CN112057155B

CN112057155B - Funnel chest orthopedic system

Info

Publication number: CN112057155B
Application number: CN202010887926.2A
Authority: CN
Inventors: 高阳; 周卧龙
Original assignee: Xiangya Hospital of Central South University
Current assignee: Xiangya Hospital of Central South University
Priority date: 2020-08-28
Filing date: 2020-08-28
Publication date: 2022-02-18
Anticipated expiration: 2040-08-28
Also published as: CN112057155A

Abstract

The invention discloses a funnel chest orthopedic system, which comprises a rib splint assembly and a sternum splint, wherein an adjustable correction gap for correcting thoracic deformity is formed between the rib splint assembly and the sternum splint, the rib splint assembly comprises a left rib splint and a right rib splint, the left rib splint and the right rib splint are detachably connected in a left-right sliding manner, and the sternum splint is detachably connected with the left rib splint or the right rib splint in an up-down sliding manner. According to the invention, through the splint type design, under the principle of conforming to the skeleton structure and human mechanics of a human body, the rib plates are arranged on the surfaces of the ribs, the sternum plates are supported on the inner surfaces of the sternums, and the width of the gap between the splint plates is adjusted and fixed through the connecting grooves, so that the problems of complicated operation and high risk brought by NUSS funnel chest orthopedic surgery, sunken rib and new deformity after surgery, cutting injury, pain, blood circulation disorder, uneven stress and the like brought to tissues by steel wire suspension are solved.

Description

Funnel chest orthopedic system

Technical Field

The invention relates to the field of medical instruments, in particular to a funnel chest orthopedic system.

Background

The funnel chest refers to the dorsal concavity deformity of sternum, costal cartilage and partial rib, forming the funnel shape, and the sternum of most funnel chests starts from the level of the 2 nd or 3 rd costal cartilage to the dorsal side to the lowest point on the xiphoid process, forming the boat-like or funnel-like deformity, which is a congenital and often familial disease.

The most common funnel chest correction operation in clinic at present is an improved NUSS operation (non-thoracoscopic assisted two-incision Nuss operation) which is characterized in that 1.5-2.5 cm transverse incisions are made at the lowest point of sternum depression between the anterior axillary space and the posterior axillary space on two sides, the subcutaneous tissue and the muscle layer are separated layer by layer from the right incision to the intercostal space, the sunken edge of the same side is dissociated to the sunken edge of the same side, the guider passes through the intercostal space from the sunken edge and is tightly attached to the anterior chest wall, the poststernal notch is carefully dissociated from the outer side of the mediastinal pleura to avoid damaging the shifted heart, pericardium, lung and great vessel pressed by the malformed sternum, the intercostal space is formed from the sunken edge of the left sternum to the left incision, the convex surface of the steel plate is guided to be pulled backwards to the right side through the sternum, the steel plate is turned over by 180 degrees to prop up the poststernal notch, and the steel plate is fixed by a fixer, which refers to the research situation of Wuss operation treatment funnel chest disclosed by Huwei Guang, Jianying, Liyong and the like. This technique has the following disadvantages: 1. the number of surgical incisions is large, and the surgical incisions are long; 2. the subcutaneous tunnel is long, and the potential wound is large; 3. high risk when crossing the anterior chest wall, especially the heart surface; 4. the operation is relatively difficult and needs to be completed by an experienced doctor; 5. the width of the chest walls on two sides is influenced, the children grow fast, and new deformity can be caused; 6. the pain of the patient is obvious.

In view of the above disadvantages, the Wang's funnel chest orthosis improves the operation of the funnel chest orthosis. However, the current funnel chest orthoses are integrated titanium plates (including a middle plate body and two side bent plate tails); an orthosis is placed through the median incision during surgery to suspend and secure the depressed sternum and costal arch with steel wires. However, this technique has the following disadvantages: 1. the steel wire is not stably suspended (the complete vertical suspension is difficult to ensure in the operation process, and the hidden danger of looseness is buried in the future); 2. the steel wire draws to cause cutting damage (the steel wire has high pressure to press tissues); 3. steel wires cause ischemia of local tissues (compression of blood vessels); 4. steel wire stretch cutting causes post-operative pain (nerve compression); 5. the integral titanium plate is difficult to be placed from a single incision (or the size of an external incision is required to be increased, or the length of an internal thoracic skin sinus is required to be increased); 6. the correction of the thoracic deformity is suspended by steel wires and the stress is uneven; 7. when the suspension is implemented in the operation process, the force is not easy to control.

