RU176258U1 - BACK PROCESSING BIT - Google Patents

Abstract

The technical solution relates to medical equipment and can be used in orthopedic operations for bone treatment, in particular in immersion osteosynthesis, in the treatment of osteomyelitis foci, or in surgical treatment of false joints, including the treatment of infected false joints with concomitant bone osteomyelitis. The return bit for processing the bone contains a handle 1, butt 2, a working part 3 equipped with a cutting edge 4. It differs in that the cutting edge 4 on the working part 3 is oriented towards the position of the handle 1. This allows you to use the principle of the reverse hammer when the blow is applied not in the forward direction from the outside of the handle, but in the opposite direction. The butt 2, with respect to the handle 1, is located on the side of the working part 3. The working part 3 consists of a rod 5 with a tip 6. The rod 5 performs the function of a guide onto which the sliding hammer is mounted. A sliding hammer is put on the rod 5 of the working part 3. Apply force to the hammer, move it along the rod 5 until it collides with the butt 2. The hammer hits the butt 2, the force from the impact is transmitted through the rod 5 to the cutting edge 4, the cutting edge 4 cuts into the bone tissue and cuts off a fragment of bone. The technical result is to ensure cleaving bone tissue from the back surface of the bone. This reduces the risk of unintentional damage to soft tissues, spalling of bone fragments larger than required size. The chisel allows you to quickly and safely process the trailing edge (edge) of the bone fragment of the bone, giving it a pointed shape. 13 s.p. f-ly 11 ill.

Description

The technical solution relates to medical equipment and can be used in orthopedic surgery for bone treatment, in particular during immersion osteosynthesis, in the treatment of osteomyelitis foci, or in surgical treatment of false joints, including the treatment of infected false joints with concomitant bone osteomyelitis.

To date, osteotomes and chisels designed for bone processing, different in geometric shape and place of application, are known. In particular, it is known for tubular bone osteotome ([1], RU 2306879). The osteotome contains a handle, which is made with a butt for striking it, and a working part. The working part is fixed on the handle and has a spike and an elongated restrictive guide plate with a convex part. The convex part of the plate extends beyond the tenon on all sides. The cutting part of the spike is made concave. The spike tip and the end of the bounding guide plate are bent towards each other. Osteotome, allows you to perform a transverse intersection of the bone with the intersection of only the cortical plate of the bone and maintaining the integrity of the contents of the medullary canal along the entire circumference of the bone, to protect the soft tissues surrounding the bone from all sides from the line of osteotomy.

Known by the osteotome ([2], SU 1297826), containing a handle made in one piece with a pick, a curved crescent-shaped working part, the end of which is provided with a pointed tenon on the concave side, and a plate with the edges protruding above the tenon on the convex side.

Known by the osteotome ([3], 1801385), containing a handle equipped with a main pick and an additional pick, a working part of a curved shape and equipped with a pointed spike at the end, over which a restrictive plate is placed on one of its sides.

Known elevator-osteotome ([4], 13535) containing a handle and a working element. The handle is equipped at the end with a shock pad, under which a hexagonal neck is located. The working element has a fold. The end of the cutting part of the working element, made in the form of a plate, has a concave rounded shape and a triangular shape in cross section. The lateral protruding parts on both sides of the end of the working part are rounded with a semicircle in cross section.

Known osteotome ([5], 11684), containing a handle in the form of a hexagon and a working element equipped with a cutting part. The handle and the working element are located on one longitudinal line. The cutting part along the entire length is made with evenly spaced teeth, with each cavity provided with a sharpening made at an angle to the longitudinal axis of the osteotome.

