RU147547U1 - SIGHTING DEVICE FOR INTRODUCING LOCKING SCREWS INTO THE INTERNAL FIXator FOR SHOULDER JOINT ARTHRODESIS - Google Patents

Abstract

A sighting device for inserting locking screws into the internal retainer for shoulder joint arthrodesis, comprising a handle, as well as a conductor and retainer branches, which are provided with parallel coaxial channels for introducing screws, and in the conductor branch the channels allow the insertion of bushings for screws and drills with the possibility of insertion into them stylet for puncture access, characterized in that the latching branch contains a groove-imprint with an end canopy and restrictive sides, as well as a slider with contact surfaces and thrust sides, the tension pin of which passes through the handle and contains the wing nut on the side of the conductor branch.

Description

The utility model relates to medical equipment, namely to traumatology and orthopedics, and can be used in surgical treatment of the consequences of serious diseases and injuries of the shoulder joint in case of indications for surgical closure - arthrodesis.

The device is used in conjunction with an “internal fixer for arthrodesis of the shoulder joint” and is intended for less traumatic puncture insertion of proximal locking screws into the scapular spine through conductors oriented to the plug holes of the device for internal fixation.

Known devices containing a handle-arc and conductive bushings through which access to the bone is made, drilling holes in the bone and ensuring accurate contact with the fixative holes, due to which osteosynthesis is closed and less traumatic.

The closest analogue is the sighting device for osteosynthesis of the neck of the humerus with blocking plates using LISS technology. The device is an arc with immersed and surface parts. The immersed part contains a disconnectable fastening to the plate, and on the surface part there are openings-channels for pair of conductive bushings, which are inserted through the stylet puncture of the skin to the surface of the plate, orient their channels to the holes of the plate and through them first drill a bone, and then insert screws for fixation plates to the bone. After the introduction of all the screws, the mount to the plate of the sighting device is opened and the latter is removed from the wound. The device allows to reduce the invasiveness of the intervention and blood loss due to the implementation of osteosynthesis in a closed manner. The disadvantages of all devices of this class are their highest specialization, i.e. Applicability is only paired with the latch for which the sighting device is designed. This forces developers with the advent of any new device for osteosynthesis, providing for the full or partial use of closed puncture introduction of fixing elements, to develop for him a new sighting device adapted specifically to this internal fixator.

The technical result of the claimed utility model is to provide puncture access to the locking holes of the device for internal fixation during arthrodesis of the shoulder joint, closed less traumatic drilling in the scapular spine of the holes and insertion of locking screws through the holes of the clamp into the scapular spine.

The technical result is achieved by the fact that in the device containing the handle, as well as the conductor and retainer branches, which are equipped with parallel coaxial channels for introducing screws, while in the conductor branch the channels allow the introduction of conductor bushings for screws and drills with the possibility of introducing a stylet for puncture access, the locking branch contains a groove-imprint with an end canopy and restrictive sides, as well as a slider with contact surfaces and thrust sides, the tension pin of which passes through the handle and contains the wing nut from the side of the branch branch.

The illustrations show:

FIG. 1. Sighting device for introducing locking screws into the internal retainer for arthrodesis of the shoulder joint in the open position, where 1 is the handle; 2 - conductive branch; 3 - latching branch; 4 - channels conductor branches; 5 - channels of the retaining branch, 6 - screw conductor sleeve, 7 - drill conductor sleeve, 8 - drill, 9 - stylet, 11 - groove-imprint; 12 - end canopy, 13 - restrictive sides, 14 - slider channel, 15 - slider, 16 - contact surface of the slider, 17 - thrust side of the slider, 18 - tension pin, 19 - wing nut, 20 - retainer (device for internal fixation with arthrodesis of the shoulder joint), 23 - blocking holes.

FIG. 2. The sighting device in the closed position with the retainer held, where 1 is the handle, 2 is the conductive branch, 3 is the fixative branch, 4 are the channels of the conductive branch, 5 are the channels of the fixative branch, 6 is the screw conductive sleeve, 7 is the drill conductive sleeve, 8 - drill, 9 - stylet, 12 - end canopy, 14 - slider channel, 15 - slider, 17 - thrust side of the slider, 18 - tension pin, 19 - wing nut, 20 - retainer, 21 - scapular spine, 22 - locking screw, 23 - locking holes.

FIG. 3. The sighting device in the closed position at which it rigidly holds the latch 20 for arthrodesis of the shoulder joint before installation. The relative positions of the latch and the sighting device before installation are shown in the section, where: 1 - the handle, 2 - the conductive branch, 3 - the fixative branch, 4 - the channels of the conductive branch, 11 - groove-imprint, 12 - end canopy, 13 - restrictive sides, 14 - channel of the slider, 15 - slider, 16 - contact surface of the slider, 17 - thrust side of the slider, 18 - tension pin, 19 - wing nut, 20 - retainer.

