A new company started by a Sanford Health trauma surgeon is developing a prototype of his invention that’s designed to be a less-invasive way to surgically treat serious cases of broken ribs.
The investigational device, invented by Steven Briggs, M.D., also earned a $20,000 proof-of-concept award from the South Dakota Governor’s Office of Economic Development funding because of its potential.
Rib fractures are one of the most common trauma injuries in the U.S., comprising nearly 10% of such cases. Surgeons currently repair them by screwing a plate onto the bone to hold the rib in place so it heals properly.
“It works very well but does require an incision that is quite significant, at times, to accomplish it,” Dr. Briggs said. “So what does the next evolution of surgical stabilization of ribs look like? I kept coming back to the hollow space in the middle of the rib. It’s there on every rib. Is there a way to utilize that canal to stabilize the rib such that you don’t need to make the big incision to put a plate on it?”
It’s that type of problem-solving and creative thinking that helps improve patient care, said Rick Evans, a research project manager on the Sanford Health Innovation and Commercialization team.
“Dr. Briggs has approached our team on several occasions with unique solutions to issues he has encountered in his clinical practice. He is always looking to solve the problems, often in ways that have not been attempted before. The intramedullary rib fracture repair device is a promising technology and I look forward to seeing the future development of the concept,” Evans said.
He helped Dr. Briggs tap the University of South Dakota Technology Readiness Acceleration Center (TRAC) program, which connects graduate students with industry inventors to help develop intellectual property. Ryan Oines, director of strategic projects in TRAC, now handles operations and finance for Dr. Briggs’ startup, Blue Sky Medical Devices.
“The concept of Blue Sky is to hopefully build a commercialization pathway,” Oines said. “Why I think it’s important for him to be able to do that is obviously we want to keep him in the OR (operating room). We want him to keep saving lives. But we also want to take his idea and create the operational components to the business.
“It’s very exciting that we can take a technology that’s come directly from the operating room and now hopefully vet out the idea and let it get more refined through prototype development and other areas of technology development and build a pathway to commercialization.”
Dr. Briggs initially came up with three possible options using drill bits and wire. Blue Sky this year partnered with Merge Medical Device Studio, which is building a new prototype by pulling elements from all three designs.
Limited options for rib fracture
Most people who suffer a broken rib recover without surgery. For the more serious fractures, doctors have this new option called rib fixation surgery, which involves reconnecting the fractured bone and placing a titanium plate across the fracture site to hold it in place and restore the chest wall anatomy.
“With surgical stabilization of rib fractures, what we’ve found is that by doing an intervention, we can significantly reduce the pain. We can significantly reduce the disability that goes with rib fractures for a period of time. The patient’s back on their feet quicker, more active, and can get back to their normal life faster,” Dr. Briggs said.
But there are limitations with the plate, said Tung Nguyen, a USD master’s of business administration student in the TRAC program who’s helping Blue Sky with product development and regulatory strategy.
“They’re rigid. Oftentimes they constrain the chest wall, so when patients breathe with these plates on it kind of constrains the breathing mechanics of the chest wall. But they are also unable to stabilize fractures in challenging anatomical locations,” said Nguyen, whose undergraduate degree is in mechanical engineering and background includes work in the oil and gas industry.
“So Dr. Briggs’ technology is novel in that way. It’s minimally invasive, requires less hardware and it can stabilize fractures in those challenging locations of the body,” he said.
Tricky locations for surgery
Two of those challenging areas could especially benefit from Dr. Briggs’ approach.
One of the most difficult fracture locations is under the scapula, the large bone that covers the back of the shoulder. Currently, the surgeon must work under the bone in a very small space to move the plate in position and screw it to the rib. The procedure often involves making a large incision and lifting the scapula, dividing muscles in the process.
Alternatively, the rib fixation device could allow the surgeon to enter the canal of the rib from a more accessible location, tunnel through the bone across the fracture and stabilize the rib.
The other tricky location is a para-spinal fracture, a break near the vertebrae where the rib connects with the transverse process, a bony protrusion off each side of the vertebra where muscles, ligaments and ribs come together. A significant number of fractures occur near that interface and can affect the person’s breathing.
Because of the curvature of the rib in this area, it’s difficult to affix a plate to the rib. Dr. Briggs said his approach could work well because it would run through the broken rib and implant itself in the canal or the transverse process.
May help aging population
The rib fixation device also could allow for treatment of fractures in other areas of the rib cage, Dr. Briggs said.
“And it may evolve into a procedure that’s much more tolerable to the patients, particularly as the population ages. We have more geriatric patients, and many of our rib-fracture patients are elderly. Having a procedure that is less invasive is much easier for them to tolerate and has the potential to get them more functional more quickly than medicines alone or medicines with a larger incision,” he said.
“We’re in the first phase of treating rib fractures. And it’s really about where do we go next. And where we go next should provide more options to patients.”
Sanford Health is focused on innovation to bring new ideas to market that improve the health and well-being of our patients, people and communities. It values the ideas and problem-solving ability of its nurses, physicians, researchers, clinical workers and support staff. Any employee with an idea for a device, therapy, software, tool or other method that helps patients is encouraged to contact the innovation and commercialization team and join the dozens of people at Sanford Health who are already inventing.
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