MD684Z - Device and method for jaw osteosynthesis - Google Patents

Device and method for jaw osteosynthesis Download PDF

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Publication number
MD684Z
MD684Z MDS20130075A MDS20130075A MD684Z MD 684 Z MD684 Z MD 684Z MD S20130075 A MDS20130075 A MD S20130075A MD S20130075 A MDS20130075 A MD S20130075A MD 684 Z MD684 Z MD 684Z
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Moldova
Prior art keywords
mandible
bone fragments
jaw
osteosynthesis
fractured
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MDS20130075A
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Romanian (ro)
Russian (ru)
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Думитру ХЫЦУ
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Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова
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Priority to MDS20130075A priority Critical patent/MD684Z/en
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Publication of MD684Z publication Critical patent/MD684Z/en

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Abstract

The invention relates to medicine, in particular to oral surgery and is intended for jaw osteosynthesis.The device for jaw osteosynthesis consists of a cylindrical metal rod of a length of 3…4 cm and a diameter of 0.2 cm, both ends of which at a distance of 0.5 cm from the edge are curved in the form of U at an angle of 90°.The method for jaw osteosynthesis consists in that is carried out a skin incision 2.0 cm below the base of the jaw, are mobilized the fractured bone fragments, at a distance of 1.0 cm from the edge of each fractured fragment is made a hole, then at the base of fractured bone fragments is made a recess of 2…3 cm of a width of 0.2 cm, at the ends of which in the direction of the vertical axis of the jaw is made a channel of a depth of 0.5 cm and a width of 0.2 cm, afterwards the bone fragments are reduced, in the recess and channels made in the jaw is used the claimed device, and bone fragments are immobilized by means of a metal wire stretched across the holes made.

Description

Invenţia se referă la medicină, în special la chirurgia maxilo-facială şi este destinată pentru osteosinteza mandibulei. The invention relates to medicine, in particular to maxillofacial surgery and is intended for osteosynthesis of the mandible.

Este cunoscut dispozitivul destinat osteosintezei mandibulei, care constă dintr-o tijă metalică cilindrică cu o lungime de 3…4 cm şi diametrul de 0,2 cm, şi metoda de osteosinteză a mandibulei cu fir şi tijă metalică aplicată în şanţul executat la baza mandibulei [1]. The device for osteosynthesis of the mandible is known, which consists of a cylindrical metal rod with a length of 3…4 cm and a diameter of 0.2 cm, and the method of osteosynthesis of the mandible with wire and metal rod applied in the groove made at the base of the mandible [1].

Dezavantajele dispozitivului şi metodei menţionate constau în aceea că dispozitivul permite rotirea în plan orizontal a fragmentelor osoase şi a părţilor laterale ale bonturilor osoase ale mandibulei, din această cauză nu este posibilă fixarea stabilă a mandibulei. The disadvantages of the device and the mentioned method are that the device allows the horizontal rotation of the bone fragments and the lateral parts of the bone stumps of the mandible, therefore stable fixation of the mandible is not possible.

Problema pe care o rezolvă invenţia constă în elaborarea unui dispozitiv şi a unei metode noi de fixare a fragmentelor fracturate ale mandibulei prin osteosinteza cu fir metalic şi tijă metalică aplicată la baza mandibulei, care nu permite deplasarea fragmentelor osoase în plan orizontal şi lateral. The problem solved by the invention consists in developing a device and a new method for fixing fractured fragments of the mandible through osteosynthesis with a metal wire and a metal rod applied to the base of the mandible, which does not allow the movement of the bone fragments in the horizontal and lateral plane.

Dispozitivul pentru osteosinteza mandibulei constă dintr-o tijă metalică cilindrică cu o lungime de 3…4 cm şi diametrul de 0,2 cm, ambele capete ale căreia la o distanţă de 0,5 cm de la margine sunt încovoiate în formă de U sub un unghi de 90°. The device for osteosynthesis of the mandible consists of a cylindrical metal rod with a length of 3…4 cm and a diameter of 0.2 cm, both ends of which, at a distance of 0.5 cm from the edge, are bent in a U-shape at an angle of 90°.

