External adjustable funnel chest correcting device

Abstract

The utility model discloses an external adjustable funnel chest correcting device which is mainly composed of an external arc-shaped plate, an adjusting screw rod and an internal fixing rod. A rectangular notch is formed in the top of the external arc-shaped plate, and a bolt device is arranged on the outer side of the rectangular notch; the adjusting screw vertically penetrates through the rectangular notch, the outer end of the adjusting screw is fixed through the adjusting nut, the external gasket is arranged between the adjusting nut and the external arc-shaped plate, and the inner end of the adjusting screw penetrates through the internal gasket through the bearing line to be connected with the internal fixing rod. Wherein the external arc-shaped plate serves as a support outside the chest, the stress area of the skin on the surface of the thorax is large, skin necrosis is not prone to being caused, and rib ectropion can be corrected; and the bearing line is used for pulling and suspending the sternum. When the orthopedic requirement is met, the bearing line is cut off, the built-in gasket, the built-in fixing rod and part of the bearing line are left in the body, and a secondary operation is avoided. In conclusion, the device has the advantages of being simple in structure, safe, convenient to use and wide in application range, and is beneficial to improvement of NUSS operation benefits and reduction of operation risks after being widely popularized.

Description

Technical Field

[0001] The utility model belongs to the technical field of pectus excavatum correction devices, and in particular relates to an externally adjustable pectus excavatum correction device. Background Art

[0002] Pectus excavatum (PE) is also known as chest depression deformity. Its appearance is characterized by the sternum and ribs being sunken inward and backward, forming a boat-shaped or funnel-shaped shape. Clinical manifestations include drooping shoulders, hunchback, concave chest, and convex abdomen. Severe cases may even lead to cardiopulmonary compression and heart displacement. Treatment of pectus excavatum is mainly surgical. Traditional surgical methods include sternal lift (Ravitch surgery), sternal rotation (Wada surgery), and pedicled sternal inversion. All of them are open surgeries with large surgical trauma and significant postoperative pain. Complications such as respiratory failure may occur after surgery.

[0003] Compared with traditional surgery, the surgical method that doctors and patients are more inclined to accept is the minimally invasive surgery for pectus excavatum (NUSS procedure). The principle is to use the ribs of the lateral chest wall as support points and use arc-shaped steel plates to lift up the sunken ribs to achieve the purpose of reshaping. The advantages of the NUSS procedure are small and beautiful incisions, short operation time, almost no bleeding during the operation, and a more stable correction effect.

[0004] With the development of technology, people have made many improvements to the traditional NUSS surgery:

[0005] With the popularity of thoracoscopy, NUSS surgery has generally adopted thoracoscopic-assisted surgery. For example: China's patented "Visual Guidance System for Minimally Invasive Surgery of Pectus excavatum" (patent number 202220850322.5, announcement date 202210047), which solves the problem of inconvenient observation during pectus excavatum surgery. However, the system has a complex structure, including many components such as a guide, a hook-shaped part, an observation groove, and a light guide groove. It is large in size, which affects the flexibility of surgical operations. It also incurs high equipment production and maintenance costs. Users also need special training and practice, making it difficult to use on a large scale.

[0006] In terms of implants, doctors are no longer limited to bulky steel plates that need to be manually adjusted. They have invented adjustable implants, 3D printed implants, etc., as well as similar improvements such as the Chinese patent "Kirschner wire for minimally invasive pectus excavatum correction surgery" (patent number 201020293538.3, announcement date 20110323), which uses Kirschner wires instead of expensive special steel plates. Although NUSS surgery is generally safer, since these implants are all internal, traditional NUSS and modified NUSS surgery are still quite traumatic, with multiple incisions, wide separation of tissues, significant pain after surgery, and the need for a second surgery to remove the implants. The risks of pneumothorax, hemothorax, infection and arrhythmia during surgery still exist. The risk is higher when the implant passes through the anterior chest wall, especially the surface of the heart, and there may be undercorrection or overcorrection. The current NUSS surgery cannot solve the problem of correcting rib (costal arch) eversion while correcting sternal indentation.

