  of the first aperture  42  to secure the rod  24  to the sternal implant  22  and the bracket  26 , respectively. In the assembled configuration, the second axis  45  may be substantially aligned with, or otherwise parallel to, the third axis  143 . 
         [0060]    It will be appreciated that a distance between the bracket  26  and the sternal implant  22 , as measured along the second axis  45 , can be adjusted by changing the location of the sternal implant  22  relative to the sternum  16  and/or by changing the location of the bracket  26  relative to the ribs  14 . As the distance between the bracket  26  and the sternal implant  22  is adjusted along the second axis  45 , the length L of the rod  24  can be adjusted such that the distal end  152  of the rod  24  may be secured within the second aperture  44  of the bracket  26 , and the proximal end  150  of the rod  24  may be secured within the first aperture  140  of the sternal implant  22 . In some configurations, the rod  24  can be trimmed or otherwise cut, such that the distal end  152  of the rod  24  can be secured within the second aperture  44 , and the proximal end  150  of the rod  24  may be secured within the first aperture  140 . In this regard, it will also be appreciated that the rod  24  can translate, or otherwise be adjusted, within the second aperture  44  in a direction substantially parallel to the second axis  45 , and/or translated, or otherwise be adjusted, within the first aperture  140  in a direction substantially parallel to the third axis  143 , such that the distal end  152  of the rod  24  can be secured within the second aperture  44 , and the proximal end  150  of the rod  24  may be secured within the first aperture  140 . In this way, the rib reconstruction assembly  10 , including the flexible or bendable rod  24 , can allow a surgeon to effectively treat and repair variously-sized defects and abnormalities in the thoracic cavity  12 , including defects in the radius of curvatures R 1 , R 2 . (i.e., horizontally extending defects and vertically extending defects). 
         [0061]    With reference to  FIG. 4 , another bracket  26   a  is provided that may be used with the rib reconstruction assembly  10 . In this regard, one or more brackets  26   a  may be used in place of, or in combination with, one or more brackets  26 . The structure and function of the bracket  26   a  may be similar or identical to the structure and function of the bracket  26  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0062]    The bracket  26   a  may include a second window  160  formed in the posterior side  68   a  of the body portion  32   a.  The window  160  may extend from the lateral end  36   a  to the flange portion  34 , such that the body portion  32   a  defines a U-shaped cross section extending from the lateral end  36   a  to the flange portion  34 . 
         [0063]    With reference to  FIG. 5 , another bracket  26   b  is provided that may be used with the rib reconstruction assembly  10 . In this regard, one or more brackets  26   b  may be used in place of, or in combination with, one or more brackets  26  or  26   a.  The structure and function of the bracket  26   b  may be similar or identical to the structure and function of the bracket  26  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0064]    The bracket  26   b  may include a second window  160   b  formed in the anterior side  68   b  of the body portion  32   b.  The window  160   b  may extend from the lateral end  36   b  to the window  46 , such that the body portion  32   b  defines a C-shaped cross section extending from the lateral end  36   b  to the window  46 . 
         [0065]    With reference to  FIG. 6 , another plate subassembly  20   c  is provided. As will be explained in more detail below, the plate subassembly  20   c  may be used with the sternal implant  22  and the rod  24 . The structure and function of the plate subassembly  20 c may be similar or identical to the structure and function of the plate subassembly  20  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0066]    The plate subassembly  20   c  may include a first rib implant or bracket  26   c  and a second rib implant or plate  28   c.  The bracket  26   c  may include a plate portion  170  and a flange portion  172 . The plate portion  170  may extend from a proximal end  176  to a distal end  178 , and may include a first lateral side  182 , a second lateral side  184 , an anterior side  186 , and a posterior side  188 . The second lateral side  184  may oppose the first lateral side  182 . The anterior side  186  of the plate portion  170  may include at least one groove or channel  192  formed therein. As illustrated in  FIG. 5 , in some configurations the anterior side  186  may include two channels  192 . It will be appreciated, however, that the anterior side  186  may include more or fewer than two channels  192  within the scope of the present disclosure. The channel  192  may extend from and between the first and second lateral sides  182 ,  184 , and may be sized and shaped to receive one of the ribs  14 . 
