BG64612B1 - Internal fixture for metal osteosynthesis - Google Patents

Abstract

The fixture is applied in traumatology in fractures of long tubular bones in their proximal, diaphysial and distal parts, as well in fractures of short tubular bones in case of spiral-type fractures, in particular in fragmented fractures with missing intermediate fragment. It contributes for attaining stable fixation of the bones and fragments by their entire diametrical engagement in the fracture zone and outside it by additional screws fixing the bones and bone fragments, and screws for stable localization of the fixtures. The part having a larger area enables to arrange the fragments in it and to be fixed by screws. The fixture comprises two semi-cylindrical plates for engaging the bone, and both end parts of the plates are clamped together. The semi-cylindrical plates are of two parts (1 and 2), different by surface, but having the same lengths and curvatures, part (2) being fabricated with teeth (3) which are self-aligned in respective windows (4) machined in part (1) in assembled form, and the other ends of the two parts are interconnected by means of holes (5) and screws (6). Longitudinal cuts (8) and apertures (9) for fixing screws are machined on the surfaces of both parts (1 and 2).

Description

Technical field

The invention relates to an internal fixator for metal osteosynthesis, which is used in traumatology, for fractures of long tubular bones in the proximal, diaphyseal and distal parts; in the case of short tubular bone fractures, in transverse, oblique and spiral fractures, and in particular in fractured and defective fractures - those with missing intermediate fragment.

BACKGROUND OF THE INVENTION

From RU 2001599 C1, an internal osteosynthesis clamp is known, which consists of a plaque that completely covers the bone. The locking element here is a strap. On one side, the ribbon is ribbed for contact with the bone, and on the opposite side there are transversally restrained stops, between which the ribbon bundles additional ribbons that intersect where the two ends of the ribbon meet after enclosing the bone ( 5).

The two ends of the plate are clamped together.

The known retainer has little possibility of relative displacement along the bone. The small area of the ribbon (several ribbons are used for longer fractures) is not sufficient to provide resistance to the strengthening of the position of the bone parts. For this reason, the retainer is ineffective when there are several additional fragments in the break zone.

Fixing and clamping the plaque only by twisting its edges is not reliable enough.

Other surgical methods using different bone fixation tools in the fracture area are intermodular osteosynthesis - IMOS, different variants of conventional IMOS, and plaque metal osteosynthesis. The fixing tools used do not fully cover the bone and problems occur when there are bone fragments to insert or are missing.

The possibility of applying IMOS is based on the fact that the long tubular hair has a medullary canal that is different in diameter along the bone. By stabbing a nail bearing the name Kuntcher in the bone canal and securing its adhesion to its walls, reliable stability is provided in the area of the fracture / 1 /.

In the version of conventional IMOS - elastic IMOS, an Ender nail is used. These nails are actually steel plates that are driven into the medullary canal and then spread in different directions. The adhesion thus provided in the groove creates a rotational stabilization of the fragments with respect to each other, but due to the elasticity of the nails, there is a potential for angular dislocation of the fragments and the migration of bone fragments along the length is possible / 2 /.

In the other variant, the locking IMOS, which is actually a conventional IMOS with locking (locking) screws placed at the ends of the bone, below and above the fracture. It overcomes the rotation, angular and longitudinal displacement of the fragments.

More significant drawbacks may be the internal trauma of the medullary canal, the diameter of which is different in length through the boring of the bone to make the same in order to provide the necessary adhesion to the nail; traumatization of healthy non-fractured parts of the bone; difficult removal of osteosynthetic material and potential for refraction when extracted.

In metallic osteosynthesis with plaques, plaques are used to fix and strengthen the bone outside the medullary canal. It is made with specially made metal implants made of high quality steel. Introduced by the AO Group - Swiss Group for Osteosynthesis and Standardization in Metal Osteosynthesis / 3 /. The plates are of different configuration and length.

The advantages of metal plate osteosynthesis are as follows. They are easier to install and fix than IMOS. It is operated with a small operating toolbox, saving time, and thus the blood loss is less. The medullary canal is not injured and the fragments are fixed with separate screws in the case of a multi-fragment fracture. However, the angular instability in the flexion of the plaque and the possibility of refraction below the implant site due to shear forces (4) remain disadvantages.

SUMMARY OF THE INVENTION

It is an object of the invention to provide an internal osteo synthesis lock to prevent injury to the medullary canal, injury to the healthy part of the bone, to avoid fractures and fractures around the implants due to shearing forces occurring under certain circumstances, Better bone modeling and healing in the presence of several fragments or in the absence of a bone fragment.

The problem is solved with an internal lock for metal osteosynthesis, consisting of two semi-cylindrical plates for bone clamping, with the two lateral ends of the plates clinging to each other. According to the invention, the half-cylindrical plates are different in area, but with equal length and curvature parts, one part being filled with teeth, which are self-contained in corresponding windows formed in the other part when assembled. The other ends of the two semi-cylindrical plates are connected to each other by holes and screws. Longitudinal cutouts and holes for fixing screws are made on the surfaces of the semi-cylindrical plates.

