RU172979U1 - DEVICE FOR OSTEOSYNTHESIS OF HUMAN BONE FRACTURES - Google Patents

Abstract

The utility model relates to medicine, in particular to the field of traumatology and orthopedics, namely, devices for shoulder osteosynthesis by means of external transosseous fixation. The device contains supports 1, 2, 3, 4 with spokes 5 mounted on them, interconnected by threaded rods 6, equipped with fasteners 7, the supports are made with through holes evenly spaced 10, the supports form two fixation blocks 11, 12, proximal and distal bone fragments, two supports 1, 2 of the fixation block of the proximal bone fragment In the form of an annular sector, at least one support of the fixation unit of the distal bone fragment is made in the form of an annular sector, while at least one support 3 is made in the form of an annular sector, which is three quarters of a flat ring, and consists of two detachably connected parts 13, 14, superimposed on each other, each part has the shape of an annular sector, making up half a flat ring. The technical result is to ensure a stable position of the fragments of the humerus when fractured in ur vnyah upper and middle third of the shoulder through the use of external fixation device with the supports, not limited to the limb to the chest. Moreover, the design of the apparatus has sufficient rigidity and provides the necessary functionality, not inferior to the apparatus with ring supports. 3 s.p. f-ly, 9 ill.

Description

Technical field

The utility model relates to medicine, in particular to the field of traumatology and orthopedics, and in particular to devices for shoulder osteosynthesis through external transosseous fixation.

State of the art

External fixation devices are widely known and used in clinical practice for osteosynthesis, in particular fractures of the humerus. Known apparatus G.A. Ilizarova for transosseous osteosynthesis ([1], SU 1055499). The device for transosseous osteosynthesis contains supports in the form of arcs (annular sector) and rings with mounted spokes, interconnected by threaded rods and forming blocks for fixing proximal and distal bone fragments. It is equipped with distractors and nodes for adjusting and fixing the position of the supports and knitting needles. The supports are made in the form of flat rings and arcs (1/2 of the ring), with through holes evenly spaced, the longitudinal axis of the holes are radially symmetric to the longitudinal axis of the ring, while the supports in the form of arcs are connected so that they form a ring. Supports in the form of arcs, made in the form of half (1/2) of a flat ring, are connected in two, so that they form a ring.

Ring supports provide rigidity of the apparatus [1] and stable fixation of bone fragments fixed in it. However, the known layouts of the Ilizarov apparatus [1] for the treatment of fractures of the humerus do not satisfy the need to improve the quality of life while maintaining the functionality of the apparatus, as well as the rigidity of fixation of bone fragments, since when installing the apparatus [1] with ring supports on the humerus, ring supports located in the upper and middle third of the humerus, do not allow the limb to be brought to the body, create pressure on the soft tissues of the chest. In this case, the annular support in the upper and middle third of the humerus abuts against the chest and forms a fulcrum, and the underlying and overlying parts of the humerus form a lever. When the patient is in a standing or sitting position, the load on the weight of the limb, on the weight of the forearm and hand, applied to the distal end of the humerus, creates a moment of force tending to displace the proximal end of the humerus with the head from the shoulder joint, which leads to a constant overstretching of the capsule-ligamentous apparatus shoulder joint. The annular support located in the upper and middle third of the humerus plays a negative role - it is the fulcrum for the lever formed by the humerus, to the long part of which a load is applied in the form of the weight of the limb. An annular support in the middle and upper third of the shoulder presses on the soft tissues of the chest and creates an unpleasant sensation for the patient, forces him to withdraw the limb from the body, creates constant inconvenience. As a result of a long stay in the apparatus with ring supports in the middle and upper third, pain and traction subluxation of the humerus head occur, which worsens the patient's quality of life and the functional result of treatment.