         [0067]    The plate portion  170  may further include at least one through-hole or aperture  196  extending from and between the anterior and posterior sides  186 ,  188 . As illustrated, the aperture  196  may extend between adjacent channels  192 , such that the aperture  196  does not intersect the channel  192 . The aperture  196  may include a threaded portion  204  to receive the stem portion  106  of the fastener  102 . 
         [0068]    The flange portion  172  may extend from a lateral end  206  to a medial end  208  along a first axis  210 . The lateral end  206  may be adjacent and/or integrally formed with, the second lateral side  184  of the plate portion  170 . 
         [0069]    As illustrated, in some configurations, the flange portion  172  may include a generally cylindrical construct. It will be appreciated, however, that the flange portion  172  may include other shapes and configurations within the scope of the present disclosure. The flange portion  172  may further include a first aperture  212  and a second aperture  214 . The first aperture  212  may be formed in the medial end  208  and may extend substantially parallel to the first axis  210  within the flange portion  172 . The first aperture  212  may be sized and shaped to receive the set screw  47 . Accordingly, in an assembled configuration, the set screw  47  can directly engage the distal end  152  of the rod  24 , to secure the rod  24  within the aperture  214 . 
         [0070]    The second aperture  214  may extend in a direction substantially perpendicular to the first axis  210 . In this regard, the second aperture  214  may be formed between the lateral and medial ends  206 ,  208  of the flange portion  172 . In this regard, the second aperture  214  may be a through-hole, such that the second aperture  214  may be in communication with the first aperture  212 . The second aperture  214  may include a serrated portion  218 . 
         [0071]    The plate  28   c  or the plate  28  may be used with the bracket  26   c.  In this regard, the structure and function of the plate  28   c  may be similar or identical to the structure and function of the plate  28  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0072]    The posterior side  88   c  of the plate  28   c  may include at least one groove or channel  92   c  formed therein. As illustrated, in some configurations the posterior side  88   c  may include two channels  92   c.  It will be appreciated, however, that the posterior side  88  may include more or fewer than three channels  92 c within the scope of the present disclosure. In this regard, it will be appreciated that the number of channels  92   c  may correspond to the number of channels  192  in the plate portion  170  of the bracket  26   c,  such that a rib  14  can be clamped within and between the channels  92   c,    192 . 
         [0073]    The plate  28   c  may further include at least one through-hole or aperture  96   c  extending from and between the anterior and posterior sides  86   c,    88   c.  As illustrated, the aperture  96   c  may extend between adjacent channels  92   c,  such that the aperture  96   c  does not intersect the channel  92   c.  In an assembled configuration, the apertures  96   c  may be aligned with the apertures  196  in the plate portion  170 . 
         [0074]    With reference to  FIGS. 7 and 8 , another rib reconstruction assembly  10   d,  including a first rib implant or bracket  26   d  is provided. As will be explained in more detail below, the bracket  26   d  may be used with the sternal implant  22  and the rod  24 . The structure and function of the bracket  26   d  may be similar or identical to the structure and function of the bracket  26   c  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0075]    The bracket  26   d  may include a plate portion  170   d  and the flange portion  172 . The plate portion  170   d  may extend from a proximal end  176   d  to a distal end  178   d,  and may include an anterior side  186   d  and a posterior side  188   d.    
         [0076]    The anterior side  186   d  may include at least one groove or channel  192   d  formed therein. The distal end  178   d  may include a flange  230  extending from the anterior side  186   d  of the plate portion  170   d.  The flange  230  may include at least one aperture  232  extending therethrough. As illustrated, in some configurations the flange  230  may include three apertures. It will be appreciated, however, that the flange portion may include more or fewer than three apertures within the scope of the present disclosure. 
         [0077]    The plate portion  170   d  may further include at least one through-hole or aperture  196   d  extending from and between the anterior and posterior sides  186   d,    188   d.  As illustrated, the aperture  196   d  may extend between adjacent channels  192   d,  such that the aperture  196  does not intersect the channel  192   d.  In this regard, the plate portion  170   d  may include three apertures  196  disposed between the proximal end  176   d  and a first channel  192   d,  and six apertures  196  disposed between the first channel  192   d  and a second channel  192   d.  It will be appreciated, however, that the plate portion  170   d  may include more or fewer than the aforementioned number of apertures disposed between the proximal end  176   d  and the first channel  192   d,  and between the first channel  192   d  and the second channel  192   d.  In an assembled configuration, the ribs  14  may be disposed within the channels  192   d.  The sutures  132  may extend through the apertures  196 , and around the ribs  14 , to secure the ribs  14  to the bracket  26   d.    
