RU129794U1 - FEMUS BONE HOLDER - Google Patents

Abstract

The femoral bone holder, consisting of two plates 90-110 mm long, 3/4 wide from the length, in its central part each of the plates is curved along the length along an arc with a radius of 18-22 mm, with a radius twice as long, so that the apex the arc corresponded to the central longitudinal axis of the plate, and the non-curved parts of the plate remained in the same plane; the concave surfaces of the arcs of both plates have longitudinal notches with a height and a width of 0.5-1 mm, a pitch of 1-2 mm, 4 rods with a diameter of 6 are inserted into one of the plates at a distance of 10-20 mm in length and width from each of the edges -8 mm, 6-8 times longer than the diameter, in another plate at the same distance from the edges, 4 round holes are made 2 mm in diameter larger than the rods so that the rods of one plate freely pass through the holes of the other plate; nuts with handles are screwed onto the thread of the rods from above, bringing one plate closer to the other.

Description

The utility model relates to medicine, in particular to traumatology and orthopedics, and can be used to hold a broken femur in a reponized state when treating a femoral canal for hip arthroplasty or for osteosynthesis.

In case of a periprosthetic fracture of the femur, when replacement of the leg of the endoprosthesis is required, or during primary endoprosthesis of the hip joint under the conditions of a diaphyseal fracture of the femur, the surgeon faces the task of simultaneously processing both the proximal and distal fragments of the femur under the leg of the endoprosthesis so that the fully formed design and the bed the size of the femoral component. Precision reposition of the fracture and firm retention of the fracture in a repaired state is required. Also, maintaining the fracture in a repaired state is necessary for femoral osteosynthesis. The holding device must not penetrate the canal of the femur so as not to interfere with its processing.

The following tools are known with which you can try to keep the reposition of the femur while processing its canal:

1. Bone holder (patent for utility model No. 79241, published in the State Register of Inventions of the Russian Federation on December 27, 2008), containing two articulated jaws with working jaws, characterized in that the jaws are equipped with a tightening element made in the form of a telescopic screw, one end of which is articulated connected to one of the branches, and the second passes through the groove of the opposite branch and is equipped with a fixing nut, and a spacer spring is installed between the branches on the telescopic screw. With the help of this bone holder, you can try to hold the repaired femur.

2. The clamp-bone holder is vertically curved to capture and hold the tubular bones with a screw lock (http://www.medinstmment.su/catalog/?section_id=381). Using the jaw of this fixator, you can also try to keep the femur in a repaired state.

The disadvantage of both tools is the small surface area that holds the fracture, and insufficient fixation strength under stress during processing of the femoral canal.

The prototype of the utility model is a large three-arm holder (http://www.intelmed.region64.ru/osz/instruments/2009/02/8858?p=0). Using the three branches of this instrument, the repaired femur can be held more firmly, however, the fixation area may not be sufficient to process the femoral canal, especially in the case of a transverse fracture.

The objective of the utility model is a femur bone holder with a large area of the fixing surfaces, approximately corresponding to the cylindrical shape and diameter of the femoral diaphysis.

The technical result is the ability to firmly hold a broken femur in a repaired state for processing its canal during arthroplasty or osteosynthesis.

The problem is solved by a skeleton holder for the femur, consisting of two plates (4) 90-110 mm long, ¾ wide from the length, in their central part each of the plates is curved along the length along an arc (1) with a radius of 18-22 mm, two times the radius, so that the vertex of the arc corresponds to the central longitudinal axis of the plate, and the non-curved parts of the plate remain in the same plane; the concave surfaces of the arcs of both plates have longitudinal notches (5) with a height and width of 0.5-1 mm, a pitch of 1-2 mm, 4 rods are inserted into one of the plates at a distance of 10-20 mm in length and width from each of the edges ( 3) with a thread with a diameter of 6-8 mm, 6-8 times longer than the diameter, in another plate at the same distance from the edges, 4 round holes are made 2 mm in diameter larger than the rods so that the rods of one plate freely pass through the holes of the other plates; nuts (2) with handles are screwed onto the thread of the rods from above, bringing one plate closer to the other.

After reposition, the femur is firmly clamped between the concave surfaces of the plates by tightening the nuts on the rods, after which it is possible to process its channel without the threat of fracture displacement. The notches prevent the instrument from sliding off the femur.

Clinical example.

Patient L. S.A., 55 years old, No. 5911 disease history, was admitted to 51 orthopedic department of the Clinical Hospital named after S.P. Botkina February 01, 2012 with complaints of pain in the left thigh, the inability to rely on the left lower limb.

Anamnesis: On June 23, 2011, she was operated on for aseptic necrosis of the head of the left femur - total endoprosthetics of the left hip joint with a cementless fixation prosthesis. February 01, 2012 fell on her left side.

On examination: deformation, pathological mobility of the left thigh in the upper and middle third.

On the presented radiographs - periprosthetic oblique fracture of the diaphysis of the left thigh in the middle third with the displacement of fragments, the femoral component of the endoprosthesis is unstable.

Clinical diagnosis: closed periprosthetic fracture of the left femur with displacement and impaired stability of the femoral component of the endoprosthesis.

Revision endoprosthetics are shown: replacement of the femoral component of the endoprosthesis with osteosynthesis of the femur.

After the preparation, on February 15, 2012, the operation was performed: revision endoprosthetics of the left hip joint.

Progress of the operation: an old postoperative scar was excised with an extension of the incision distally along the outer surface of the left thigh. The fracture site is exposed in layers. Revealed: oblique fracture of the left femur at the level of the leg of the endoprosthesis, the latter is unstable. After removal of the endoprosthesis leg, the fracture was repositioned. The fracture zone is superimposed with plates of the proposed bone holder, with concave surfaces to the femur, with the help of nuts the plates are compressed together. A stable fixation of the fracture was achieved, against the background of which the simultaneous development of both the proximal and distal fragments was performed with trimmers for the revision conical pedicle. After development, the femoral component Wagner Rev. was installed, after which the bone support was removed. When checking movements, the fracture zone is stable. The head of the endoprosthesis was installed, after which the reduction and layer-by-layer suturing of the wound was carried out with the provision of drainage.

On radiographs - a repaired femoral fracture with a revised femoral component, the position of the components is correct.

On radiographs after 4 months, a complete consolidation of the fracture is noted, the full load on the operated lower limb is allowed.

The femoral bone holder made it possible to firmly hold the repaired femur while developing it under the revision component of the endoprosthesis, correctly install the revision femoral component and achieve a good clinical result.

Claims (1)

The femoral bone holder, consisting of two plates 90-110 mm long, 3/4 wide from the length, in its central part each of the plates is curved along the length along an arc with a radius of 18-22 mm, with a radius twice as long, so that the apex the arc corresponded to the central longitudinal axis of the plate, and the non-curved parts of the plate remained in the same plane; the concave surfaces of the arcs of both plates have longitudinal notches with a height and a width of 0.5-1 mm, a pitch of 1-2 mm, 4 rods with a diameter of 6 are inserted into one of the plates at a distance of 10-20 mm in length and width from each of the edges -8 mm, 6-8 times longer than the diameter, in another plate at the same distance from the edges, 4 round holes are made 2 mm in diameter larger than the rods so that the rods of one plate freely pass through the holes of the other plate; nuts with handles are screwed onto the thread of the rods from above, bringing one plate closer to the other.

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