кольца, в верхней трети плечевой кости, концы дуги направлены к телу (грудной клетке).The known arrangement of the apparatus for transosseous osteosynthesis ([2], AD Lee, RS Bashirov. Guide to transosseous compression-distraction osteosynthesis. Figure 41. Tomsk: Red Banner, 2002. - 307 pp. - ISBN 5-7511 -1464-7). The layout [2] contains supports connected by threaded rods, spokes are fixed to the supports, which are held in bone fragments. The layout [2] contains two ring supports in the middle third and one open support in the form of an arc (ring sector), component

rings, in the upper third of the humerus, the ends of the arc are directed to the body (chest).

The disadvantage of this arrangement [2] is that in the middle third of the humerus contains two annular supports, supports abut against the chest, do not allow the limb to be brought to the body and create conditions for the capsular ligamentous apparatus of the shoulder joint to overstretch. The greatest effort from the weight of the limb is distributed on the middle support (upper ring support), it is located closer to the shoulder joint, between the shoulder and the body, and presses on the soft tissues.

The essence of the technical solution

The technical problem to which the utility model is directed is to improve the functional result of the treatment of a fracture of the humerus, to improve the quality of life of the patient during the fixation of the humerus in the apparatus, by eliminating pressure from the elements of the apparatus on the chest (eliminating the fulcrum for the lever formed by the limb )

The technical result is to ensure a stable position of the fragments of the humerus during a fracture at the levels of the upper and middle third of the shoulder, by applying external fixation by the apparatus with supports that do not limit the limb to the chest. Moreover, the design of the apparatus has sufficient rigidity and provides the necessary functionality, not inferior to the apparatus with ring supports.

The technical result is achieved by the fact that in the apparatus for osteosynthesis of fractures of the humerus containing supports with spokes mounted on them, interconnected by threaded rods equipped with fasteners, supports are made with through evenly spaced holes, the supports form two fixation blocks, for fixing the proximal and distal bone fragments two supports of the fixation unit of the proximal bone fragment are made in the form of an annular sector, at least one support of the fixation unit of the distal bone gmenta bone formed in the shape of an annular sector. At least one support, and mainly two, is made by the team in the form of an annular sector, which makes up three quarters of a flat ring, and consists of two detachably connected parts superimposed on each other, each part has the shape of an annular sector, which makes up half a flat ring.

The above essence ensures the achievement of the claimed technical result.

It is envisaged that the block for fixing the proximal fragment of the bone may contain two supports, one is made in the form of an annular sector, which makes up half the ring, the second assembly in the form of an annular sector, which makes up three quarters of the flat ring, and consists of two detachably connected parts, with free ends directed to the chest.

The block for fixation of the distal fragment of the bone contains two supports, one support team, made in the form of an annular sector, comprising three quarters of a flat ring, and consists of two detachably connected parts, the second support is made in the form of a ring.

The fixation unit of the distal fragment of the bone may contain one precast support in the form of an annular sector, which is three quarters of a flat ring. Fasteners are made in the form of nuts and brackets.

The utility model is illustrated by graphic materials.

FIG. 1 - apparatus for osteosynthesis of fractures of the humerus at the levels of the upper and middle third, the layout for the fracture at the level of the middle third, front view;

FIG. 2 - apparatus for osteosynthesis of humerus fractures at the levels of the upper and middle third, the layout of the fracture at the level of the middle third, a General side view;

FIG. 3 - apparatus for osteosynthesis of humerus fractures at the levels of the upper and middle third, the layout for the fracture at the level of the upper third, general front view;

FIG. 4 - apparatus for osteosynthesis of fractures of the humerus at the levels of the upper and middle third, the layout for the fracture at the level of the upper third, general side view;

FIG. 5 - assembly support of the apparatus for osteosynthesis of fractures of the humerus at the levels of the upper and middle third, general view;

FIG. 6 - apparatus for osteosynthesis of fractures of the humerus at the levels of the upper and middle third, the layout for the fracture at the level of the middle third, a general view of the freely lowered shoulder;

FIG. 7 - apparatus for osteosynthesis of fractures of the humerus at the levels of the upper and middle third, the layout for the fracture at the level of the middle third, a general view of flexion in the elbow joint;

FIG. 8 - apparatus for osteosynthesis of humerus fractures at the levels of the upper and middle third, the layout of the fracture at the level of the upper third, a General view of the freely lowered shoulder;

FIG. 9 - apparatus for the osteosynthesis of humerus fractures at the levels of the upper and middle third, the layout for a fracture at the level of the upper third, a general view of flexion in the elbow joint.

