Pectus bar, stabilization device, and method

Abstract

A pectus bar assembly may include a first pectus bar and a second pectus bar that are engageable with the sternum. The pectus bar assembly may also include a first bar link that is connectable to and movable along the first pectus bar, and a second bar link that is connectable to and movable along the second pectus bar. The pectus bar assembly may also include a bridge defining a longitudinal axis. The bridge may be connectable to the first bar link and the second bar link. The first and second bar links may be independently movable along the bridge, and the first and second bar links may be independently rotatable around the longitudinal axis of the bridge.

Description

Technical Field

[0001] (Claim of Priority) This patent application claims the benefit of priority of U.S. Patent Application No. 63 / 450,202, entitled "PECTUS BAR AND STABILIZER DEVICES AND METHODS," filed on March 6, 2023, by Shay O'Brien, the first named inventor, pursuant to 35 U.S.C. § 119(e), the entire disclosure of which is hereby incorporated by reference in its entirety.

Background Art

[0002] Funnel chest and pigeon chest are conditions that affect the rib cage of a person, which may be caused by congenital diseases or injuries. In some cases of funnel chest and pigeon chest, doctors attach metal objects to the patient's rib cage to reshape the rib cage. During funnel chest correction procedures, one or more pectus bars can be inserted into the patient's thoracic cavity, at least partially within the thoracic cavity. The bar can then be reversed to push the sternum and rib cage into the appropriate position, and the ends of the bar can be fixed to one or more ribs.

Brief Description of the Drawings

[0003] The drawings are not necessarily drawn to scale, and in these drawings, like numbers can describe like elements from different perspectives. Like numbers with different trailing letters can represent different examples of like elements. The drawings generally illustrate, by way of example, various embodiments discussed in this document, but are not limiting.

[0004] [Figure 1] FIG. 1 shows an X-ray image of a pectus bar assembly mounted within a patient's rib cage. [Figure 2] FIG. 2 shows an isometric view of a portion of the pectus bar assembly. [Figure 3] FIG. 3 shows an isometric view of a portion of the pectus bar assembly. [Figure 3A] FIG. 3A shows an isometric view of a portion of the pectus bar assembly. [Figure 4] Figure 4 shows an isometric view of the pectus bar assembly in the first configuration. [Figure 5] Figure 5 shows an isometric view of the pectus bar assembly in the second configuration. [Figure 6] Figure 6 shows an isometric view of a portion of the pectus bar assembly. [Figure 7] Figure 7 shows an isometric view of the pectus bar assembly in the first configuration. [Figure 8] Figure 8 shows an isometric view of the pectus bar assembly in the second configuration. [Figure 9] Figure 9 shows an isometric view of the pectus bar assembly. [Figure 10] Figure 10 shows an enlarged isometric view of a portion of the pectus bar assembly. [Figure 11] Figure 11 shows a schematic diagram of the method. [Figure 12] Figure 12 shows an isometric view of a portion of the pectus bar assembly. [Figure 13] Figure 13 shows an isometric view of a portion of the pectus bar assembly. [Figure 14] Figure 14 shows a side view of a portion of the pectus bar assembly. [Figure 15] Figure 15 shows a side view of a portion of the pectus bar assembly. [Figure 16] Figure 16 shows a side view of a portion of the pectus bar assembly. [Figure 17] Figure 17 shows a side view of a portion of the pectus bar assembly. [Figure 18] Figure 18 shows an isometric view of the pectus bar assembly. [Figure 19] Figure 19 shows an isometric view of a portion of the pectus bar assembly. [Figure 20] Figure 20 shows a cross-sectional view of a portion of the pectus bar assembly. [Figure 21] Figure 21 shows an isometric view of a portion of the pectus bar assembly. [Figure 22]Figure 22 shows an isometric view of a portion of the pectus bar assembly. [Figure 23] Figure 23 shows an isometric view of a portion of the pectus bar assembly. [Overview of the project] [Problems that the invention aims to solve]

[0005] When pectus carinatum or pectus excavatum requires surgical correction, a common corrective procedure involves fixing a pectus bar to the patient's rib cage to reshape and stabilize the rib cage. This procedure may include the steps of: creating opposing incisions on each side of the patient's rib cage; inserting a curved pectus bar into one of the incisions; integrating the pectus bar through a rib having a recessed side of the bar facing the anterior side of the sternum; inverting the pectus bar to press it against the anterior side of the sternum and expand the rib cage to the desired shape; fixing the pectus bar to the rib cage; fixing a stabilizer to the pectus bar; fixing the stabilizer to the rib cage; and closing the incisions. Depending on the patient's anatomical structure, existing metal solutions may be difficult to fix to the patient's ribs. [Means for solving the problem]

[0006] In some of these surgical procedures, two pectus bars are used to help maintain the sternum in a desired position. Hardware can be used to interconnect the pectus bars and help prevent them from reversing after the procedure. However, hardware can be relatively cumbersome and time-consuming to install, while limiting the adjustability. The devices and methods discussed herein can help address these problems by including a pectus bar bridge that is easy to install and allows for easy adjustment of the pectus bars relative to each other.

[0007] For example, a pectus bar assembly can include a first pectus bar and a second pectus bar that can engage with the sternum. The pectus bar assembly can also include a first bracket connectable to the first pectus bar and a second bracket connectable to the second pectus bar. The assembly can include a bridge connectable to the first bracket and the second bracket so that the first bracket and the first pectus bar move along the bridge and the second bracket and the second pectus bar move independently of the first pectus bar along the bridge.

Best Mode for Carrying Out the Invention

[0008] The above description is intended to provide an overview of the subject matter of this patent application. It is not intended to provide an exclusive or exhaustive description of the invention. The following description is provided to provide additional information about this patent application.

[0009] FIG. 1 shows an X-ray image of a pectus bar assembly 100 that can include a pectus bar 102 and stabilizers 104a and 104b. Also shown in FIG. 1 is a rib cage 50 that includes ribs 52. FIG. 1 shows a method of fixing the pectus bar 102 to the rib cage together with the stabilizers 104. FIGS. 2 to 10 illustrate further details of various pectus bar assemblies and procedures.

[0010] FIG. 2 shows an isometric view of a portion of a pectus bar assembly 200. FIG. 3 shows an isometric view of a portion of a pectus bar assembly 200. FIGS. 2 and 3 are discussed together below. The pectus bar assembly 200 can be similar to the above-described pectus bar assembly 100 in that the pectus bar assembly 200 can be configured to be attached to the ribs for the correction of funnel chest or pigeon chest. The pectus bar assembly 200 can be different in that the pectus bar assembly 200 can include a plurality of pectus bars and different hardware. Any of the pectus bar assemblies described above or below can be modified to include the features of the pectus bar assembly 200.

[0011] The pectoral bar assembly 200 can include a pectoral bar 202a (e.g., a first pectoral bar) and a pectoral bar 202b (e.g., a second pectoral bar) (collectively referred to as the pectoral bar 202). Each pectoral bar 202 can be a rigid or semi-rigid bar made of materials such as metal and plastic. For example, the pectoral bar 202 can be composed of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), polyetherketoneketone (PEKK), etc.

[0012] The pectoral bar 202 can have an elongated body that forms a curve such as a C-shape, is rigid (or semi-rigid), but can have sufficient flexibility to be bent to conform to the curve of the patient's rib cage using a tool such as a bar bender. As shown in FIG. 2, the pectoral bar 202 can include bar holes 206a and 206b that can be disposed near the ends of the pectoral bar 202 (e.g., the pectoral bar 202a). The bar holes 206 can be configured to receive fasteners such as bone screws or sutures to fix the pectoral bar 202 to the ribs and / or soft tissue of the rib cage 50. Optionally, the bar holes 206 can be threaded.

