Patent ID: 12239348

DETAILED DESCRIPTION

In some cases of a broken rib, surgeons use plates and screws to bridge the fracture and to secure rib segments to each other. However, these plates and fasteners can be palpable to a patient and in some cases may be prone to catching on nearby soft tissues, causing further discomfort.

This disclosure provides a solution to these issues through use of an implant that includes stems and a body that are insertable into an intramedullary canal of the ribs. An implant that is insertable into the intramedullary canal can help reduce palpability. Further, the implant can include one or more components made of porous material configured to promote bone ingrowth with can help effect fixation of the implant to the ribs.

In some other cases, a nonunion of rib sections may occur due to damaged rib portions or improper healing. In these cases, a portion of the rib may require removal. To regain anatomical integrity between the rib segments and to protect organs directly behind the ribcage, surgeons can use donor bones from a cadaver or donor bone from the patient (such as from the patient's femur). In some of these cases, surgeons may use plates and screws to bridge the void and to fasten the rib segments and donor materials to each other. However, these plates and fasteners can be palpable to a patient and can in some cases catch on nearby soft tissues causing further discomfort. Also, a gap may remain when plates are used to bridge the gap. Further, when patients require use of donor bone material from themselves, there may be associated pain and suffering. For example, a patient may donate femoral bone for a rib fracture repair.

This disclosure provides a solution to these issues through use of an implant that includes a body configured to provide a substantially natural transition between resected rib sections. The implant can also include one or more components made of porous material configured to promote bone ingrowth which can help effect fixation of the implant to the ribs. The implant can further include plates, flanges, and fasteners to further secure the implant to the rib portions.

As used herein, the terms “proximal” and “distal” should be given their generally understood anatomical interpretation. The term “proximal” refers to a direction generally toward the torso of a patient or base or handle of a tool, and “distal” refers to the opposite direction of proximal, i.e., away from the torso of a patient or toward the working end of the tool.

FIG.1shows an isometric view of a rib implant coupled to a rib cage of a patient, in accordance with an example of the present disclosure.FIG.1shows rib cage50including ribs52A-52E and implant100. In some examples, rib cage50can be a rib cage of a human, such as a patient, where rib52E can be a fractured rib of rib cage50. In this example, rib implant100can be secured to adjacent ends of rib52E, which may be fractured and/or resected. Once secured to adjacent ends of rib52E, rib implant100can provide a bridge between rib portions. Further details of rib implant100are discussed below with respect toFIG.2.

FIG.2illustrates an isometric view of rib implant100secured to rib52E, in accordance with at least one example of this disclosure. Rib implant100can include body102, medial stem104, and lateral stem106. Also shown inFIG.2is rib52E, which can include medial end54and lateral end56. Medial end54can include intramedullary canal54IM and medial end56can include intramedullary canal56IM. Also shown inFIG.2are widths W1and W2and orientation indicators Medial and Lateral.

Rib implant100can be a rigid or semi-rigid member made of a single piece (or multiple pieces in some examples). Rib implant100can be made of solid biocompatible materials such as stainless steels, cobalt chromium, titanium, combinations thereof, or the like. In some examples, portions of rib implant100can be made of porous or semi-porous materials configured to promote bone ingrowth to enhance fixation (such as through osseointegration) of implant100to rib52E.

One porous material that can be used is OsseoTi™ porous metal from Zimmer Biomet™ (Warsaw, Ind.). OsseoTi can be made of Ti6Al4V and can have a porous structure that generally mimics a porous structure of human cancellous bone. Also, the porous material can be Trabecular Metal™, also from Zimmer Biomet. Such a material may be formed from a reticulated vitreous carbon foam substrate that can be infiltrated and coated with a biocompatible metal, such as tantalum, such as using a chemical vapor deposition (“CVD”) process in the manner disclosed in detail in U.S. Pat. No. 5,282,861. Also, the porous material can be Regenerex®, also from Zimmer Biomet. In other examples, other porous materials can be used.

Body102can be a rigid or semi-rigid member and can be sized to bridge medial end54and lateral end56of rib52E. In this example, body102can be sized to replace a portion of rib52E, such that body102abuts each of ends54and56, as shown inFIG.2. In some examples, body102can be sized and shaped to match a size and a shape of each of rib portion54and rib portion56to create a substantially uniform bridge between the first end and the second end. In other examples, body102can be sized to be inserted into an intramedullary canal of rib52E, as discussed below with respect toFIGS.3A-3C.

