RU153023U1 - DEVICE FOR SURGICAL TREATMENT OF PERTHESA DISEASE - Google Patents

Abstract

A device for cryosurgical treatment of Perthes disease, characterized in that it consists of a conductor tube connected to a refrigerant supply system, the conductor tube being made of titanium nickelide with double walls, with an outer diameter of 4 mm and an inner diameter of 3 mm, the thickness of each of the walls 0.3 mm, the distance between the outer and inner walls of 0.4 mm, the length of the tube is 150 mm, while a semicircular nozzle made of porous titanium nickelide with a pore diameter of 400 μm and a degree porosity of 60%, the diameter of which does not exceed the outer diameter of the conductor tube, and at its distal end there is a thread for tight connection to the refrigerant supply system.

Description

The utility model relates to medical equipment, cryosurgical instruments and can be used for cryosurgical treatment of Perthes disease in children.

Diseases of the musculoskeletal system leading to social maladaptation occupy a leading position in modern society. Among the most common and disabling orthopedic diseases is a group of nosologies, accompanied by the presence of aseptic necrosis of bone tissue. The most relevant treatment for lesions of the femoral head, since it significantly affects the quality of life of patients [1].

The effectiveness of surgical treatment of Perthes disease consists of several components. The generally accepted pathogenetically substantiated scheme consists of hardware dynamic unloading of joint components, biostimulation of the cervical-epiphyseal region of the thigh and correction of impaired metabolism. Of the operational methods, palliative operations should be considered that optimize osteoreparation in the diseased joint to stimulate rarefied bone foci. The most commonly used is the tunneling of the femoral neck for osteoregeneration of the femoral head necrosis zone. However, in order to increase the efficiency of biostimulating tunneling, a number of scientific papers have been published in which it is supplemented by chemical, physical, or biological effects on the cryonecrosis region [2]. The development of devices with which you can access the foci of necrosis and conduct a therapeutic effect is relevant.

A device for the surgical treatment of Perthes disease in children is proposed by a team of authors led by S. Berenstein. from Aktobe State Medical Institute. To access the focus of osteonecrosis, a tunnel is performed in the femoral neck. A current conductor (Kirschner spoke) is introduced into the obtained channel. The conductor is insulated with a PVC pipe with the exception of its distal end (0.5-1.0 cm), which is in direct contact with the center of destruction of the pineal gland of the femoral head. The proximal end of the current conductor is brought out to the lateral surface of the thigh. The electrode is connected to a constant current source. In the first three days after the operation, a positive battery charge is brought to him, and a negative battery is placed cutaneous in the thigh or lower leg area. Starting from the 4th day, the polarity is changed. Electrical stimulation of the bone destruction site by a current of negative polarity is continued for 20 hours per day and 4 hours by a current of positive polarity.

The known device allows for electrical stimulation of the pathological focus, to suspend the pathological process in the femoral head, inhibits the development in the femoral head and prevents the development of deforming arthrosis on the affected side [2].

However, it has the following disadvantages. Firstly, an open surgical wound with a current conductor installed increases the likelihood of infection due to the addition of a highly virulent nosocomial infection and complicates the process of wound care and hygienic care of the patient. Secondly, due to the vulnerability of the child's psyche, this device can cause a negative reaction of the child (fear, fear of live wires, ridicule of roommates). The scope of the known device is limited - it is not suitable for the treatment of Perthes disease by cryostimulation of rarefied bone foci.

A new technical task is the development of a device for cryosurgical treatment of aseptic necrosis of the femoral head, ensuring the delivery of refrigerant to the osteonecrosis region through the tunnel of the femoral neck, without thermal damage to surrounding biological tissues and uniform cooling in the osteonecrosis focus.

To achieve a new technical result, a device for cryosurgical treatment of Perthes disease consists of a conductor tube connected to a refrigerant supply system, and the conductor tube is made of titanium nickelide with double walls, with an outer diameter of 4 mm and an inner diameter of 3 mm, each of the walls of 0.3 mm, the distance between the outer and inner walls of 0.4 mm, the length of the tube is 150 mm, while a semicircular nozzle made of porous titanium nickelide with a diameter of soldered to the working end of the conductor tube m pore 400 microns and porosity of 60%, the diameter of which is less than the outer diameter of the tube, and the distal end of the tube conductor thread is arranged for hermetic attachment to the coolant supply system.

The proposed device in Fig 1 consists of a conductor tube with double walls 1, with an outer diameter of 4 mm and an inner diameter of 3 mm, made of titanium nickelide. The thickness of each wall is 0.3 mm. The outer and inner walls form a heat-insulating cavity 0.4 mm wide. The length of the conductor tube is 150 mm. A semicircular nozzle 3, made of porous titanium nickelide with a pore diameter of 400 μm and a degree of porosity of 60%, the diameter of which does not exceed the outer diameter of the conductor pipe 1, serves as a conductor (directly contacting tip) for uniform cooling tissues of the focus of osteonecrosis. The distal end 4 of the conductor tube 1 is equipped with a threaded connection 5 of the type bayonet type with a diameter of 8 mm with a thread pitch of 1.2 mm, selected to the refrigerant supply system, for example, in this case, for the portable cryo-device "Cryoine".

The device operates as follows. After tunneling of the femoral neck, a conductor tube 1 is inserted into the obtained channel and a cryoagent is fed into the osteonecrosis zone through the tip of porous titanium nickelide 3. The implementation of the tip 3 of porous titanium nickelide provides uniform cooling in the focus of osteonecrosis and prevents injury to surrounding tissue in the tunnel when inserted into the neck of the thigh due to the wall structure of the conductor tube, between the outer and inner walls of which a heat-insulating cavity is formed. The conductor tube 1 is hermetically connected by a threaded connection 5 to the refrigerant supply system 6, for example, the cryosurgical apparatus Krioin, which provides an adequate supply of refrigerant in subdestructive dosages.

The choice of technical parameters of the proposed device: material, dimensions of the conductor tube is based on an analysis of experimental and clinical research data.

Thus, the proposed utility model allows effective treatment of Perthes disease through safe targeted cryotherapy to the osteonecrosis zone after tunneling of the femoral neck to improve the metabolism of necrotic bone tissue and without unnecessary thermal and mechanical trauma to the surrounding tissues.

List of sources of information taken into account when writing the description:

1. Dudarev V.A., Kirgizov I.V., Gorbunov N.S. et al. A method for the treatment of aseptic necrosis of the femoral head and Perthes disease. RF patent No. 2357736 dated February 1, 2008.

2. Volkov M.V., Bizer V.A. Homoplasty of bone tissue in children - M., "Medicine". 1969 .-- 216.

3. Berenstein S.S., Seitzhanov Zh.M., Murzalin M.Zh. A method of treating Perthes disease in children. RF patent No. 2005506 dated January 15, 1994

Claims (1)

A device for cryosurgical treatment of Perthes disease, characterized in that it consists of a conductor tube connected to a refrigerant supply system, the conductor tube being made of titanium nickelide with double walls, with an outer diameter of 4 mm and an inner diameter of 3 mm, the thickness of each of the walls 0.3 mm, the distance between the outer and inner walls of 0.4 mm, the length of the tube is 150 mm, while a semicircular nozzle made of porous titanium nickelide with a pore diameter of 400 μm and a degree porosity of 60%, the diameter of which does not exceed the outer diameter of the conductor tube, and at its distal end there is a thread for tight connection to the refrigerant supply system.

Images