[0013] As shown in FIG. 3, the pectoral bar assembly 200 can include stabilizers or brackets 204a to 204d (collectively referred to as the stabilizer 204). As will be described in more detail below, the stabilizers 204a and 204b can be connected to the ends of the pectoral bar 202a, and the stabilizer 204c can be connected to the end of the pectoral bar 202b. The stabilizers 204 can each be a rigid or semi-rigid component made of materials such as metal and plastic. For example, the stabilizer 204 can be composed of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), polyetherketoneketone (PEKK), etc.

[0014] Figure 3 also shows that each ballast 204 may include a hole 208 configured to receive a fastener 210 at least partially therein. The fastener 210 may extend at least partially into the bar hole 206b and the hole 208 to secure the ballast 204b to the pectus bar 202a. The hole 208 may be threaded to connect the fastener 210 to the hole 208, and therefore to the pectus bar 202 and the ballast 204. Any ballast 204 may include such a hole and may be secured to the respective bar hole 206 in a similar manner. Further details of the ballast 204 are described below with respect to Figure 3A.

[0015] Figure 3A shows an isometric view of a portion of the pectus bar assembly 200. The pectus bar assembly 200 in Figure 3A can be adapted to the pectus bar assembly 200 in Figures 2 to 3 described above. Figure 3A shows additional details of the pectus bar assembly 200. For example, Figure 3A shows that the ballast 204b may include a base 212 and a receiver 214 connected to the base 212. The receiver 214 may define an opening 216 configured to at least partially receive the end 218 of the pectus bar 202a so as to align the bar hole 206b with the hole 208 of the ballast 204b. The receiver 214 may also include a slot 220. The slot 220 can be configured (e.g., dimensioned or molded) to allow the fastener 210 and the end 218 to be inserted into the receiver 214 when the fastener 210 is connected to the end 218 through the hole 206b, which can help simplify the process.

[0016] The ballast 204b may also include a boss 222 that can extend from the surface of the base 212. The boss 222 defines holes 224a and 224b that can be configured (e.g., threaded) to receive fasteners, as described below. The boss 222 may also be configured (e.g., dimensioned or molded) to be insertable into a bracket, as discussed below. The ballast 204b will be described with reference to Figure 3A, but any ballast may include components of the ballast 204b.

[0017] Figure 4 shows an isometric view of the pectus bar assembly 200 in the first spacing configuration. Figure 5 shows an isometric view of the pectus bar 200 assembly in the second spacing configuration. Figures 4 and 5 are discussed together below. The pectus bar assembly 200 in Figures 4 and 5 can be adapted to the pectus bar assembly 200 in Figures 2 to 3A described above. Figures 4 and 5 show additional details of the ballast 204. Figure 4 also shows a pectus bar assembly 200 in which one rib (for example, one of the ribs 52) is adjusted to the spacing between pectus bars 202a and 202b, and Figure 5 shows a pectus bar assembly 200 in which two ribs are adjusted to the spacing between pectus bars 202a and 202b, and Figures 4 and 5 also show additional components of the pectus bar assembly 200.

[0018] For example, Figures 4 and 5 show that the pectus bar assembly 200 may include bridges 226a and 226b (collectively referred to as bridge 226). Each bridge 226 may include a body 228 defining a slot 230. The body 228 may include ends 232 that can be tapered (or beveled or rounded) to help reduce the tactile feel of the bridge after installation. Each bridge 226 may be a rigid or semi-rigid component made of a material such as metal and plastic. For example, bridge 226 may be made of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK).

[0019] Bridge 226b may be connectable to stabilizers 204b and 204d to allow stabilizer 204b and the first pectus bar 202a to move along the bridge, and stabilizer 204d and the second pectus bar 202b to move along bridge 226b independently of the first pectus bar 202a. Bridge 226a can similarly act to allow independent adjustment or movement of pectus bars 202a and pectus bars 202b. The movement of pectus bar 202 brought about by the stabilizer is not limited or independent. This allows the surgeon to position the bar as desired or as needed by procedure, whereas many devices of the prior art include discrete incremental holes to separate the pectus bars, limiting the choice of positioning within the pectus bar and potentially leading to interference with the ribs.

[0020] The pectus bar assembly 200 may also include fasteners 234a and 234b (collectively referred to as fastener 226). The ballast 204 can receive fasteners 234a and 234b into holes 224a and 224b, respectively. Fasteners 234a and 234b can engage with the outer surface 236 of the bridge 226b to secure the bridge 226b to the ballast 204b. Ballast 204d can be similarly connected to the bridge 226b, and ballasts 204a and 204c can be similarly connected to the bridge 226a.

[0021] To secure the ballast 204b to the bridge 226b, the slot 230 may be configured to receive at least a portion of the fastener 234 through it. The slot 230 may also be configured to receive at least a portion of the boss 222 therein, and the boss 222 may be movable inside the slot 230 to allow the movement of the ballast 204b along the bridge 226b. The boss 222 is movable inside the slot 230 when the fastener 234 is secured to the ballast 204b but not tightened against the outer surface 236 (or when the fastener 234 is not secured to the ballast 204b), allowing adjustment of the bar 202 during treatment or allowing connection of the ballast 204 to the bridge 226 at various positions.

[0022] For example, as shown in Figure 4, pectus bars 202a and 202b can be spaced apart from each other so that one rib is positioned between bars 202a and 202b. However, as shown in Figure 5, the stabilizer 204 can be connected to the bridge 226 so that two or more ribs can be fitted between bars 202a and 202b. The stabilizer 204 can be moved between the positions shown in Figures 4 and 5 when the stabilizer 204 is connected via fasteners 234 and not tightened as described above. When fasteners 234a and 234b are fixed to holes 224a and 224b respectively and tightened to engage with the outer surface 236, the movement of the stabilizer 204b relative to the bridge 226b can be restricted. Additionally, engagement of the boss 222 with the end of the slot 230 can restrict the movement of the stabilizer 204b relative to the bridge 226b.

[0023] Figure 6 shows an isometric view of a portion of the pectus bar assembly 600. Figure 7 shows an isometric view of the pectus bar assembly 600 in the first configuration. Figure 8 shows an isometric view of the pectus bar assembly 600 in the second configuration. Figures 6 to 8 are discussed together below. The pectus bar assembly 600 can be adapted to the pectus bar assembly described above. The pectus bar assembly 600 may include hardware for adjusting the bars vertically or the bridge horizontally. Any of the pectus bar assemblies described above or below can be modified to include the features of the pectus bar assembly 600.

[0024] The pectus bar assembly 600 may include pectus bars 602a and 602b, which may be similar to bars 202a and 202b discussed above. The pectus bar assembly 600 may also include ballasts 604a to 604d. Ballasts 604a and 604b may be configured to connect to pectus bar 602a, and ballasts 604C and 604D may be configured to connect to pectus bar 602b.

[0025] Each ballast 604 may include a base 638, as most clearly shown in Figure 6. Each base 638 may include holes 640a and 640b, which can be configured to receive fasteners 634a and 634b, respectively, at least partially, as shown in Figures 7 to 8. For example, the holes 640a and 640b may be threaded to receive screws or bolts. The base 638 may be configured to engage with the first side 637 (or back or rear side) of the bridge 626. The base may also be insertable into a recess 642 of the bridge 626, which can at least partially surround the slot 630 of the bridge 626.