Disclosure of Invention

The invention aims to provide a funnel chest orthopedic system, so that the problems of complicated operation and high risk, new rib depression and deformity after operation, inconvenience in placing an integrated titanium plate, instability in fixing, steel wire traction injury and postoperative pain of a patient caused by NUSS funnel chest orthopedic operation are solved.

In order to achieve the purpose, the invention discloses a funnel chest orthopedic system, which comprises a rib splint assembly and a sternum splint, wherein an adjustable correction gap for correcting thoracic deformity is formed between the rib splint assembly and the sternum splint, the rib splint assembly comprises a left rib splint and a right rib splint, the left rib splint and the right rib splint are detachably connected in a left-right sliding manner, and the sternum splint is detachably connected with the left rib splint or the right rib splint in an up-down sliding manner.

Further, the left rib splint, the right rib splint and the sternum splint are provided with fixing through holes for preventing movement.

Furthermore, the tip of one of them of left side rib splint and right side rib splint is provided with horizontal dysmorphism groove and screw through-hole, another be provided with can with horizontal dysmorphism inslot sliding connection's horizontal slider, the screw through-hole link up horizontal dysmorphism inslot and along the sliding direction equipartition of horizontal slider, be provided with the locating hole on the horizontal slider, be provided with in the screw through-hole and peg graft the set screw of locating hole.

Furthermore, the tip of left side rib splint or right side rib splint is provided with vertical dysmorphism groove and clearance adjustment screw hole, sternum splint be provided with can with the vertical slider of vertical dysmorphism groove sliding connection, the tip of vertical slider is provided with the threaded connection hole, the threaded connection hole of clearance adjustment is provided with in the screw hole can peg graft clearance adjustment screw in the threaded connection hole.

Further, still including bullet pad and locking screw end cap, the threaded connection hole is relative two at least that set up, be provided with the screw thread counter bore on the clearance adjustment screw hole, the bullet pad cup joints on the clearance adjustment screw, locking screw end cap and screw thread counter bore are connected and are leaned on the clearance adjustment screw.

Furthermore, the end parts of the left rib splint and the right rib splint are provided with splint hook plates bent towards the rib edges, and the splint hook plates are arranged in a telescopic way relative to the left rib splint and the right rib splint.

Further, still including installing the end plate of left side rib splint and right side rib splint tip, the tip of left side rib splint and right side rib splint is provided with rib splint hole and guiding hole, be provided with guide pin and spring loop bar on the splint collude the board, the guide pin passes the end plate with the guiding hole sliding connection, the spring loop bar passes the end plate inserts in the rib splint is downthehole, has cup jointed the spring on this spring loop bar, the one end of spring supports and leans on the locating part of spring loop bar one end, and the other end supports and leans on the end plate.

The breastbone splint device comprises a breastbone splint tray, an adjusting rod, an upper pressing plate and an upper pressing plate loading mechanism, wherein the breastbone splint tray is provided with a pressure sensor, the adjusting rod is provided with a display connected with the pressure sensor, the upper pressing plate is provided with a sliding connection hole in sleeve connection with the adjusting rod, and the loading end of the upper pressing plate loading mechanism acts on the upper pressing plate.

Furthermore, one side of the upper pressing plate is provided with an upper pressing plate hook plate which can hook the edge of the left rib splint or the right rib splint, and one side of the sternum splint tray is provided with a tray hook plate which can hook the edge of the sternum splint.

Furthermore, top board loading mechanism includes application of force swivel nut and sets up external screw thread portion on adjusting the pole, application of force swivel nut with external screw thread portion thread bush connects, the upper end of adjusting the pole is provided with handheld portion.

