Method and apparatus for the nonsurgical correction of chest wall deformities
One embodiment of a method and apparatus for the correction of pectus excavatum, having two arch shaped braces (22), made of a rigid durable material, and connected by a flexible belt (42 and 34), each half having the ability of applying positive pressure (26) to the flared ribs caused by the condition. Positive pressure is to be applied to the ribs while a suction cup or other device simultaneously pulls or pushes the sternum to a natural position. Other embodiments are described and shown.
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It has been estimated that Pectus Excavatum affects up to 1 percent of the world's population, making it the most common of the chest wall deformities. This deformity can effect major organs and impair breathing and heart function.
In the 1940's the Ravitch procedure was developed, this involved removal of the ends of the ribs as they attach to the sternum In the depressed area. The lining membrane around the rib is left in place. The sternum is then broken horizontally at the point where it turns downward and is straightened out. It is held in this position using stitches, the adjacent ribs and usually a metal bar or strut that goes under the sternum to keep it in an outward position. This all takes place under the skin, and is not without its complications. Side effects can Include post operative pain, infection, and fluid collection under the skin. In addition the ribs must grow back for complete chest wall stability to occur.
The Nuss procedure (U.S. Pat. No. 6,024,759) has become more popular over the last 10 years. This operation has been described generally as “minimally invasive.” An incision is made on each side of the chest wall. A bar is bent into the desired shape of the chest wall. A large surgical clamp is passed through one side of the chest, under the sternum and out the other side. The bar is pulled through using the clamp with the curve of the bar in the opposite direction. It then is flipped over and, in the process, bends the sternum outward, stretching the ribs as it does so. The bar is left in place for several months or years. A comparison of the Nuss “minimally invasive” procedure and the Ravitch procedure, published in the Journal of Pediatric Surgery, shows no advantage for the Nuss procedure. The likelihood of recurrence of the chest deformity following the Nuss procedure has been slightly greater than with the Ravitch procedure. There have been ongoing modifications of the Nuss procedure to improve the results and eliminate complications, some of which have been life threatening.
Recently the use of a vacuum bell (U.S. Pat. No. 7,229,422) for the elevation of the sternum has become popular, though a similar device was used as early as 1910 by Lange. The suction cup is applied over the depressed area of the chest. Air is removed from the chamber creating a vacuum which lifts the sternum temporarily. After several hours the chest returns to its original position. The use of a suction device alone has proven ineffective in maintaining long term results.
Lastly, the dynamic chest compressor, introduced by Haje, Involves a brace that is applied to the lower chest. Pressure is applied to front side of the rib cage. The brace must be worn for a good portion of the day in order to be effective. A Dynamic Chest Compressor (DCC) brace by itself is useless unless it is made correctly and worn for the correct daily number of hours according to each period of the treatment, and applied along with an appropriate program of exercises. In addition, the Dynamic Chest Compressor (DCC) is a device that must be manufactured according to each individual deformity for successful treatment.
SUMMARYIn accordance with one embodiment, a means of pushing the flared ribs back into their normal position, while a suction cup or other device pulls or pushes the sternum upward into its natural position.
ADVANTAGESThus several advantages of one or more aspects are as follows: to provide a safe means of correcting the condition known as pectus excavatum without having to undergo a risky surgical procedure, to provide a means for the correction of the flared ribs associated with pectus excavatum, to provide a means of nonsurgical correction that does not involve hours of strenuous exercise per day, to provide a means of correction that does not involve the wearing of a brace for the majority of the day, to provide a brace that is one size fits all and does not have to be specially tailored to each individual. I have found that the depression of the sternum is caused by an overgrowth of the flared ribs. In order to correct the position of the sternum the position of the ribs must be addressed. Other advantages of one or more aspects are to address the funnel in the chest by simultaneously addressing the flared ribs, thus permanently correcting the position of both the sternum and the ribs. These and other advantages of one or more aspects will become apparent from a consideration of the ensuing description and accompanying drawings.
Connected to brace 22 is a spacer 24, best shown in
Each brace 22 has a bolt 26 which secures to the brace 22 by virtue of a threaded opening in the brace to accept the threaded bolt, being best depicted in
The rib compressor assembly and suction device of this embodiment are to be used in unison; however they can also be used separately. As shown in
The front and rear belts 34 and 42 are adjustable, allowing the patient to adjust the brace to fit to their own body, thus eliminating the need for a custom manufactured brace.
The bolts 26 have a clutch mechanism 27 that can be calibrated as needed to meet each individual patients needs at different phases of their treatment. This allows a means for the patient to apply the prescribed amount of pressure to the ribs.
Description Alternative-Embodiment—FIGS. 3, 5b and 5cThere are various possibilities with regard to the means of exerting pressure to the flared ribs.
The piston chamber 46 being best depicted in
There are also various possibilities with regard to the brace.
Accordingly the reader will see that, according to one embodiment of the invention, I have provided a practical means of permanently correcting the chest wall deformity typically referred to as pectus excavatum (also known by other names such as funnel and sunken chest). In addition to the correction of the sternum, the reader will find that according to one embodiment, the displaced ribs typically associated with pectus excavatum are also provided with a means of correction.
While the above description contains many specificities these should not be construed as limitations on the scope of any embodiment, but as exemplifications of various embodiments thereof. Many other ramifications and variations are possible within the teachings of the various embodiments. For example, the means of compressing the ribs inward could be an inflatable flexible envelope that when inflated would expand and place the required pressure on the ribs. Additionally, the rib compressor may, on occasion, be used alone in order to only treat the outwardly deformed ribs of a patient.
Thus this scope should be determined by the appended claims and their legal equivalents, and not by the examples given.
Claims
1. A rib compressor comprising:
- a. a rib brace for deformed ribs designed to envelop the body beneath the arms at the affected area and
- b. in combination, having one or more transfer surface areas and means for providing and transferring force from said transfer area to the deformed rib whereby pushing the rib or ribs inward.
2. The rib compressor of claim 5 wherein said brace has a spacer attached at opposite ends to create space between the patients ribcage and the brace.
3. The rib compressor of claim 5 wherein said brace transfers Mechanical force to the ribs via hand grip bolts.
4. The bolt of claim 5 wherein a clutch mechanism dictates the amount of force transferred to the ribs.
5. The rib compressor of claim 5 wherein said brace transfers pneumatic force to the ribs via a piston.
6. The rib compressor of claim 5 wherein said brace transfers hydraulic force to the ribs via a piston.
7. The rib compressor of claim 5 wherein said brace is made of plastic.
8. The rib compressor of claim 5 wherein said brace is made of Metal.
9. The rib compressor of claim 5 wherein said brace is composed of opposing halves held together by a belt.
10. The rib compressor of claim 5 wherein said brace being continuous encircles the body.
11. The brace of claim 14 wherein said brace has a hinge for the purpose of opening and closing the brace.
12. The rib compressor of claim 5 wherein said transfer surface has a soft padding.
13. The rib compressor of claim 5 wherein said brace is supported by a shoulder strap.
14. A suction device comprising:
- a. a triangular shape with rounded edges composed of a pliable material having a sufficient size to lift the sternum
- b. a plurality of elongated support members being joined to the undersurface of said suction device at spaced locations so as to support the ceiling of said suction device.
- c. a tube for the removal of air located at the rear of said subject device.
Type: Application
Filed: Mar 12, 2012
Publication Date: Aug 16, 2012
Applicant: (Miami, FL)
Inventor: Alejandro Castro (Miami Beach, FL)
Application Number: 13/385,878
International Classification: A61F 5/00 (20060101);