FIG. 4. The sighting device holds the latch 20. The relative position of the latch and the sighting device at the time of its installation on the scapular spine, where 1 is the handle, 2 is the conductive branch, 3 is the fixative branch, 4 are the channels of the conductive branch, 5 are the channels of the fixative branch, 6 - screw conductor sleeve, 7 - drill conductor sleeve, 8 - drill, 9 - stylet, 10 - leather, 12 - end canopy, 13 - restrictive sides, 14 - channel of the slider, 15 - slider, 17 - thrust side of the slider, 18 - tension hairpin, 19 - wing nut, 20 - retainer, 21 - scapular spine, 22 - blocking Int, 23 - block the opening.

The sighting device for introducing locking screws into the internal retainer for arthrodesis of the shoulder joint (Fig. 1-5) contains a handle 1, from which two branches extend: the conductive 2 and the fixative 3. In the conductive branch 2 there are four parallel channels 4, whose axes coincide with the axes of the channels 5 of the locking branch 3. In the conductor channels 4 are located with the possibility of extracting the screw conductor bushings 6 with drill conductor bushings 7 inserted into them, into which the drill 8. can be inserted 8. In the conductor channel 4 instead of con a pair of pairs 6-7, a stylet 9 can be introduced for piercing the skin 10. On the outer side surface of the retaining branch 3 there is a groove-imprint 11 with an end canopy 12, restrictive sides 13 and four channels 5, the inner diameter of which is equal to the inner diameter of the screw conductor bushings 6 The handle 1 comprises a through longitudinal channel 14 in which a slider 15 is located with contact surfaces 16, stop flanges 17 and a tension pin 18, onto which a wing nut 19 is screwed from the side of the branch branch 2. Device for arthrodesis of the shoulder joint 20 is located in the groove-imprint 11, to which is pressed by the thrust side 17 of the slider 15, drawn into the channel 14 by the tensioning pin 18 while tightening the wing nut 19.

This device is used as follows. Before installing on the bones, the latch 20 is placed in the groove-imprint 11 in accordance with the affected side and tightening the wing nut 19 pull the slider 15 into the handle 1 and press the latch 20 to the groove-imprint.

Installation on the left and right humerus suggests a corresponding mutually opposite arrangement of the sighting device and the latch 20 in the groove-imprint 11 of the left or right outer lateral surface, depending on the side of the closable shoulder joint. Assembled sighting device with a latch is ready for installation on the scapular spine. In this assembled form, the holes 22 for the locking screws 23 are aligned coaxially with the channels 4 and 5 in both branches of the guide and, respectively, the axes of the conductors 6 and 7. After resection of the shoulder joint, the operating surgeon palpates the base of the scapular bridge 21 and puts on it a device for internal fixing during arthrodesis of the shoulder joint 20 so that the blocking holes 23 are on the surfaces of the scapular spine 21 until the latch 20 stops against this bone 21. The conductor branch 2 of the sighting device tsya on the scapular area of the patient's skin. In the conductor channels 4 of the conductor branch 2, a stylet 9 is inserted sequentially with which soft tissues are pierced to the surface of the internal fixator 20. After contact with the latter 20, the stylet 9 is removed and a conductor pair 6-7 is inserted into the channel 4, i.e. the drill sleeve 7 is pre-inserted into the channel of the screw sleeve 6, after which it is inserted all the way into the latch 20. Then a drill 8 is inserted into the conductive pair 6-7 and a hole 25 is drilled in the blade shaft 21 and the drill 8 and the drill sleeve 7. are removed. the screw conductor bush 6 left in the channel 4 is inserted with a locking screw 22 into the internal retainer for arthrodesis of the shoulder joint 20. Similarly, the remaining screws 22 are inserted, after which the wing nut 19 is unscrewed. In this case, the slider 15 ceases to press on its fixed shoulder 17 20 and-groove connection between the imprint 11 and the clamp 20 is opened, which allows to remove from the wound and sighting device for osteosynthesis complete open procedure.

The device allows you to:

- minimize trauma and blood loss during surgery of the arthrodesis of the shoulder joint at the stage of fixation to the scapula due to closed puncture access to the scapular spine;

- to ensure with closed processing of the scapular spine the exact penetration of the drill and screws into the blocking holes of the device for internal fixation during arthrodesis of the shoulder joint;

Literature.

1. Harmful R.R. A practical guide to orthopedics. - L., 1936. - OGIZ. - 606 s. - from. 285;

2. USSR author's certificate No. 906551, 1982. - 3 s;

3. Beltran T.E., Trilla J.S., Barjau R. A simplified compression arthrodesis of the shoulder. // J. Bone and Joint Surgery. - 1975. - V. 57 - A. - N. 5. - p. 534-539.

4. Stark D.M., Bennett J.B., Tullos J.S. Rigid Internal Fixation for Shoulder Arthrodesis. // Orthopedocs. - 1991. - V. 14. - N. 8. - p. 849-855.

Claims (1)

A sighting device for inserting locking screws into the internal retainer for shoulder joint arthrodesis, comprising a handle, as well as a conductor and retainer branches, which are provided with parallel coaxial channels for introducing screws, and in the conductor branch, the conduits allow the insertion of bushings for screws and drills with the possibility of insertion into them stylet for puncture access, characterized in that the latching branch contains a groove-imprint with an end canopy and restrictive sides, as well as a slider with contact surfaces and thrust sides, the tension pin of which passes through the handle and contains the wing nut on the side of the conductor branch.

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