[0007] Based on the shortcoming of NUSS surgical internal fixation that is prone to trauma, Ge Tiejun applied a screw structure in the Chinese patent "Screw-lifting pectus excavatum therapeutic device" (patent number 200420006194.8, announcement date 20051228) to transform the treatment of pectus excavatum from inside the chest wall to outside the chest wall. The patient is treated by wearing a close-fitting device outside the thorax. The device has a threaded structure and is fixed on the patient's sternum to lift the sunken sternum. The device may have three disadvantages: the first disadvantage is that the "X"-shaped cover has a small contact area with the skin, and the local pressure is large, which is easy to cause local skin necrosis. At the same time, due to the small cover, the rib eversion cannot be corrected; the second disadvantage is that the coarse internal sternal thread used may cause sternal compressive absorption, and the bone fixed by the screw on the sternum is absorbed, resulting in the loosening of the screw. The third disadvantage is that a second operation may still be required to remove the coarse internal sternal thread.

[0008] There are also reports of devices that use subcutaneous support plates: the Australian patent "Device for use insurgical treatment of funnel chest and method of treatment" (patent number AU2009284221, publication date 20100225) uses a 1mm to 5mm thick steel plate buried subcutaneously as a support plate, and the sternum lifting device used is one or more bone screws. Although it is mentioned that the sternum can be gradually lifted, it may cause serious sternal bone damage, which is a very fatal disadvantage; the Chinese patent "A shaping plate for Wang surgery on funnel chest" (patent number 2022229623640, announcement date 20230919) inserts an integrated titanium plate subcutaneously as a support plate through a midline incision during Wang surgery, and uses steel wire to suspend and fix the depressed sternum and rib arch. This method proves the feasibility of the suspension method, but there are still disadvantages: a second operation to remove the steel plate; if the correction does not meet the requirements, multiple operations may be required. Both correction methods use subcutaneous implants. During implantation, the skin sinus tract provides an invasion channel for external bacteria and other microorganisms, leading to an increased risk of infection. During subcutaneous implantation, the tissue in the sinus tract and the implant adhere to each other, which can easily lead to skin damage, scar formation, and skin discomfort or pain.

[0009] Lv Fangqi et al. (Clinical application and extended research of external chest suspension fixation for the treatment of neonatal funnel chest. Shandong Province, Taishan Medical College, 2011-04-01) designed an external chest suspension fixation surgery method for the correction of funnel chest in newborns and infants based on the NUSS surgical principle. This procedure uses low-cost Kirschner wires to make support rods, fold out force rods at both ends of the Kirschner wires and wrap gauze to reduce chest compression injuries, and lift the sternum with silk thread to fix it on the support rod to implement external chest suspension fixation. This method proves the feasibility of the suspension method. However, this method is only applicable to newborns and infants. It is difficult for older adolescents and even adults with better bone development to complete the correction by supporting the sternum with Kirschner wires, and a second operation is also required to remove the Kirschner wires. Summary of the invention

[0010] The technical problem to be solved by the utility model is to provide an externally adjustable pectus excavatum correction device which is simple in structure, safe, convenient and has a wide range of applications.

[0011] In order to solve the above technical problems, the utility model adopts the following technical solutions:

[0012] The external adjustable pectus excavatum correction device is mainly composed of an external arc plate, an adjusting screw and an internal fixing rod; a rectangular notch is arranged on the top of the external arc plate, and a latch device is arranged on the outside of the rectangular notch; the adjusting screw passes vertically through the rectangular notch, the outer end of the adjusting screw is fixed by an adjusting nut, an external gasket is arranged between the adjusting nut and the external arc plate, and the inner end of the adjusting screw passes through the internal gasket via a load-bearing line to connect to the internal fixing rod.

[0013] The external arc plate, the latch device, the adjusting screw, the internal fixing rod, the adjusting nut, the load-bearing line, the external gasket and the internal gasket are all made of medical stainless steel or alloy.

[0014] The external curved plate covers the anterior chest wall from the sternal angle to the lowest point of the costal arch and to the mid-axillary line on both sides.

[0015] The rectangular notch is arranged at the middle of the edge of the top of the external arc-shaped plate near the sternal xiphoid process, and the rectangular notch is open toward the sternal xiphoid process.

[0016] The width of the rectangular notch matches the diameter of the adjusting screw but is smaller than the outer diameter of the adjusting nut, and the depth of the rectangular notch is half the width of the external arc plate.

[0017] The built-in fixing rod is a cylinder, and its axial length is equal to the diameter of the built-in gasket; a clamping groove is arranged on the outer surface of the cylinder.

[0018] One end of the load-bearing line is connected to the inner end of the adjusting screw rod by welding, and the other end of the load-bearing line is connected to the built-in fixing rod; one end of the load-bearing line is provided with a needle.

[0019] The diameter of the built-in gasket is smaller than the maximum transverse diameter of the sternum, and a perforation is arranged at the center of the built-in gasket.

