EP1691702A1 - Implant pour corriger un thorax en entonnoir - Google Patents

Implant pour corriger un thorax en entonnoir

Info

Publication number
EP1691702A1
EP1691702A1 EP04761067A EP04761067A EP1691702A1 EP 1691702 A1 EP1691702 A1 EP 1691702A1 EP 04761067 A EP04761067 A EP 04761067A EP 04761067 A EP04761067 A EP 04761067A EP 1691702 A1 EP1691702 A1 EP 1691702A1
Authority
EP
European Patent Office
Prior art keywords
bracket
implant
stabilizer plate
implant according
correction
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP04761067A
Other languages
German (de)
English (en)
Inventor
Alexander Rokitansky
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP1691702A1 publication Critical patent/EP1691702A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • A61B17/8076—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones for the ribs or the sternum

Definitions

  • the invention relates to an implant for funnel breast correction with a bow and at least one stabilizer plate that can be connected to the bow for fastening the implant to the rib cage.
  • the funnel chest (pectus excavatum) is the most common malformation of the chest wall, which occurs more frequently in boys than in girls and is usually recognizable in the child's first year of life. A family relationship was observed in a third of the cases. In older patients, asymmetrical funnel formation also occurs, with the bend no longer only in the cartilaginous but also from the bony part of the rib.
  • Therapeutic management includes physical therapy supplemented by surgical correction.
  • surgical correction includes physical therapy supplemented by surgical correction.
  • the spectrum of surgical techniques for correcting the funnel breast in addition to the cartilage-resecting standard procedure according to Ravich, Welsh and Rehbein (Ravich MM: The operative Treatment of Pectus excavatum. Ann. Surg. 129, 429-444 (1949); Welsh KJ Satisfactory surgical correction of pectus excavatum deformity in childhood. J. Thor. Surg. 36, 697-701 (1958)) using a minimally invasive method which was first described by Nuss in 1998 (Croitoru, DP et al.: Experience and Modification Update for Minimally Invasive Nuss Technique for Pectus Excavatum Repair in 303 patients.
  • Currently available implants for funnel breast correction consist of a bracket, the so-called “Pectus Bar”, which is made of stainless implant steel for medical purposes in various sizes (usually from 20, 5-45, 5cm). The edges of the implant are rounded on all sides and At both ends of the bracket there is a perforation and notches for fixation in the tissue. Stabilizer plates, which are also made of stainless implant steel for medical purposes, are attached to the bracket on the lateral ends of the funnel-shaped bracket. The stabilizer plates have a rectangular or triangular shape and contain Perforations for fixation.
  • the minimally invasive surgical method for funnel breast correction with an implant as described above is ideal, especially for those aged 6 and over, ideally between the ages of 8 and 12, since the thorax is still soft and elastic in these age groups.
  • the intercostal space should have a minimum width of 1 cm.
  • 2-3 small, only a few centimeters long skin incisions are made, through which the individually curved metal bracket (pectus bar) is inserted into the chest.
  • the implantation takes place under thoracoscopic, mediastinoscopic and digital control.
  • the use of certain templates, which are offered by the implant manufacturers, is recommended for the production of the individual bending of the bracket.
  • the templates are externally adapted to the shape of the thorax and the implant is chosen to be 1-2 cm shorter than the template, as this ultimately lies in the subcutaneous area.
  • the pectus bar is pulled into the thorax using a band, with the ends of the C-shaped bow pointing in the ventral direction.
  • the implant is covered with special implantation aids Rotated 180 ° and the stabilizer plates attached to the sides of the bracket and fixed to the bracket with a wire seam.
  • the stabilizer plates are secured by non-absorbable sutures on the lateral chest wall muscles.
  • the curved bow lifts the breastbone and forces the chest back to its normal growth over the period of the implantation, which is usually in the range of 2-3 years.
  • the bow is removed again in a further operation.
  • the implant bracket is positioned horizontally at the level of the deepest funnel point. The places where the bow passes through the intercostal space must be chosen exactly and should be medial to the funnel edge. In older patients and those with a stiff thorax, two brackets may have to be implanted in a parallel arrangement.
  • a surgical supplement can consist of a small incision that detaches the distal sternum from the anterior mediastinal portion. Injury to large organs such as the heart or liver is excluded with this implantation method with a high degree of probability.-
  • the minimally invasive temple implant can be supplemented by additional partial rib resections according to Ravitch, Welsh.
