METHOD OF TREATING KEEL-SHAPED DEFORMITY OF THE CHEST WITH A COMPRESSION ORTHOSIS Russian patent published in 2020 - IPC A61F5/00 A61F5/02 

FIELD: medicine.

SUBSTANCE: invention refers to medicine, namely to orthopedics, and can be used for correction of sternocostal hump and fixation of sternocostal complex in treatment of keel-shaped deformity of thorax. Orthosis is made according to individual parameters of patient, wherein anterior thoracic plate corresponds to geometric shape of protruding part of breast. Value of the resistance force of the deformed thoracic segment is measured by compression with a press machine; a compression force is measured to affect the deformed thoracic region in order to correct the shape and to eliminate the protrusion. Anterior-posterior and lateral size of the thorax is measured. Compression test is performed, for this purpose in position of patient standing near wall, compression of deformed thoracic region is performed by hand, chest stiffness is evaluated, painless redirection of protrusion indicates possibility of orthosis treatment. Anterior-posterior size of the deformed thorax is measured. Compression force is determined to affect a deformed thoracic region in order to correct the shape and eliminate protrusion by pressing the protruding part with a press machine. Orthosis is installed, for this purpose the orthosis back plate is placed on the back, the front thoracic plate is placed above the deformed thoracic region, for patients with an increased size of mammary glands, an anterior chest plate of an anatomical shape is used with projections designed to locate the mammary glands. At the first stage of the orthosis treatment, a compression force is created in range of 6 to 8 kg. Orthosis is set for 10 to 15 days. Longitudinal compressing platform of orthosis is moved, placing it above area of deformation, changing position of side plates of orthosis changes value of compression force, fastening shoulder belts using quick-release locks. After 10–15 days of wearing the orthosis, it is removed and palpation is used to determine chest resistance, the value of intrathoracic pressure and assessing the presence of pain under the orthosis. If the chest stiffness is increased and the pain is absent, the second stage of treatment is started. At the second stage of the treatment, a compression force of the orthosis is created in range of 8 to 10 kg, an orthosis is set for period of 15 to 20 days. During the second stage of the treatment, the patient is prescribed therapeutic exercises, the skin condition under the orthosis is constantly monitored. After 15–20 days of wearing the orthosis, it is removed and palpation is determined by chest resistance, the value of intrathoracic pressure and the presence of pain under the orthosis. If the chest stiffness increases, the third stage of treatment is started. At the third stage of treatment, compression orthosis involves a chest without compression and provides compression force only during inspiration, orthosis is worn for 8 to 12 months, every 20 to 30 days of treatment, the compression force is progressively weakened by adjusting the size of the orthosis from the side by rearranging the side plates and in the adjustment holes on the anterior thoracic plate. During the whole length of treatment, additional pillows, layers, for example from silicone rubber, are added under the front compression platform of the orthosis. Soft compression bandage is applied on the area of ribs bending and correction of kyphosis is performed with the help of a soft posture corrector. Duration of orthosis is not less than 22 hours a day. In 7–8 months from the beginning of treatment, at the third stage, the period of wearing the orthosis is reduced every month for 1 hour, and from 10 to 11 months, the length of wearing is increased again, gradually increasing to 22 hours a day. Before installing the orthosis, a template of a chest circumference on the side of mammary glands is formed for girls. Front thoracic orthosis plate is formed by the template taking into account a prognosis of the breast size increase in the period of up to 18 months for the given patient. Front thoracic plate is placed so that no contact is made with the breast plates. Compression platform of orthosis is installed between mammary glands on protruding part of thorax. At the first stage of treatment, orthosis is carried out with compression force of 6 kg for 10–14 days. If the breast compression process appears in the process of treatment, a front thoracic plate is removed and under the front chest plate layer by layer is gradually added sufficient level of soft rubber pad to achieve sufficient compression force of orthosis and eliminating contact of plate with mammary glands.

EFFECT: method provides eliminating a protrusion in the thorax by staged wear of the orthosis.

6 cl, 18 dwg