With the other type of retainer, the two assembled parts form the surface of a truncated cone for fractures near the joints.

The advantage of the retainer is that it offers new fixation and strengthening of the bones and fragments by their complete diametrical coverage in the area of the fracture and beyond with additional retaining bones and bone fragments screws and screws for the permanent localization of the retainer.

The larger surface area of the VF allows the fragments to be arranged there and secured by screws or the fragments can be enclosed if they are not previously repositioned with the second semi-cylindrical part as a container.

Cutouts with openings and specialized openings are used for fixing the fragments as well as for fixing and stabilizing the bones in the missing fragment through a screw ve. They are also required for bone growth and indirectly provide the opportunity to avoid an increase in intraocular pressure. Moreover, once they are filled with newly formed bone, the bone bridges thus formed will provide stability even after the removal of VF.

Determination of bone fusion can be done by X-ray, if appropriate alloys are used for the WF parts, or by scintigraphy. The faster healing of bone by the use of UV will be governed by the fact that the bone marrow is not borated. Easy mounting is ensured with the use of the VF due to its simple construction and no special installation tools are required. Operational time is saved and blood loss is less. Rotary, longitudinal and angular stability is ensured. The medullary canal and healthy bones are not injured, which is a prerequisite for faster healing. The risk of under-implant refractures is reduced. Subsequently, muscle can be sutured to the resulting bone grafts.

Description of the attached figures

An exemplary embodiment of the invention is shown in the accompanying drawings, of which:

Figure 1 shows an internal retainer with two semi-cylindrical plates assembled;

FIG. 2 is a section AA from FIG. 1;

Figure 3 shows part 1 of the WF with the larger area;

Figure 4 shows part 2 of the smaller surface area UV;

Figure 5 is an embodiment of the retainer; 6 is a node I of FIG. 2;

7 is a node II of FIG. 2.

An embodiment of the invention

The inner retainer consists of two parts 1 and 2, representing semi-cylindrical plates that form a cylindrical surface surrounding the bone. Part 1 has a larger cylindrical surface than Part 2. Part 2 has formed teeth 3 at one end, which pass through the corresponding windows 4 of Part 1 and self-lock in it when assembled to the bone. The other ends of the two parts have corresponding openings 5 and are pulled together by a screw 6 passing through 5 and a nut 7 not fixed to part 1. Both parts 1 and 2 of the VF have cutouts 8 with shaped holes for fixing screws, part 1 has two such cutouts and part 1 one. In addition, both parts have openings 9 for passing through them with locking screws.

The use of internal fixation for metallic osteosynthesis in femur fracture is via lateral or posterior operative access. The skin incision runs along the anterior region of the sulcus femoris lateralis, which corresponds to the posterior margin of the musculus vastus lateralis. Cut the subcutis and determine the furrow along the fascia lata, the densest part of which corresponds to the beginning of the septum intermusculare laterale. Longitudinally cut the femoral fascia two centimeters in front of the septum along the femoral diaphysis. Detect musculus vastus lateralis and separate its posterior edge to linea aspera from the barrier. Eject the musculus vastus lateralis forward and open the thigh diaphysis. With the help of a splitter, the bone surface is loosened and the larger cylindrical part 1 of the retainer on the lower diaphyseal surface is introduced by the hook. The introduction continued to penetrate the openings of the part 1 into the visible operative field. This is followed by the insertion of the other part 2 and its teeth 3 into the windows 4 of the first part 1. After assembling them at the other end with screws 7, the insertion of the rotation screws and the diameter adjustment screws is introduced. If necessary, fixing screws are also inserted.

Claims (4)

Claims 1. Kuntscher G. / 1940 /, Die marknagelung von Knochenbruchen. Archiv fur Klinische Chirugie. An internal fixation for metallic osteosynthesis consisting of two semi-cylindrical plates for complete enclosure of the bone, the two lateral ends of the plates being clamped to one another, characterized in that the semi-cylindrical plates are of two parts (1 and 2. Rush L., Dynamic intramedullary fracture fixation of the femur. A clamp according to claim 1, characterized in that the two parts (1 and 2) assemble together to form the surface of a truncated cone for fractures near the joints. Attachment: 7 figures Literature 2), varying in area but of equal length and curvature, the part (2) being filled with teeth (3) which are self-contained in corresponding windows (4), formed in part (1) by the assembled type and the other ends the two parts are connected to each other by screws (6) through openings (5), with longitudinal notches (8) and holes (9) for fixing screws made on the surfaces of the two parts (1 and 2). 3. Sanders R., Regazzoni P. / 1989 /, Treautment of subtrochanteric femur fractures using dynamic condylar screw. 4. Kinasti C., et al. / 1989 / Subtrochanteric fractures of the femur. Results of treatment with the 95 condylar blade-plate.