Compared with the prior art, the invention has the advantages that:

according to the invention, through the splint type design, under the principle of conforming to the skeleton structure and human mechanics of a human body, the rib plates are arranged on the surfaces of the ribs, the sternum plates are supported on the inner surfaces of the sternums, and the width of the gap between the splint plates is adjusted and fixed through the connecting grooves, so that the problems of complex operation and high risk of operation brought by NUSS funnel chest orthopedic surgery, sunken rib and new deformity of the axillary rib after the operation, cutting injury, pain, blood circulation disorder, uneven stress and the like brought to tissues by steel wire suspension are solved;

in order to facilitate the clamping operation of the splint and visually control the force, the invention adopts the power-assisted clamping device, the sternum plate tray is jointed and fixed with the sternum plate, the pressure sensor is arranged on the bottom surface, and the pressure is visually displayed through the top end display, thereby being beneficial to holding the force in the operation process of a clinician. Furthermore, through thread transmission, the force application threaded sleeve moves up and down along the adjusting rod, so that the distance between the costal splint component and the sternum splint can be continuously adjusted, meanwhile, the force application threaded sleeve is labor-saving and convenient to rotate, the force application threaded sleeve can be self-locked through threads, and the force application threaded sleeve cannot back up after the hand is loosened, so that a surgeon can easily lock and fix the position of the sternum-costal splint.

The invention prevents the fixed sternum-rib splint from moving laterally, and small holes are arranged in the sternum plate and the rib plate, and can be penetrated and fixed by suture or steel wires. Simultaneously, in order to prevent that measurement and actual error lead to the rib board length improper, divide into two left and right independent boards with the rib board, finely tune through adjustable connector. Furthermore, in order to solve the problem that the beauty of the operation incision is greatly influenced due to the fact that the rib plate is too long, the rib plate is divided into a left plate and a right plate which are independent, a small opening can be formed, the left plate and the right plate can be inserted respectively, and the operation incision is reduced to the maximum extent.

The present invention will be described in further detail below with reference to the accompanying drawings.

Drawings

The accompanying drawings, which are incorporated in and constitute a part of this application, illustrate embodiments of the invention and, together with the description, serve to explain the invention and not to limit the invention. In the drawings:

FIG. 1 is a first isometric illustration of a funnel chest orthotic system according to the preferred embodiment of the present invention;

FIG. 2 is a second axial schematic view of the funnel chest orthotic system disclosed in accordance with the preferred embodiment of the present invention;

FIG. 3 is an exploded view of the funnel chest orthotic system disclosed in accordance with the preferred embodiment of the present invention;

FIG. 4 is an enlarged schematic view of FIG. 3 at A;

FIG. 5 is a schematic illustration of a power-assisted clip applier of the funnel chest orthopedic system, in accordance with a preferred embodiment of the present invention;

fig. 6 is a schematic structural view of a left rib splint (or a right rib splint) and a splint hook plate of the funnel thoracic orthopedic system according to the preferred embodiment of the present invention.

Illustration of the drawings:

1. a rib splint assembly; 2. a sternum splint; 3. the gap can be corrected in an adjustable way; 4. left lateral rib splints; 5. right lateral rib splints; 6. a transverse profile groove; 7. a threaded through hole; 8. a transverse slide block; 9. positioning holes; 10. a set screw; 11. a vertical profile groove; 12. a clearance adjustment threaded hole; 13. a vertical slide block; 14. connecting a threaded hole; 15. a gap adjustment screw; 16. a splint hook plate; 17. a sternum splint tray; 18. adjusting a rod; 19. an external threaded portion; 20. a force application threaded sleeve; 21. an upper pressure plate; 22. sliding connection holes; 23. an operation hole; 24. an upper pressing plate hook plate; 25. a hand-held portion; 26. a spring; 27. an end plate; 28. a guide hole; 29. a guide pin; 30. a pressure sensor; 31. a display; 32. a spring loop bar; 33. a limit nut; 34. rib splint holes; 35. a spring pad; 36. the anti-loosening threaded plug; 37. a fixing through hole; 38. and a tray hook plate.

Detailed Description

The embodiments of the invention will be described in detail below with reference to the drawings, but the invention can be implemented in many different ways as defined and covered by the claims.

