Patent Publication Number: US-9833269-B2

Title: Fixator for bar of pectus excavatum repair operation

Description:
CROSS-REFERENCE TO RELATED APPLICATIONS 
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     STATEMENT REGARDING FEDERALLY SPONSORED RESEARCH OR DEVELOPMENT 
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     THE NAMES OF THE PARTIES TO A JOINT RESEARCH AGREEMENT 
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     BACKGROUND OF THE INVENTION 
     Technical Field 
     The present invention relates to a fixation device for a correction bar used in the operation of pectus excavatum, and more particularly, to a fixation device for securing the correction bar inserted into a thoracic cavity to ribs in an operation of correcting pectus excavatum, which is a sort of chest malformation. 
     Description of Related Art 
     A malformation of a chest wall constituting a chest can be largely divided into a pectus excavatum, which is called a depressed chest, and a pectus carinatum, which is called a protruding chest. The causes of such malformation have not been accurately revealed, but it is known that it is caused by genetic factors. As shown in  FIG. 1 , the bones of the chest are constructed by connecting ribs  10 , a sternum  20 , costal cartilages  30 , and a vertebral column  40 , and the pectus excavatum and the pectus carinatum are not caused by malformation of the ribs, but are caused by the abnormality of the costal cartilages  30  constituting a front side of the chest and connecting the sternum  20  to the ribs  10 . Such malformation can become severe as people grow, while it was not severe at the time of birth. 
     Especially, in case of pectus excavatum, the depressed chest walls compress a heart or lungs to bring about malfunction thereof to thereby make the exercise function deteriorated. Furthermore, in case of children, problems are caused in that their respiratory organs become worse or their growing is delayed due to having frequent cold and the repetition of pneumonia, and in addition, they may have emotional and psychological disturbance when they are in childhood, boyhood, and juvenile period. 
     One of the conventional operation methods for correcting the pectus excavatum is a Lavich operation method, in which the front chest is opened large and almost all of the cartilages are removed. However, the operating method causes problems that the chest walls become weak after the operation, or adhesion is caused to thereby cause the loss of the smooth exercise function of the chest, in addition to forming the big scar on the chest. 
     In 1997, Donald Nuss who lives in U.S.A. proposes a new operation method (this is called a “Nuss operation method” for correcting the pectus excavatum in place of the conventional Lavich operation method. 
     As shown by a hatch line in  FIG. 2( a ) , the Nuss operation method is carried out wherein a curved correction bar  100  is inserted after incising a portion under both armpits of a patient with depressed chest walls by about 
     Thus, the Nuss operation method has some advantages in comparison with the Lavich operation method, in that operation trace remains at both sides of the chest by a size of about 1˜2 normal chest walls to thereby maintain the flexibility and elasticity of the chest. In addition, the operation time is short and bleeding is little at the time of the operation. 
     However, the Nuss operation method has a problem that it is not possible to observe the inside of the thoracic wall while the correction bar is being passed through the inside of the thoracic wall so that the operation should be carried out by means of experiences, when the correction bar is pulled out from the opposite side of the chest after it is inserted into the thoracic wall from one side of the chest of the patient. In other words, several cases were reported to cause that the correction bar excessively compressed the internal organs directly affecting the life of a patient, such as a heart or lungs, big vascular tract in the thoracic wall during the passage of the correction bar through the thoracic wall, to damage them or generate bleeding, resulting in the danger of the patient. Also, it was not easy to pull out the correction bar from the opposite side of the chest. 