  • US Pat. No. 6,024,759 A describes a method and a device for funnel breast correction of the type just described.
  • the disadvantage here is that the stabilizer plates pushed over the attachment can slide off the bracket and the bracket can be displaced or rotated in the body. This shift or rotation of the bracket is the most frequently described complication in this surgical procedure.
  • the stabilizer and the bracket are usually connected with surgical wire. Since the wire can break, this is also not an ideal solution.
  • the use of two stabilizer plates on both ends of the bracket is intended to prevent this problem of sliding off due to the double securing. In the area of the slid-on stabilizer plates, the implant becomes relatively thick, which affects tissue tolerance. This can lead to implant bed necrosis.
  • US 3 946 728 A describes an implant for funnel breast correction, in which two stirrups are connected to one another and fixed using a complicated device in order to achieve a stable unit.
  • the ends of the stirrups are anchored directly into the costal bones in elaborate cartilage-resecting operations.
  • the implant lies in front of the breastbone and is connected to the breastbone via the device mentioned for connecting the two brackets. Both the implant and the surgical method are very complicated or complex.
  • the implant should be as simple as possible.
  • the object of the invention is achieved in that the bracket is made in one piece with a stabilizer plate arranged at one end of the bracket.
  • the implant can be made flatter overall and the constructions such as rails or the like which are usually required on the bracket and on the stabilizer plate fall. to push the stabilizer plate away on the bracket.
  • This makes the implant more tissue-compatible overall. Due to the one-piece construction of the bracket with the stabilizer plate, a better connection of the implant can be achieved, which is not as good due to the wire seams usually used.
  • the second contralateral stabilizer plate is usually dispensed with, which means that the implant can grow with the patient.
  • the stabilizer plate has at least one opening for attaching a corresponding seam.
  • openings for seam attachment or for attaching a tool during the implantation can also be provided at the ends of the bracket.
  • the opening is provided with a thread or a quick fastener, for example a bayonet fastener or the like, by means of which the special instrument can be anchored.
  • the rotary instruments which rotate the C-shaped bow by 180 °, are attached in particular via the openings at the ends of the bow.
  • the bracket and the stabilizer plate are advantageously provided with rounded edges.
  • the implant is advantageously made of stainless medical steel.
  • the implant can be provided with a coating made of biocompatible material.
  • a stabilizer bar on the other end of the bracket. In this case, this is pushed onto the bracket by means of appropriate constructions or the like and fixed using a wire seam.
  • FIG. 1 shows a plan view of an embodiment variant of the implant
  • FIG. 2 shows a side view of the implant according to FIG. 1
  • 3 shows the application of the implant during the operation
  • 4 shows the position of the implant after rotation
  • Fig. 5 shows the detail V from Fig. 3 in an enlarged view.
  • the implant 1 and 2 show an embodiment of the implant according to the invention consisting of a bracket 1 with a stabilizer plate 2 produced at one end in one piece with the bracket 1.
  • the stabilizer plate 2 consists of two elliptical plates 3 arranged on both sides of the bracket 1
  • Stabilizer plate 2 has a plurality of openings 4, via which the implant can be fixed in the chest. The number, position and size of the openings 4 on the stabilizer plate 2 can be changed individually.
  • the bracket 1 has notches 5 at its end, which serve for fixation in the tissue.
  • openings 6 are provided at the ends of the bracket 1, which on the one hand can be used to fix the bracket 1 with a seam and on the other hand can be used to attach a tool during the implantation.
  • the opening 6 preferably has a thread 7 or a quick-release fastener, such as e.g. a bayonet catch (not shown).
  • a quick-release fastener such as e.g. a bayonet catch (not shown).
  • the edges of the bracket 1 and the stabilizer plate 2 and all the openings 4 and 6 are preferably rounded.
  • the bracket 1 is bent into a C-shape in accordance with the desired shape of the thorax and inserted into the thorax via two openings 8, so that the ends of the bracket 1 are aligned ventrally.
  • special rotary instruments 9 are fastened via the openings 6 at the ends of the bracket 1, for example screwed into the thread 7, as shown in FIG. 5.
  • the bracket 1 is rotated (see FIG. 4) and, after the rotary instruments 9 have been removed, the stabilizer plate 2 is connected to the tissue.
  • the new implant according to the present invention brings about a therapeutic improvement compared to known implants.