[0020] Ventilation holes arranged in a honeycomb pattern are evenly distributed on the external curved plate.

[0021] The latch device is a spring latch.

[0022] In response to the problems existing in NUSS surgery, the inventor designed an external adjustable pectus excavatum correction device based on the principle of suspension method, which is mainly composed of an external arc plate, an adjusting screw and an internal fixing rod; a rectangular notch is arranged on the top of the external arc plate, and a latch device is arranged on the outside of the rectangular notch; the adjusting screw passes vertically through the rectangular notch, the outer end of the adjusting screw is fixed by an adjusting nut, an external gasket is arranged between the adjusting nut and the external arc plate, and the inner end of the adjusting screw passes through the internal gasket via the load-bearing line to connect to the internal fixing rod. Among them, the external arc plate is used as support outside the chest, and the force-bearing area of ​​the skin on the chest surface is large, which is not easy to cause skin necrosis and can correct the rib eversion; the external arc plate can be set with multiple ventilation holes evenly distributed in a honeycomb pattern, which is conducive to air circulation, reduces the stuffiness and sweating of the local skin, and ensures the ventilation effect without affecting the strength of the plate; the latch device can prevent the adjustment screw and the adjustment nut from moving horizontally relative to the rectangular notch; the external arc plate can adjust the shape according to the patient's age and body shape, which is not only suitable for infants and young children, but also for adults to correct funnel chest. The setting of an external gasket can increase the contact area between the adjustment nut and the external arc plate, reduce the pressure on the arc plate, and prevent loosening. The load-bearing line is connected to the built-in fixing rod on the inner side of the concave sternum for pulling and suspending the sternum. During traction, the load-bearing line transfers the force to the built-in gasket, so that the force range of the inner side of the sternum is large, so that the sternum will not be cut by the wire and cause traction failure. The internal fixation rods, internal gaskets and load-bearing lines implanted in the body are basically surrounded by surrounding tissues for 2 to 3 years, and the surrounding tissue organization limits their displacement. Therefore, when the correction meets the requirements, the load-bearing lines are cut, and the internal gaskets, internal fixation rods and part of the load-bearing lines remain in the body to avoid secondary surgery. In summary, the externally adjustable pectus excavatum correction device of the utility model has the characteristics of simple structure, safety and convenience, wide range of application, gradually increasing traction force to prevent severe pain, stopping traction in the later stage to observe the correction effect to prevent insufficient or excessive treatment. Wide promotion is conducive to improving the benefits of NUSS surgery and reducing surgical risks, which is specifically reflected in the following aspects:

[0023] 1. The surgery is more minimally invasive, with only an incision made under the xiphoid process and a stitch at the lower end of the sternum using a wire needle. It can be done under local anesthesia.

[0024] 2. The extent of correction can be gradually increased to avoid the severity of pain.

[0025] 3. The external steel plate has a wider contact with the raised ribs, pressing down on the raised ribs and correcting rib valgus at the same time.

[0026] 4. The sternal traction can be released for observation to prevent overcorrection or undercorrection.

[0027] 5. It can avoid the need for a second operation to remove the steel plate. Only the traction wire needs to be cut, and the internal stainless steel rod and internal stainless steel sheet remain in the body. BRIEF DESCRIPTION OF THE DRAWINGS

[0028] Figure 1 The utility model is a schematic diagram of the structure and use status of the externally adjustable pectus excavatum correction device.

[0029] Figure 2 for Figure 1 Schematic diagram of the structure of the external curved plate in the external adjustable pectus excavatum correction device.

[0030] Figure 3 for Figure 1 Schematic diagram of the structure of the adjusting nut and external gasket in the external adjustable pectus excavatum correction device, in the figure: A adjusting nut, B external gasket.

[0031] Figure 4 The present invention is a schematic structural diagram of an adjusting wrench used in conjunction with the externally adjustable pectus excavatum correction device of the present invention.

[0032] Figure 5 for Figure 1 Schematic diagram of the structure of the built-in stainless steel load-bearing wire in the externally adjustable pectus excavatum correction device.

[0033] Figure 6 It is a schematic diagram of the structure of the spring plug in the externally adjustable pectus excavatum correction device in the figure.