     In this regard, a technology disclosed in Korean Patent No. 740193 has been developed to solve such problems arising in the Nuss operation method, which is filed by the same applicant as the present invention. 
     Moreover, the correction bar can support the thoracic wall to a normal form only when the correction bar is secured to the ribs after lifting the depressed thoracic wall. Conventionally, a sewing thread or a steel wire, and the like are used to bind and secure the correction bar with the surrounding ribs so as to fix the correction bar to the ribs. However, in such a case, a problem occurs in that the supporting force is weakened because the right side and the left side of the correction bar are respectively connected to one rib. 
     In this regard, as shown in  FIG. 4 , after installing a fixation device  110  shown in  FIG. 3  at both ends of the correction bar  100 , a sewing thread or a steel wire  113  is inserted into a through-hole  111  formed at both sides of the fixation device  110 , and then the sewing thread or the steel wire  113  is wound around the surrounding ribs  10  to make a knot to solve such a problem arising in the conventional art. 
     However, several disadvantages have been caused such that big operation trace remains to thereby rather go off the advantages of the Nuss operation method because the fixation device has no function of self-fixation, and the skin should be more incised up to a portion surrounding the ribs  10  to wind and secure the fixation device around the ribs. 
     Moreover, there is a possibility of the damage and complication of the organs such as the lungs and the vascular tract by a sewing needle for securing the sewing thread or the steel wire around the ribs. In addition, disadvantages may occur in that fixation fails or re-operation ratio is high. 
     BRIEF SUMMARY OF THE INVENTION 
     Technical Problem 
     Accordingly, the present invention has been devised to solve such conventional problems, and a primary object of the present invention is to provide a fixation device which can secure the correction bar used in the operation of pectus excavatum without excessive incision of skin, thereby improving the beauty effect, and can carry out the fixation of the correction bar, without any sewing on the periphery of ribs. 
     Also, another object of the present invention is to provide a fixation device which can accurately secure the correction bar to a predetermined position by dispersing load from the correction bar to the surrounding ribs. 
     Technical Solution 
     To achieve the above objects, the present invention provides a fixation device of a correction bar used in the repair operation of pectus excavatum and having through-holes bored in a direction of thickness, including a plurality of rib fixation units fastened to the correction bar and each having a rib support portion and a fastening portion formed at both ends thereof the rib support portion being formed of a hook portion bent in such a manner as to be hooked and secured to a rib, and the fastening portion being formed of a rectangular through-hole or a slot; and a fastening screw unit comprising a bottom portion, a fixation portion protruding upward from a top surface of the bottom portion, a skid-preventing means for preventing the fixation portion from skidding when engaged with the through-hole of the correction bar, and a screw formed on a top surface of the fixation portion. 
     Also, a female screw of the fastening screw unit can be machined on the correction bar. 
     Advantageous Effects 
     Therefore, according to the present invention, it is advantageous for cosmetic treatment because the skin can be preferably incised up to a thickness of the correction bar, and the operation can be carried out without any sewing on the periphery of the ribs, and bleeding can be minimized. 
     In addition, the operation is simple because the load of the correction bar can be dispersed and the correction bar can be accurately secured and removed easily. 
    
