RU1830250C - Compression distraction device - Google Patents

Abstract

Usage: in traumatology and orthopedics for compression, distraction, derotation and fixation of fragments of tubular bones. SUMMARY OF THE INVENTION: the apparatus comprises supports in the form of outer and inner rings fixed between each other by screws, stitches made by components with the possibility of changing the length using a rod installed in parts of the stitch with a middle section under the key and extreme sections with multidirectional threads, knitting needles with nickel plated, fixed to the inner and outer rings by means of spoke holders, and removable permanent magnets placed at the ends of the spokes. 2 s. P. f-ly, 7 ill.

Description

The invention relates to medicine, namely to traumatology, and can be used in general surgical and orthopedic traumatology departments to eliminate rotational disturbance of long tubular bones, reposition and fixation of bone fragments during fresh fractures, as well as for compression and distraction of bone fragments in the treatment of fractures.

The purpose of the invention is to increase the rigidity of fixation of fragments and the prevention of suppurative processes in bone and soft tissues.

In FIG. 1 shows the support of the apparatus in the form of outer and inner rings; in FIG. 2 - node I in FIG. 1; in FIG. 3 is a view along arrow A in FIG. 1; in FIG. 4 - node II in FIG. 3; in FIG. 5 - the proposed apparatus assembly, superimposed on a long tubular bone: in FIG. 6 - node III in FIG. 5: in FIG. 7 - node IY in FIG. 5.

The compression distraction apparatus for treating tubular braid fractures contains rings 1 and 1a, placed

inside the outer wheels 2 and 2a with the possibility of free relative movement. The joint of the rings 3 is a continuous protrusion on the rings 1 and 1a, which is included in the reciprocal circular recess on the rings 2 and 2a. The relative position of rings 1 and 2, as well as 1a and 2a, is fixed using steel side screws 4. Moreover, the pointed end of the screw is hardened to a hardness of HRC 45-50 units.

The rings have evenly spaced openings 5 for installing spoke holders and stitches. All rings are made up of two parts, connected by precision screws in the places of the rings 7. The precision screw 6 has a precisely made cylindrical guide 8, which acts as a pin, and is fixed with a nut 9. A handle 10 is welded on top of the screw 6, which serves as a handle tion in the process of derotation.

The outer rings 2 and 2a are connected by stitches 11, and the inner rings 1 and 1a by stitches 12. All stitches are fixed to the rings with nuts 13 on both sides.

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On the inner and outer rings are installed 16 spoke holders 14, 14a. The spokes 15 and 15 and two for each fragment are fixed in the spoke holders x 14 and 14a. The eight permanent magnets 16 are mounted on the ends of the spokes 15 and 15a. The magnets 16 are applied in a ring shape with N-S-N-S poles connected in series, with the possibility of magnetic flux passing through the nickel coating of the spokes and through the adjacent soft and bone tissues (scattering fluxes). The magnets are made of Kh25K15YUB alloy and have the parameters: 1.0 T, N 30-40 kA / m.

Each stitch 11 and 12 (a total of seven pieces) contains a means for compression (or distraction), consisting of a rod with right 17 and left 18 threads at their ends and a turnkey square head 19 and nuts 20.

All the main parts of the proposed device are made of duralumin (for example, grade D16AT) except for knitting needles, screws with right and left threads, side clips, as well as small screws and nuts that are made of stainless steel grade 12X18H10T.

The spokes are coated with a layer of chemically pure nickel with a thickness of at least 18 microns and an optimum coating thickness of 0.5 mm. Nickel provides a decrease in resistance when a needle is inserted into the bone (and when it is removed), therefore, it does not burn the bones in the places where they were carried out using an electric drill. The use of nickel in combination with a magnetic field (throughout the treatment) prevents suppuration of soft tissue at the points of needles. A magnetic field improves osteosynthesis, reduces inflammation and swelling of soft tissues. By improving blood circulation, it has a bactericidal effect.

The apparatus is used as follows (using the example of a pituitary femoral fracture).

Under anesthesia, after appropriate treatment of the limb with antiseptics, four spokes 15 and 15a are transdermally transected using an electric drill, two spokes for each fragment - distal and proximal.

The first pair of spokes 15 is carried out transversely, indented 1 cm from the fracture level, crosswise, at an angle of 90 ° C to each other, on a distal 1 fragment (level D in FIG.

5).

The second pair of spokes 15a is cross-wise, at an angle of 90 ° to each other, the indentation is 1.5-2 cm from the fracture line proximal (proximal fragment, level And in FIG.

5). Then, the spokes are mounted on the supports 14 in a tensioned state on the inner rings 1 and 1a, after which the outer rings 2 and 2a are connected to each other by four stitches 11. Carry out the necessary distribution of stitches 11. Using the inner rings 1 and 1a under the control of the clinic and radiography eliminate the rotation of bone fragments (proximal or distal,

0 or both fragments at the same time as indicated by m). Side screws 4 fix the relative location of the outer and inner rings. In this case, a stable fixation of the rings among themselves is ensured by 5 with the design of the fixation assembly 3. 4 and the choice of material of the contacting pair (the annular protrusion is made of duralumin and the end of the screw 4 is made of hardened steel). When screwing in screw 4

0 the hardened sharp end is embedded in the softer surface of the protrusion 3. In addition, by applying the screw 4 to the stop, they create a slight bias in the mutual arrangement of the inner and outer rings, which leads to an imperceptible increase in the clearance from the side of the screw 4 and the appearance of a large friction area between the rings on the opposite side.

Then rings 1 and 1a are fixed between

0 by three stitches 12. The ends of stitches 12 are fixed to the distal 1 and proximal 1a rings with nuts.

After that, the ends of the spokes 15 and 15a are additionally fixed with the help of spacers 5a to the outer rings 2 and 2A in order to stabilize the tension of the spokes in one position during the treatment, which makes it possible not to additionally pull the patient in the dynamics of treatment

0 knitting needles at specific times after application of the apparatus.

The constant tension of the spokes promotes stable osteosynthesis and prevents suppuration of soft tissues in places

5 passing the needle through the soft tissue.

During treatment, if necessary, magnets 16 are mounted on the spokes.

Due to the increased mechanical stability of the apparatus, the use of permanent magnets and the successful design, the time of fusion of bone fragments is reduced by an average of 2-3 weeks compared with other known types of CDA.

5 FORMULA AND PREPARATION

1. A compression-distraction apparatus containing supports with knitting needles attached to them with the help of knitting needles, connected by stitches, the supports being made in the form of outer and inner rings with holes for the knitting needles and stitches, and the inner rings are installed in the outer the possibility of rotation around their common center and fixation with screws, characterized in that, in order to increase the rigidity of fixation of fragments and the prevention of suppurative processes in bone and soft tissues, the apparatus is equipped with additional spoke holders, mounted on the outer ring, and removable permanent magnets located at the ends of the spokes, the rings are made up of two half rings fixed to each other by fixing elements, the outer and inner rings are interconnected by a lateral protrusion on the inner ring and the side

recesses on the outer ring, the stitch is made compound with the possibility of changing its length using a rod installed in parts of the stitch with a middle turnkey section and extreme sections with multidirectional threads, the spokes are coated with chemically pure nickel and are located at an angle of 90 ° one to another.

2. The device according to l. 1, characterized in that the screws fixing the inner rings

on the outer rings are made of steel with a hardened tip, and the rings are made of duralumin.

3. The device according to l. 1, characterized in that the fixing elements of the half rings are made in the form of screws with head-handles.

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Editor T. Gor Cheva

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Compiled by T. Novikova

Tehred M. Morgenthal Corrector M. Andrushenko

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