[0026] Each ballast 604 may include a plate 644, as most clearly shown in Figure 6. The plate 644 can engage with the second side 636 (or front side or front side) of the bridge 626 and can be connected to the plate 644 via a snap interface or the like. Part of the base 638 or part of the plate 644 may extend at least partially through the slot 630 to secure the base 638 and plate 644 to the bridge 626. When the base 638 and plate 644 are connected to the bridge 626, the base 638 and plate 644 may be movable along the slot 630. The plate 644 may also include holes 646a and 646b that can align with holes 640a and 640b of the base 638 when the base 638 is connected to the plate 644. As shown in Figure 6, the plate 644 may engage with the first side of the pectus bar 602a.

[0027] As shown in Figures 7 and 8, each ballast 604 may include a cap 648. The cap 648 may be engageable with the pectus bar 602a and may be fixed to the plate 644. The cap 648 may include holes 650a and 650b configured to receive fasteners 634a and 634b at least partially in or through them. For example, at least portions of the fasteners 634a and 634b may extend through the holes 650a and 650b of the cap 648 and through the holes 646a and 646b of the plate 644, respectively, into the holes 640a and 640b of the base 638, respectively, in order to fasten the cap 648, the plate 644, and the base 638 together.

[0028] When fasteners 634a and 634b are fixed to the cap 648, plate 644, and base 638 but are not tightened, the cap 648, plate 644, base 638, and pectus bar 602a can be moved along the bridge 626b. For example, as shown in Figure 7, pectus bars 602a and 602b can be spaced apart from each other so that one rib can be positioned between bars 602a and 602b. As shown in Figure 8, the stabilizer 604 can be moved along the bridges 626a and 626b so that two or more ribs can be fitted between bars 602a and 602b. That is, when the cap 648, base 638, and plate 644 are connected and the fasteners 634 are not tightened, the stabilizer 604 can be moved between the positions shown in Figures 7 and 8.

[0029] Furthermore, although fasteners 634a and 634b are fixed to the cap 648, plate 644, and base 638, when fasteners 634a and 634b are not tightened, the cap 648, plate 644, base 638, and bridge 626b can be moved along the pectus bar 602a. Also, when fasteners 634 are connected to the cap 648 and base 638 but are not tightened, the bridge 626 and stabilizer 604 can be moved along the bar 602. When fasteners 634a and 634b are tightened to the cap 648, plate 644, and base 638, the movement of stabilizer 604 (and bar 602) relative to bridge 626 can be restricted or prevented, and the movement of stabilizer 204 and bridge 626 relative to bar 602 can be restricted or prevented. In this way, the assembly 600 can be adjusted during treatment as needed to suit individual patients.

[0030] Figure 9 shows an isometric view of the pectus bar assembly 900. The pectus bar assembly 900 can be similar to the pectus bar assembly described above. The pectus bar assembly 900 may include hardware for quickly fastening the pectus bars together. Any of the pectus bar assemblies described above or below can be modified to include the features of the pectus bar assembly 900.

[0031] The pectus bar assembly 900 may include pectus bars 902a and 902b, which may be similar to the pectus bars described above. The pectus bar assembly 900 may also include ballast assemblies 952a and 952b. Each ballast assembly may include a first bracket 954 and a second bracket 956. The first bracket 954 may be connected to the pectus bar 902a, and the second bracket 956 may be connected to the pectus bar 902b. Optionally, one of the first brackets 954 and one of the second brackets 956 may be connected to the pectus bar 902a, and one of the first brackets 954 and one of the second brackets 956 may be connected to the pectus bar 902b. That is, one of the ballast assemblies 952 may be connected to the bar 902 in the opposite configuration to the other.

[0032] The first bracket 954 and the second bracket 956 may be rigid or semi-rigid components made of materials such as metal and plastic, respectively. For example, the first bracket 954 and the second bracket 956 may be made of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK).

[0033] Figure 10 shows an enlarged isometric view of a portion of the pectus bar assembly 900. The pectus bar assembly 900 in Figure 10 can be matched with the pectus bar assembly 900 in Figure 9, and Figure 10 shows further details of the pectus bar assembly 900. For example, Figure 10 shows that the first bracket 954 may include a bar slot 958 which may be a recess, opening, or hole extending at least partially into the body 960 of the first bracket 954. The bar slot 958 may extend throughout the body 960 to allow the pectus bar 902a to pass through the first bracket 954. Optionally, the bar slot 958 may extend only partially into the body 960 to restrict the movement of the pectus bar 902a relative to the first bracket 954.

[0034] Similarly, the second bracket 956 may include a bar slot 964, which may be a recess, opening, or hole extending at least partially within the body 962 of the second bracket 956. The bar slot 964 may extend throughout the body 962 to allow the pectus bar 902b to pass through the second bracket 956. Optionally, the bar slot 964 may extend only partially within the body 962 to restrict the movement of the pectus bar 902b relative to the second bracket 956.

[0035] The first bracket 954 may also include a receiver 966 defining a slot 968 that extends at least partially into the body 960. The slot 968 may terminate in the body 960 before drawing attention to the bar slot 958. The slot 968 may be perpendicular to the bar slot 958, or it may be oriented in a manner not parallel to the bar slot 958. The first bracket 954 may also include a claw portion 970 connected to the receiver 966. The claw portion 970 may include one or more projections that extend at least partially into the slot 968. The claw portion 970 may be configured to be reversibly flexible. The claw portion 970 may be integrally formed with the body 960 via a living hinge or the like. Optionally, the claw portion 970 may be connected to the body 960.

[0036] The second bracket 956 may include a projection 974 extending from the body 972 of the second bracket 956. The projection 974 can be inserted into the receiver 966 to connect the first bracket 954 to the second bracket 956 and to secure the first pectus bar 902a to the second pectus bar 902b. The projection 974 and the receiver 966 together form a ratchet interface that can secure the first bracket 954 to the second bracket 956. For example, the projection 974 may include a plurality of teeth 976 that can engage with the claw 970 when the projection 974 is inserted into the receiver 966. The claw portion 970 engages with the teeth portion 976 and flexes as the protruding portion 974 moves into the receiver. The claw portion 970 engages with and holds one or more teeth portions 976, thereby restricting the movement of the protruding portion 974 outside the receiver 966. In this way, the receiver 966 and the protruding portion 974 can be connected relatively quickly and reliably, and the pectus bar 902a can be fixed to the pectus bar 902b.

[0037] Optionally, the protruding portion 974 can be made to engage with the slot 968 in order to restrict the movement of the protruding portion 974 into the slot. For example, the protruding portion 974 can be measured and cut to a desired length prior to insertion so that the engagement between the protruding portion 974 and the slot 968 can be used to position the pectus bars 902a and 902b relative to each other.

[0038] Optionally, the pectus bar assembly 900 may include one or more fasteners, such as fasteners 910, which can be screw-mounted into holes in the second bracket 956 and may be insertable through holes in the pectus bar 902b to restrict the movement of the pectus bar 902b relative to the second bracket 956. The first bracket 954 may optionally be configured similarly.

