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SPiN Thoracic Navigation System® used for Precise Sternal Fracture Localization

LOCALIZATION OF STERNAL FRACTURE WITH SPIN PERC®
Author
Dr. Karen Gersch

Cardiothoracic Surgeon

Trident Medical Center

Charleston, SC

Patient Information: 24 y/o, F

Scan Protocol: Veran Inspiration/Expiration CT Scan Protocol

Instruments Used: Always-On Tip Tracked® Guidewire and SPiN Perc® Navigated Stylet

Conclusion: Successful localization and fixation of sternal fracture

Observations

“Similar to my use of Veran of localizing rib fractures for minimally invasive plating, I wanted to make the incision as small as possible for this young patient.”

Patient History
This young patient was involved in a car accident where her sternum was completely fractured. Weeks later, she was still experiencing persistent pain around the fracture site. She was referred to Dr. Gersch for a surgical fixation of the fracture to help the healing process.

Planning
The vPads® were placed on the patient’s chest with the main pad two inches to the right of the midline, contralateral to the fracture site on the left. The patient was scanned in the supine position using Veran CT scan protocol. Upon reviewing the CT scan, Dr. Gersch identified and dropped a 10mm sphere to mark the exact location of the fracture site using SPiN Planning® software.

Procedure
The patient was taken to the operating room for the sternal fixation procedure. After the patient was positioned and prepped for surgery, Dr. Gersch first used the Always-On Tip Tracked® Guidewire to perform endobronchial registration. The procedure transitioned to SPiN Perc® for cutaneous localization of the sternal fracture in order for Dr. Gersch to accurately plan her incision site. Using the SPiN Perc® navigated stylet, she marked the location of the fracture on the patient’s skin. This process took a total of only 5 minutes. After incision, Dr. Gersch noted the sternal fracture was readily identified with spot-on correlation with the cutaneous marking. Without localization, Dr. Gersch noted she would have made her incision superior to the actual fracture, causing a larger incision and more invasive surgery. The fracture site was successfully fixated and plated.

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