Abstract

L'invention concerne un implant utilisé pour corriger un thorax en entonnoir, qui comprend un arceau (1) et au moins une plaque stabilisatrice (2) qui peut être reliée à l'arceau et sert à fixer l'implant à la cage thoracique. Pour créer un tel implant destiné à la correction d'un thorax en entonnoir, qui soit simple à fabriquer et apporte une amélioration thérapeutique, il est prévu que l'arceau (1) ne forme qu'une seule pièce avec une plaque stabilisatrice (2) placée à une extrémité de l'arceau (1). La plaque stabilisatrice (2) comporte au moins une ouverture (4) pour la fixation par suture.
EP04761067A 2003-12-12 2004-10-12 Implant pour corriger un thorax en entonnoir Withdrawn EP1691702A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
AT20012003A AT413479B (de) 2003-12-12 2003-12-12 Implantat für die trichterbrustkorrektur
PCT/AT2004/000345 WO2005055844A1 (fr) 2003-12-12 2004-10-12 Implant pour corriger un thorax en entonnoir

Publications (1)

Publication Number Publication Date
EP1691702A1 true EP1691702A1 (fr) 2006-08-23

Family

ID=34658440

Family Applications (1)

Application Number Title Priority Date Filing Date
EP04761067A Withdrawn EP1691702A1 (fr) 2003-12-12 2004-10-12 Implant pour corriger un thorax en entonnoir

Country Status (4)

Country Link
EP (1) EP1691702A1 (fr)
AT (1) AT413479B (fr)
DE (1) DE202004021763U1 (fr)
WO (1) WO2005055844A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9801671B2 (en) 2013-07-11 2017-10-31 Stryker European Holdings I, Llc Fixation assembly with multiple sections for securing parts of a sternum
US11259853B2 (en) 2015-01-09 2022-03-01 Stryker European Operations Holdings Llc Implant for bone fixation
US11596458B2 (en) 2016-11-11 2023-03-07 Stryker European Operations Holdings Llc Implant for bone fixation

Families Citing this family (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010020606A1 (fr) * 2008-08-19 2010-02-25 Corporació Sanitària Parc Taulí Dispositif destiné à être utilisé dans le traitement chirurgical du pectus excavatum, et procédé de traitement afférent
DE102009024691A1 (de) 2009-06-12 2010-12-16 Schrot, Günter, Dr. Implantat für die Trichterbrustkorrektur
CN201481536U (zh) * 2009-08-14 2010-05-26 上海交通大学医学院附属新华医院 漏斗胸矫形手术用钢板
US8333768B2 (en) * 2010-01-08 2012-12-18 William Gallo Method and apparatus for nonsurgical correction of chest wall deformities
TW201129339A (en) * 2010-02-23 2011-09-01 Ying-Jie Su Guidance apparatus for correcting pectus excavatum (funnel chest)
CN105662559B (zh) * 2016-04-12 2018-10-26 广州中大医疗器械有限公司 漏斗胸矫形器及其制造方法
WO2019046626A1 (fr) * 2017-08-31 2019-03-07 Notrica David M Appareil et procédés de traitement de pectus excavatum
AT524655B1 (de) 2021-06-02 2022-08-15 Rokitansky Alexander Vorrichtung zur nichtinvasiven Trichterbrustkorrektur

Family Cites Families (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DK279374A (fr) * 1973-05-28 1975-01-20 Protek Ag
FR2353274A1 (fr) * 1976-06-03 1977-12-30 Martin Franck Attelle costale
EP0583520A1 (fr) 1992-08-18 1994-02-23 Nauchno-Proizvodstennoe Obiedinenie " Ekran" Dispositif pour traiter une cage thoracique en forme d'entonoir
US6024759A (en) 1998-05-08 2000-02-15 Walter Lorenz Surgical, Inc. Method and apparatus for performing pectus excavatum repair
KR100504682B1 (ko) * 2002-09-28 2005-08-05 메딕스얼라인 주식회사 흉곽기형 교정용 인공보철물
AR037254A1 (es) * 2002-11-06 2004-11-03 Horacio Abramson Un aparato para correccion de malformaciones de la caja toracica, tales como "pectus excavatum" y "pectus carinatum" y metodo para correccion del "pectus carinatum"

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO2005055844A1 *

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9801671B2 (en) 2013-07-11 2017-10-31 Stryker European Holdings I, Llc Fixation assembly with multiple sections for securing parts of a sternum
US10433889B2 (en) 2013-07-11 2019-10-08 Stryker European Holdings I, Llc Fixation assembly with a flexible elongated member for securing parts of a sternum
US11576707B2 (en) 2013-07-11 2023-02-14 Stryker European Operations Holdings Llc Fixation assembly with a flexible elongated member for securing parts of a sternum
US11259853B2 (en) 2015-01-09 2022-03-01 Stryker European Operations Holdings Llc Implant for bone fixation
US11596458B2 (en) 2016-11-11 2023-03-07 Stryker European Operations Holdings Llc Implant for bone fixation

Also Published As

Publication number Publication date
AT413479B (de) 2006-03-15
WO2005055844A1 (fr) 2005-06-23
DE202004021763U1 (de) 2010-09-30
ATA20012003A (de) 2005-08-15

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