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Novel Repair of Disruption of the Costal Margin without associated
Diaphragmatic Hernia
Renée M. Tholey, Christine E. Feldmeier, Michael J. Walker
Eastern Cardiothoracic Surgery Society Annual Meeting
October 23-26, 2013
Patient Case Presentation
• We present a case of a 58 year old man with right-sided rib pain and shortness of breath following a fall on his left side.
• On physical exam there was an obvious disruption of the right anterior costal margin with a large separation between the eighth and ninth ribs causing chest wall instability.
Patient Case Presentation
• CT Chest demonstrated a herniation of lung between the eighth and ninth ribs.
• There was no evidence of a diaphragmatic hernia.
Patient Case Presentation• Our patient was taken to the operating room where a
novel technique was used to re-approximate and stabilize the eighth and ninth ribs by employing two Sternal Talon® devices.
Patient Case Presentation
• We put forth this case report as both a rare occurrence of costal margin disruption in the absence of diaphragmatic hernia, as well as a novel and never-reported technique to repair this abnormality.
• Stabilization of the patient’s chest wall provided relief of his pain, as well as improved lung mechanics.