Medial stem104can be a portion of rib implant100extending medially from a medial face of body102. Similarly, lateral stem106can be a portion of rib implant100extending laterally from a lateral face of body102. In some examples, medial stem104and lateral stem106can be of various sizes. In the example ofFIG.2, medial stem104and lateral stem106can have a width that is smaller than a width W2, which can be smaller than a width W1of body102. This can allow medial stem104to be insertable into intramedullary canal54IM and can allow lateral stem106to be insertable into intramedullary canal56IM, as shown inFIG.2. In other examples, body102can have a width similar to that of W2so that body102can be inserted into both intramedullary canal54IM and intramedullary canal56IM.

In some examples, one or more of medial stem104and lateral stem106can include one or more barbs, or sharp directional projections, configured not to limit insertion of the stems into the intramedullary canals, and configured to engage the bone to help prevent back-out the stem from the rib portions. For example, a barb on medial stem104can help prevent back-out of medial stem104from rib portion54.

In some examples, one or more of medial stem104and lateral stem106can have consistent dimensions throughout a medial-to-lateral length of each of the medial stem104and lateral stem106, respectively. For example, when each of medial stem104and lateral stem106are substantially oval in geometric shape, each of medial stem104and lateral stem106can have a consistent width and height throughout the length. In other examples, either of of medial stem104and lateral stem106can be tapered throughout the medial-to-lateral length to help make insertion into intramedullary canal541M easier and to help ensure that each of medial stem104and lateral stem106can engage the bone of respective rib portions54and56.

In this example, body102can be made of solid biocompatible materials such as stainless steels, cobalt chromium, titanium, combinations thereof, or the like. Also, medial stem104and lateral stem106can each be made of, or coated with, porous or semi-porous materials configured to promote bone ingrowth to enhance fixation (such as through osseointegration), such as Trabecular Metal™, Regenerex®, or OsseoTi®, described above. In other examples, other porous materials can be used.

In operation of some examples, rib52E can be prepared to receive implant100. Preparations can include resecting rib52E, as discussed further below. When rib52E is ready to receive implant100, medial stem104can be inserted into intramedullary canal541M of rib portion54until a medial face of body102abuts a lateral face of rib portion54. In some examples, width wl can be sized to be substantially the same size as rib portions54and56to help limit translation of medial stem104and lateral stem106into respective intramedullary canals. Body102can help reduce palpability of implant100and catching of implant100on nearby soft tissues, by having width W1that is of similar size to rib portions54and56.

Once medial stem104is fully inserted into intramedullary canal541M, lateral stem106can be inserted into intramedullary canal56IM until a lateral face of body102contacts a medial face of rib portion56, limiting translation of lateral stem106into intramedullary canal561M and ensuring insertion of stem104into intramedullary canal54IM. In some examples, each of medial stem104and lateral stem106can engage each of intramedullary canal541M and intramedullary canal561M, respectively, in a press-fit (or interference fit) engagement. In these examples, width W2of each of medial stem104and lateral stem106can be sized to promote the press-fit engagement to secure implant100to rib portions54and56to provide support for rib52E.

After both of medial stem104and lateral stem106are secured within respective intramedullary canals, the procedure can be completed. Following the procedure, each of medial stem104and lateral stem106, being made of a porous material, can promote bone ingrowth from respective rib portions into medial stem104and lateral stem106to further secure medial stem104and lateral stem106to rib portions54and56, respectively. Because body102can be of a non-porous material, body102can help limit ingrowth of soft tissues into body102, to help increase patient comfort of implant100.

In other examples, each of medial stem104and lateral stem106can engage each of intramedullary canal541M and intramedullary canal56IM in other configurations, as discussed further in the examples below. Though installation of implant100is described above using the example of installing medial stem104first, lateral stem106can be installed first in some examples. In other examples, medial stem104and lateral stem106can be inserted simultaneously, such as when rib52E is a floating rib.

FIG.3Aillustrates an isometric view of fractured rib62, in accordance with at least one example of this disclosure.FIG.3Billustrates an isometric view of rib implant300, in accordance with at least one example of this disclosure.FIG.3Cillustrates an isometric view of a rib implant secured to a rib, in accordance with at least one example of this disclosure.FIGS.3A-3Care discussed together below.