Utility Model Implementation

The apparatus for osteosynthesis of humerus fractures at the levels of the upper and middle third (hereinafter referred to as the apparatus) contains supports 1, 2, 3 (Fig. 1; 2; 3; 4), 4 (Fig. 1; 2) with 5 spokes installed on them Fig. 1; 2; 3; 4), interconnected by threaded rods 6 (Fig. 1; 2; 3; 4), equipped with fasteners 7 (Fig. 1; 2; 3) in the form of nuts 8 (Fig. 1 ; 2; 3; 4) and brackets 9 (Fig. 1; 2; 3; 4). Supports 1, 2, 3, 4 are made with through evenly spaced holes 10 (Fig. 1; 2; 3; 4; 5). Supports 1, 2, 3, 4 form two blocks of fixation 11, 12 (Fig. 1; 2; 3; 4), proximal and distal bone fragments.

The supports 1, 2 of the fixation block 11 of the proximal fragment of the bone are made in the form of an annular sector. The support 3 of the fixation unit 12 of the distal bone fragment is made in the form of an annular sector. The fixation block 11 of the proximal fragment of the bone contains two supports 1, 2, one support 1 is made in the form of an annular sector, which makes up half the ring, the second support 2 is assembled, made in the form of an annular sector, which makes up three quarters of a flat ring, and consists of two detachable connected parts 13, 14 (Fig. 5), free ends directed towards the chest. Parts 13, 14 are connected by bolts 15 (Fig. 5) with nuts 16 (Fig. 5). Each part 13, 14 has the shape of an annular sector, making up half a flat ring.

When treating a fracture at the level of the middle third of the humerus, the arrangement of the apparatus (Fig. 1; 2; 6; 7) in the fixation unit 12 of the distal bone fragment contains two supports 3, 4 (Fig. 1; 2). One support 3 team (Fig. 5), the second support 4 is made in the form of a ring. The support 3 (Fig. 1; 2; 3; 4) is made by the national team (Fig. 5) in the form of an annular sector, which is three quarters of the flat ring, and consists of two detachably connected parts 13, 14 (Fig. 5) superimposed Each other. Parts 13, 14 are connected by bolts 15 (Fig. 5) and with nuts 16 (Fig. 5). Each part 13, 14 has the shape of an annular sector, making up half a flat ring.

When treating a fracture at the level of the upper third of the humerus, the apparatus arrangement (Fig. 3; 4; 8; 9) in the fixation unit 12 of the distal bone fragment contains one support 3 (Fig. 3; 4). The support 3 assembly (Fig. 5), made in the form of an annular sector, comprising three quarters of a flat ring, and consists of two detachably connected parts 13, 14 (Fig. 5), superimposed on each other. Parts 13, 14 are connected by bolts 15 (Fig. 5) and with nuts 16 (Fig. 5). Each part 13.14 has the shape of an annular sector, making up half a flat ring. The spokes 5 are fixed to the supports 1, 2, 3, 4 with clamping bolts 17 (Fig. 1; 2; 3; 4).

