RU163252U1 - COMBINED FORKLING PLATE FOR OSTEOSYNTHESIS OF Fractures and False Joints of the Key - Google Patents

Abstract

Combined fork plate for osteosynthesis of fractures and false joints of the clavicle, containing a osseous plate with holes and a fixing unit in the form of a “fork”, characterized in that the teeth are arcuately curved along the longitudinal relief of the front surface of the outer third of the clavicle, and the tooth sections adjacent to the acromial part of the plate directed fan-shaped, and the end sections of the teeth are directed in parallel to each other planes, to accommodate between them an acromial fragment of the clavicle, the plate is curved S- figuratively, in the medial part there are compression holes, and in the acromial part of the hole are made angle-stable.

Description

The utility model relates to medical equipment, namely to traumatology and orthopedics, and can be used in the surgical treatment of fractures and false joints of the clavicle.

A device is known - a 2.7 / 3.5 mm VA-LCP (Variable Angle Locking Compression Plate) Synthes / AO-ASIF (1) plate which is placed on the front surface of the clavicle, having previously modeled it taking into account the anatomical features of the patient’s bone.

The disadvantages of this device are the difficulty in application associated with the need to use original tools and screws of two sizes, a multi-stage implantation process, provided by the technology, which increases the duration of the operation. So, in order to comply with the implantation technology of this fixator, nine special tools are necessary, five of which are highly specific for this implant. To comply with the implantation technology of the plate with a minimum number of screws, a total of more than thirty actions must be performed using nine special tools. In complex cases (multifibre fracture of the external third, pseudoarthrosis with osteoporosis or fragmentation of a short lateral fragment), only two screws can be inserted into the fragment, which is not enough for reliable fixation. An attempt to use gypsum immobilization does not increase efficiency, because, together with the weight of the upper limb, it overloads the metal structure, can lead to its failure and loss of fixation.

The device is known as “Fork plate for osteosynthesis of fractures and false joints of the clavicle” (2), containing a osseous plate with holes and a fixing unit in the form of a “fork”, the teeth are made curved along the longitudinal relief of the front surface of the outer third of the clavicle and fan-shaped diverging parallel to each other planes for placement of the outer fragment between them, and the longitudinal part of the plate is curved S-shaped, selected as the closest. The disadvantage of this fixative is the low resistance to eruption of conventional cortical screws in the cancellous bone of the acromial end of the clavicle when using inter-fragment compression. With extreme degrees of osteoporosis, this threatens the migration of screws and loss of stability.

The technical result of this utility model is to increase the reliability of fixation in a multi-fragmented fracture or false joint with clavicle osteoporosis.

The technical result is achieved by the fact that in the device containing the osseous plate with holes and the fixing unit in the form of a “fork”, the teeth are made arcuately curved along the longitudinal relief of the front surface of the outer third of the clavicle, and the tooth sections adjacent to the acromial part of the plate are fan-shaped, and the end sections the teeth are directed in parallel planes to accommodate between them an acromial fragment of the clavicle, the plate is curved S-shaped, in the medial part there are compression holes, and in the acromial part of the hole are made angularly stable.

The illustrations show:

Fig 1. Fork plate for osteosynthesis of fractures and false joints of the clavicle front view.

In the figure 1: 2 - the medial part, 3 - the acromial part, 6 - the teeth, 7 - fork fixation unit "fork", 8 - the plane of the teeth, 9 - angle-stable hole, 10 - combined hole, 11 - oval hole.

Fig 2. Fork plate for osteosynthesis of fractures and false joints of the clavicle side view.

In the figure 2: 1 - S-shaped bend, 2 - the medial part, 3 - the acromial part, 6 - the teeth, 7 - fork locking node "fork", 8 - the plane of the teeth, 9 - angle-stable hole, 10 - combined hole, 11 - oval hole.

Fig 3. Fork plate for osteosynthesis of fractures and false joints of the clavicle axonometric view.