[0039] Figure 11 shows a schematic diagram of Method 1100 according to at least one example of the present disclosure. Method 1100 may also be a method for mounting a pectus bar. More specific examples of Method 1100 are described below. The steps or operations of Method 1100 are shown in a particular order for convenience and clarity, and many of the operations discussed may be performed in different orders or in parallel without substantially affecting other operations. Method 500 described includes operations performed by multiple different actors, devices, and / or systems. A subset of the operations described in Method 500 may be attributable to a single operating entity, device, or system and may be considered a separate standalone step or method.

[0040] The procedure can begin in step 1102, which involves inserting the first pectus bar and the second pectus bar into the pleural cavity, such as pectus bar 202a and pectus bar 202b. In step 1104, the first bracket can be connected to the first pectus bar, and the second bracket can be connected to the second pectus bar. For example, stabilizer 204b can be connected to pectus bar 202a, and stabilizer 204d can be connected to stabilizer 204b.

[0041] In step 1106, the bridge may be connected to a first bracket and a second bracket. For example, bridge 226b may be connected to ballasts 204b and 204d. In step 1108, the first bracket and the second bracket are adjustable relative to the bridge. For example, ballast 204b or 204d may be moved along bridge 226b. In step 1110, the pectus bar may be adjusted relative to the bridge. For example, pectus bars 602a and 602b may be adjusted relative to ballasts 604a through 604d by moving the ballast (and bridge 626) along pectus bar 602. In step 1114, the brackets may be fixed. For example, ballast 204 may be tightened to bridge 226 or fixed in another way, such as to fix pectus bar 202 to bridge 226. The additional steps described above with respect to Figures 2 to 10 may be incorporated into method 1100.

[0042] Figure 12 shows an isometric view of a portion of the pectus bar assembly 1200. The pectus bar assembly 1200 may be similar to the pectus bar assemblies discussed above or below. The pectus bar assembly 1200 may include bar links that can be fixed to the pectus bar and can be fixed to the bridge to help stabilize the assembly after transplantation.

[0043] The pectus bar assembly 1200 may include a first pectus bar 1202a and a second pectus bar 1202b (both shown in Figure 18), and a first bar link 1204a and a second bar link 1204b. The pectus bar assembly 1200 may also include a bridge 1226. Although the pectus bar assembly 1200 is described as including two pectus bars and two bar links, the pectus bar assembly 1200 may include one, two, three, four, five, six, etc. pectus bars and one, two, three, four, five, six, etc. bar links (or ballasts or brackets).

[0044] The pectus bar 1202 may be similar to the pectus bar described above (e.g., 202) in that the pectus bar 1202 may be a rigid or semi-rigid bar composed of one or more biocompatible materials such as metal and plastic. For example, the pectus bar 1202 may be composed of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). The pectus bar 1202 may have an elongated body that forms a curve, such as a C-shape, so that it is flexible but rigid (or semi-rigid) enough to be bent to conform to the curve of the patient's thoracic cavity using a tool such as a bar bender.

[0045] Bar links 1204a and 1204b may be connectable to portions of pectus bars 1202a and 1202b, respectively, and may be movable along pectus bars 1202a and 1202b, respectively, as will be discussed in more detail below. Bar links 1204a and 1204b may be rigid or semi-rigid components made of materials such as metal and plastic, respectively. For example, bar links 1204a and 1204b may be made of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). Bar links 1204a and 1204b may have the same configuration, but may be rotatable, and in other embodiments, bar links 1204a and 1204b may be mirror copies of each other.

[0046] Bridge 1226 can be connected to pectus bar 1202 by bar link 1204 so that it can reinforce pectus bar 1202 as an assembly. Bridge 226 can be a rigid or semi-rigid component made of materials such as metal and plastic. For example, bridge 226 can be made of one or more biocompatible materials such as stainless steel alloy, cobalt-chromium, titanium, titanium alloy, polyetheretherketone (PEEK), and polyetherketoneketone (PEKK). The bridge may be cylindrical, but may have other shapes such as a rectangular prism, hexagonal prism, or octagonal prism.

[0047] Each bar link 1204 may include a body 1228 and an arm 1229 connected to the body 1228. The body 1228 and the arm 1229 together can form a slot 1230 for receiving a bridge 1226 at least partially in or through it. The arm 1229 may be connected to the body 1228 by a living hinge 1231, and the arm 1229 and the body 1228 together can form a clamp biased to the open position by the living hinge 1231. The living hinge 1231 may be integrated with the body 1228 and the arm 1229, and the living hinge 1231 may at least partially form the slot 1230. The living hinge 1231 may be configured to be elastically deformable, bend, or move to allow relative movement of the arm 1229 with respect to the body 1228, which may cause a change in the dimensions of the slot 1230.

[0048] The bar link 1204 may also include an arm actuator 1232 that can be connected to the body 1228 and the arm 1229. The arm actuator 1232 extends through the arm 1229 and is screwable into a hole 1240 (shown in Figure 13) in the body 1228, where the hole 1240 is screwable. The arm actuator 1232 may be a set screw, cam, screw, bolt, fastener, etc., which is operable to move between a first position in which the bridge 1226 is movable relative to the body 1228 and a second position in which the arm 1229 and the body 1228 engage with the bridge 1226 to clamp the bridge 1226 and fix the bar link 1204 to the bridge 1226. Since the arm 1229 is connected to the body 1228 by a living hinge 1231, when the arm actuator 1232 moves the arm 1229, the living hinge 1231 can elastically flex the arm 1229 relative to the body 1228. The arm 1229 can also be biased by the living hinge 1231 to an open or partially open position. Each bar link 1204 can be connected to the body 1228 and may include an actuator 1234 that can be actuated to fix the bar link 1204 to the pectus bar, as will be discussed in more detail below.

[0049] When the arm 1229 (for example, of the bar link 1204a) is in the open or unlocked position, the bar link 1204a may be translatable or movable along axis A of the bridge 1226. The bar link 1204a may also be rotatable around the bridge 1226 (for example, around axis A of the bridge 1226). The bar link 1204 is independently adjustable along and around the bridge 1226. Optionally, if the bar link 1204 is fixed to the pectus bar, the bridge 1226 can be adjusted relative to the bar link 1204. The movement and rotation brought about by the bar link 1204 are not limited or separate. This allows the surgeon to position the bar as desired or as needed by the procedure, whereas many devices of the prior art include discrete incremental holes for separating the pectus bar, limiting the choice of positioning on the pectus bar and potentially leading to interference with the ribs.

[0050] Figure 12 also shows that each burlink 1204 may include a head 1278 which can be connected to the body 1228. The head 1278 may be used by a physician to position the burlink 1204 relative to an anatomical structure, a pectus bar 1202, or a bridge 1226. The head 1278 may also include a rib 1280 which may be configured to be grasped by an instrument such as a needle holder or forceps for manipulating or positioning the burlink 1204, which may be useful for positioning relative to the bridge 1226 when the bridge 1226 is a cylindrical rod, as shown in Figure 12. The head 1278 may also be used to deform the body 1228 at least partially for the removal or explantation of one or more components of the pectus bar assembly 1200, as will be discussed in more detail below. The head 1278 may be lower than the arm 1229 (e.g., the posterior) to help limit or reduce the palpability of the head 1278.

[0051] Figure 14 shows a partial side view of the pectus bar assembly 1200. Figure 15 shows a partial side view of the pectus bar assembly 1200. Figure 16 shows a partial side view of the pectus bar assembly 1200. Figure 17 shows a partial side view of the pectus bar assembly 1200. Figures 14 to 17 are discussed together below. The pectus bar assembly 1200 in Figures 14 to 17 can be made consistent with Figures 12 and 13 described above, and Figures 14 to 17 show additional details of the pectus bar assembly 1200. For example, Figures 14 to 17 show how the pectus bars 1202a and 1202b and the bar links 1204a and 1204b can be connected to the first pectus bars 1202a and 1202b, respectively.

