Plate for stabilizing sternocostal complex

FIELD: medical engineering.

SUBSTANCE: plate for stabilizing sternocoastal complex comprises openings for permitting securing it to costae and is made of a material possessing the shape memory effect, with shape retrieval temperature being from 10 to 37°C, which provides loading on sternum to be from 20 to 100 N.

EFFECT: decreased traumatizing.

1 cl, 2 dwg

 

The invention relates to medical equipment, namely to devices used in orthopedics for the stabilization of the sternocostal complex when thoracoplasties.

When conducting thoracoplasty, for example during surgical correction of funnel chest deformity, it is necessary to stabilize the sternocostal complex after resection of ribs and transverse sternotomy.

The known method of stabilization with titanium plate, which is behind the breastbone and is fixed to the bone parts of the ribs using ligatures. The use of such plates allows a good fixation of the sternocostal complex /Geras'kin V., Rudakov, S., Vasiliev G.S., Herberg A.N. "Magnetokaloricheskii correction of funnel chest deformity". - M.: Medicine, 1986, p.17-18/.

The disadvantages of such a plate is the difficulty of installation and the loss of the achieved correction of the sternum as a result of irreversible plastic deformation of the plate. In addition, due to the high rigidity of the plate compared to the low rigidity of the sternocostal complex under physiological loads possible migration of the plate and offset it in the intercostal period.

The last disadvantage is partially eliminated in the invention and the process for the stabilization of the sternocostal complex (Patent RF №2202979, And 6 In 17/68), in accordance with which the plate has one end that is extended in the form of a triangle, and the other is hinged shank. The width of the triangle and the length of the shank allow you to secure the plate using ligatures to two edges, and avoid bias in the intercostal period. The invention adopted for the prototype.

The disadvantages of the invention is the possibility of plastic deformation of the plate under functional loads and loss achieved in the process of correction of the sternum. In addition, correction of the sternum with the use of these devices and instantaneous, resulting in considerable strain on the ligament and cartilage structures of the sternocostal complex and their injury.

The present invention is to provide stabilization of the sternocostal complex with the required correction of the sternum, at the minimum traumatized soft tissue and ligament and cartilage structures.

The problem is solved due to the fact that the plate containing holes with fixing it on the edges, is made of a material with shape memory effect with temperature recovery time from 10 to 37°providing the force exerted on the sternum, from 20 to 100 N. In addition, the plate has a bend corresponding to the correct anatomic p is the position of the sternum relative to the ribs.

The impact on the chest with a force of from 20 to 100 N can gradually bring it in the correct anatomical position.

When exposed to the sternum with less than 20 N, the force required correction of the sternum is not achieved, the effect on the sternum force 100 N leads to a one-stage correction of the sternum and soft tissue injury.

1 shows a General view of the claimed device.

Plate (1) for the stabilization of the sternocostal complex has a rectangular cross-section with a width of 10-20 mm and a thickness of 1-3 mm, the ends of which holes (2) for fastening on the resected ribs. In addition, the plate may have a bend corresponding to the correct anatomical curve of the chest.

The installation plate is carried out as follows (figure 2). After incision and exposure of the sternum and ribs is the mobilization of the sternocostal complex by resection of the deformed sections of the rib cartilage and transverse sternotomy on the upper level deformation of the sternum. Spend the fixation of the sternum in skorrigirovanna position by suturing the suture line sternotomy or special locks, including from a material with shape memory effect. Before installing the plate is cooled in a physiological solution with a temperature of 5°and model so that it can easily which would be under the sternum, i.e. bend in the direction opposite to the given plate bending. In this state it is conducted in Zagorodnoe space so that its ends above the resected ribs (figure 2,a). The plate is attached to the ribs (3) using ligatures (4)held through the holes at the ends of the plate, after which the wound is sutured in layers. Due to the heat of the human body plate is heated to a temperature of 36-37°and, in an effort to acquire its original form, relying on ribs, displays the sternum in the correct anatomical position (figure 2,b) (5). The whole process lasts from one to several hours. The gradualness of the process allows you to relax stress in biological tissues sternocostal complex, and therefore injury to soft tissue and ligament and cartilage structures does not occur. In addition, since the rigidity of the plate of material with shape memory effect is approximately 2 times lower than the hardness of the titanium plates of similar size and 4 times lower than steel for functional loads on the chest plate of a material with shape memory effect dampens them, reducing the force exerted by the plate on the edge. This prevents the destruction of the ligatures that secure the plate, and migration of the device.

Thus, the proposed device allows to reduce the invasiveness of the surgery due to ensure the ecene ease of installation and gradual correction of the sternum in the postoperative period and to provide stabilization of the sternocostal complex with the desired rigidity.

1. Plate for stabilization of the sternocostal complex containing holes with fixing it on the ribs, characterized in that it is made from a material with shape memory effect with temperature recovery time from 10 to 37°providing the force exerted on the sternum from 20 to 100N.

2. Plate according to claim 1, characterized in that it has a curve corresponding to the correct anatomical position of the sternum relative to the ribs.



 

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