Synthes VEPTR, Техническое руководство

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Fused ribs and scoliosis
After superior and inferior points of attachment have been
chosen, perform an opening wedge thoracostomy through
the fused ribs at the apex of the thoracic deformity from the
tip of the transverse process to the costochondral junction.
Cut a transverse osteotomy from the transverse process to
the sternum, in the line of the normal rib.
4
Distract chest wall if necessary
Required instruments
Standard Vein Retractor
U22-64010 Retractor, longitudinal, single,
with ratchet lock and two joints
388.486 Foot for Rib Retractor No. U22-64010
399.100 Bone Spreader, speed lock, width 8 mm,
length 210 mm
399.130 Bone Spreader, speed lock, width 12 mm,
length 270 mm
Assemble the Feet for Rib Retractor to the Retractor. Distract
ribs using the Rib Retractor assembly as needed. Bone
Spreaders in conjunction with Vein Retractors can also be
used to gently distract the chest wall at the site of an open-
ing wedge thoracostomy.
Additional resection of medial fused ribs may be required if
distraction is difficult.
Only resect visible bone adjacent to the spine. Be aware of
anomalous arteries due to the abnormal anatomy.
Primary Procedure
Separate the fusion mass into multiple longitudinal sections
of the approximate width of normal ribs in the patient.
Ensure the continuity between the anterior and posterior at-
tachments of the newly separated ribs.
26 Synthes VEPTR Technique Guide