         [0078]    The bracket  26   d  may be manufactured using an additive manufacturing process, such as three-dimensional printing. In this regard, the bracket  26   d  may be constructed from a suitable biocompatible material, such as a biocompatible polymer. A method of manufacturing the bracket  26   d  may include obtaining an image of a patient&#39;s thoracic cavity  12  in the manner described above. The image may include data representing certain characteristics of the ribs  14 , such as a radius of curvature. The image, and/or data representing the image, may be communicated to an additive manufacturing machine (e.g., a three-dimensional printer). The additive manufacturing machine may manipulate or otherwise use the data in order to produce a bracket  26   d  having characteristics (e.g., shape, size, etc.) that match, or are otherwise compatible with, the certain characteristics of the patient&#39;s thoracic cavity  12  and/or ribs  14 . In this way, the bracket  26   d  can be manufactured or otherwise customized for a specific patient. 
         [0079]    With reference to  FIGS. 9 and 10 , another rib reconstruction assembly  10   e  is provided. The rib reconstruction assembly  10   e  is shown operatively associated with the thoracic cavity  12 , including the plurality of ribs  14 , and the sternum  16 . As will be explained in more detail below, the rib reconstruction assembly  10   e  may be used to treat large defects in the thoracic cavity  12 . 
         [0080]    The rib reconstruction assembly  10   e  may include a sternal implant  22   e,  the rod  24 , a bracket  26   e,  and the support member  30 . The structure and function of the sternal implant  22   e  may be similar or identical to the structure and function of the sternal implant  22  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0081]    The sternal implant  22   e  may include a sternum receiving portion  120   e  and a rod receiving portion  122   e.  The sternum receiving portion  120   e  may include a first arm  124   e  and a second arm  126   e.  The first and second arms  124   e,    126   e  may define an L-shaped cross section, shaped to receive the sternum  16  between the first and second arms  124   e,    126   e.  In this regard, the second arm  126   e  may extend from a distal end  240  to a proximal end  242  in a first direction. 
         [0082]    The proximal end  242  may be adjacent to, and integrally formed with, the first arm  124   e.  In the assembled configuration, the first arm  124   e  may be disposed on an anterior side of the sternum  16 , and the second arm  126   e  may be disposed on a lateral side of the sternum  16 . 
         [0083]    The first arm  124   e  may include at least one through-hole or aperture  130   e.  As illustrated, in some configurations, the first arm  124   e  may include four apertures  130   e.  It will be appreciated, however, that the first arm  124   e  may include more or fewer than four apertures  130   e  within the scope of the present disclosure. In this regard, the apertures  130   e  may be arranged in a series of rows and/or columns. The apertures  130   e  may be sized and shaped to receive the suture  132  or a suitable mechanical fastener  241  (e.g., screw or bolt) for securing the sternal implant  22   e  to the sternum  16 . 
         [0084]    The rod-receiving portion  122   e  may extend from, and be integrally formed with, the second arm  126   e.  In this regard, the rod-receiving portion  122   e  may include a flanged portion of the sternal implant  22   e.  The rod-receiving portion  122   e  and the sternum receiving portion  120   e  may define a monolithic construct. The rod-receiving portion  122   e  may include at least one first through-hole or aperture  140   e  extending along a third axis  143   e.  As will be explained in more detail, below, the first aperture  140   e  may be sized and shaped to receive the rod  24 . In the assembled configuration, the first aperture  140   e  may extend in a substantially horizontal direction, relative to the view in  FIG. 9 . 
         [0085]    The structure and function of the bracket  26   e  may be similar or identical to the structure and function of the bracket  26  described above, apart from any exceptions described below and/or shown in the figures. Accordingly, similar features will not be described again in detail. Like reference numerals are used hereinafter and in the drawings to identify like components, while like reference numerals containing letter extensions are used to identify those components that have been modified. 