As shown in fig. 1-6, the present invention discloses a funnel chest orthopedic system, which includes a rib splint assembly 1 and a sternum splint 2, both of which are made of titanium alloy steel plate (or other steel plate materials for orthopedics), an adjustable correction gap 3 for correcting a thoracic deformity is formed between the rib splint assembly 1 and the sternum splint 2, the rib splint assembly 1 includes a left rib splint 4 and a right rib splint 5, the left rib splint 4 and the right rib splint 5 are detachably connected in a left-right sliding manner, the sternum splint 2 is detachably connected in a vertical sliding manner with the left rib splint 4 or the right rib splint 5, so as to prevent the length of the rib plate from being inappropriate due to measurement and actual errors, the rib plate is divided into left and right independent plates, and fine adjustment is performed through an adjustable connector. Furthermore, the rib plate is divided into two parts, so that the problem that the surgical incision is large and the appearance is affected due to the fact that the rib plate is too long is solved, the rib plate is divided into a left plate and a right plate which are independent, a small opening can be formed, the left plate and the right plate can be inserted respectively, and the surgical incision is reduced to the maximum extent.

In this embodiment, the left and right

costal splint plates

4, 5 and the sternum splint 2 are provided with fixing through holes 37 for preventing movement, and can be passed through and fixed by sutures or wires when in use.

In this embodiment, in order to realize the detachable left-right sliding connection between the left rib splint 4 and the right rib splint 5, one end of the left rib splint 4 and the right rib splint 5 is provided with a transverse special-shaped groove 6 and a threaded through hole 7, the transverse special-shaped groove 6 is a T-shaped groove, the other one is provided with a transverse slider 8 capable of sliding with the transverse special-shaped groove 6, the transverse slider 8 is a T-shaped slider matched with the T-shaped groove, so that the transverse slider 8 can slide transversely but cannot rotate, the threaded through hole 7 penetrates into the transverse special-shaped groove 6 and is uniformly distributed along the sliding direction of the transverse slider 8, the transverse slider 8 is provided with a positioning hole 9, the threaded through hole 7 is internally provided with a positioning screw 10 capable of being inserted into the positioning hole 9 to limit the relative sliding, and the positioning screw 10 is matched with different positioning holes 9, so as to adapt to patients with different rib widths, specifically, the threaded through hole 7, the positioning screw 10 and the positioning hole 9 are distributed on two sides of the transverse special-shaped groove 6, so that the fixing strength of the transverse sliding block 8 is enhanced.

In order to realize the up-and-down sliding adjustment of the vertical special-shaped groove 11, the end part of one of the left rib splint 4 and the right rib splint 5 is provided with the vertical special-shaped groove 11 and a gap adjusting threaded hole 12, in the embodiment, the vertical special-shaped groove 11 is a T-shaped groove and is arranged on the left rib splint 4, the sternum splint 2 is provided with a vertical sliding block 13 which can be in sliding connection with the vertical special-shaped groove 11, the vertical sliding block 13 is also a T-shaped sliding block, the end part of the vertical sliding block 13 is provided with a threaded connecting hole 14, and the gap adjusting threaded hole 12 is internally provided with a gap adjusting screw 15 which can be inserted into the threaded connecting hole 14, so that when in use, the continuous stepless adjustment of the adjustable correction gap 3 can be realized by adjusting the gap adjusting screw 15, and further the pressing force acting on the sternum can be adjusted.