Metoda de osteosinteză a mandibulei constă în aceea că se efectuează o incizie a pielii cu 2,0 cm mai jos de baza mandibulei, se mobilizează fragmentele osoase fracturate, la o distanţă de 1,0 cm de la marginea fiecărui fragment fracturat se efectuează câte un orificiu, apoi la baza fragmentelor osoase fracturate se efectuează o adâncitură de 2…3 cm cu lăţimea de 0,2 cm, la capetele căreia în direcţia axei verticale a mandibulei se efectuează câte un canal cu adâncimea de 0,5 cm şi lăţimea de 0,2 cm, după care se reduc fragmentele osoase, în adâncitura şi canalele executate în mandibulă se aplică dispozitivul revendicat, iar fragmentele osoase se imobilizează cu ajutorul unui fir metalic întins prin orificiile executate. The method of osteosynthesis of the mandible consists in making a skin incision 2.0 cm below the base of the mandible, mobilizing the fractured bone fragments, making an opening 1.0 cm from the edge of each fractured fragment, then making a 2…3 cm deep recess with a width of 0.2 cm at the base of the fractured bone fragments, at the ends of which in the direction of the vertical axis of the mandible a channel with a depth of 0.5 cm and a width of 0.2 cm is made, after which the bone fragments are reduced, the claimed device is applied to the recess and channels made in the mandible, and the bone fragments are immobilized with the help of a metal wire stretched through the holes made.

Avantajele invenţiei constau în aceea că se obţine o imobilizare a mandibulei în plan orizontal, în jurul axei sale şi în plan vertical mai rapid, mai puţin traumatic, se micşorează timpul intervenţiei chirurgicale, dispozitivul revendicat este uşor de confecţionat şi de dimensiuni mai mici, se asigură un confort la aplicarea acestuia şi o stabilitate excelentă a fragmentelor osoase. The advantages of the invention consist in that it achieves a faster, less traumatic immobilization of the mandible in the horizontal plane, around its axis and in the vertical plane, reduces the time of the surgical intervention, the claimed device is easy to manufacture and smaller in size, ensures comfort when applying it and excellent stability of the bone fragments.

Rezultatul tehnic constă în obţinerea unei imobilizări în direcţia axelor orizontală şi verticală ale mandibulei, datorită aplicării în adâncitura şi canalele executate în mandibulă a dispozitivului revendicat. Invenţia se explică cu ajutorul figurii, unde 1 reprezintă tija metalică cilindrică, iar 2 - capetele încovoiate în formă de U sub un unghi de 90°. The technical result consists in obtaining an immobilization in the direction of the horizontal and vertical axes of the mandible, due to the application in the recess and channels made in the mandible of the claimed device. The invention is explained with the help of the figure, where 1 represents the cylindrical metal rod, and 2 - the ends bent in a U shape at an angle of 90°.