Tubular bone after a violation of integrity, for example, by a fracture or osteotomy, is divided into at least two bone fragments. Each of the bone fragments has a lateral surface, an end face, and an edge. The butt is the surface of the bone fragment located in the direction of the fracture (or osteotomy). The edge is located on the outer edge of the end face, at the junction of the side surface into the end face. For surgical access to the site of violation of the integrity of the bone (fracture, osteotomy) using an incision (dissection) of soft tissues, puncture of soft tissues. Equally, for surgical access to the site of violation of the integrity of the bone can be used dissection of tissues obtained as a result of trauma, that is, a wound. For a better understanding of the essence of the technical solution, the applicant explains the following concepts. The lateral surface of the bone, located in depth closer to the place of surgical access, dissection (incision, wound) of soft tissues, is called the front surface. The lateral surface of the bone located deeper (deeper) from the place of surgical access, dissection (incision, wound) of soft tissues, is called the posterior surface. The same designations apply to bone fragments obtained as a result of violation of the integrity of the bone, in relation to their location to the site of surgical access, the anterior surface of the bone fragment is located closer to the incision depth, the posterior surface of the bone fragment is located further in depth further from the incision.

In analogues [1, 2, 3, 4, 5], the cutting edge of the bit is directed to the side "from the handle", and they are not adapted to act on the processed bone from the side opposite to the cut - from the back surface side. By analogs, it is impossible to accurately process the surface of the bone located deep in the wound without damaging the adjacent soft tissues. Chisels and osteotomes [1, 2, 3, 4, 5] are intended for processing the bone using direct exposure of the cutting edge to the bone. The impact is transmitted from the side of the handle from its outer end, through the working part. Analogs [1, 2, 3, 4, 5] are used as follows. The working part of the bit is inserted into the soft tissue incision (or wound), set with a sharp cutting edge on the bone or bone fragment (fragment), and hit the pickaxe (at the outer end of the handle) with a hammer in the direction of the cutting edge. With this effect, the force from the butt and through the handle is transmitted to the working part and the cutting edge and then transferred to the bone, from the force of the impact of the cutting edge cutting, or chipping, parts of the bone tissue occurs. To form a strong connection of bone fragments (fragments of a tubular bone), it is customary to process their adjacent ends so that a recess (hole) is formed at the end of one bone fragment, and a chamfer (pointed end) is formed at the adjacent end of the second bone fragment. A chamfer is formed along the entire outer edge of the end face of the bone fragment, cutting off the edge. Using osteotomes [1, 2, 3, 4, 5], it is convenient to process only the portion of the bone fragment located closer to the surface of the wound (incision), that is, the front surface. When forming a chamfer on the front edge of the end of the bone fragment, located close to the cut surface, not deep in the wound, when exposed directly to the bit [1, 2, 3, 4, 5], the working part of which is placed in the cut at an angle to the surface of the bone fragment, the cutting edge abuts against the lateral surface of the bone fragment near its end and moves towards the end, a controlled dissection of the cortical layer occurs, and the bone fragment (fragment) is chipped off to form a chamfer. When processing the trailing edge of the end of the bone fragment, remote from the surface of the incision located deep in the wound, with direct exposure to the cutting edge from the side of the end, uncontrolled chipping of part of the bone occurs, a large extended bone fragment (fragment) is formed, which leads to an increase in bone tissue defect and undesirable shortening the bone fragment. To form a chisel [1, 2, 3, 4, 5], a uniform chamfer along the entire outer contour of the end face of the bone fragment, cutting the edge, from one access is almost impossible. Another drawback of the analogues [1, 2, 3, 4, 5] is that when they process the trailing edge of the end of the bone fragment, there is a risk of damage to the soft tissues by the cutting edge of the bit, which, after hitting the butt with a hammer and breaking off part of the bone, penetrates deep soft tissue and can damage blood vessels and nerves. It is also possible inadvertent sliding of the working part of the bit [1, 2, 3, 4, 5], from the lateral surface of the bone to the sides, which is also fraught with damage to soft tissues. In order to prevent possible slipping of the working part of the bit and damage to soft tissues, it is necessary to install additional devices for protecting soft tissues. When installing protection, it is necessary to increase the operational wound, skeleton the bone unnecessarily (to separate the periosteum), which increases blood loss, the duration of the operation, and the risk of purulent and trophic complications. In order to sharpen the end of a bone fragment with a chisel [1, 2, 3, 4, 5], sometimes you have to resort to performing an additional soft tissue incision, which is an undesirable trauma. The claimed technical solution, the reverse bit for processing the bone (hereinafter the bit), was created to facilitate the process of processing the bone from the back surface, which is carried out with the aim of imparting congruency to the bone fragments during osteosynthesis.

