RU163862U1 - PLATE FOR OSTEOSYNTHESIS OF EXTREME FEMORAL FRACTURES - Google Patents

Abstract

A plate for osteosynthesis of transverse fractures, repeating the anatomical bending of the femur, characterized in that it contains at least one dumbbell-shaped double hole, including oval and round parts drilled in the shape of a cone in which the diameter of the surface of the hole adjacent to the bone is less than the diameter located on the outside with respect to to the bone surface; simple screws pass through the oval part of the hole; in the round part, thread for screws with angular stability; in the proximal section of the plate, the axis of the thread is positioned at an angle of 30-40 ° to the horizontal plane, in the distal section at an angle of 55-65 ° to the frontal plane.

Description

PLATE FOR OSTEOSYNTHESIS OF EXTREME FEMORAL FRACTURES

The utility model relates to medicine, namely to orthopedics traumatology.

The utility model provides for osseous fixation of transverse hip fractures in patients with osteoporosis and in old age.

A known fixator for osteosynthesis of transverse femoral fractures is a dynamic DHS femoral screw containing a compression screw with an external thread for placement in the proximal fragment of the bone, an opening with an internal thread for a tightening screw and an overlay with holes for cortical screws (Manual for internal osteosynthesis. Moscow 1996. Allgover M., Muller M.E., Schneider R., Willinger X. p. 270-276).

The disadvantage of this device is the complication of fixing a hip fracture in the central fragment for the cancellous bone, which in patients with osteoporosis and in old age has low strength, and also in the presence of comminuted transverse fractures in the projection of the introduction of the femoral dynamic screw DHS, the stability of osteosynthesis is reduced.

A device for osteosynthesis of transverse femoral fractures is known, which is a plate repeating the anatomical bending of the femur (patent RU 2293537).

The disadvantage of this device is the violation of periosteal blood flow due to pressing the plate to the bone; as well as the possibility of secondary displacements, migration of retainers in the process of rehabilitation and fusion.

The technical result is the prevention of complications in the fixation of transverse hip fractures for the cancellous bone; preservation of periosteal blood flow; improving the reliability of fixation of transverse hip fractures.

The device includes the following elements: proximal (1) and distal (2) departments, between which there is a bend (3) at an angle from 120 to 135˚. The plate thickness is 0.35--0.8 cm, length is from 8 to 14 cm, width is 1.2-1.5 cm. At least one dumbbell-shaped double hole (4) is made in the proximal (1) and distal (2) sections, including oval (5) and round (6) parts. Both parts of the dumbbell-shaped double hole (4) are drilled in the shape of a cone so that the diameter of the surface of the hole (4) adjacent to the bone (9) is smaller than the diameter of the surface (10) located on the outer surface of the bone. The oval portion (5) of the hole (4) is for simple screws. In the round part (6) of the hole, a thread is cut for screws with angular stability. In the proximal section (1), the axis of the thread is positioned at an angle of 30-40 ° to the horizontal plane, and in the distal section (2) - at an angle of 55-65 ° to the frontal plane. The plate is superimposed on the front surface of the femur so that the proximal (1) end is directed toward the femoral head, and the distal (2) end is towards the distal pineal gland. Through holes (4) in the proximal (1) section of the plate, screws are inserted into the femoral neck through both cortical layers of the femur (7).

The device involves the use of both simple and lockable screws with angular stability, used with plates with angular stability - LCP plates (Traumatology and Orthopedics: a manual for doctors / edited by N.V. Kornilova in 4 volumes - T.1: General issues of traumatology and orthopedics / edited by N.V. Kornilov and E.G. Gryaznukhin - St. Petersburg: Hippocrates, 2004, from 324-327).

The achievement of the angular and rotational stability of bone fragments is created by blocking the screw head in the hole (4) of the plate, and not by pressing the plate to the bone (7), periosteal blood flow is preserved due to the absence of an excessively dense attraction of the plate to the bone (7), there are no secondary displacement, migration of retainers in the process of rehabilitation and fusion. Since the plate repeats the anatomical bends of the anterior surface of the cervical-diaphyseal region of the femur (7), the fixation of fragments occurs regardless of the presence of small fragments in the area of the fracture line (8).

The device operates as follows. Under anesthesia or spinal anesthesia in the position of the patient lying on his back, an incision is made along the anteroposterior surface of the hip joint 13-16 cm. The fracture site is exposed on the front surface of the thigh. Fragments are repaired. The edge of the joint capsule is cut to a plate width of 1.2-1.5 cm (Fig. 1), through the hole in the joint capsule along the front surface of the femoral neck, the proximal section (1) of the plate is inserted. Above the double dumbbell-shaped holes (4), plates in the area of the femoral neck are perforated with a joint capsule for drilling and inserting screws into the central fragment. 1-3 screws are inserted, depending on the fracture line, into the proximal section (1) of the plate through double holes (4) and 2-4 screws, depending on the fracture line (8), into the distal section (2) of the plate through holes (4).

Description of the drawings.

FIG. 1 Plate with angular stability

1- proximal

2- distal section

3- bend

4 - holes

5- oval part of the hole

6- round part of the hole

figure 2 An example of the imposition of a plate with angular stability on the femur.

1- proximal

2- distal section

3- bend

4 holes

5- oval part of the hole

6- round part of the hole

7- femur

8- fracture line

9 - diameter of the hole on the surface of the plate adjacent to the bone

10 - diameter of the hole on the surface of the plate opposite from the bone

FIG. 3 Fragment of a plate with angular stability illustrating the conical shape of the hole.

9 - diameter of the hole on the surface of the plate adjacent to the bone

10 - diameter of the hole on the surface of the plate opposite from the bone

Claims (1)

A plate for osteosynthesis of transverse fractures, repeating the anatomical bending of the femur, characterized in that it contains at least one dumbbell-shaped double hole, including oval and round parts drilled in the shape of a cone in which the diameter of the surface of the hole adjacent to the bone is smaller than the diameter located on the outside with respect to to the bone surface; simple screws pass through the oval part of the hole; in the round part, thread for screws with angular stability; in the proximal section of the plate, the axis of the thread is positioned at an angle of 30-40 ° to the horizontal plane, in the distal section at an angle of 55-65 ° to the frontal plane.

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