RU179631U1 - S-SHAPED FLAT CHISEL FOR BONE PROCESSING - Google Patents

Abstract

The technical solution relates to medicine, to a surgical instrument for mechanically treating bone, removing bone tumors, for cutting off contaminated, pathologically altered bone tissues. The bit contains a handle 1, butt 2, working part 3. The end 4 of the working part is flat and equipped with a cutting edge 5. The working part is made with two bends of 7.8, so that the longitudinal axis 9 of the end of the working part is offset from the longitudinal axis 10 of the handle and is at an angle to it in the range from 0 to 10 degrees. The length of the working part is from 200 to 300 mm. The technical result is to provide the ability to mechanically process the bone when fixing it in the external fixation apparatus. 4 s.p. f-ly, 2 ill.

Description

The technical solution relates to a surgical instrument intended for mechanical processing of bone, removal of bone tumors, for cutting off contaminated, pathologically altered bone tissues.

In the surgical treatment of bone lesions, its mechanical treatment is required. There are osteotomes and chisels of various geometrical shapes and locations. Known for osteotome for tubular bone ([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 straight flat, fixed on the handle and has a cutting edge (blade) at the end, a spike and an elongated restrictive guide plate with a convex part. 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.

However, this analogue [1] does not allow bone processing when the longitudinal axis of the handle is parallel, or almost parallel, to the longitudinal axis of the bone. The location of the working end relative to the longitudinal axis of the handle of the analog [1], does not allow you to set the working end on the side surface of the bone fragment to cut it, so that the handle was parallel, or almost parallel, to the longitudinal axis of the bone fragment. The analogue [1] is adapted for transverse osteotomy; it is not convenient for processing the end face of a bone fragment with overgrown bone tissue along the lateral surface of the bone, when bone is separated from soft tissues and scars. The working part is short.

Known by the osteotome ([2], 1801385), containing a handle equipped with a main pick and an additional pick, the working part is curved. The working end is equipped with a pointed tenon over which a restriction plate is placed on one of its sides.

This analogue [2] is intended for transverse osteotomy of the bone, the working end does not have a displacement relative to the longitudinal axis of the handle, the geometric shape of the working end does not allow you to effectively handle the growth of bone tissue along the lateral surface of the bone fragment. The analogue [2] is not convenient for processing bone fragments, when they are fixed in the Ilizarov apparatus, the working part does not have the required length. Chisels and osteotomes [1, 2] are intended for processing the bone by direct impact on the bone with a sharp edge (cutting edge, blade), the handle is installed perpendicular to the longitudinal axis of the bone or at an angle to it. In some surgical cases, for example, when treating a focus of ostomyelitis, false joints, sequesters, when the limb is fixed in an external fixation device, it is not possible to perform osteotomy of the bone by setting a bit in the wound perpendicular to the longitudinal axis of the bone. Treatment with analogues [1, 2], in this case, requires an increase in the incision (wound) and is accompanied by damage to the soft tissues adjacent to the bone. Such bits [1, 2] do not allow safe and high-quality processing of the bone fragment along the lateral surface. In hard-to-reach places, when bone tissue from the soft tissues and scars is prevented from overgrowing the bone tissue of the ends of the bone fragments, or when the bone fragment is processed, with direct exposure to an osteotome [1, 2], the bone must be unnecessarily skipped (to separate the periosteum), which leads to increased blood loss, increased time of surgery, increased risk of purulent and trophic complications. When working with straight chisels [1, 2] on the lateral surface of the bone (on the front or back surface), there is a high risk of the chisel or osteotome slipping off the bone with damage to blood vessels and nerves; it is not possible to quickly and efficiently process the end face of the bone fragment to the desired shape.

The claimed technical solution, a flat S-shaped bit curved for bone processing (hereinafter referred to as the bit) is aimed at solving an applied problem - facilitating the process of machining a bone fragment and its end face in order to give it the desired shape, when immersing osteosynthesis, when treating an osteomyelitis focus, when removing necrotic tissue, with corrective osteotomy of the bone. The chisel allows you to quickly and safely handle the lateral surface and the end of the bone fragment. The geometric shape of the working part, and its length, provides the working end and the cutting edge with easy access to the bone fragment through the wound, even when fixing bone fragments with an external fixation device. Ease of impact with a surgical hammer is ensured, with a minimal chance of the blade sliding deep into the soft tissue, where vessels and nerves are usually located.

The technical result consists in providing the ability to mechanically process the bone when fixing it in the external fixation apparatus.

The technical result is ensured by the fact that the bit contains a handle, a butt, a working part, the end of the working part is flat and equipped with a cutting edge. It differs in that the working part is made with two bends, so that the longitudinal axis of the end of the working part is offset from the longitudinal axis of the handle and is at an angle to it in the range from 0 to 10 degrees, the length of the working part is in the range from 200 to 300 mm.