[0034] In the figure: 1 external arc plate; 2 adjusting nut; 3 adjusting screw; 4 load-bearing line; 5 internal gasket; 6 internal fixing rod; 7 sternum; 8 external gasket; 9 spring plug; 90 plug movable rod; 10 vent hole; 11 rectangular notch; 21 adjusting wrench. DETAILED DESCRIPTION

[0035] 1. Basic structure

[0036] like Figures 1 to 6 As shown, the externally adjustable pectus excavatum correction device of the utility model is mainly composed of an external arc plate 1, an adjustment screw 3 and an internal fixing rod.

[0037] The external curved plate has evenly distributed ventilation holes 10 arranged in a honeycomb pattern, and the diameter of the holes is about 3 mm. The hole spacing can be adjusted according to the size of the plate, which reduces the weight of the entire plate while ensuring the strength of the plate, providing a better ventilation effect. The external curved plate covers the chest wall from the sternal angle to the lowest point of the costal arch (to compress and correct the valgus costal arch), and to the mid-axillary line on both sides. The rectangular notch 11 is set in the middle of the edge of the top of the external curved plate near the sternal xiphoid process, and the rectangular notch is open toward the sternal xiphoid process. The width of the rectangular notch matches the diameter of the adjusting screw, but is smaller than the outer diameter of the adjusting nut to accommodate the passage of the adjusting screw, and the depth of the rectangular notch is half the width of the external curved plate.

[0038] A latch device is provided on the outside of the rectangular notch, and the latch body is perpendicular to the long side of the rectangular notch, that is, parallel to the arc edge of the arc-shaped steel plate. The latch device can be a spring latch 9 or the like. When the spring is extended, the latch movable rod 90 clamps the adjusting nut and the adjusting screw to limit their horizontal movement relative to the rectangular notch; when the spring is compressed by external force, the latch movable rod is retracted, and the rectangular notch is opened, so that the external arc plate can move horizontally relative to the screw. When the latch movable rod is extended, it crosses the rectangular notch, and when it is retracted, it does not cross the edge of the rectangular notch. The vertical distance between the latch movable rod and the deepest part of the rectangular notch = (outer diameter of the adjusting nut + inner diameter of the adjusting nut) / 2. The diameter of the latch movable rod is less than (thickness of the adjusting nut + thickness of the external gasket).

[0039] The adjusting screw passes vertically through the rectangular notch, the outer end of the adjusting screw is fixed by the adjusting nut 2, an external gasket 8 is provided between the adjusting nut and the external arc plate, and the inner end of the adjusting screw passes through the internal gasket 5 via the load-bearing line 4 to connect with the internal fixing rod 6.

[0040] The external arc plate, the latch device, the adjusting screw, the internal fixing rod, the adjusting nut, the load-bearing line, the external gasket and the internal gasket are all made of medical stainless steel or alloy.

[0041] The built-in fixing rod is a cylinder, and its axial length is equal to the diameter of the built-in gasket; a clamping groove is arranged on the outer surface of the cylinder to clamp the load-bearing line.

[0042] One end of the load-bearing line is connected to the inner end of the adjusting screw rod by welding, and the other end of the load-bearing line is connected to the built-in fixing rod; one end of the load-bearing line is provided with a needle for suturing through the sternum.

[0043] The diameter of the internal gasket is slightly smaller than the maximum transverse diameter of the sternum, and a hole for passing the load-bearing line is arranged at the center of the internal gasket. The external gasket is in the shape of a ring, and its outer diameter and inner diameter are equal to the outer diameter and inner diameter of the adjusting nut.

[0044] 2. Usage

[0045] The external arc plate is placed in front of the chest wall. The adjusting screw, adjusting nut and external gasket are assembled and passed through the rectangular notch to complete the external assembly. A latch device is set on one side of the rectangular notch to prevent the adjusting screw from falling off during the correction process. When disassembling, it can be removed by loosening the adjusting nut and moving it horizontally from the rectangular notch.

[0046] After local anesthesia, a 1.5 cm transverse incision is made under the xiphoid process. The load-bearing line welded in advance and embedded in the inner end of the adjusting screw is passed through the lower end of the sternum (the most concave part of the sternum) through a suture needle. Then a gasket is inserted into the incision under the xiphoid process, and the load-bearing line passes through the center hole of the built-in gasket. Then, the built-in fixing rod is inserted in the same way as above. The load-bearing line is wrapped around the slot of the built-in fixing rod and tied to fix it behind the sternum.

[0047] The matching adjustment wrench 21 is used to rotate the adjustment nut to pull the load-bearing line, thereby pulling the built-in fixing rod to drive the built-in gasket to support the sunken sternum 7 upward. The external arc plate serves as an external support, and the built-in gasket and the built-in fixing rod support the sternum in the body, and the entire device is formed in one piece through the adjustment screw and the load-bearing line.