FIGS.3A-3Cshow an example of a procedure of installing rib implant300in rib62. In some examples, implant300can be a splint configured to help fill a void between rib portions64and66. The previously discussed implants may be used in similar procedures.FIG.3Ashows rib62, which can include ends64and66with fracture68separating portions64and66.FIGS.3B and3Cshow implant300, which can include body302, medial stem304, lateral stem306, and fasteners308and310. Also shown inFIGS.3A-3Care orientation indicators Medial and Lateral.

In the example ofFIGS.3A-3C, implant300can be similar to implant100described above with respect toFIGS.1and2, except that body302can be sized to have a width such that body302can be insertable into intramedullary canals of rib portions64and66. As shown inFIG.3C, body302can be fully inserted into intramedullary canals of rib portions64and66to create a splint between rib portions64and66. In this example, each of medial stem304and lateral stem306are also inserted into rib portions64and66and can made of porous materials, such as those described above with respect toFIGS.1and2.

Body302can be made of either porous or non-porous materials. For example, body302can be made a porous or semi-porous material, such as Trabecular Metal™, Regenerex®, or OsseoTi®, described above. In some examples, body302can be non-porous, as described above with respect toFIGS.1and2to help limit soft tissue attachment and to help reduce friction during insertion. In some examples, implant300can be made of a resorbable material, or a material configured to be absorbed by the body over time. In one example, the resorbable material can be Lactosorb® of Zimmer Biomet™ (Warsaw, Ind.).

In other examples, for example when a gap between rib portions64and66(fracture68) is a small gap and when soft tissue attachment may be less of a concern, body302can be a made of a porous material, to help promote bone ingrowth into body302and implant300to help secure implant300to rib62.

In some examples, body302can be of the same width and height as medial stem304and lateral stem306, such that implant300(or the splint) can be of a consistent shape and size throughout an entire medial-to-lateral length of implant300.

In some examples, as shown inFIG.3C, fasteners308and310can be screws, bolts, rivets, or the like, configured to engage rib portions64and/or66and implant300. In one example, fastener308can engage rib portion64and body302and fastener310can engage rib portion66and body302to secure rib portions64and66to body302. In this way, fasteners308and310can help limit movement of implant300relative to rib portions64and66. ThoughFIG.3Cshows two of fasteners308and310, fewer fasteners, such as only fastener308or310can be used in some examples. In other examples, more fasteners can be used, such as 3, 4, 5, 6, 7, 8, 9, 10, or the like. In some example, pilot holes through rib portions64and/or66can be used and in other examples, pilot holes may not be used. Similarly, bores or holes in body302may or may not be used to receive fasteners308and310.

FIG.4Aillustrates an isometric view of rib72, in accordance with at least one example of this disclosure.FIG.4Billustrates an isometric view of fractured rib72and cut guide420, in accordance with at least one example of this disclosure.FIG.4Cillustrates an isometric view of resected rib72, in accordance with at least one example of this disclosure.FIG.4Dillustrates an isometric view of rib implant400, in accordance with at least one example of this disclosure.FIG.4Eillustrates an isometric view of rib implant400secured to rib72, in accordance with at least one example of this disclosure.FIG.4Fillustrates an isometric view of rib implant400fastened to rib72, in accordance with at least one example of this disclosure.

FIGS.4A-4Eshow an example of a procedure of installing rib implant400in rib72. Any of the previously discussed implants may be used in similar procedures.FIGS.4A-4C,4E, and4Fshow rib72, which can include rib portions74and76separated by fracture77(FIGS.4A and4B). Rib portion74can include resected end78and rib portion76can include resected end80(FIGS.4C,4E, and4F). Cut guide420(shown inFIG.4B) can be a part of a system including implant400, where cut guide420can include guides422(including slot426) and424(including slot428). Implant400(shown inFIGS.4D-4F) can include body402, medial stem404, and lateral stem406.

As shown inFIG.4A, rib72, which can be a rib of a patient, can have fracture77separating ends74and76. As shown inFIG.4B, cut guide420can be positioned relative to rib72, for example, such that guide422is on a medial side of fracture77(aligned with a portion of rib portion74) and guide424is on a lateral side of fracture77(aligned with a portion of rib portion76). In some examples, when cut guide420is in a desired position, a blade or saw can be passed through opening426of guide422to resect rib portion74at a desired location. Similarly, the blade or saw can be passed through opening428of guide424to resect rib portion76at a desired location. After resection, rib portion74can have resected end78and rib portion76can have resected end80. In some examples, guides422and424can be sized and shaped to create resected ends78and80, respectively, so that resected ends78and80are better suited to receive implant400.

