RU163085U1 - PLATE FOR INTERFERELINE FRACTURES AND FEMOR OSTEOTOMIES - Google Patents

Abstract

A plate for intertrochanteric fractures and osteotomies of the femur, containing a metadiaphyseal part with combined holes and an epiphyseal fixation unit with a spit bend, angle-stable holes and trochanteric and neck channels for sighting spokes, the axes of which are parallel to two channels of rotary angle-stable screws and four channels characterized in that in the metadiaphyseal part the device is provided with intermediate angle-stable holes for angle-stable screws o, having an intermediate position and direction between the trochanteric, cervical and angle-stable canals of the combined metadiaphysial openings, and the canal of the trochanteric aiming needle is oriented to the top of the greater trochanter of the femur.

Description

The device relates to medical equipment, namely to traumatology and orthopedics, and can be used for internal fixation of fragments during intertrochanteric fractures and osteotomies of the femur, with false joints of this localization that developed after such osteotomies, as well as with corrective osteotomies due to post-traumatic deformities .

A device (1) is known in the form of a fixator for osteosynthesis of basal, transtrochanteric and extratrochanteric fractures of the femur in the form of a lining consisting of a metaphysial part having an opening for the femoral screw and peripheral holes for derotation screws and the diaphyseal part having openings for cortical fixing screws, characterized the fact that a compression screw is inserted into the thigh screw at an angle of 130-140 ° to the surface of the patch, in which all holes are made with an internal thread to block all screws. The disadvantage of this device is that in the proximal femur is introduced insufficient for stable fixation number of carbon-stable screws, as well as the lack of fixation of the zone of the greater trochanter of the femur.

Closest to the claimed are the device "Smith & Nephew PERI-LOC PFP 4.5 mm Proximal Femur Locking Plate" (2). It is used in cases of fractures of the trochanteric region, as well as the proximal femur in an open or minimally invasive installation. The device consists of a osseous part with openings for carbon-stable and cortical screws, which are inserted into the neck and metadiaphysis of the femur. The main disadvantages of this device are the insufficient number and distribution of carbon-stable screws in the proximal fragment of the femur, which may be required in some cases of intertrochanteric osteotomies and subtrochanteric fractures in which fixation may be unsuccessful. A disadvantage is the lack of fixation of the zone of the greater trochanter of the femur, which may be required for multi-fragmented fractures, as well as the possibility of using carbon-stable screws on the metadiaphysis, which is necessary in the treatment of patients with severe forms of osteoporosis.

The technical result of this utility model is stable interfragmental fixation during intertrochanteric osteotomies, traumatic intertrochanteric fractures and false joints of this localization.

The result of the utility model is achieved by the fact that the plate for intertrochanteric fractures and osteotomy of the femur contains a metadiaphyseal part with combined openings and an epiphyseal fixing unit with a spit bend, angle-stable holes and trochanteric and neck channels for sighting spokes, the axes of which are parallel to two channels of rotary angle-stable screws four channels of neck angle-stable screws, respectively. In this case, the device is equipped with intermediate angle-stable holes for angle-stable screws having an intermediate position and direction between the trochanteric, cervical and angle-stable channels of the combined metadiaphyseal holes, and the channel of the trochanteric aiming needle is oriented to the top of the greater trochanter of the femur.

The illustrations show:

FIG. 1. A plate for intertrochanteric fractures and osteotomy of the femur (top view), where: 1 - epiphyseal fixing node; 2 - metadiaphyseal part of the plate; 4 - spit channel for sighting knitting needle; 8 - rotary angle-stable holes; 9 - cervical canal for sighting spokes; 13 - cervical angle-stable holes; 19 - intermediate angle-stable holes; 20 - combined holes.

FIG. 2. The same side view, where 1 is the epiphyseal fixing node; 2 - metadiaphyseal part of the plate; 3 - spit bending of the plate; 4 - spit channel for sighting knitting needle; 7 - axis of the rotary angle-stable holes; 8 - rotary angle-stable holes; 9 - cervical canal for sighting spokes; 12 - axis of the cervical corner-stable hole; 13 - cervical angle-stable holes; 19 - intermediate angle-stable holes; 20 - combined holes.