[0048] The external curved plate can be adjusted to fit the chest wall support by bending the size of the patient's chest. According to the degree of sternal depression and the degree of pain that the patient can bear, the degree of traction of the load-bearing line can be gradually adjusted by operating the adjusting nut and adjusting screw. In the later stage of sternal traction, the load-bearing line can be appropriately loosened, and the degree of traction of the screw and the load-bearing line on the internal gasket and the internal fixation rod can be adjusted according to whether the sternum sinks and rebounds to prevent overcorrection or insufficient correction; the internal fixation rod, internal gasket and the load-bearing line in the body are basically surrounded by surrounding tissues for 2 to 3 years in the body, and the surrounding tissue organization limits their displacement. Therefore, when the correction meets the requirements, the load-bearing traction line is cut off, and the internal gasket, internal fixation rod and part of the load-bearing line remain in the body to avoid secondary surgery. The external curved plate, adjusting nut and adjusting screw can be reused after the correction of funnel chest is completed, reducing the economic burden on patients.

[0049] In summary, the utility model has a simple structure, is safe and convenient, has a wide range of applications, and is used for the correction and treatment of pectus excavatum. The external curved plate is attached to the skin of the chest wall and covers the sunken sternum and the everted and raised sternum; a wrench can be used to operate the adjusting nut to raise and lower the adjusting screw, and then adjust the tightness of the load-bearing line, so as to achieve the purpose of pulling the built-in fixing rod to drive the built-in gasket to support the sunken sternum and finally correct the pectus excavatum. The external curved plate is used as a support outside the chest, and has a wider contact with the raised ribs, which can press down the raised ribs and support the sunken sternum. The skin on the surface of the thorax has a large force area and is not easy to cause skin necrosis; the shape of the external curved plate is adjusted according to the patient's age and body shape. It is not only suitable for infants and young children, but also can be used for the correction of pectus excavatum in adults. The load-bearing line pulls and suspends the sternum, and the load-bearing line is wound and connected with the built-in fixing rod on the inner side of the sunken sternum. During traction, the internal fixation rod transfers the force to the internal gasket, so that the force range on the inner side of the sternum is larger, so that the sternum will not be cut by the wire and cause traction failure; during corrective treatment, the traction of the load-bearing line can be loosened for observation, which can prevent over-correction or insufficient correction.

Claims

1. An externally adjustable pectus excavatum correction device, characterized in that It is mainly composed of an external arc plate, an adjusting screw and an internal fixing rod; a rectangular notch is arranged on the top of the external arc plate, and a latch device is arranged on the outside of the rectangular notch; the adjusting screw passes vertically through the rectangular notch, the outer end of the adjusting screw is fixed by an adjusting nut, an external gasket is arranged between the adjusting nut and the external arc plate, and the inner end of the adjusting screw passes through the internal gasket via a load-bearing line to connect to the internal fixing rod.

2. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The external arc plate, the latch device, the adjusting screw rod, the internal fixing rod, the adjusting nut, the load-bearing line, the external gasket and the internal gasket are all made of medical stainless steel or alloy.

3. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The external arc-shaped plate covers the range of the anterior chest wall from the sternal angle to the lowest point of the costal arch and from left to right to the mid-axillary line on both sides.

4. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The rectangular notch is arranged at the middle of the edge of the top of the external arc-shaped plate near the xiphoid process of the sternum, and the rectangular notch is open toward the xiphoid process of the sternum.

5. The externally adjustable pectus excavatum correction device according to claim 4, characterized in that: The width of the rectangular notch matches the diameter of the adjusting screw but is smaller than the outer diameter of the adjusting nut, and the depth of the rectangular notch is half the width of the external arc plate.

6. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The built-in fixing rod is a cylinder, and its axial length is equal to the diameter of the built-in gasket; a slot is arranged on the outer surface of the cylinder.

7. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: One end of the load-bearing line is connected to the inner end of the adjusting screw rod by welding, and the other end of the load-bearing line is connected to the built-in fixing rod; one end of the load-bearing line is provided with a needle.

8. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The diameter of the built-in gasket is smaller than the maximum transverse diameter of the sternum, and a perforation is arranged at the center of the built-in gasket.

9. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The external curved plate is evenly distributed with ventilation holes arranged in a honeycomb shape.

10. The externally adjustable pectus excavatum correction device according to claim 1, characterized in that: The latch device is a spring latch.

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