In this embodiment, consider that postoperative left side rib splint 4, right side rib splint 5 and breastbone splint 2 can put into the human body in the long-term installation, in order to prevent the not hard up that breastbone splint 2 connects, still including two kinds of locking designs of the locking of bullet pad 35 and locking screw end cap 36, be provided with the screw thread counter bore on the clearance adjustment screw hole 12, bullet pad 35 cup joints on clearance adjustment screw 15, locking screw end cap 36 and screw thread counter bore are connected and are leaned on clearance adjustment screw 15, it is further, threaded connection hole 14 is relative two at least that set up, two threaded connection mutual constraints, thereby realize thorough locking purpose. In this embodiment, the end of the left rib splint 4 and the right rib splint 5 is provided with a splint hook plate 16 bent towards the rib edge, and the splint hook plate 16 can be telescopically arranged relative to the left rib splint 4 and the right rib splint 5, so that to the underage in the fast growth period of 7-13 years old, even if the rib grows, the splint hook plate 16 can be telescopically ensured to be matched with the rib, so as to prevent the left rib splint 4 and the right rib splint 5 from moving left and right, and further prevent the depression of the underarm rib caused by the transverse limitation caused by the conventional integrated titanium plate. When the device is specifically arranged, the device further comprises an end plate 27 which is installed at the end parts of the left rib splint 4 and the right rib splint 5 through screws, rib splint holes 34 and guide holes 28 are formed at the end parts of the left rib splint 4 and the right rib splint 5, a guide pin 29 and a spring sleeve rod 32 are arranged on the splint hook plate 16, the guide pin 29 passes through the end plate 27 and is connected with the guide holes 28 in a sliding manner, the spring sleeve rod 32 passes through the end plate 27 and is inserted into the rib splint hole 34, a spring 26 is sleeved on the spring sleeve rod 32, one end of the spring 26 is abutted against a limiting part at one end of the spring sleeve rod 32, the limiting part is a limiting nut 33 in threaded connection, the other end of the limiting nut is abutted against the end plate 27, when the splint hook plate 16 is pushed outwards, the guide pin 29 on the splint hook plate 16 can move outwards through the guide holes 28, meanwhile, the splint hook plate 16 is ensured to be attached to the rib through the spring 26, the outer diameter of the limiting nut 33 is larger than the hole in the sliding connection on the end plate 27, thereby preventing the chucking plate 16 from falling off.

In this embodiment, in order to facilitate the clamping operation of the splints and visually control the force, the device further comprises a force-aid clamp applicator, the force-aid clamp applicator comprises a sternum splint tray 17, an adjusting rod 18, an upper pressing plate 21 and an upper pressing plate loading mechanism, the sternum splint tray 17 is fixed at the lower end of the adjusting rod 18 through screws, the sternum splint tray 17 is provided with a pressure sensor 30, the adjusting rod 18 is provided with a display 31 connected with the pressure sensor 30, the upper pressing plate 21 is provided with a sliding connection hole 22 sleeved with the adjusting rod 18, the loading end of the upper pressing plate loading mechanism acts on the upper pressing plate 21, when in use, the sternum splint tray 17 supports the sternum splint 2, the upper pressing plate 21 presses on the left rib splint 4 or the right rib splint 5, the sternum splint tray 17 and the upper pressing plate 21 are closed through the upper pressing plate loading mechanism, so that the left rib splint 4, the right rib splint 5 and the sternum splint 2 clamp the sternum, when a certain clamping force is reached, the gap-adjusting screw 15 is tightened until the force on the display 31 drops to zero (the center of the upper press plate 21 is provided with an operation hole 23 for tightening the gap-adjusting screw 15, facilitating the driver to enter into operation).

In this embodiment, one side of the upper pressing plate 21 is provided with an upper pressing plate hook plate 24 capable of hooking the edge of the left rib splint 4 or the right rib splint 5, one side of the sternum splint tray 17 is provided with a tray hook plate 38 capable of clamping and hooking the edge of the sternum splint 2, and the tray hook plate 38 and the upper pressing plate hook plate 24 are oppositely arranged. Thereby preventing the upper pressing plate 21 and the sternum splint tray 17 from deviating when the upper pressing plate loading mechanism is loaded.

In this embodiment, specifically, the upper pressure plate loading mechanism includes a force application threaded sleeve 20 and an external threaded portion 19 disposed on the adjusting rod 18, the force application threaded sleeve 20 is in threaded sleeve connection with the external threaded portion 19, and a hand-held portion 25 is disposed at the upper end of the adjusting rod 18, so that on one hand, manual continuous loading can be realized, and at the same time, due to self-locking of threads, the force application threaded sleeve 20 can still maintain the acting force on the upper pressure plate 21 even if the surgeon leaves the force application threaded sleeve 20.

The above is only a preferred embodiment of the present invention, and is not intended to limit the present invention, and various modifications and changes will occur to those skilled in the art. Any modification, equivalent replacement, or improvement made within the spirit and principle of the present invention should be included in the protection scope of the present invention.