The specified entity ensures the achievement of the claimed technical result.

In this case, the total length of the bit should be from 300 to 400 mm, where the length of the handle with a butt is from 100 to 200 mm. The handle, the butt and the working part can be made integrally and be integral, or they can be made separately as separate parts from which the bit is assembled. The bit is preferably made metal, from an alloy of stainless corrosion-resistant steel or titanium alloys approved for use in medicine. The working part can be heat treated to give it high hardness and wear resistance. The hardness of the working part should be in the range from 48 to 65 HRC. The surface of the metal parts of the bit must be shiny or matte. Roughness from 0.16 microns to 0.63 microns. The working part can be processed by electrochemical polishing with a roughness of 0.32 mm.

The technical solution is illustrated by graphic materials.

FIG. 1 - bit, side view;

FIG. 2 - bit, top view.

Implementation of a technical solution.

The bit contains a handle 1 (Fig. 1; 2), butt 2 (Fig. 1; 2), the working part 3 (Fig. 1; 2). The end 4 (Fig. 1; 2) of the working part 3 has a pointed shape and a cutting edge 5 (Fig 1; 2). The body 6 (Fig. 1; 2), the working part 3 is made with two bends 7, 8 (Fig. 1). The end 4 is offset relative to the handle 1. The longitudinal axis 9 (Fig. 1) of the end 4 is offset relative to the longitudinal axis 10 (Fig. 1) of the handle 1 by a distance "e" equal to 25 mm (Fig. 1) and a flat surface 11 (Fig. 2 ) is located at an angle of 3 ° to it. The end 4 with a flat surface 11 faces the longitudinal axis 10 of the handle 1. The total length "L" of the bit is (Fig. 2) 400 mm, the length " a " of the working part 3 (Fig. 3) is 300 mm, the length is "c" the end 4 of the working part 3 is 55 mm, the width "b" of the end 4 of the working part 3 is 20 mm The end 4 of the working part has a one-sided sharpening from the outside, the edge of the sharpening and a flat surface 11 at the intersection form the cutting edge 5 (blade). The bit is made of an alloy of stainless corrosion-resistant steel approved for use in medicine. The working part 3 is heat treated to give it high hardness and wear resistance, hardness is 58 HRC. The surfaces have a roughness in the range from 0.16 μm to 0.32 μm. Using a technical solution.

The technical solution can be used during operations in the treatment of the musculoskeletal system with purulent lesions and their consequences resulting from high-energy injuries, military injuries, unsuccessful surgical interventions. In particular, it can be used in the treatment of osteomyelitis foci, in the surgical treatment of false joints, in the treatment of infected false joints with concomitant bone osteomyelitis, and in the removal of foreign objects (screw fragments, bone cement, sequesters) from the bone.

In the operational incision, the working part of 3 bits is introduced. Spend the end of 4 bits deep into the surgical wound and set on the surface of the bone fragment. The length of the working part 3 allows you to enter the end of the 4 bits in the operational incision with the imposed supports of the Ilizarov apparatus. It is convenient for the surgeon to use a long chisel, as the handle 1 is located outside the supports and they do not interfere with the manipulation, do not limit the movement. The cutting edge 5 abuts against the bone fragment. Hold the bit in the desired position for the handle 1 with one hand. Take a surgical hammer with your free hand and strike the butt 2. The force from the blow is transferred to the cutting edge 5, the cutting edge 5 cuts into the bone tissue and cuts off (cuts off) a fragment of bone tissue. The cutting edge 5 of the bit is successively moved along the workpiece surface of the bone fragment and hit with a hammer on the butt 2, the bone fragments are cut down and the required geometry of the bone fragment is formed. The curved geometric shape of the working part 3 allows you to enter the end 4 of the working part 3 bits deep into the wound, set the cutting edge 5 on the back, side surface of the bone fragment. The chisel allows you to process the front, back, entire lateral surface of the bone fragment, including sharpening the end of the bone fragment, and making a transverse osteotomy.

The claimed technical solution is made and tested by the authors in the Ilizarov Center, Kurgan.

Claims (5)

1. A flat S-shaped bit curved for processing bone containing a handle, a butt, a working part, the end of the working part is flat and equipped with a cutting edge, characterized in that the working part is made with two bends, so that the longitudinal axis of the end of the working part is offset relative to the longitudinal the axis of the handle and is located at an angle of up to 10 degrees to it, the length of the working part is in the range from 200 to 300 mm. 2. The bit according to claim 1, characterized in that the total length of the bit is 400 mm. 3. The bit according to claim 1, characterized in that it is made collapsible. 4. The bit according to claim 3, characterized in that it is made of an alloy of stainless corrosion-resistant steel. 5. The bit according to claim 1, characterized in that the hardness of the working part is in the range from 48 to 65 HRC.

Images