[0052] Figures 14 to 17 also show additional details of the bar link 1204. For example, Figures 14 to 17 show that each body 1228 of the bar link 1204 may include, or may define, an opening 1282 which can be configured to receive at least a portion of a pectus bar 1202. The opening 1282 may be at least partially defined by a shelf portion 1284 of the body. The shelf portion 1284 may be molded to fit either the end 1203a or 1203b of the first pectus bar 1202a or the second pectus bar 1202b. That is, the shelf portion 1284 may receive at least a portion of the end 1203a when the first pectus bar 1202a is inserted into the opening 1282, for example, as shown in Figures 14 to 17. The shelf section 1284 and the actuator 1234 can be molded and sized together so that the bar link 1204 can be positioned on the pectus bar 1202 from above (or from the front).

[0053] Figures 14 to 17 show further details of the hole 1240 of the arm actuator 1232, which can extend at least partially through the body 1228. The arm 1229 may also include an actuator hole 1241 that can extend at least partially through the arm 1229 and be aligned (e.g., coaxially) with the hole 1240. The upper part of the actuator hole 1241 may be tapered or angled so as to be complementary to the underside of the head of the arm actuator 1232, so that the arm actuator 1232 cannot pass the arm 1229 toward the body 1228. The body 1228 may include a crimping portion of the hole 1240 within the body 1228, which may be formed together with the head and the actuator hole 1241 to help capture or seize the arm actuator 1232. Optionally, when the arm actuator 1232 is rotated (for example clockwise), the hole 1240 may be screwed to engage with the threaded portion of the arm actuator 1232 so that the arm actuator 1232 moves into the body 1228, bringing the arm 1229 closer to the body 1228, closing the slot 1230, and clamping down onto the bridge 1226, thereby restricting the rotation of the bar link 1204a relative to the bridge 1226 and restricting the movement of the bar link 1204a along the bridge 1226. The bar link 1204b can be configured or operated similarly.

[0054] Figures 14 to 17 also show actuators 1234 positioned at least partially within the holes 1246 of the body 1228 of each bar link 1204. The actuator 1234 may be a set screw, cam, screw, bolt, fastener, etc., and may be operable to move between a first position (shown in Figures 14 and 15) in which the pectus bar 1202 is movable relative to the body 1228 and a second position in which the actuator 1234 engages with the pectus bar 1202 and clamps the bar link 1204 to the pectus bar 1202. As shown in Figures 14 and 15, the actuator 1234 may be in a fully retracted position, for example, that allows the pectus bar 1202a to be inserted into the opening 1282 of the bar link 1204a. The actuator 1234 can be moved relative to the body 1228 by rotating the actuator 1234 relative to the body 1228 using a cam, screw, or bolt, etc.

[0055] The actuator 1234 can be restricted or prevented from moving beyond its retracted position by means of stopping, crimping, etc., which can be configured to help to capture or seize the actuator 1234 in at least partially within the hole 1246. During assembly, the actuator 1234 can be screwed into the hole 1246 through the opening 1282. Following insertion, the actuator 1234 can be crimped near its proximal side (or forward side away from the opening 1282). Similarly, the actuator 1234 can be restricted or prevented from moving beyond its extended position by stopping, such as screw runout in the distal portion of the actuator 1234, or stopping in the hole 1246 or other stops of the actuator 1234.

[0056] As shown in Figures 16 and 17, the actuator 1234 can be operated (for example, by rotating it through the threaded portion of the hole 1246) to engage the first end 1203a with the shelf portion 1284 opposite the actuator 1234, thereby engaging with the second end 1203b of the pectus bar 1202, so that the bar link 1204 can be fixed to the pectus bar 1202. Such engagement can be reversed by reversing the actuator 1234 (for example, by rotating it counterclockwise) to release the bar link 1204 from the pectus bar 1202.

[0057] As shown in Figure 17, the actuator 1234 may be molded to have a flattened distal tip portion 1286 connected to a curved, arcuate, or rounded portion 1288 connected to a body 1290 which may be a threaded portion (e.g., threaded portion 1290). The radial portion 1288 may be configured to engage with the curved surface or portion of the second end portion 1203b. The arcuate or radius of curvature of the radial portion 1288 may be complementary to the end portion 1203b (e.g., molded to accept or fit). The radius of curvature of the rounded portion 1288 may be from 0.5 millimeters (mm) to 2.5 mm, for example from 1 mm to 2 mm. For example, the radius of curvature may be 1.1 mm, 1.2 mm, 1.3 mm, 1.4 mm, 1.5 mm, 1.6 mm, 1.7 mm, 1.8 mm, 1.9 mm, etc. Furthermore, the distal tip 1286 can have a diameter of 0.5 mm to 2.5 mm, for example, 1 mm to 2 mm. For example, the diameter of the distal tip 1286 may be 1.1 mm, 1.2 mm, 1.3 mm, 1.4 mm, 1.5 mm, 1.6 mm, 1.7 mm, 1.8 mm, 1.9 mm, etc. In one example, the distal tip may be about 1.6 mm, and the radius of curvature may be about 1.65 mm.

[0058] The flattened distal tip 1286 and the radial portion 1288 can also be molded together such that the flattened distal tip 1286 does not engage with the end 1203b when the actuator 1234 extends from its retracted position to its extended position while the pectus bar 1202a is inside the opening 1282, and as a result, the force applied to the pectus bar 1202b can push the pectus bar 1202b out of the opening 1282. Alternatively, the flattened distal tip 1286 and the radial portion 1288 can be shaped so that the actuator 1234 extends into the opening 1282, and the flattened distal tip 1286 does not engage with the second pectus bar 1202b, with only the radial portion 1288 engaging with the end 1203b, thereby simplifying the installation of the pectus bar assembly 1200 by applying force toward the body 1228 or shelf portion 1284.

[0059] Figures 14 to 17 also show that the head 1278 can extend from the body 1228 away from the actuator 1234, and the head 1278 can be connected to the body 1228 on the same side as the shelf 1284. The body 1228 can also include a recess 1292 (shown in Figure 16) which can create a relatively thin portion of the body 1228 between the recess 1292 and the shelf 1284, and can be used as described in Figure 18 below.

[0060] Figure 18 shows an isometric view of the pectus bar assembly 1200. The pectus bar assembly 1200 in Figure 18 can be made compatible with Figures 12 through 17 discussed earlier. Figure 18 shows how the head 1278 may be used. For example, when removing, detaching, or explanting one or more components of the pectus bar assembly 1200, it may be required to detach the bar link 1204b from the second pectus bar 1202b, which requires operating the actuator 1234 to detach the second pectus bar 1202b. However, tissue or bone may grow on or in the recess of the actuator 1234 configured to receive a tool or instrument, such as a hexagonal tubular interface, a hexagonal interface, or a cruciform interface. In such situations, it may be difficult to insert the instrument into the interface, or it may take a long time to remove the debris. When this state occurs, the main body 1228 bends around the recess 1292 (shown in Figure 16), increasing the size of the opening 1282. This allows the head 1278 to be inserted into the opening 56 of the bender 54 and the bender 54 to be operated to deform the main body 1228, enabling the bur link 1204b to be removed from the second pectus bar 1202b without operating the actuator 1234. The head 1278 of the bur link 1204a can be operated similarly to release the bur link 1204a from the first pectus bar 1202a, and the pectus bar assembly 1200 can be removed without operating the actuator 1234.