Claims

1. The utility model provides a funnel chest orthopedic system, its characterized in that, includes rib splint subassembly (1) and sternum splint (2), form adjustable correction clearance (3) that are used for correcting the thorax deformity between rib splint subassembly (1) and sternum splint (2), rib splint subassembly (1) includes left side rib splint (4) and right side rib splint (5), the removable side to side sliding connection of left side rib splint (4) and right side rib splint (5), sternum splint (2) with the removable upper and lower sliding connection of left side rib splint (4) or right side rib splint (5).

2. The funnel chest orthotic system according to claim 1, wherein the left rib splint (4), the right rib splint (5) and the sternum splint (2) are provided with fixation through holes (37) for preventing movement.

3. The funnel chest orthotic system according to claim 1, wherein one of the left and right rib splints (4, 5) is provided with a transverse profile groove (6) and a threaded through hole (7) at an end thereof, and the other is provided with a transverse slider (8) slidably connected with the transverse profile groove (6), the threaded through hole (7) penetrates into the transverse profile groove (6) and is uniformly distributed along the sliding direction of the transverse slider (8), the transverse slider (8) is provided with a positioning hole (9), and the threaded through hole (7) is provided with a positioning screw (10) capable of being inserted into the positioning hole (9).

4. The funnel chest orthotic system according to claim 3, wherein the end of the left or right rib splint (4, 5) is provided with a vertically profiled groove (11) and a gap adjustment threaded hole (12), the sternum splint (2) is provided with a vertical slider (13) which can slide in the vertically profiled groove (11), the end of the vertical slider (13) is provided with a threaded connection hole (14), and a gap adjustment screw (15) which can be inserted into the threaded connection hole (14) is provided in the gap adjustment threaded hole (12).

5. The funnel chest orthotic system according to claim 4, further comprising an elastic pad (35) and a locking threaded plug (36), wherein the threaded connection holes (14) are at least two oppositely arranged, the gap adjusting threaded hole (12) is provided with a threaded counter bore, the elastic pad (35) is sleeved on the gap adjusting screw (15), and the locking threaded plug (36) is connected with the threaded counter bore and abuts against the gap adjusting screw (15).

6. The funnel chest orthotic system according to claim 1, wherein the ends of the left and right rib splints (4, 5) are provided with a splint hook plate (16) bent towards the rib edge, the splint hook plate (16) being telescopically arranged relative to the left and right rib splints (4, 5).

7. The funnel chest orthotic system according to claim 6, further comprising end plates (27) mounted at the ends of the left and right rib splints (4, 5), rib splint holes (34) and guide holes (28) are arranged at the end parts of the left rib splint (4) and the right rib splint (5), the splint hook plate (16) is provided with a guide pin (29) and a spring loop bar (32), the guide pin (29) passes through the end plate (27) and is in sliding contact with the guide hole (28), the spring sleeve rod (32) passes through the end plate (27) and is inserted into the rib clamp hole (34), a spring (26) is sleeved on the spring loop bar (32), one end of the spring (26) abuts against the limiting piece at one end of the spring loop bar (32), and the other end of the spring loop bar abuts against the end plate (27).

8. The funnel chest orthotic system according to any one of claims 1 to 7, further comprising a power-assisted clip applier, wherein the power-assisted clip applier comprises a sternum splint tray (17), an adjusting rod (18), an upper pressing plate (21) and an upper pressing plate loading mechanism, a pressure sensor (30) is arranged on the sternum splint tray (17), a display (31) connected with the pressure sensor (30) is arranged on the adjusting rod (18), a sliding hole (22) sleeved with the adjusting rod (18) is arranged on the upper pressing plate (21), and a loading end of the upper pressing plate loading mechanism acts on the upper pressing plate (21).

9. The funnel chest orthotic system according to claim 8, wherein one side of the upper plate (21) is provided with an upper plate hook (24) that can hook the edge of the left or right rib splint (4, 5), and one side of the sternum splint tray (17) is provided with a tray hook (38) that can hook the edge of the sternum splint (2).

10. The funnel chest orthotic system according to claim 8, wherein the upper platen loading mechanism includes a force application threaded sleeve (20) and an externally threaded portion (19) disposed on the adjustment rod (18), the force application threaded sleeve (20) being threadably received by the externally threaded portion (19), the upper end of the adjustment rod (18) being provided with a hand-held portion (25).