         [0086]    The bracket  26   e  may include a rod-receiving portion  244 . The rod-receiving portion  244  may be coupled to, or otherwise integrally formed with, the bracket  26 e. The rod-receiving portion  244  may be formed near the medial end  38   e  of the bracket  26   e,  and may include a seat portion  246 , a first arm  248  and a second arm  250 . The seat portion  246 , the first arm  248 , and the second arm  250  may define a rod-receiving aperture or channel  252 . In the assembled configuration, the rod  24  may be disposed within the channel  252 , such that the rod  24  engages the seat portion  246 . The first arm  248  and the second arm  250  may include a threaded portion  260  for threadably mating with a set screw  264  or other suitable fastener. As will be explained in more detail below, in an assembled configuration, the set screw  264  can secure the rod  24  within the rod-receiving channel  252 , such that the rod  24  extends from the sternal implant  22  in a substantially horizontal direction. 
         [0087]    As illustrated, in the assembled configuration, the proximal end  110  of the support member  30  may be adjustably received within the third aperture  70  of a first bracket  26   e,  and the distal end  112  of the support member  30  may be adjustably received within the third aperture  70  of a second bracket  26   e.  A first rod  24  may be adjustably received within the rod-receiving channel  252  of the first bracket  26   e  and within one of the first apertures  140   e  of the sternal implant  22   e.  Similarly, a second rod  24  may be adjustably received within the rod-receiving channel  252  of the second bracket  26   e  and within another of the first apertures  140   e  of the sternal implant  22   e.  In this regard, the support member  30  may extend in a substantially vertical direction (relative to the view in  FIG. 9 ), and the first and second rods  24  may extend in a substantially horizontal direction (relative to the view in  FIG. 9 ). The rods  24  may be secured within the first apertures  140   e  using a set screw, a press fit configuration, or any other suitable technique. 
         [0088]    A distance between the sternal implant  22   e  and the rod-receiving portion  244  of the bracket  26   e,  as measured along the third axis  143   e,  may be adjusted by changing the location of the sternal implant  22   e  relative to the sternum  16  and/or by changing the location of the bracket  26   e  relative to the rib  14 . As the distance between the rod-receiving portion  244  and the sternal implant  22   e  is adjusted, the length of the rod  24  can be adjusted, such that the proximal end  150  of the rod  24  may be secured within the rod-receiving channel  252  of the bracket  26   e,  and the distal end  152  of the rod  24  may be secured within the first aperture  140   e  of the sternal implant  22   e.  In some configurations, the rod  24  can be trimmed or otherwise cut, such that the proximal end  150  of the rod  24  can be secured within the rod-receiving channel  252 , and the distal end  152  of the rod  24  may be secured within the first aperture  140   e.  In this regard, it will also be appreciated that the rod  24  can translate, or otherwise be adjusted, within the second rod-receiving channel  252  in a direction substantially parallel to the third axis  143   e,  and/or translate, or otherwise be adjusted, within the first aperture  140   e  in a direction substantially parallel to the third axis  143   e,  such that the proximal end  150  of the rod  24  can be secured within the rod-receiving channel  252 , and the distal end  152  of the rod  24  can be secured within the first aperture  140   e.  Similarly, the support member  30  can be slid or otherwise moved within the third aperture  70  of a first bracket  26   e,  such that a distance between brackets  26   e,  as measured along in a direction substantially perpendicular to the third axis  143   e,  can be adjusted. In this way, the rib reconstruction assembly  10   e,  including the flexible or bendable rod  24  and the adjustable support member  30 , can allow a surgeon to effectively treat and repair variously-sized defects and abnormalities in the thoracic cavity  12 , including defects in the radius of curvatures R 1 , R 2  (i.e., horizontally extending defects and vertically extending defects). 
         [0089]    The foregoing description of the embodiments has been provided for purposes of illustration and description. It is not intended to be exhaustive or to limit the disclosure. Individual elements or features of a particular embodiment are generally not limited to that particular embodiment, but, where applicable, are interchangeable and can be used in a selected embodiment, even if not specifically shown or described. The same may also be varied in many ways. Such variations are not to be regarded as a departure from the disclosure, and all such modifications are intended to be included within the scope of the disclosure. 
         [0090]    Example embodiments are provided so that this disclosure will be thorough, and will fully convey the scope to those who are skilled in the art. Numerous specific details are set forth such as examples of specific components, devices, and methods, to provide a thorough understanding of embodiments of the present disclosure. It will be apparent to those skilled in the art that specific details need not be employed, that example embodiments may be embodied in many different forms and that neither should be construed to limit the scope of the disclosure. In some example embodiments, well-known processes, well-known device structures, and well-known technologies are not described in detail.