[0061] Figure 19 shows an isometric view of a portion of the pectus bar assembly 1200. The pectus bar assembly 1200 in Figure 19 can be made compatible with Figures 12 through 18 described above. Figure 19 also shows another way in which the head 1278 can be used. For example, it may be desirable to manipulate or position the bur link 1204a relative to the first pectus bar 1202a, bridge 1226, or anatomical structure during installation or removal. In such cases, the rib 1280 can be grasped using a gripping instrument 58 (e.g., an instrument including a jaw, such as a needle holder or forceps), allowing a physician or surgeon to easily position the bur link 1204a along or around the bridge 1226 using the instrument 58.

[0062] Figure 20 shows a cross-sectional view of a portion of the pectus bar assembly 1200. The pectus bar assembly 1200 in Figure 20 can be aligned with Figures 12 through 19 described above. Figure 20 shows how the bridge 1226 can interact with the slot 1230. More specifically, the slot 1230 may include a main hole 1294 and an angled portion 1295 in which the main hole 1294 can define a diameter D1 and the tapered portion can define a diameter D2 that is greater than the diameter D1. The angled portion 1295 may be tapered or inclined and may extend from the main hole 1294, which may be near the center of the slot 1230, toward each end of the slot 1230.

[0063] The bridge 1226 may include a shaft 1296 having a diameter D4 along the length of the shaft 1296, which may be the majority of the length of the bridge 1226. The bridge 1226 may also include flared or enlarged portions 1297 positioned at the ends of the shaft 1296. The bridge 1226 may include enlarged portions at each of its ends. The enlarged portions 1297 may have or be defined a diameter D5 that is larger than the diameter D4 of the shaft 1296. This enlarged diameter may be slightly larger than the diameter D1 so that there is some resistance to the insertion or removal of the bridge 1226 into or out of the slot 1230 as the bridge 1226 moves through the slot 1230.

[0064] Furthermore, since diameter D2 can be larger than the diameter D4 of shaft 1296, and diameter D1 is only slightly larger than the diameter D4 of shaft 1296, when the arm actuator 1232 is in the unlocked configuration, the bar link 1204 can be configured to tilt in multiple directions with respect to the longitudinal axis A of bridge 1226 even after the bridge 1226 has been inserted into slot 1230, thereby allowing the bar link 1204 to be positioned at various angles with respect to the bar link 1204a.

[0065] When two pectus bars are used to correct deformities such as pectus excavatum, the bars (e.g., 1202) are often not perfectly aligned (or parallel) to each other. The bars also do not have to be in the same plane and may be tilted or rotated relative to each other. Due to these features, the bar link 1204 can accommodate misalignment between the two bars 1202. These features (and optionally, the bending of the bridge 1226) also allow the bar link 1204 to be used with pectus bars mounted in a cross configuration, an X configuration, or other non-parallel configuration. When the bridge 1226 and bar link 1204a are in their desired positions, the orientation of the bridge 1226 relative to the bar link 1204a can be fixed using the arm actuator 1232.

[0066] This adjustment feature, which tilts the bar link 1204 relative to the bridge 1226 together with the bar link 1204, is adjustable along the pectus bar 1202, the bar link 1204 is adjustable along the bridge 1226, and the bar link 1204 is rotatable around the bridge 1226, allowing the pectus bar assembly 1200 to be positioned or adjusted in any direction, and enabling the pectus bar assembly 1200 to be attached to patient anatomical structures of various shapes and sizes.

[0067] Figure 21 shows an isometric view of a portion of the pectus bar assembly 2100. Figure 22 shows an isometric view of a portion of the pectus bar assembly 2200. Figure 23 shows an isometric view of a portion of the pectus bar assembly 2300. Figures 21 to 23 are discussed together below. The pectus bar assemblies 2100, 2200, and 2300 may be similar to the pectus bar assembly 1200 described above. Figures 21 to 23 show various ways in which the assemblies can be used.

[0068] As shown in Figure 21, the pectus bar assembly 2100 can include two pectus bars 2102a and 2102b, two ballasts 2104a and 2104b, and a single bridge 2226. As shown in Figure 22, the pectus bar assembly 2200 can include three pectus bars 2102a and 2102b, four ballasts 2104a to 2104d, and two bridges 2226a and 2226b. In this configuration, bar 2102b can accept two ballasts 2104b and 2104c to connect bars 2102a and 2102c. As shown in Figure 23, the pectus bar assembly 2300 may include three pectus bars 2102a and 2102b, but since there are three ballasts 2104a to 2104c and only one bridge 2226, fewer pieces of hardware can be used to interconnect the three pectus bars. Figures 21 to 23 show that the pectus bar assembly 2200 can be used in systems using one or more pectus bars, such as one, two, three, four, five, etc.

[0069] (Notes and Implementation) The following non-limiting embodiments will, in particular, illustrate specific aspects of the subject matter in order to solve the problems and provide the benefits discussed herein.

[0070] Embodiment 1 is a pectus bar assembly comprising a first pectus bar and a second pectus bar engaged with the sternum, a first bracket connectable to the first pectus bar, a second bracket connectable to the second pectus bar, and a bridge connectable to the first bracket and the second bracket, such that the first bracket and the first pectus bar move along the bridge, and the second bracket and the second pectus bar move along the bridge independently of the first pectus bar.

[0071] In Example 2, the subject of Example 1 optionally includes a first bracket comprising a base and a receptor connected to the base, the receptor being configured to receive the end of the first pectus bar.

[0072] In Example 3, the subject of Example 2 optionally includes a first bracket which includes a boss extending from the base surface, and a bridge which includes a slot configured to receive at least a portion of the boss.

[0073] In Embodiment 4, the subject of Embodiment 3 optionally includes the boss being movable inside the slot to allow the first bracket to move along the bridge.

[0074] In Example 5, the subject of Example 4 optionally includes a first fastener that can be fixed to a boss and engaged with the bridge in order to fix the first bracket to the bridge and to restrict the movement of the first bracket along the bridge.

[0075] In Example 6, the subject of Example 5 optionally includes a second bracket comprising a base and a receptor connected to the base, wherein the receptor is configured to receive the end of a second pectus bar therein.

[0076] In Example 7, the subject of Example 6 optionally includes a second bracket that includes a boss extending from the base surface, the boss being movable inside the slot of the bridge to allow the second bracket to move relative to the bridge.

[0077] In Example 8, the subject of Example 7 optionally includes a second fastener that can be fixed to a boss on the second bracket and engageable with the bridge in order to fix the second bracket to the bridge and to restrict the movement of the second bracket relative to the bridge.

[0078] In Example 9, one or more themes from Examples 1 to 8 optionally include a first bracket comprising a base that can engage with a first side of the bridge, and a plate that can be fixed to the base and can engage with a second side of the bridge opposite to the first side of the bridge, wherein the plate can engage with a first pectus bar, and the base and plate are movable together along the bridge.

[0079] In Example 10, the subject of Example 9 optionally includes a first bracket having a cap that is engageable with a first pectus bar and can be fixed to a plate, wherein the cap, plate, base, and bridge are movable together along the first pectus bar.

[0080] In Example 11, the subject of Example 10 optionally includes fixing a first bracket to a first pectus bar, and fasteners that can be fixed to the cap and base to restrict the movement of the cap, plate, base and bridge along the first pectus bar, and fasteners that can be fixed to the plate to restrict the movement of the base and plate along the bridge.