Metoda se efectuează în felul următor: se prelucrează şi se izolează câmpul operator, se efectuează anestezia după regulile generale ale chirurgiei, se efectuează o incizie de 8 cm a pielii cu 2 cm mai jos de baza mandibulei, pe straturi se ajunge la fragmentele fracturate, se efectuează hemostaza, se examinează fragmentele fracturate şi chiuretajul spaţiului interfragmentar, se incizează periostul la o distanţă de 1,5 cm de la marginile fracturate, apoi el se decolează, la o distanţă de 1,0 cm de la marginea fiecărui fragment fracturat se efectuează câte un orificiu, iar la baza fragmentelor osoase fracturate se efectuează o adâncitură de 2…3 cm cu lăţimea de 0,2 cm, la capetele căreia în direcţia axei verticale a mandibulei se efectuează câte un canal cu adâncimea de 0,5 cm şi lăţimea de 0,2 cm, după care se reduc fragmentele osoase, în adâncitura şi canalele executate în mandibulă se aplică dispozitivul revendicat, iar fragmentele osoase se imobilizează cu ajutorul unui fir metalic întins prin orificiile executate, după care se examinează calitatea reducerii şi imobilizării, apoi plaga se prelucrează cu soluţii antiseptice. Pe plagă se aplică suturi pe straturi cu catgut în profunzime şi aţă atraumatică pe piele, se drenează plaga şi se aplică o pungă cu gheaţă. Pentru controlul calităţii reducerii servesc următoarele semne: restabilirea configuraţiei feţei, dispariţia simptomelor „de treaptă”, restabilirea sensibilităţii. The method is performed as follows: the operating field is processed and isolated, anesthesia is performed according to the general rules of surgery, an 8 cm incision of the skin is made 2 cm below the base of the mandible, the fractured fragments are reached in layers, hemostasis is performed, the fractured fragments are examined and the interfragmentary space is curetted, the periosteum is incised at a distance of 1.5 cm from the fractured edges, then it is lifted off, at a distance of 1.0 cm from the edge of each fractured fragment an opening is made, and at the base of the fractured bone fragments a 2…3 cm indentation with a width of 0.2 cm is made, at the ends of which in the direction of the vertical axis of the mandible a channel with a depth of 0.5 cm and a width of 0.2 cm is made, after which the bone fragments are reduced, the claimed device is applied in the indentation and channels made in the mandible, and The bone fragments are immobilized with a metal wire stretched through the holes made, after which the quality of the reduction and immobilization is examined, then the wound is treated with antiseptic solutions. The wound is sutured in layers with deep catgut and atraumatic thread on the skin, the wound is drained and an ice pack is applied. The following signs serve to control the quality of the reduction: restoration of the facial configuration, disappearance of "step" symptoms, restoration of sensitivity.

După intervenţia chirurgicală se efectuează ortopantomografia, pentru stabilirea calităţii reducerii şi a imobilizării fragmentelor osoase. After surgery, orthopantomography is performed to establish the quality of reduction and immobilization of bone fragments.