Implant400can be similar to implant100described above with respect toFIGS.1-2, such that body402can be sized to have a width configured to engage resected ends78and80, respectively, of rib portions74and76. In some examples, substantially matching the width of body402to rib portions74and76(for example, by using cut guide420and/or by providing body402with a desired width) can help provide a relatively consistent profile across rib portion74, body402, and rib portion76, to help reduce palpability and to help provide a natural feel to a patient to help increase patient comfort.

As shown inFIGS.4E and4F, each of medial stem404and lateral stem406can be inserted into rib portions74and76and can made of porous materials, such as those described above with respect to stems104and106ofFIGS.1and2, to help promote bone ingrowth. In some examples, body402can be made of either porous or non-porous materials. In this example, body402can be non-porous, as described above with respect toFIGS.1and2, to help limit soft tissue attachment and to help reduce friction between body402and soft tissue.

Fasteners408and410are shown inFIG.4F, which can be screws, bolts, rivets, or the like. Though two fasteners are shown, a single fastener can be used in other examples. For example, only fastener408can be used to secure rib portion74to medial stem404. By keeping rib portion76free from lateral stem406, relatively small movement may occur following installation, which can help healing and proper setting, in some examples. In other examples, where it is desired that implant400not move at all (or move very little), two or more fasteners can be used to secure each of medial stem404and lateral stem406to rib portions74and76, respectively. In other examples, more than two fasteners can be used, such as 3, 4, 5, 6, 7, 8, 9, 10, or the like.

As shown inFIG.4F, fastener408can be sized to pass through rib portion74, through medial stem404, and into a portion of rib portion74but not extending beyond rib portion74(remaining within rib portion74). In other examples, fastener408can be sized to extend partially into medial stem404. Fastener410can be sized similarly to fastener408, in some examples.

FIG.5illustrates an isometric view of rib implant500secured to rib82, in accordance with at least one example of this disclosure. Rib implant500can include stems and can also include plates extending medially and laterally, where the plates engage an outer surface of the rib for affixing the implant to the rib using fasteners. Any of the previously discussed implants can be modified to include plates.

Rib implant500can include body502, medial stem504, lateral stem506, medial plate514, and lateral plate516. Medial stem504can include stem bore518and lateral stem506can include stem bore520. Medial plate518can include plate bores522and524and lateral plate520can include plate bores526and528. Also shown inFIG.5is rib82(including rib portions84and86) and orientation indicators Medial and Lateral.

Rib implant500can be similar to rib implants100and400discussed above in that body502can be sized to abut two resected ends of rib82to span rib portions84and86, such as to create a substantially uniform section of rib82. Rib implant500can differ, in one example, in that rib implant500can include medial plate514and lateral plate516. Medial plate514can extend medially from outer portion502A of body502. In some examples, medial plate514can be substantially parallel to medial stem504. Similarly, lateral plate516can extend laterally from outer portion502A of body502. In some examples, lateral plate516can be substantially parallel to lateral stem506.

In some examples, one or more of medial plate514and lateral plate516can have a peanut-shape from a top perspective with respect toFIG.5. That is, for example, a width of medial plate514can be smaller between bores522and524. This reduced width can help allow for medial plate514to be bent or shaped to match a contour of rib portion84. Lateral plate516can be optionally similarly configured.

Bores518and520of medial stem504and lateral stem506, respectively, can be configured to receive a fastener (such as a screw, rivet, bolt, or the like) therethrough. Similarly, each of bores522,524,526, and528can be configured to receive a fastener (such as a screw, rivet, bolt, or the like) therethrough. In some examples, bore522of medial plate514can be substantially aligned or coaxial with bore518of stem504such that bores522and518can receive a common fastener therethrough. Bores526of lateral plate516and520of lateral stem506can be similarly aligned to receive a common fastener. Also, bore524of medial plate514can receive a fastener therethrough and bore528of lateral plate516can receive a fastener therethrough. Though two bores of each of medial plate514and lateral plate516are shown, each of medial plate514and lateral plate516can include fewer bores, such as one each, or more bores, such as 3, 4, 5, 6, 7, 8, 9, 10, or the like.

In some examples, one or more of bores522,524,526, and528can be threaded bores. In some examples, the threading of bores522,524,526, and528can allow for each of bores522,524,526, and528to receive locking fasteners (such as a locking screw or bolt) to secure to each of bores522,524,526, and528to help prevent back-out of each fastener from medial stem504, medial plate514, lateral stem506, and/or lateral plate516.