The technical result is to ensure cleaving bone tissue from the back surface of the bone. This reduces the risk of unintentional damage to soft tissues, spalling of bone fragments larger than required size. The chisel allows you to quickly and safely process the trailing edge (s) of the bone fragment of the bone, giving it a pointed shape. As a result, the bone fragment does not undergo excessive skeletonization, the surgical wound is minimal in size, blood loss is reduced, the time of surgery is reduced, and the risk of trophic and purulent complications is reduced.

The technical result is achieved in that the bit contains a handle with a butt, a working part equipped with a cutting edge, the cutting edge on the working part is oriented towards the handle.

The specified entity ensures the achievement of a technical result. The front surface of the cutting edge is oriented towards the handle, is located at an angle to the longitudinal axis of the working part. The cutting edge transfers the cutting force in the direction opposite to the direction of the working part. The butt, in relation to the handle, is located on the side of the working part. Depending on the manufacturing technology, manufacturing cost, at a particular production plant, ease of use, the bit can be made with some differences. The handle, the butt and the working part can be integral and integral, or they can be made separately as detachable parts. The butt may be located at the junction of the handle in the working part, or on the working part as its structural element. The working part may be prefabricated and consist of a rod and a tip that contains a cutting edge. The handle and the working part can be connected with the possibility of separation, while a threaded connection, or a threaded connection of the "father-mother" type equipped with a latch, can be used. The bit is preferably made metal, from an alloy of stainless corrosion-resistant steel or titanium alloys approved for use in medicine. In this case, the handle can be made of non-metallic materials, for example, PCB, fluoroplastic, and other polymeric materials. The butt is preferably made of metal, while it can be integral with the handle, and can be made as a separate structural element. The cutting edge can be made of hard alloy, for example in the form of a removable plate mounted on the working part. The working part can be made of solid metal, while the cutting edge is thermally processed to give it high hardness and wear resistance.

The technical solution is illustrated by graphic materials.

FIG. 1 - bit, general view, monolithic embodiment;

FIG. 2 - bit, side view, a monolithic embodiment;

FIG. 3 - bit, top view, monolithic embodiment;

FIG. 4 is a bit, a view with exploded parts, a prefabricated embodiment;

FIG. 5 - a sliding hammer with a handle top view;

FIG. 6 - a side view of a bit with a sliding hammer installed;

FIG. 7 - a chisel with a hammer installed (without a handle) side view, a dotted line and an arrow show the direction of movement of the hammer;

FIG. 8 - a bit with a textolite handle, side view;

FIG. 9 - bit tip (for a monolithic version), general view;

FIG. 10 - bit tip (for prefabricated version), sectional side view;

FIG. 11 - bit tip, bottom view (for all options).

Implementation of a technical solution. The bit can be made in various versions, while maintaining the essence of the technical solution. For example, as a monolithic embodiment, shown in FIG. one; 2; 3; 6.