Exemplu Example

Pacientul C., anul naşterii 1987, s-a adresat de sine stătător la CNPŞDMU pe data de 2012. 08.13. Din anamneza bolii s-a constatat că a suferit o traumă recentă. La policlinica de la locul de trai i s-a aplicat imobilizarea cu atele individuale şi s-a indicat un tratament medicamentos. Pe 2012. 08.14 s-a adresat repetat de sine stătător la CNPŞDMU pentru tratament complex. Pacientul a fost examinat clinic şi paraclinic, stabilindu-se diagnosticul de fractură a mandibulei bilateral: angulară pe stânga (38) şi mentonieră pe dreapta (43) cu deplasarea fragmentelor osoase, a fost spitalizat în secţia de chirurgie oro-maxilo-facială. Pacientul a fost supus intervenţiei chirurgicale cu repoziţia şi fixarea fragmentelor fracturate ale mandibulei şi restabilirea formei şi funcţiei mandibulei. Metoda de osteosinteză s-a efectuat în felul următor: s-a prelucrat şi s-a izolat câmpul operator, s-a efectuat anestezia după regulile generale ale chirurgiei, s-a efectuat o incizie de 8 cm a pielii cu 2 cm mai jos de baza mandibulei, pe straturi s-a ajuns la fragmentele fracturate, s-a efectuat hemostaza, s-au examinat fragmentele fracturate şi s-a efectuat chiuretajul spaţiului interfragmentar, s-a efectuat o incizie a periostului la o distanţă de 1,5 cm de la marginile fracturate, apoi el s-a decolat, la o distanţă de 1,0 cm de la marginea fiecărui fragment fracturat s-a executat câte un orificiu, apoi la baza fragmentelor osoase fracturate s-a efectuat o adâncitură de 2…3 cm cu lăţimea de 0,2 cm, la capetele căreia în direcţia axei verticale a mandibulei s-a efectuat câte un canal cu adâncimea de 0,5 cm şi lăţimea de 0,2 cm, s-au redus fragmentele osoase deplasate prin mişcări energice dozate invers direcţiei de deplasare a fragmentelor fracturate la auzul unei crepitaţii osoase, în adâncitura şi canalele executate în mandibulă s-a aplicat dispozitivul revendicat, iar fragmentele osoase s-au imobilizat cu ajutorul unui fir metalic întins prin orificiile executate, după care s-a examinat calitatea reducerii şi imobilizării, apoi plaga s-a prelucrat cu soluţii antiseptice. Pe plagă s-au aplicat suturi pe straturi cu catgut în profunzime şi cu aţă atraumatică pe piele, s-a drenat plaga şi s-a aplicat punga cu gheaţă. Pentru controlul calităţii reducerii au servit următoarele semne: restabilirea configuraţiei feţei, dispariţia simptomelor „de treaptă”, restabilirea sensibilităţii. Patient C., born in 1987, independently addressed the CNPŞDMU on 2012. 08.13. From the anamnesis of the disease it was found that he had suffered a recent trauma. At the polyclinic at the place of residence, he was immobilized with individual splints and a drug treatment was indicated. On 2012. 08.14, he repeatedly independently addressed the CNPŞDMU for complex treatment. The patient was clinically and paraclinically examined, establishing the diagnosis of a bilateral mandibular fracture: angular on the left (38) and mental on the right (43) with displacement of bone fragments, he was hospitalized in the oral-maxillofacial surgery department. The patient underwent surgical intervention with the repositioning and fixation of the fractured fragments of the mandible and the restoration of the shape and function of the mandible. The osteosynthesis method was performed as follows: the operating field was processed and isolated, anesthesia was performed according to the general rules of surgery, an 8 cm incision of the skin was made 2 cm below the base of the mandible, the fractured fragments were reached in layers, hemostasis was performed, the fractured fragments were examined and the interfragmentary space was curettage was performed, an incision of the periosteum was made at a distance of 1.5 cm from the fractured edges, then it was lifted off, at a distance of 1.0 cm from the edge of each fractured fragment an opening was made, then at the base of the fractured bone fragments a 2…3 cm indentation with a width of 0.2 cm was made, at the ends of which in the direction of the vertical axis of the mandible a channel with a depth of 0.5 cm and a width of of 0.2 cm, the displaced bone fragments were reduced by energetic movements dosed opposite to the direction of movement of the fractured fragments upon hearing a bone crepitation, the claimed device was applied in the recess and channels made in the mandible, and the bone fragments were immobilized with the help of a metal wire stretched through the holes made, after which the quality of the reduction and immobilization was examined, then the wound was processed with antiseptic solutions. The wound was sutured in layers with catgut in depth and with atraumatic thread on the skin, the wound was drained and an ice pack was applied. The following signs served to control the quality of the reduction: restoration of the facial configuration, disappearance of the "step" symptoms, restoration of sensitivity.

Cu ajutorul dispozitivului şi metodei revendicate au fost trataţi 2 pacienţi în clinica de chirurgie oro-maxilo-facială. Pe baza investigaţiilor radiologice se poate trage concluzia că intervenţia chirurgicală a fost efectuată cu succes, restabilindu-se complet integritatea mandibulei. Astfel putem trage concluzia că dispozitivul şi metoda revendicată pot fi propuse pentru efectuarea osteosintezei mandibulei. With the help of the claimed device and method, 2 patients were treated in the oral-maxillofacial surgery clinic. Based on the radiological investigations, it can be concluded that the surgical intervention was successfully performed, completely restoring the integrity of the mandible. Thus, we can conclude that the claimed device and method can be proposed for performing osteosynthesis of the mandible.