Rib implant500can also differ in that body502can include an outer portion502A and inner portion502B. In some examples, outer portion502A can be, for example, a non-porous biocompatible material, which can be selected to help prevent soft tissue adhesion and reduce friction between body502and soft tissues. Inner portion502bcan be comprised of a porous or semi-porous material, such as Trabecular Metal™, Regenerex®, or OsseoTi®, which can help promote bone ingrowth from rib portions84and86into inner portion502B to enhance fixation (such as through osseointegration). In this way, body502can promote fixation of implant500to rib82while helping to reduce unwanted adherence of soft tissue to outer portion502A of body502.

FIG.6illustrates an isometric view of rib implant600secured to rib82, in accordance with at least one example of this disclosure. Rib implant600can include plates extending medially and laterally, where the plates engage an outer surface of the rib for affixing the implant to the rib using fasteners. Any of the previously discussed implants can be modified to include plates.

Rib implant600can include body602, medial plate614(including bores622and624) and lateral plate616(including bores626and628). Rib implant600can be similar to rib implant500, except that rib implant600does not include stems.

In operation of some examples, body602can be positioned between rib portions84and86to create a substantially uniform bridge therebetween. In these examples, fasteners can be passed through bores622,624,626, and/or628to affix medial plate614and lateral plate616(and therefore implant600) to rib portions84and86.

In the example ofFIG.6, body602can differ from body502in that body602can be made of only one material. For example, body602can be made of a non-porous material. Using only a single material for body602and plates614and616can help to reduce cost of implant600.

FIG.7Aillustrates an isometric view of rib implant700A secured to rib92, in accordance with at least one example of this disclosure. Rib implant700A can include a body having a cylindrical shape that can be bent by a surgeon to match a patient's anatomy such as a contour of the rib. Rib implant700A can also include one or more tapered stems to help ensure engagement between the stem and the intramedullary canal of the rib. Rib implant700A can also include one or more flanges on either side of the body to help limit translation of rib implant. Any of the previously discussed implants can be modified to include one or more tapered stems, flanges, and/or a body having a cylindrical shape.

Implant700A can include body702, medial stem704, lateral stem706, medial flange724, and lateral flange726. Also shown inFIG.7Ais rib82, which can include rib portions84and86. Rib portion84can include intramedullary canal84IM and rib portion86can include intramedullary canal86IM. Also shown inFIG.7Aare orientation indicators Medial and Lateral.

Body702can be a rigid or semi-rigid member having a substantially cylindrical geometric shape. Body702can be comprised of biocompatible materials that are relatively bendable, such as stainless-steel alloys, titanium alloys, and the like.

Medial flange724and lateral flange726can be flanges or end plates coupled to respective medial and lateral ends of body702. In some examples, medial flange724and lateral flange726can be formed of a single piece with body702and in other examples, medial flange724and lateral flange726can be secured to body702, such as through a welding process. Medial flange724and lateral flange726can be sized to abut respective rib portions84and86and to create a substantially uniform transition between medial flange724and lateral flange726and respective rib portions84and86. In some examples, medial flange724and lateral flange726can be sized to limit translation of implant700relative to rib82through contact between medial flange724and lateral flange726and rib portions84and86, respectively.

Stems704and706can extend medially and laterally, respectively, from medial flange724and lateral flange726and can taper as they extend away. In some examples, each of stems704and706can have multiple tapered portions of varying taper sizes and/or styles including Brown, Morse, Jarno, Jacobs, and the like tapers. In other examples, each of stems704and706can have a single taper. Each of stems the tapers of stems704and706can be sized and shaped to engage intramedullary canals84IM and861M, respectively, to ensure engagement between stems704and706and respective intramedullary canals84IM and861M. In some examples, each of stems704and706can be made of a porous or semi-porous material configured to promote ingrowth of rib portions84and86into stems704and706, respectively. Any of the porous materials discussed above can be used.

In operation of some examples, stem704can be inserted into rib portion84in a medial direction until flange714contacts a lateral end of rib portion84and/or until stem704contacts an inner width of cortical bone forming intramedullary canal84IM. Stem706can then be inserted into rib portion86in a similar manner. As in the examples discussed above, either of stems704and706can be inserted first and in some examples, stems704and706can be inserted simultaneously. Either prior to insertion of stems704and706or after insertion, body702can be bent, such as by a surgeon using a bending tool, such as a rod bender. Body702can be bent to help match a natural curvature of rib82, helping to improve respective alignment between stems704and706and intramedullary canals84IM and86IM, which can help improve comfort and can help secure implant700to rib82.

