The use of artificial bones in the construction of

the rib cage

A surgical team at Bagedo and Dr. Irfan General Hospital in Jeddah succeeded in eradicating a malignant tumor from the front wall of the chest, the size of an orange with an extension of 10-15 cm, then reshaping and rebuilding the chest cage by artificial bone, and making a muscle graft to cover the bones. The patient, who is 75 years old, came to the hospital suffering from a recurrent tumor in the thyroid gland (it was removed about 3 years ago), but he had not been following up his illness since that date, which caused the tumor to return and to enlarge and enlarge.

And with the formation of a surgical team to study the case and develop a treatment plan by Dr. Abdullah Hussein Awad, consultant of general surgery and organ transplantation and the chief physician at the hospital, Dr. Diauddin Abu Al-Saud, consultant cardiothoracic surgery, Dr. Muhammad Abdul Rahman Salem, consultant anesthesia, and a team of surgeons assistants. The patient was prepared before the surgery by performing the necessary tests, breathing functions, and CT scans of the chest and neck, which showed the large size of the tumor that had penetrated the chest bone, which is the first rib and the collar bone on the sides of the chest and the cage bone from the front and center of the chest, and from the inside adjacent to the aorta (aorta) and arteries The arms and their veins, as well as the arteries, nerves and veins of the neck, and the tumor was connected to the muscles of the neck, causing the patient to be unable to move the head to the left or right.

Surgery

The surgery, which took about five hours, began with an accidental wound in the neck, through which Dr. Abdullah Awad successfully partially removed the tumor from the trachea and neck muscles successfully from the upper part. Then the part of chest surgery began by removing the cancerous tumor from the left and right neck arteries, by performing the surgery from the same previous opening. But due to the large size of the tumor, a longitudinal incision was made to the middle of the cage bone in the middle of the chest, and the conversation was by Dr. Diaa Al-Sayed Abu Al-Saud, a consultant cardiothoracic surgery, in order to be able to remove half of the collar bone from the right and the left and then remove the first rib from both sides, and it was also partial, in order to reach For the remaining part of the tumor, which is the posterior part adjacent to the aorta and the right and left part adjacent to the arteries, veins and nerves of the arms, successfully.

It became clear from the progress of the surgery that the tumor had penetrated into the bone, so the bone was removed up to the healthy areas, in order to ensure the complete eradication of the cancerous cells, then half of the bone of the cage was removed, then the tumor was completely removed after ensuring that no cancer cells or parts remained in the place of the operation.

As a result of the complete removal of the cancerous tumor, an empty space of tissue and bone was found approximately half the front of the front chest. Then Dr. Diaa Al-Din Abu Al-Saud detailed the replacement prosthetic part using artificial bones after detailing a new sternum, as well as two ribs and two clavicle bones in a manner that fits the remaining empty space and ensures that the functional and cosmetic aspect of the rib cage is preserved from causing any permanent impairment as a result of cancer eradication.

Artificial bones

The replacement prosthetic part has been detailed by Gentamycin Bone Cement within a strong network of Proline by making an artificial medical bone on a "sandwich", which means two layers of proline, between which the medical cement is, after drawing and designing the native prosthetic part that is characterized by its solidity and durability to match the bone Natural after about 8-9 minutes only. Then this artificial part was fixed to the remaining natural bones at the front of the anterior thoracic wall and the cage bone by a surgical thread and an iron wire made of stainless steel completely so that it is similar to the natural bone in terms of steel, durability and function as well.

As for the last part of this surgery, which is the cosmetic part, it was also performed by Professor Diaa Al-Din Abu Al-Saud, by creating a skin muscle patch by extending it from the sides of the chest in order to cover the part covered with artificial bone, and this was already done, after placing another network of Medical proline between the left and right pectoral muscles group, and it was fixed in this group by Dr. Abdullah Awad, which increased the rigidity and durability of the new front wall of the rib cage and preserved both the full function, as well as the aesthetic aspect of the chest. The neck muscles were also fixed again in the bones, which helps the patient after the operation to move the head and neck left and right again.