1. BURLIBAŞA Corneliu. Chirurgie Orală şi Maxilofacială. Editura Medicală, Bucureşti, 1999, p. 617-618 1. BURLIBAŞA Corneliu. Oral and Maxillofacial Surgery. Medical Publishing House, Bucharest, 1999, p. 617-618

Claims (2)

1. Dispozitiv pentru osteosinteza mandibulei, care constă dintr-o tijă metalică cilindrică cu o lungime de 3…4 cm şi diametrul de 0,2 cm, ambele capete ale căreia la o distanţă de 0,5 cm de la margine sunt încovoiate în formă de U sub un unghi de 90°.1. Device for osteosynthesis of the mandible, which consists of a cylindrical metal rod with a length of 3…4 cm and a diameter of 0.2 cm, both ends of which at a distance of 0.5 cm from the edge are bent in a U-shape at an angle of 90°. 2. Metodă de osteosinteză a mandibulei, care constă în aceea că se efectuează o incizie a pielii cu 2,0 cm mai jos de baza mandibulei, se mobilizează fragmentele osoase fracturate, la o distanţă de 1,0 cm de la marginea fiecărui fragment fracturat se efectuează câte un orificiu, apoi la baza fragmentelor osoase fracturate se efectuează o adâncitură de 2…3 cm cu lăţimea de 0,2 cm, la capetele căreia în direcţia axei verticale a mandibulei se efectuează câte un canal cu adâncimea de 0,5 cm şi lăţimea de 0,2 cm, după care se reduc fragmentele osoase, în adâncitura şi canalele executate în mandibulă se aplică dispozitivul definit în revendicarea 1, iar fragmentele osoase se imobilizează cu ajutorul unui fir metalic întins prin orificiile executate.2. Method of osteosynthesis of the mandible, which consists in making a skin incision 2.0 cm below the base of the mandible, mobilizing the fractured bone fragments, at a distance of 1.0 cm from the edge of each fractured fragment, an opening is made, then at the base of the fractured bone fragments a 2…3 cm indentation with a width of 0.2 cm is made, at the ends of which in the direction of the vertical axis of the mandible a channel with a depth of 0.5 cm and a width of 0.2 cm is made, after which the bone fragments are reduced, the device defined in claim 1 is applied to the indentation and channels made in the mandible, and the bone fragments are immobilized with the help of a metal wire stretched through the holes made.
MDS20130075A 2013-04-23 2013-04-23 Device and method for jaw osteosynthesis MD684Z (en)

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU573155A1 (en) * 1976-03-01 1977-09-25 Khajrullin Almas F Device for osteosynthesis at surgery on lower jaw bone
SU1560178A1 (en) * 1988-07-25 1990-04-30 Казанский государственный институт усовершенствования врачей им.В.И.Ленина Device for treating lower jaw bone fractures
SU1598994A1 (en) * 1988-11-23 1990-10-15 Н. И. Мурашкин и Device for reposition lower jaw fragments
MD333Z (en) * 2010-07-23 2011-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for reduction of zygomatic complex fractures through the oral cavity
  • 2013

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU573155A1 (en) * 1976-03-01 1977-09-25 Khajrullin Almas F Device for osteosynthesis at surgery on lower jaw bone
SU1560178A1 (en) * 1988-07-25 1990-04-30 Казанский государственный институт усовершенствования врачей им.В.И.Ленина Device for treating lower jaw bone fractures
SU1598994A1 (en) * 1988-11-23 1990-10-15 Н. И. Мурашкин и Device for reposition lower jaw fragments
MD333Z (en) * 2010-07-23 2011-09-30 Государственный Медицинский И Фармацевтический Университет "Nicolae Testemitanu" Республики Молдова Device and method for reduction of zygomatic complex fractures through the oral cavity

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
BURLIBAŞA Corneliu. Chirurgie Orală şi Maxilofacială. Editura Medicală, Bucureşti, 1999, p. 617-618 *

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