    
     
       BRIEF DESCRIPTION OF THE DRAWINGS 
         FIG. 1  is a view showing a structure of bones constituting a chest; 
         FIGS. 2 a  and 2 b    are views showing a principle of a Nuss operation; 
         FIG. 3  is a view showing a conventional fixation device; 
         FIG. 4  is a view showing an operation result obtained by using a conventional fixation device; 
         FIG. 5  is an exploded perspective view showing the fixation device of the present invention; 
         FIG. 6  is a view showing an operation result obtained by using a fixation device of the present invention; 
         FIGS. 7( a ) to 7( f )  are views showing several embodiments of a rib fixation unit of the present invention; 
         FIG. 8  is a view showing a screw used in the present invention, which is machined on the end of the correction bar; 
         FIGS. 9( a ) to 9( d )  are views showing several forms of the fastening screw unit used in the present invention; and 
         FIG. 10  is an exploded view showing usage of the screw of  FIG. 9( b ) ,  FIG. 10( a )  showing a state before inserting the fastening screw unit into a through-hole of the correction bar, and  FIG. 10( b )  showing a state after inserting the fastening screw unit into a through-hole of the correction bar. 
     
    
    
     In the drawings, a reference numeral  10  denotes a rib, a reference numeral  100  denotes a correction bar, and a reference numeral  300  denotes a fastening screw unit. 
     DETAILED DESCRIPTION OF THE INVENTION 
     Herein,  FIG. 5  is an exploded perspective view showing a fixation device for a correction bar for use in the operation of pectus excavatum according to the present invention. 
     In the present embodiment, a correction bar  100  is operated generally to be rotated to lift a sinking thoracic wall, after it is inserted into the thoracic wall as shown in  FIG. 2( b ) . 
     In addition, a rib fixation unit  200  is constructed of a rib support portion  210  formed at one side thereof to support ribs and a fastening portion  220  formed at the other side thereof, and it is inserted into the skin through a portion incised to insert the correction bar. 
     As shown in  FIG. 6 , the rib fixation unit  200  inserted under the skin, is operated to hook and secure the rib support portion  210  to the rib  10 , which is positioned below or above the correction bar  100 , and then another rib fixation unit  200  is inserted to make the rib support portion  210  to be hooked and secured to the rib  10 , so that the rib fixation unit  200  is secured to the correction bar  100  by means of a fastening screw unit  300  penetrating through the fastening portion  220  of the rib fixation unit  200  formed as a rectangular through-hole and the through-hole  102  formed at the end of the correction bar  100 . 
     In the present embodiment, although the rib support portion  210  is explained to be provided with a hook portion formed to be bent to a -like shape, as shown in  FIGS. 7( a ) to 7( f ) , the rib support portion  210  can be formed to various shapes to support the ribs. In addition, as shown in  FIG. 7( f ) , the rib support portion  210  can be provided with a groove supporting the ribs. Moreover, the rib support portion can be configured to have a variety of shapes, in so far as it can be supported to the ribs without using a separate sewing thread or a steel wire. 
     Furthermore, the fastening portion is formed at one end of a rib fixation unit, which is opposite to the rib support portion. Also, as shown in  FIGS. 7( a ) to 7( f ) , it may be machined as a rectangular through-hole or a slot shape, to facilitate the adjustment of the position of the peripheral ribs and the correction bar by an operator. 
     Moreover, in the present embodiment, while the fastening screw unit is explained to be a separate male screw and a female screw. However, as shown in  FIG. 8 , it will be possible to form the through-hole of the correction bar  100  to be round and machine the inside thereof to be a female screw  310  so that it can be fastened to a male screw. Also, several through-holes can be provided on the correction bar  100 . 
     The fastening screw unit of the present invention can be machined into various forms as shown in  FIGS. 9( a ) to 9( d ) . It is also preferable to provide a fixation portion  320  in various forms, so that it is inserted into the through-hole of the correction bar to fix the position of the correction bar when the screws are fastened to each other. 
     The fastening screw unit as shown in  FIG. 9( c )  comprises a bottom portion ( 330 ), a fixation portion ( 320 ) protruding upward from a top surface of the bottom portion ( 330 ), a skid-preventing means, comprising a flat portion ( 321 ) cut out from a part of a side of the fixation portion ( 320 ), for preventing the fixation portion from skidding when engaged with the through-hole of the correction bar, and a screw formed on a top surface of the fixation portion. 
     The fastening screw unit such as  FIG. 9( a ) ,  FIG. 9( b ) , and  FIG. 9( d )  comprises a rectangular bottom portion ( 330 ), a side wall portion ( 340 ) extended upward from both ends of the bottom portion ( 330 ) and formed, a fixation portion ( 320 ) protruding upward from a top surface of the bottom portion ( 330 ) between the side wall portions ( 340 ), and a screw ( 350 ) formed on a top surface of the fixation portion ( 320 ). 
     The fastening screw unit shown in  FIG. 9( b ) , as shown in  FIG. 10 , has the fixation portion ( 320 ) inserted through the through-hole ( 102 ) of the correction bar ( 100 ), and the correction bar ( 100 ) is inserted into two concave grooves ( 360 ) formed by the side wall portion ( 340 ), the bottom portion ( 330 ), and the fixation portion ( 320 ), and in operation the fastening screw unit would not be disengaged from the correction bar. Since the fastening screw unit engaging the correction bar is fixed without skidding when rotating and engaging the female screw ( 370 ) after inserting the fastening portion of the rib fixation unit into the male screw ( 350 ), the fixation and engagement are convenient. 
     INDUSTRIAL APPLICABILITY 
     As described above, according to the fixation device of the present invention, for fixing the correction bar inserted into the thoracic wall in the operation of correcting the pectus excavatum, which is a type of malformation of the chest, following advantageous effects can be achieved. 
     It is advantageous for the cosmetic treatment because the skin can be preferably incised to a thickness of the correction bar, and the operation can be carried out without the sewing on the periphery of the ribs, and the bleeding can be minimized. 
     In addition, the operation is simple because the load of the correction bar can be dispersed and the correction bar can be accurately secured and removed easily.