Use of utility model

The device is mounted on a damaged limb 18 (Fig. 6; 7; 8; 9), on the patient’s shoulder with a bone fracture at the level of the upper and middle third. Spokes 5 are drawn into the distal and proximal fragment of the humerus. The support 2 and the support 3 are assembled (Fig. 6; 7; 8; 9); for this, part 13 is connected to part 14 with bolts 15 and nuts 16 (Fig. 5). In case of a fracture in the middle third of the humerus, the free ends of the spokes 5 are fixed to the supports 1, 2, 3, 4 (Fig. 1; 2; 6; 7), fixing the position of the spokes 5 with clamping bolts 17. Supports 1 and 2 (Fig. 6; 7) the free ends are directed away from the shoulder to the chest, so that they do not limit the reduction of the shoulder to the body. The block of fixation 11 of the proximal fragment of the bone is assembled (Fig. 6; 7). To do this, connect support 1 and support 2 with threaded rods 6. Threaded rods 6 are installed using fasteners 7 - nuts 8 and brackets 9. Assemble the fixation unit 12 (Fig. 6; 7) of the distal bone fragment. To do this, connect the support 3 and the support 4 with threaded rods 6. The support 3 is thus installed so that it does not limit the bend in the elbow joint 19 (Fig. 7). The threaded rods 6 are installed using fasteners 7 - nuts 8 and brackets 9. The fixation block 11 of the proximal bone fragment with threaded rods 6 is connected to the fixation block 12 of the distal bone fragment. Threaded rods 6 perform compression.

In case of a fracture in the upper third of the humerus, the free ends of the spokes 5 are fixed to the supports 1, 2, 3 (Fig. 3; 4; 8; 9), fixing the position of the spokes with the clamping bolts 17. The supports 1 and 2 with their free ends are directed away from the shoulder to chest, so that they do not limit the adduction of the shoulder to the body. The block of fixation 11 of the proximal fragment of the bone is assembled (Fig. 8; 9). To do this, connect support 1 and support 2 with threaded rods 6. Threaded rods 6 are installed using fasteners 7 - nuts 8 and brackets 9. Fixation block 11 of the proximal bone fragment with threaded rods 6 is connected to the support 3 of the fixation block 12 of the distal bone fragment (Fig. 8; 9). The support 3 is set so that it does not limit the bend in the elbow joint 19. The threaded rods 6 carry out compression.

Thus, a rigid external structure of the apparatus is obtained, which stabilizes two fragments of the humerus, while the movement of the shoulder and forearm is not limited to the supports of the apparatus. Using the apparatus allows to improve the functional result of the treatment of a fracture of the humerus, to improve the quality of life of the patient during the fixation of the humerus in the apparatus. The absence of pressure on the chest from the side of the apparatus supports mounted on the shoulder avoids the development of subluxation of the shoulder joint, eliminates the forced limb abduction. The location and shape of the supports allows you to increase comfort during the patient’s stay in the device.

The device can be made of materials resistant to the external environment, biological fluids and tissues, such as stainless steel, titanium alloys or composite materials, using modern industrial equipment, and can be used as intended in specialized trauma departments of medical institutions for fractures of the humerus levels of the upper and middle third.

Claims (4)

1. Apparatus for osteosynthesis of humerus fractures, containing supports with spokes mounted on them, interconnected by threaded rods, equipped with fasteners, supports made with evenly spaced openings, supports form two fixation blocks for fixing proximal and distal bone fragments, characterized in that the supports of the fixation unit of the proximal bone fragment are made in the form of an annular sector, one of the supports of the fixation unit of the distal bone fragment is made in the form of an annular sect and comprises a prefabricated support, in the shape of a ring sector comprising three-quarters of a flat ring and consisting of two detachably connected parts, superimposed on each other, each part has the shape of annular sectors constituting a half annulus. 2. The apparatus for osteosynthesis of fractures of the humerus according to claim 1, characterized in that the fixation unit of the proximal fragment of the bone contains two supports, one is made in the form of an annular sector, making up half the ring, the second assembly support in the form of an annular sector, making up three quarters of the flat rings, and consists of two detachably connected parts. 3. The apparatus for osteosynthesis of fractures of the humerus according to claim 2, characterized in that the fixation unit of the distal fragment of the bone contains two supports, one support team, made in the form of an annular sector, comprising three quarters of a flat ring, and consists of two detachably connected parts, the second support is made in the form of a ring. 4. The apparatus for osteosynthesis of fractures of the humerus according to claim 2, characterized in that the fixation unit of the distal fragment of the bone contains one precast support in the form of an annular sector, which is three quarters of a flat ring.

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