FIG.7Billustrates an isometric view of a rib implant secured to a rib, in accordance with at least one example of this disclosure. Rib implant700can include one or more plates and one or more fasteners extendable through the plates and into the rib. Any of the previously discussed implants can be modified to include one or more plates and/or fasteners.

Implant700B can include body702, medial stem704, lateral stem706, fasteners708and710, medial plate714, lateral plate716, medial flange724, and lateral flange726. Also shown inFIG.7Ais rib82, which can include rib portions84and86. Rib portion84can include intramedullary canal84IM and rib portion86can include intramedullary canal861M. Also shown inFIG.7Bare orientation indicators Medial and Lateral.

Implant700B can be similar to implant700A described above with respect toFIG.7A, except that implant700B can also include medial and lateral plates714and716and fasteners708and710. In some examples, medial plate714can extend medially from a substantially outer width or outer portion of medial flange724. Similarly, lateral plate716can extend medially from a substantially outer width or outer portion of lateral flange726. Each of medial and lateral plates714and716can include bores configured to receive fasteners therethrough. Fasteners708and710can be secured to medial and lateral plates714and716and to rib portions84and86in one or more ways.

As shown inFIG.7B, fastener708can extend through medial plate714into rib portion84. In some examples, fastener708can extend through cortical bone of rib portion84and into intramedullary canal841M In other examples, fastener708can extend through intramedullary canal84IM and into cortical bone on the opposite side of intramedullary canal84IM. In the example ofFIG.7B, fastener708can be adjacent to medial stem704to help limit translation of implant700relative to rib724. In some examples, a bore in medial plate714can guide the placement of fastener708relative to medial stem704.

As also shown inFIG.7B, fastener710can extend through lateral plate716(such as through a bore of lateral plate716) and into lateral stem706. In some example, fastener710can extend through lateral stem706. In either example, fastener710can help secure implant700B to rib82.

In some examples, bores in plates714and716can be recessed (similar to those of implant600so that fasteners708and710can be substantially flush relative to medial and lateral plates714and716to help reduce palpability of fasteners708and710.

FIG.8illustrates an isometric view of rib implant800secured to rib92, in accordance with at least one example of this disclosure. The example ofFIG.8can be similar to those discussed above where implant800is secureable to rib92, except that implant800is a multi-piece assembly. Implant800can include stem802, stem804, and coupler806. Also shown inFIG.8is rib92having rib portions94and96. Also shown inFIG.8are orientation indicators Medial and Lateral.

Each of stems802and804can be rigid or semi-rigid members comprised of biocompatible materials. In some examples, each of stems802and804can include a portion insertable into a rib portion, where the insertable portion can be made of a porous or semi-porous material configured to promote bone ingrowth. Each of stems802and804can be similarly sized (or can be of different sizes in some examples) and can be sized and shaped for engagement with coupler806. Coupler806can be a rigid or semi-rigid member configured to receive each of stems802and804therein and configured to secure each of stems802and804thereto such as through a clamping, threaded, or locking mechanism. In some examples, coupler806can slide over one or more of stems802and804for positioning of coupler806.

The multi-piece assembly of implant800can allow for individual insertion of stems802and804where a small gap (or fracture) between rib portions94and96is desired (or exists) and a single piece implant is difficult to secure within intramedullary canals of rib portions94and96.

FIG.9illustrates an isometric view of rib implant900secured to rib92, in accordance with at least one example of this disclosure. The example ofFIG.9can be similar to the example ofFIG.8discussed above, such that the member coupling the multi-piece assembly of implant900is a fastener, such as a screw or bolt.

Implant900can include medial stem902, lateral stem904, and coupler906. Medial stem902can include female end908and bore910. Lateral stem904can include male end912and bore914.

Each of stems902and904can be similar to those discussed above, except that medial stem902can include female end908located at a lateral portion of medial stem902, where female end908can be configured to receive male end912of lateral stem904therein to secure lateral stem904within medial stem902. Once lateral stem904is inserted into medial stem902, fastener906can be passed through bore910of medial stem902and bore914of lateral stem904to further secure medial stem902and lateral stem904. In some examples, fastener906can be excluded, such as where male end912and female end908engage in a threaded (or otherwise locking) fashion.