The chisel (Fig. 1; 2; 3) is made of stainless steel. The bit contains a handle 1 (Fig. 1; 2; 3; 6), butt 2 (Fig. 1; 2; 3; 6), a working part 3 (Fig. 1; 2; 3; 6). The working part 3 is equipped with a cutting edge 4 (Fig. 1; 2; 3; 6). The cutting edge 4 on the working part 3 is oriented towards the location of the handle 1. The butt 2, with respect to the handle 1, is located on the side of the working part 3. The handle 1 and the butt 2 are made in one piece and are integral (Fig. 1; 2; 3) . The working part 3 consists of a rod 5 (Fig. 1; 2; 3; 6; 7), with a tip 6 (Fig. 1; 2; 3; 6; 7; 9). The rod 5 performs the function of a guide onto which, with the possibility of longitudinal movement, a sliding hammer 7 is installed (Fig. 5). The tip 6 contains a working end 8 (Fig. 9) of a hook-shaped rounded shape, a thrust surface 9 (Fig. 9), a cutting edge 4 located at the intersection of the front 10 (Fig. 9) and the rear surfaces 11 (Fig. 9). The rear surface 11 is made in the form of a groove 12 (Fig. 11). The working end 8 is bent in the opposite direction (towards the handle). In a longitudinal section, the front surface 10 is located at an angle of 67 degrees to the longitudinal axis and at an angle of 62 ° to the thrust surface 9, the rear surface 11 is located at an angle of 33 degrees to the longitudinal axis.

Using a technical solution.

The technical solution is used in the treatment of patients with purulent lesions of the musculoskeletal system and their consequences resulting from high-energy injuries, military injuries, and surgical interventions. In the surgical wound, obtained by surgical incision of the soft tissues or available from dissection as a result of injuries, the working part of 3 bits is inserted. Spend the working part 3 deep into the wound between the bone fragments 13 (Fig. 6). Substitute the working end 8 of the tip 6 with a sharp cutting edge 4 from the side of the back surface of the bone fragment 13, under the trailing edge of the end of the bone fragment 13, resting the thrust surface 9 on the end of the bone fragment 13. Install a sliding hammer 7 on the working part 3 (Fig. 5; 6 ) Use a sliding hammer 7 with a slot. The sliding hammer 7 with a slot is put on the rod 5 of the working part 3. Apply force to the sliding hammer 7, move it along the rod 5 until it collides with the butt 2. The sliding hammer 7 hits the butt, the force from the impact is transmitted through the rod 5 to the cutting edge 4, the cutting edge 4 cuts into the bone tissue and cuts off the bone fragment. Sequentially moving the cutting edge 4 of the bit along the edge of the end face of the bone fragment 13 along the back surface and hitting the bone fragment 2 with the sliding hammer 7, cut off the bone fragments and form a chamfer. The front side surface of the bone fragment 13 is treated with a conventional straight bit. Point the end of the bone fragment.

An assembled embodiment is shown in FIG. four; 7. The bit contains a handle 1 (Fig. 4; 7), butt 2 (Fig. 4; 7), a working part 3 (Fig. 4; 7). The working part 3 is equipped with a cutting edge 4 (Fig. 4). The cutting edge 4 on the working part 3 is oriented towards the location of the handle 1. The handle 1 and the butt 2 are one piece. The working part 3 consists of a rod 5 (Fig. 4), and a tip 6 (Fig. 4). The tip 6 is installed at one end of the rod 5 through a threaded connection. The handle 1 with the butt 2 is installed on the opposite end of the rod 5 also through a threaded connection. The rod 5 performs the function of a guide onto which, with the possibility of longitudinal movement, a sliding hammer 7 is installed (Fig. 5). The tip 6 contains a working end 8 (Fig. 10) of a hook-shaped rounded shape, a thrust surface 9 (Fig. 10), a cutting edge 4 located at the intersection of the front 10 (Fig. 10) and the rear surfaces 11 (Fig. 10). The rear surface 11 is made in the form of a groove 12 (Fig. 11). The working end 8 is bent in the opposite direction (towards the handle). The rod 5 may be equipped with a limiter 14 (Fig. 7). All elements are made of titanium alloy.

Using. This version of the bit is used similarly to the variant described above. Moreover, this option allows the use of a sliding hammer 7 (Fig. 7) equipped with a through hole, but without a slot and without a handle. Install the sliding hammer 7 without a slot as follows. Unscrew the handle 1 with the butt 2 from the rod 5. Install a sliding hammer 7 on the rod (Fig. 7). Screw the handle 1 with the butt 2 on the rod 5. Then apply a force to the sliding hammer 7, move it along the rod 5 until it collides with the butt 2, the sliding hammer 7 hits the butt, the force from the impact is transmitted through the rod 5 to the cutting edge 4, the cutting edge 4 cuts into bone tissue and cuts off a bone fragment. The limiter 14 ensures the stop of the sliding hammer 7.