FIG. 3. General view of the device on the bone, where 1 is the epiphyseal fixing node; 2 - metadiaphyseal part of the plate; 5 - trochanteric sighting needle; 6 - axis of the trochanteric sighting needle; 10 - cervical sighting needle; 11 - axis of the cervical sighting needle; 14 - neck angle-stable screws; 15 - axis of cervical angle-stable screw; 16 - the neck of the femur; 17 - rotary angle-stable screw; 18 - axis of the rotary angle-stable screw; 21 - angle stable screws; 22 - cortical screws; 23 - zone of fracture or osteotomy of the femur; 24 - metadiaphysis of the femur; 25 - the top of the greater trochanter of the femur;

The device (Fig. 1-3) consists of an epiphyseal fixing unit 1, and a metadiaphysic part 2. In the epiphyseal fixing unit 1 there is a spit bend 3, a spit channel 4 for a spit aiming pin 5, the axis of which 6 is parallel to the axes 7 of the rotary angle-stable holes 8, which are part of the epiphyseal fixing node 1. In its center 1 is the cervical canal 9 for the cervical sighting needle 10, the axis of which 11 is parallel to the axes 12 of the cervical angle-stable holes 13. These holes 13 are located in the metadiaphyseal part 2 and are intended for I insertion of cervical angle-stable screws 14 parallel to their axes 15 into the neck of the femur 16 parallel to the aiming cervical spoke 10. Rotary angle-stable holes 8 are intended for insertion of rotary angle-stable screws 17 parallel to their axes 18 and rotary aiming spoke 5. The metadiaphyseal part of the plate 2 contains intermediate angle-stable 19 and combination openings 20 for angle-stable 21 and cortical 22 screws.

The device is used as follows. After surgical access and comparison of fragments in the zone of fracture or osteotomy of the femur 23 (in case of fractures after an open or closed reposition of fragments), the device is placed on the metadiaphysis of the femur 24, orienting the tip of the epiphyseal fixing node to the top of the greater trochanter 25. Under image intensifier control along the axis of the femoral neck 16, a cervical aiming needle 10 is carried out. Then, a plate is put on the cervical aiming needle 10 by the cervical spoke channel 9, which orientates the axis of the cervical angle-stable holes 12 parallel to the axis of the spoke 10 and along the axis of the neck of the femur 16. Through the trochanteric channel after the plate is finally installed on the bone, the trochanteric aiming spoke 5 is inserted to temporarily fix the device to the metadiaphysis 24 of the femur. The plate is pre-fixed with one cortical screw 22 to the metadiaphysis 24 without compression. Then, angle-stable screws 14, 17 are sequentially inserted into the neck 13 and spit 8 angle-stable holes, taking into account the nature and extent of the fracture zone or the direction and orientation of the surfaces of the osteotomy. The number of angle-stable screws 14, 17, 21 inserted into the epiphyseal fixing unit 1 is determined by the nature of the damage and the quality of the bone tissue. In osteoporosis, their number can be increased up to filling all the angle-stable holes 8, 13, 19 of the epiphyseal fixing unit 1. By tightening one or two cortical screws 22 in the combined hole 20, inter-fragment compression is performed. Then the fixation of the metadiaphyseal part of the plate 2 is strengthened by the introduction of angle-stable screws 21 into the combined holes 20. The operation is completed by removing the cervical 10 and trochanteric 5 temporary needles, draining the wound according to indications and layer-by-layer suturing of the wound. Immobilization in the postoperative period is not applied. The reliability of fixation of fragments of the femur is sufficient for active movements that begin before the removal of sutures.

When the plate is closed, through the puncture access in the metadiaphyseal area of the femur 24, the plate is placed on the bone, orienting the top of the epiphyseal fixation unit 1 to the top of the greater trochanter 25, then separate limited access to the trochanteric area is performed to visualize and control the position of the epiphyseal fixation unit 1. Introduction cortical 22 or angle-stable screws 14, 17, 21 in the metadiaphyseal part of the plate 2 is carried out by minimally invasive technology.

The device allows you to:

- to provide reliable inter-fragment fixation of fragments of the femur during intertrochanteric fractures and osteotomies;

- to ensure a uniform distribution of angle-stable screws throughout the proximal volume and their exact entry into the neck of the femur;

- effectively use internal fixation in osteoporosis.

Bibliography:

1. Babovnikov A.V., Rubekina L.N., Tomashevskaya I.V. A fixator for osteosynthesis of basal, extratrochanteric and subtrochanteric fractures of the femur. RF patent №127614, priority of November 30, 2013

2. http://www.smith-nephew.com/professional/products/trauma/plates-and-screws/peri-loc-pfp/

Claims (1)

A plate for intertrochanteric fractures and osteotomies of the femur, containing a metadiaphyseal part with combined holes and an epiphyseal fixation unit with a spit bend, angle-stable holes and trochanteric and neck channels for sighting spokes, the axes of which are parallel to two channels of rotary angle-stable screws and four channels characterized in that in the metadiaphyseal part the device is provided with intermediate angle-stable holes for angle-stable screws o, having an intermediate position and direction between the trochanteric, cervical and angle-stable canals of the combined metadiaphyseal holes, and the canal of the trochanteric aiming needle is oriented to the top of the greater trochanter of the femur.

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