[0081] In Example 12, the subject of Example 11 optionally includes a second bracket comprising: a base that is engageable with a first side of the bridge and engageable with a second pectus bar; a plate that is fixable to the base and engageable with a second side of the bridge opposite to the first side, and is movable with the base; a cap that is engageable with the second pectus bar and fixable to the plate, the cap, plate, base and bridge are all movable along the second pectus bar; and fasteners that are fixable to the cap and base to fix the second bracket to the second pectus bar and to restrict the movement of the cap, plate, base and bridge along the second pectus bar, and fasteners that are fixable to the plate to restrict the movement of the base and plate along the bridge.

[0082] Example 13 is a pectus bar assembly comprising a first pectus bar and a second pectus bar engaged with the sternum, a first bracket connectable to the first pectus bar and defining a receptor, and a second bracket connectable to the second pectus bar and including a projection, the projection being insertable into the receptor to connect the first bracket to the second bracket and to secure the first pectus bar to the second pectus bar.

[0083] In Example 14, the subject of Example 13 optionally includes the projection and the receiver both forming a ratchet interface for securing the first bracket to the second bracket.

[0084] In Example 15, one or more subjects of Examples 13 to 14 optionally include a first bracket comprising a claw portion connected to a receiver, a projection comprising a plurality of teeth, and the plurality of teeth being able to engage with the claw portion to allow the projection to move into the receiver and restrict the projection from moving out of the receiver when the projection is inserted into the receiver.

[0085] In Example 16, one or more themes from Examples 13 to 15 optionally include a first bracket that is movable along a first pectus bar and a second bracket that is movable along a second pectus bar.

[0086] In Example 17, the subject of Example 16 optionally includes fasteners that can be fixed to the first pectus bar and the first bracket in order to restrict the movement of the first bracket along the first pectus bar.

[0087] In Example 18, one or more themes from Examples 13 to 17 optionally include a projection that is engageable with a receptor to restrict the movement of a second bracket and a second pectus bar toward a first bracket and a first pectus bar.

[0088] Example 19 is a method for installing a pectus bar assembly, comprising inserting a first pectus bar and a second pectus bar into the sternum, connecting a first bracket to the first pectus bar, connecting a second bracket to the second pectus bar, connecting a bridge to the first bracket and the second bracket, moving the first bracket along the bridge, moving the second bracket along the bridge, fastening the first bracket to the bridge, and fastening the second bracket to the bridge.

[0089] In Example 20, the subject of Example 19 optionally includes fastening the first bracket to the first pectus bar and fastening the second bracket to the second pectus bar.

[0090] In Example 21, one or more themes from Examples 19 to 20 optionally include connecting the first cap to the first bracket and moving the first bracket and bridge along the first pectus bar.

[0091] In Example 22, the subject of Example 21 optionally includes connecting the second cap to the second bracket and moving the second bracket and bridge along the second pectus bar.

[0092] Embodiment 23 is a pectus bar assembly comprising: a first pectus bar and a second pectus bar engaged with the sternum; a first bar link connectable to the first pectus bar and movable along the first pectus bar; a second bar link connectable to the second pectus bar and movable along the second pectus bar; and a bridge defining a longitudinal axis and connectable to the first bar link and the second bar link, wherein the first bar link and the second bar link are independently movable along the bridge and independently rotatable about the longitudinal axis of the bridge.

[0093] In Example 24, the subject of Example 23 optionally includes a first bar link comprising a body and a shelf connected to the body, wherein the shelf is configured to receive the first end of a first pectus bar therein.

[0094] In Example 25, the subject of Example 24 optionally includes an actuator extending through a hole in the main body, the actuator being operable between an unlocked position in which it is not engaged with the first pectus bar and a locked position in which the actuator engages with the second end of the first pectus bar to create an engagement between the first end of the pectus bar and the shelf, and to fix the first bar link to the first pectus bar.

[0095] In Example 26, the subject of Example 25 optionally includes the actuator being rotatable and moving the actuator within a hole in the main body.

[0096] In Example 27, the subject matter of Example 26 optionally includes the actuator being trapped within a hole in the main body.

[0097] In Example 28, one or more themes from Examples 26 to 27 optionally include being shaped such that the distal portion of the actuator avoids engagement with the anterior portion of the first pectus bar when the actuator is moved from the unlocked position to the locked position.

[0098] In Example 29, one or more subjects from Examples 25 to 28 optionally include a first bar link, the first bar link including a head extending away from the body and actuator, the head being movable to deform the body and release the first bar link from the first pectus bar.

[0099] In Example 30, the subject of Example 29 optionally includes a head that includes a rib capable of gripping the bridge and the first bar link for manipulating the first pectus bar.

[0100] In Embodiment 31, the subject of Embodiment 30 optionally includes a first bar link, which includes an arm connected to a body, the arm and the body together defining a slot configured to receive a bridge at least partially therein, and an arm actuator connected to the body and the arm, which is operable to move between a first position in which the bridge is movable relative to the body and a second position in which the arm and the body engage with the bridge to fix the first bar link to the bridge.

[0101] In Example 32, the subject matter of Example 31 optionally includes the case where the arm and the body together form a clamp.

[0102] In Embodiment 33, the subject of Embodiment 32 optionally includes the connection of the arm to the body by a living hinge configured to allow the arm to bend elastically relative to the body as the arm moves between a first position and a second position.

[0103] In Embodiment 34, the subject of Embodiment 33 optionally includes a hole in which the slot includes a portion angled to the opening of the hole, configured to allow the first bar link to tilt with respect to the longitudinal axis of the bridge when the bridge is positioned within the slot of the first bar link and the arm actuator is in the first position.

[0104] In Example 35, one or more themes from Examples 33 to 34 optionally include the living hinge forming at least a portion of a slot.

[0105] In Example 36, one or more themes from Examples 23 to 35 optionally include the bridge being a cylindrical rod.

[0106] Embodiment 37 is a pectus bar assembly comprising a first pectus bar and a second pectus bar engaged with the sternum, a first bar link connectable to the first pectus bar and movable along the first pectus bar, a second bar link connectable to the second pectus bar and movable along the second pectus bar, and a rod extending along the longitudinal axis, wherein the rod is connectable to the first bar link and the second bar link, the first bar link and the second bar link are independently movable along the rod, and the first bar link and the second bar link are independently rotatable about the longitudinal axis of the bridge.

[0107] In Example 38, the subject of Example 37 optionally includes a first bar link comprising a body, a shelf connected to the body and configured to receive the first end of the first pectus bar, and an actuator extending through a hole in the body, which is rotatable between an unlocked position in which the actuator is disengaged from the first pectus bar and a locked position in which the actuator engages with a second end of the first pectus bar, causing engagement between the first end of the pectus bar and the shelf, thereby fixing the first bar link to the first pectus bar.

[0108] In Example 39, the subject matter of Example 38 optionally includes the actuator being trapped inside the hole by the main body.

[0109] In Example 40, one or more themes from Examples 38 to 39 optionally include being molded such that the distal portion of the actuator avoids engagement with the forward portion of the first pectus bar when the actuator is moved from the unlocked position to the locked position.

[0110] In Example 41, one or more subjects from Examples 38 to 40 optionally include a first bar link, the first bar link being a head extending away from the body and actuator, and including a head that is movable to deform the body and release the first bar link from the first pectus bar.

