Posts Tagged ‘injectable sternoplasty’

Would Injectable Kryptonite Be Good For My Sternal Deformity?

Friday, July 1st, 2011

Q: I have a minor case of pectus excavatum on the bottom of my sternum, although I do not believe it is causing me any physical problems such as breathing. I find its indentation to be very disturbing and affects my self-image. I was reading about the case study: Injectable Sternoplasty with Kryptonite Cone Cement on one of your websites and was wondering if this is the treatment would be good for me as I have about the same level of severity as shown in that person. I have had quite a difficult time researching any relevant plastic surgery options for treating this problem.

A: It is no surprise that you have had a difficult time finding any treatment options for minor to moderate sternal contour deformities as they really don’t exist. Short of treatment for more significant cases of pectus excavatum with the Nuss procedure or the older radical method of rib resection, there is no reported methods for sternal ‘augmentation’. In the past, plastic surgeons have occasionally used custom or carved implants for sternal augmentation but these required large incisions to place and were often associated with postoperatuve problems of seromas, infection or implant mobility. Whatever is placed on the sternum, it must be fixed and adhere to the bone to prevent these problems. This is why I have applied a cranioplasty approach to the sternum, specifically a Kryptonite injection approach. This material bonds to the bone and can flow through a very small tube for placement. In my experience with it I have learned that it takes less material than one thinks to fill a lower sternal indentation, usually less than 5 grams due to the expansion of the material

Dr. Barry Eppley

Indianapolis Indiana

 

Would Kryptonite Bone Cement Work for My Pectus Deformity?

Tuesday, August 31st, 2010

Q: I read in Dr. Eppley’s blog about using Kryptonite Bone Cement for pectus excavatum. I had the Nuss procedure done 5 years ago and breast implants done 4 years ago. I got very good results with the procedure and implants with the lower part of my ribs; however, the upper area (below the collarbone) is still indented. I would like to inquire about this procedure and whether or not I would be a viable candidate.

A: Kryptonite bone cement is a new type of bone filler/replacement that works well as an onlay, meaning to build out a bone surface to create a better contour. Currently it is approved in the United States for cranioplasty, the filling in or building out of skull bone contours. While it has never been formally tested for use on the sternum, there is no reason to think that it would not work just as well there as on the skull. What makes Kryptonite a possibility in the sternum is that it can be injected after it is mixed before it sets up into a hard mass. This is a very unique characteristic of a bone cement and no prior ones have ever had this physical property. As valuable as that material property is in the skull, it becomes a critical material characteristic in the sternum as incisions of any size are easily seen there.

For an upper sternal problem, a small incision inside the sternal notch can be used to develop the subperiosteal/supraperiosteal pocket. It is into this pocket that the material is injected and molded. The critical step in injectable sternoplasty, like injectable cranioplasty, is to make a good recipient pocket that matches the external outline of the contour defect.

Dr. Barry Eppley

Indianapolis, Indiana