The multi-piece assembly of implant900can allow for insertion of stems902and904where a small gap (or fracture) between rib portions94and96is desired (or exists) and a single piece implant is difficult to secure within intramedullary canals of rib portions94and96.

FIG.10illustrates a schematic of method1000, in accordance with at least one example of this disclosure. Method1000can be a method of securing an implant to a rib of a patient. The steps or operations of method1000are illustrated in a particular order for convenience and clarity; many of the discussed operations can be performed in a different sequence or in parallel without materially impacting other operations. Method1000as discussed includes operations performed by multiple different actors, devices, and/or systems. It is understood that subsets of the operations discussed in method1000attributable to a single actor, device, or system could be considered a separate standalone process or method.

Method1000can begin at step1002where rib portions can be resected, such as rib portions74and76ofFIGS.4A-4F. In some examples, a resection may not be performed, such as with the steps shown inFIGS.3A-3C. At step1004, a first stem can be inserted into a first rib portion. For example, stem104can be inserted into rib portion54, as shown inFIG.2. At step1006, a second stem can be inserted into a second rib portion. For example, stem106can be inserted into rib portion56, as shown inFIG.2.

At step1008, a body of the implant can be inserted into the ribs. For example, body302can be inserted into rib portions64and66. In some examples where the body does abut the rib portions (as shown inFIG.2), step1008may not be performed. At step1010the implant can be secured to the ribs. For example, fasteners408and410can be secured to rib portions74and76and medial and lateral stems404and406to secure implant400to rib72.

EXAMPLES

The following, non-limiting examples, detail certain aspects of the present subject matter to solve the challenges and provide the benefits discussed herein, among others.

Example 1 is a rib implant securable to first and second rib portions of a rib, the rib implant comprising: a body the body including a first end and an opposite second end, the body configured to span a first rib portion of a rib at the first end and a second rib portion of the rib at the second end; a first porous stem extending from the first end of the body, the first porous stem insertable into a first intramedullary canal of the first rib portion; and a second porous stem extending from the second end of the body opposite the first porous stem, the second porous stem insertable into a second intramedullary canal of the second rib portion to secure, together with the first porous stem, the first rib portion and the second rib portion.

In Example 2, the subject matter of Example 1 optionally includes wherein the body is comprised of a porous material configured to promote bone ingrowth.

In Example 3, the subject matter of any one or more of Examples 1-2 optionally include wherein the body is comprised of a resorbable material.

In Example 4, the subject matter of any one or more of Examples 1-3 optionally include wherein one or more of the body, the first porous stem, and the second porous stem is comprised of Lactosorb.

In Example 5, the subject matter of any one or more of Examples 1-4 optionally include wherein the first porous stem is comprised of a porous material configured to promote bone ingrowth.

In Example 6, the subject matter of any one or more of Examples 1-5 optionally include wherein one or more of the body, the first porous stem, and the second porous stem is comprised of a material selected from a group consisting of Trabecular metal, Regenerex, and OsseoTi.

In Example 7, the subject matter of any one or more of Examples 1-6 optionally include wherein the body is comprised of a solid material and is sized and shaped to match a size and a shape of each of the first rib portion and the second rib portion to create a substantially uniform bridge between the first rib portion and the second rib portion.

In Example 8, the subject matter of any one or more of Examples 1-7 optionally include wherein the first porous stem is configured to create an interference fit with the first intramedullary canal.

In Example 9, the subject matter of any one or more of Examples 1-8 optionally include a fastener extendable through the first stem to secure the first stem to the first rib portion.

In Example 10, the subject matter of any one or more of Examples 1-9 optionally include a plate extending from the body substantially parallel to the first stem, the plate configured to engage a face of the first rib portion.

In Example 11, the subject matter of Example 10 optionally includes wherein the plate includes a plate bore and the first stem includes a stem bore substantially coaxial with the plate bore.

In Example 12, the subject matter of any one or more of Examples 1-11 optionally include a fastener extendable through the plate bore and the stem bore to secure the first stem and the plate to the first rib portion.

In Example 13, the subject matter of anyone or more of Examples 1-12 optionally include wherein the body comprises a substantially cylindrical rod.

In Example 14, the subject matter of Example 13 optionally includes wherein the rod is bendable to match a curvature of a rib of a patient.

In Example 15, the subject matter of any one or more of Examples 13-14 optionally include a flange secured to the body between the body and the first stem.