In the figure 3: 1 - S-shaped bend, 2 - the medial part, 3 - the acromial part, 4 - the acromial end (fragment) of the clavicle, 5 - the clavicle, 6 - the teeth, 7 - forked fixing unit "fork", 8 - plane teeth, 9 - an angle-stable hole, 10 - a combined hole, 11 - an oval hole, 12 - a cortical screw, 13 - a medial fragment of the clavicle, 14 - a multi-fragmented fracture or nonunion zone, on which the use of the claimed fixative is effective, 15 - an angle-stable screw.

Fork plate for osteosynthesis of collarbone fractures (Fig. 1-3), contains an S-shaped bend 1, the medial part 2 and the acromial part 3, to capture the acromial end 4 of the clavicle 5 from the acromial part 3 two teeth 6 form a forked fixing node ( "plug") 7. The teeth 6 are made arcuately curved along the longitudinal relief of the front surface of the outer third 4 of the clavicle 5, the adjacent sections of the teeth 6 adjacent to the acromial part of the plate are fan-shaped, and the end sections of the teeth 6 are directed in parallel to each other planes 8 for placing between them an acromial fragment of the clavicle 5. In the acromial part 3, there are three angle-stable 3.5 mm holes 9, oriented to the acromial end 4 of the clavicle 5. Between the acromial part 3 and the medial part 2 there is a combined 3.5 mm hole 10, and of the medial part 2 there are oval holes 11 for introducing 3.5 mm cortical screws 12 into the medial fragment 13.

This device is used as follows. After performing surgical access and reaching the front edge of the clavicle, the plane of 8 teeth 6 is oriented in the direction of the upcoming insertion on the surface of the acromial end (fragment) 4 and is put on it with a certain force 4. In this case, the planes 8 of the teeth 4 act as raspators, making their way between the soft tissues and bone 4. If there is a mismatch between the thickness of the fragment and the gap between the planes of 8 teeth 4, the latter are bent (reduced or parted) by 0.5-1 mm with tools. For the final landing on the bone 4, the latch is pounded with a light blow. When the acromial fragment 4 is clamped between the planes 8 in the fork 7, repositioning is performed by manipulating the fixator as a bone holder, the medial part 2 is laid on the medial fragment 13 and fixed with a cortical screw 12. With a wide area 14 of a multi-fragmented fracture, you can not insert screws into it 14 using principle of bridge fixation. The angle-stable screws 15 are inserted into the holes 9 of the acromial part 3, after which compression is performed for non-fragmented transverse fractures and false joints. Cortical screws 12 are inserted through openings 11 into the medial fragment. Layered sutured wound. In the postoperative period, limb function begins after cessation of postoperative pain. External immobilization is not indicated.

The device allows you to:

- in case of comminuted fractures and false joints of the clavicle, to increase the reliability of fixation due to the combination of angle-stable screws and a tight fit of the forked fixing unit on the cortical surfaces of the acromial end of the clavicle;

- exclude intraoperative fitting of the fixative to the individual anatomy of the clavicle of different patients;

- optimize the specific load on the spongy bone of a less durable lateral fragment;

- facilitate and accelerate the operation at the stage of fixation of the external fragment and use the plug of the device as a bone holder.

Literature.

1. Manual on the implantation surgical technique http://www.synthes.com/MediaBin/US%20DATA/Product%20Support%20Material s / Technique% 20Guides / SUSA / SUTG27-35VALCPAntClavJ9860B.pdf 2010.)

2. Voronkevich I.A., Lavrentiev A.V., Komissarova I.E., Polyanskaya E.V. Fork plate for osteosynthesis of fractures and false joints of the clavicle. Patent No. 2254090, priority dated June 30, 2003.

Claims (1)

Combined fork plate for osteosynthesis of fractures and false joints of the clavicle, containing a osseous plate with holes and a fixing unit in the form of a “fork”, characterized in that the teeth are arcuately curved along the longitudinal relief of the front surface of the outer third of the clavicle, and the tooth sections adjacent to the acromial part of the plate directed fan-like, and the end sections of the teeth are directed in parallel to each other planes, to accommodate between them an acromial fragment of the clavicle, the plate is curved S- figuratively, in the medial part there are compression holes, and in the acromial part of the hole are made angle-stable.

Images