A prefabricated version with a butt on the working part is shown in FIG. 8.

The bit contains a handle 1 (Fig. 8), butts 2 (Fig. 8), the working part 3 (Fig. 8). The handle 1 is made of PCB. The working part 3 is equipped with a cutting edge 4 (Fig. 8) and is made of stainless steel. The cutting edge 4 on the working part 3 is oriented towards the location of the handle 1. The working part 3 consists of a rod 5 (Fig. 8) and a tip 6 (Fig. 8). The tip 6 is installed at one end of the rod 5 through a threaded connection. The handle 1 is mounted on the opposite end of the rod 5 through a threaded connection. The rod 5 contains a butt 2 and performs the function of a guide onto which, with the possibility of longitudinal movement, a sliding hammer 7 is installed (Fig. 8). The tip 6 contains a working end 8 (Fig. 10) of a hook-shaped rounded shape, a thrust surface 9 (Fig. 10), a cutting edge 4 located at the intersection of the front 10 (Fig. 10) and the rear surfaces 11 (Fig. 10). The rear surface 11 is made in the form of a groove 12 (Fig. 11). The working end 8 is bent in the opposite direction (towards the handle). The rod 5 is additionally equipped with a limiter 14 (Fig.7). The tip 6 is made of metal and is subject to heat treatment. In a longitudinal section, the front surface 10 is located at an angle of 67 degrees to the longitudinal axis and at an angle of 62 degrees to the abutment surface 9, the rear surface 11 is located at an angle of 33 degrees to the longitudinal axis.

Using

 This option is used similarly to the monolithic version. In this case, the sliding hammer 7 with a slot is located on the portion of the shaft 5 between the stop 14 and the butt 2. The stop 14 prevents the sliding hammer from moving towards the working end 8.

The claimed technical solution is manufactured and tested by the authors at the Ilizarov Center. The technical solution ensures the achievement of the specified result and can be produced at a manufacturing enterprise, using modern equipment and well-known metal processing technologies.

Claims (14)

1. The return bit for processing bone containing a handle, a butt, a working part equipped with a cutting edge, characterized in that the cutting edge on the working part is oriented towards the location of the handle. 2. The return bit for processing the bone according to claim 1, characterized in that the butt, with respect to the handle, is located on the side of the working part. 3. The return bit for processing the bone according to claim 1, characterized in that the handle and the butt are made in one piece and are integral. 4. The return bit for processing the bone according to claim 1, characterized in that the handle and the butt are made as separate structural elements. 5. The reverse bit for processing bone according to claim 1, characterized in that the butt is made as a structural element of the working part. 6. The return bit for processing the bone according to claim 1, characterized in that the working part consists of a rod and a tip, the tip contains a cutting edge. 7. The return bit for processing the bone according to claim 1, characterized in that the front surface of the cutting edge is oriented towards the handle at an angle in the range of 10-90 ° from the longitudinal axis of the working part. 8. The return bit for processing the bone according to claim 1, characterized in that the handle and the working part are made as a whole. 9. The return bit for processing bone according to claim 1, characterized in that the handle and the working part are made with the possibility of separation. 10. The return bit for processing bone according to claim 6, characterized in that the handle, the shaft and the tip are made with the possibility of separation. 11. The reverse bit for processing bone according to claim 1, characterized in that it is made of metal from an alloy of stainless steel. 12. The return bit for processing the bone according to claim 1, characterized in that the working part is made of metal, the butt is made of metal, the handle is made of textolite. 13. The return bit for processing bone according to claim 1, characterized in that the cutting edge is made of hard alloy. 14. The reverse bit for processing bone according to claim 6, characterized in that the tip is made of metal from a hard alloy.

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