In Example 16, the subject matter of any one or more of Examples 13-15 optionally include wherein at least one of the first stem and second stem comprises a tapered extension.

Example 17 is a rib implant system comprising: an implant securable to a first rib portion of a rib and a second rib portion of the rib, the implant comprising: a body the body including a first end and an opposite second end, the body configured to span a first rib portion of a rib at the first end and a second rib portion of the rib at the second end; a first porous stem extending from the first end of the body, the first porous stem insertable into a first intramedullary canal of the first rib portion; and a second porous stem extending from the second end of the body opposite the first porous stem, the second porous stem insertable into a second intramedullary canal of the second rib portion to secure, together with the first porous stem, the first rib portion and the second rib portion.

In Example 18, the subject matter of Example 17 optionally includes a cut guide configured to guide resection of the first rib portion and the second rib portion so that the rib implant is positionable therebetween.

In Example 19, the subject matter of any one or more of Examples 17-18 optionally include a fastener securable to the first rib portion and the first stem to secure the rib implant to the first rib portion.

Example 20 is a rib implant securable to a medial rib portion of a rib and a lateral rib portion of the rib, the rib implant comprising: a first porous stem including a medial portion and a lateral portion, the medial portion insertable into a first intramedullary canal of the medial rib portion; and a second porous stem including a medial portion and a lateral portion, the lateral portion insertable into a lateral intramedullary canal of the lateral rib portion, the lateral portion of the first porous stem securable to the medial portion of the second porous stem to secure the medial rib portion and the lateral rib portion.

In Example 21, the subject matter of Example 20 optionally includes wherein the medial portion of the second porous stem is insertable into the lateral portion of the first porous stem.

In Example 22, the subject matter of any one or more of Examples 20-21 optionally include a coupler securable to the medial portion of the second porous and the lateral portion of the first porous stem.

In Example 23, the system, device, or method of anyone of or any combination of Examples 1-22 is optionally configured such that all elements or options recited are available to use or select from.

Additional Notes

The above detailed description includes references to the accompanying drawings, which form a part of the detailed description. The drawings show, by way of illustration, specific embodiments in which the invention can be practiced. These embodiments are also referred to herein as “examples.” Such examples can include elements in addition to those shown or described. However, the present inventors also contemplate examples in which only those elements shown or described are provided. Moreover, the present inventors also contemplate examples using any combination or permutation of those elements shown or described (or one or more aspects thereof), either with respect to a particular example (or one or more aspects thereof), or with respect to other examples (or one or more aspects thereof) shown or described herein.

In the event of inconsistent usages between this document and any documents so incorporated by reference, the usage in this document controls.

In this document, the terms “a” or “an” are used, as is common in patent documents, to include one or more than one, independent of any other instances or usages of “at least one” or “one or more.” In this document, the term “or” is used to refer to a nonexclusive or, such that “A or B” includes “A but not B,” “B but not A,” and “A and B,” unless otherwise indicated. In this document, the terms “including” and “in which” are used as the plain-English equivalents of the respective terms “comprising” and “wherein.” Also, in the following claims, the terms “including” and “comprising” are open-ended, that is, a system, device, article, composition, formulation, or process that includes elements in addition to those listed after such a term in a claim are still deemed to fall within the scope of that claim. Moreover, in the following claims, the terms “first,” “second,” and “third,” etc. are used merely as labels, and are not intended to impose numerical requirements on their objects.

The above description is intended to be illustrative, and not restrictive. For example, the above-described examples (or one or more aspects thereof) may be used in combination with each other. Other embodiments can be used, such as by one of ordinary skill in the art upon reviewing the above description. The Abstract is provided to comply with 37 C.F.R. § 1.72(b), to allow the reader to quickly ascertain the nature of the technical disclosure. It is submitted with the understanding that it will not be used to interpret or limit the scope or meaning of the claims. Also, in the above Detailed Description, various features may be grouped together to streamline the disclosure. This should not be interpreted as intending that an unclaimed disclosed feature is essential to any claim. Rather, inventive subject matter may lie in less than all features of a particular disclosed embodiment. Thus, the following claims are hereby incorporated into the Detailed Description as examples or embodiments, with each claim standing on its own as a separate embodiment, and it is contemplated that such embodiments can be combined with each other in various combinations or permutations. The scope of the invention should be determined with reference to the appended claims, along with the full scope of equivalents to which such claims are entitled.