RU180686U1 - DEVICE FOR SURGERY OF THE ILLUM - Google Patents

Abstract

The utility model relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of patients with bone defects of various etiologies. The device for the collection of an iliac graft, consisting of a handle with an anvil, a body, characterized in that the body of the device has two branches, one of which is made integral with it, the other has a thread corresponding to the thread of a pulley with a roller drawn through the device’s body, with the possibility of movement due to the worm gear; each branch has a cutting part sharpened at an angle of 30 °, and a stop located at a distance of at least 2 mm from each other; on the outer surfaces of the limiters, scales are applied in increments of 1 mm.

Description

The utility model relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of patients with bone defects of various etiologies.

In the treatment of patients with false joints, osteomyelitis, slowly consolidating fractures, bone tumors, patient's own tissues taken from standard donor zones are used to replace a bone defect. The most used area for this purpose is the ilium wing. In this case, a three-cortical graft is taken, which often leads to the appearance of chronic pain syndrome, hematoma, postoperative soft tissue retraction in the donor zone, and cosmetic defect.

A device for collecting bone tissue containing an all-metal tube with a cutting part, a side slot and a handle (1) is known. The disadvantage of this device is to obtain a transplant column with a fixed diameter without the possibility of changing it.

A device is known comprising a tubular body with a cutting surface on the working body and a guide handle (2). The disadvantage of this device is the risk of damage to the cortical layer of the ilium and surrounding soft tissues.

A device for collecting a spongy substance transplant is known, comprising a working part: a drill screw with two cutting edges and chip splitting grooves (3). The disadvantage of this device is to obtain an autograft in the form of bone chips.

A device is known comprising a handle with an anvil, a body and a working cutting part; the device has a removable movable guide in the form of a locking needle (4). The disadvantage of this device is the inability to maintain the lateral cortical layers of the ilium wing, soft tissue injury during graft formation, the inability to control the depth of the osteotomy and the height of the graft to be taken, the need for repeated use for the formation of the graft. This device served as a prototype for creating a utility model.

The technical result of creating a utility model is to ensure the collection of the transplant from the ilium. This technical result is achieved by the fact that the device body has two branches, one of which is fused with it, the other has a thread corresponding to the thread of a pulley with a roller held through the device body, with the possibility of movement due to the worm gear; each branch has a cutting part sharpened at an angle of 30 °, and a stop located at a distance of at least 2 mm from each other; on the outer surfaces of the limiters, scales are applied in increments of 1 mm.

The presence of limiters, which, when the device is installed, leads beyond the cortical layers, allows you to protect soft tissues from injury during the formation of the graft.

The worm mechanism due to the breeding of the jaws allows you to adjust the distance between them relative to the thickness of the iliac wing of a particular patient.

Scales on the external surfaces of the limiters allow us to evaluate the height of the taken part of the bone tissue and the depth of the osteotomy.

A distance of 2 mm between the stop and the cutting part of each jaw ensures the preservation of two cortical layers of the iliac wing during graft collection. This prevents the formation of a significant bone defect and retention of soft tissues in the donor zone.

The device consists of a handle with an anvil and a body. The housing has two branches, one of which is made integrally with it, the other has a thread corresponding to the thread of a pulley with a roller drawn through the housing of the device, with the possibility of movement due to the worm gear. Each jaw has a cutting part sharpened at an angle of 30 ° and a stop located at least 2 mm apart. On the outer surfaces of the limiters, scales are applied in increments of 1 mm.

Comparison of the claimed device with devices known in this field of medicine, showed its compliance with the criteria of a utility model.

The utility model is illustrated by graphic material. In FIG. No. 1 shows a device for collecting the transplant from the ilium in the frontal plane, in FIG. No. 2 - in isometric view.

The device consists of a handle 1 with an anvil 2, body 3, two jaws 4. One of the jaws is fixedly connected to the body 3. The second jaw 4 has a thread 5 corresponding to the thread of the pulley 6, and is movable due to the worm mechanism formed together with the pulley 6, having a roller 7. Each of the jaws 4 has a stop 8 and a cutting part 9, sharpened at an angle of 30 °. The limiters are marked with a scale of 10 in increments of 1 mm.

The device is used as follows: after dissection of the skin and soft tissues, the iliac wing is accessed, the device is placed vertically on the ridge. The fixed jaw is set by the limiter for the inner surface of the ilium wing, after which the required distance between the jaws corresponding to the thickness of the patient’s bone is set by the roller of the pulley using the worm mechanism. After that, the limiter of the movable jaw is located behind the external cortical layer of the ilium wing. Perform hammer blows on the anvil of the handle, adjusting the depth of the osteotomy on the scales on the outer surfaces of the limiters. In this case, the cutting parts form slots with the preservation of two cortical iliac plates. Using the osteotome, a transverse osteotomy is performed between the formed slots of the formed cutting parts of the device. Take the transplant. The resection area is treated by electrocoagulation or medical wax. A hemostatic sponge is placed in the cavity. Soft tissue is sutured in layers.

The use of the device is illustrated by a clinical example.

Patient A., 47 years old, was in SOKOD from 02.02.2017 to 02.20.2017 with a diagnosis of enchondroma of the lower third of the right femur. 02.03.2017, the operation was performed: resection of the lower third of the right femur, replacement of the defect with an autograft taken from the wing of the right iliac bone, plate osteosynthesis. The bone autograft graft was performed using the proposed device. Intraoperatively, the device made it possible to quickly and easily perform a graft collection, without damaging the soft tissues, while maintaining two cortical iliac plates. In the early postoperative period at the site of autograft withdrawal, there is no soft tissue retraction. Pain in the donor area was evaluated at 2 points according to YOUR.

The device is easy to use, can be used in clinical conditions in trauma, orthopedic and surgical hospitals.

INFORMATION SOURCES:

1) RF patent for the invention “A device for bone graft collection” No. 2110223 dated 05/10/1998, authors - Korolev A.G., Arsen E.V., Shuklin SB

2) RF patent for utility model “Device for bone tissue collection” No. 125835 of 03/20/2013, authors - G.P. Kotelnikov, A.Yu. Terskov, Ivanov V.V.

3) RF patent for the invention "Device for the collection of spongy substances" No. 2223056 dated 02/10/2004, authors - Semkin V.A., Lyashev I.N., Krasheninnikov L.A.

4) RF patent for the invention of "Chisel" No. 2 076 640 of 10.20.2002, authors - Barabash A.P., Sergeev S.S.

Claims (1)

The device for the transplant of the iliac bone, consisting of a handle with an anvil, the body, characterized in that the body of the device has two branches, one of which is made integral with it, the other has a thread corresponding to the thread of the pulley with a roller held through the body of the device, with the ability to move due to the worm gear; each branch has a cutting part sharpened at an angle of 30 °, and a stop located at a distance of at least 2 mm from each other; on the outer surfaces of the limiters, scales are applied in increments of 1 mm.

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