[0111] In Embodiment 42, the subject of Embodiment 41 optionally includes a first bar link, which includes an arm connected to a body, the arm and the body together defining a slot configured to at least partially receive a bridge therein, and an arm actuator connected to the body and the arm, which is operable to move between a first position in which the bridge is movable relative to the body and a second position in which the arm and the body engage with the bridge to fix the first bar link to the bridge.

[0112] In Example 43, any one or any combination of the apparatus or method from Examples 1 to 42 may be optionally configured so that all of the enumerated elements or options are available or selectable.

[0113] The above detailed description has reference to the accompanying drawings which form part of the detailed description. The drawings illustrate specific embodiments that can carry out the present invention as examples. These embodiments are also referred to herein as “Examples,” and such Examples may include elements in addition to those shown or described. However, the inventors also intend to include examples in which only the elements shown or described are provided. Furthermore, the inventors also intend to include examples in which, with respect to a particular example (or one or more embodiments thereof), or with respect to multiple embodiments of other embodiments shown or described herein, any combination or substitution of the elements shown or described (or one or more embodiments thereof) is used.

[0114] In the event of any inconsistent use between this document and any document so as to be invoked by the standards, the use in this document shall prevail. In this specification, the terms “including” and “in which” are used as plain English synonyms for the terms “comprising” and “where.” Furthermore, in the following claims, the terms “including” and “comprising” are open-ended; that is, systems, apparatus, articles, compositions, formulations, or processes are deemed to be included in the scope of the claim, in addition to the elements described after such terms.

[0115] In this specification, the terms "a" or "an" are used to include one or more, independently of other examples or uses of "at least one" or "one or more," as is common in patent literature. In this specification, the term "or" is used to indicate non-exclusive elements. For example, "A or B" includes "A but not B," "B but not A," and "A and B," rather than "B," unless otherwise specified. In this specification, the terms "including" and "in which" are used as plain English synonyms for the terms "comprising" and "wherein," respectively. Furthermore, in the following claims, the terms "including" and "comprising" are open-ended; that is, systems, apparatus, articles, compositions, formulations, or processes are considered to be included in the scope of the claim, in addition to the elements described after such terms in the claim. Moreover, in the following claims, terms such as "first," "second," and "third" are used merely as labels and are not intended to impose numerical requirements on their subject matter.

[0116] The above are illustrative and not limiting. For example, the above embodiments (or one or more of their embodiments) may be used in combination with one another. Other embodiments may be used, for example, by a person skilled in the art considering the above description. An abstract is provided in accordance with 37 C. FR § 1.72(b) to allow the reader to quickly confirm the nature of the technical disclosure. It should be understood that the abstract is not used to interpret or limit the claims. In the above detailed description, various features may be grouped together to streamline the disclosure. This should not be interpreted as meaning that any disclosed features not claimed are essential to any claim. Rather, the subject matter of the invention may reside in fewer features than all the features of a particular disclosed embodiment. Accordingly, the following claims are incorporated into the detailed description as examples or embodiments, and each claim stands independently as a separate embodiment, and it is intended that such embodiments can be combined with one another in various combinations or permutations. The scope of the invention should be determined by reference to the appended claims and the entire scope of equivalents to which such claims are entitled.

Claims

1. A pectus bar assembly, A first pectus bar and a second pectus bar that can engage with the sternum, A first bar link is connectable to the first pectus bar and movable along the first pectus bar, A second bar link is connected to the second pectus bar and is movable along the second pectus bar, A bridge having a defined longitudinal axis and connectable to a first bar link and a second bar link, wherein the first bar link and the second bar link are independently movable along the bridge and independently rotatable about the longitudinal axis of the bridge, A pectus bar assembly comprising [a specific feature].

2. The first bar link described above is The main unit and A shelf connected to the main body, the shelf being configured to receive the first end of the first pectus bar, The assembly according to claim 1, comprising:

3. The first bar link described above is An actuator extending through a hole in the main body, wherein the actuator is operable between an unlocked position in which the actuator is disengaged from the first pectus bar and a locked position in which the actuator engages with a second end of the first pectus bar to create engagement between the first end of the pectus bar and the shelf portion, and to fix the first bar link to the first pectus bar, The assembly according to claim 2.

4. The assembly according to claim 3, wherein the actuator is rotatable so as to move the actuator inside the hole of the main body.

5. The assembly according to claim 4, wherein the actuator is captured inside the hole of the main body.

6. The assembly according to claim 4, wherein the distal portion of the actuator is shaped to avoid engagement with the front portion of the first pectus bar when the actuator is moved from the unlocked position to the locked position.

7. The assembly according to claim 3, wherein the first bar link is a head extending away from the body and the actuator, and the head is movable for deforming the body and releasing the first bar link from the first pectus bar.

8. The assembly according to claim 7, wherein the head includes a rib that can grip the bridge and the first pectus bar to operate the first bar link.

9. The first bar link described above is An arm connected to the main body, wherein the arm and the main body together define a slot configured to at least partially receive the bridge, An arm actuator connected to the main body and the arm, which is operable to move between a first position in which the bridge is movable relative to the main body and a second position in which the arm and the main body engage with the bridge to fix the first bar link to the bridge, The assembly according to claim 8, comprising:

10. The assembly according to claim 9, wherein the arm and the body together form a clamp.

11. The assembly according to claim 10, wherein when the arm moves between the first position and the second position, the arm is connected to the body by a living hinge configured to be elastically flexible relative to the body.

12. The assembly according to claim 11, wherein the slot is a hole including an angled portion of the opening of a hole configured to tilt the first bar link with respect to the longitudinal axis of the bridge when the bridge is positioned within the slot of the first bar link and the arm actuator is in the first position.

13. The assembly according to claim 11, wherein the living hinge forms at least partially the slot.

14. The assembly according to claim 1, wherein the bridge is a cylindrical rod.

15. A pectus bar assembly, A first pectus bar and a second pectus bar that can engage with the sternum, A first bar link that is connectable to the first pectus bar and movable along the first pectus bar, A second bar link that is connectable to the second pectus bar and movable along the second pectus bar, A rod extending along the longitudinal axis and connectable to the first bar link and the second bar link, wherein the first bar link and the second bar link are independently movable along the rod and are independently rotatable about the longitudinal axis of the bridge, A pectus bar assembly comprising [a specific feature].

16. The first bar link described above is The main unit and A shelf connected to the main body, the shelf configured to receive the first end of the first pectus bar, An actuator extending through a hole in the main body, wherein the actuator is operable between an unlocked position in which it is disengaged from the first pectus bar and a locked position in which it engages with the second end of the first pectus bar to create engagement between the first end of the pectus bar and the shelf portion, and to fix the first bar link to the first pectus bar, The assembly according to claim 15, comprising:

17. The assembly according to claim 16, wherein the actuator is captured inside the hole by the main body.

18. The assembly according to claim 16, wherein the distal portion of the actuator is shaped to avoid engagement with the front portion of the first pectus bar when the actuator is moved from the unlocked position to the locked position.

19. The assembly according to claim 16, wherein the first bar link is a head extending away from the body and the actuator, and the head is movable for deforming the body and releasing the first bar link from the first pectus bar.

20. The first bar link described above is An arm connected to the main body, wherein the arm and the main body together define a slot configured to at least partially receive the bridge, An arm actuator connected to the main body and the arm, which is operable to move between a first position in which the bridge is movable relative to the main body and a second position in which the arm and the main body engage with the bridge to fix the first bar link to the bridge, The assembly according to claim 19, comprising:

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