RU198882U1 - Osteosynthesis device - Google Patents

Abstract

This utility model relates to the field of medicine and veterinary medicine, namely to traumatology and orthopedics, and is intended for use in the restoration of injured limb bones in humans and animals. The technical result in an osteosynthesis device containing a plate with multiple mounting holes and bone screws is achieved by that at least one wedge-shaped element and at least one tie are additionally introduced, the wedge-shaped element is connected to the plate at one end, and at the opposite end has at least one retainer of the wedge-shaped element; the tie includes a head at one end configured to be installed in at least one additional hole made in the plate and the tie-down lock on the opposite side; the wedge-shaped element and the tie-down are made with the possibility of interlocking by means of a detachable connection formed by the tie-down lock and the wedge-shaped element lock. spines for fixing bone fragments.

Description

AREA OF TECHNOLOGY

This utility model relates to the field of medicine and veterinary medicine, namely to traumatology and orthopedics, and is intended for use in the restoration of damaged limb bones in humans and animals.

LEVEL OF TECHNOLOGY

Known devices for osteosynthesis, including plates used in traumatology and orthopedics for the surgical treatment of fractures and deformities of bones [Mueller ME, Algover M., Schneider R., Villinger H. - Guide to internal osteosynthesis. Springer-Verlag, AdMorginem, M. 1996.]. They are intended for fixing bones, the so-called bone osteosynthesis, which is carried out as follows. When treating a bone fracture, using an open (through a soft tissue incision and access to the fracture) or closed (under fluoroscopy control) method, the displacement of bone fragments is eliminated, the so-called. reposition. Bone fragments are held in the position of reduction manually or by temporarily fixing them using special bone forceps, clamps, distractors, or temporarily connected with needles. Then, through the incision of the soft tissues, the plate is installed on the bone and fixed to the bone using screws, which are passed through the holes in the plate above and below the fracture. When the screws are inserted, first, using a drill of the appropriate diameter and a guide, a channel is formed opposite the plate hole. Then a tap is used to form a thread for a screw of the appropriate size, after which the screw is started with a screwdriver. Osteosynthesis in the treatment of deformities differs from that in the treatment of fractures only in that osteotomy (surgical bone transection) and deformity correction (removal of bone fragments into the correct position) are performed.

At present, in orthopedic practice, a variety of extra-bone plates are used, differing in shape, size, depending on the purpose, location of the fracture or deformation. The standard plate chosen as an analogue has the following disadvantages:

- low stability of osteosynthesis in the treatment of all types of fractures, except for simple ones;

- high risks of metal structure fractures and screw migration;

- high risks of secondary deformations;

- high risks of non-union (formation of a false joint);

In principle, the most modern inserts are distinguished by the presence of so-called angular stability. Specifically a plate with angular stability or Less Contact Plate (LCP) [Paul Dan Sirbu, Tudor Petreus, Razvan Asaftei, Grigore Berea and Paul Botez (2011). Minimally Invasive Plate Osteosynthesis (MIPO) in Long Bone Fractures - Biomechanics - Design - Clinical Results, Biomechanics in Applications, Dr Vaclav Klika (Ed.), ISBN: 978-953-307-969-1, InTech, available at: http : //www.intechopen.com/books/biomechanics-in-applications/minimally-invasive-plate-osteosynthesis-mipoin-long-bone-fractures-biomechanics-design-clinical-res] shown in FIG. 1, item 1 is chosen for the closest analogue - the prototype. The term angular stability means the following. The holes in the plate are internally threaded, and the screw heads of FIG. 1 item 2 have a corresponding external thread. When the screw is inserted, its head is blocked in the plate, which enhances the stability of fixation of bone fragments.

Disadvantages of angularly stable plate osteosynthesis:

- due to the one-sided arrangement of the plate relative to the bone, the stability of fixation with one plate is insufficient for the treatment of multifragmental intra-articular fractures, in which there is no contact of bone fragments both from the side of the plate installation and from the opposite side;

- insufficient stability during osteosynthesis of diaphyseal fractures of the long bones of the lower extremities (femur, tibia), which is the cause of frequent fractures of the metal structure, the formation of deformities and false joints.

These significant technical shortcomings complicate the treatment process, making it highly traumatic, and are the reason for the increased risks of fracture nonunion (formation of a false joint), fracture and migration of the metal structure with the formation of deformity.

The objective of this technical solution is to create a device for osteosynthesis, which provides an increase in the stability of fixation of bone fragments.

DISCLOSURE

The technical result in the inventive device for osteosynthesis is to increase the stability of fixation of bone fragments due to an improved mechanism for fixing the plate.

The technical result in a device for osteosynthesis containing a plate with a plurality of mounting holes and bone screws is achieved by the addition of at least one wedge-shaped element and at least one tie,

the wedge-shaped element is connected to the plate at one end, and at the opposite end has at least one retainer of the wedge-shaped element;

the tie includes a head at one end, configured to be inserted into at least one additional hole made in the plate, and a tie retainer at the opposite;

the wedge-shaped element and the tie are made with the possibility of interlocking by means of a detachable connection formed by the tie lock and the wedge-shaped element lock.

Possible specifying features of the proposed technical solution:

- the plate and the wedge-shaped element are made as a single element and represent a blade plate;

- the clamp of the wedge-shaped element is a grip with a hole, and the clamp of the tie is a pin made with the possibility of locking in the said hole of the clamp of the wedge;

- the fastener of the tie is a grip with a hole, and the lock of the wedge-shaped element is a pin made with the possibility of locking in the said opening of the lock of the tie;

- plate and wedge-shaped element are made with the possibility of detachable connection;

- the plate includes at least one hole for mounting the wedge-shaped element;

- the wedge-shaped element is made in the form of a rod with a head at one end and a wedge-shaped element retainer at the opposite, and the head is made with the possibility of detachable connection with a hole for installing the wedge-shaped element;

- the hole for installing the wedge-shaped element contains a spherical insert, which, in turn, has a through groove and an internal threaded hole, and the head of the wedge-shaped element is made with the possibility of locking in the spherical insert of the corresponding hole for installing the wedge-shaped element by means of a threaded connection with said internal threaded hole;

- the wedge-shaped element is made in the form of a wedge of a substantially rectangular cross-section with a head at one end and a wedge-shaped element retainer at the opposite, and the head is made with the possibility of detachable connection with a hole for installing the wedge-shaped element;

- the additional mounting hole contains a spherical insert, which, in turn, has a through groove and an internal threaded hole, and the head of the tie is made with the possibility of locking the corresponding additional mounting hole in the spherical insert by means of a threaded connection with the said internal threaded hole;

- the tie is detachable in the middle part and includes a tie screw and a tie sleeve;

- the tie clamp located at the end of the tie is pivotally connected to the tie sleeve;

- the detachable connection of the wedge-shaped element and the tie is made in the form of a threaded connection, and the retainer of the wedge-shaped element is made in the form of a grip with a hole and has an internal thread, and the fastener of the tie is made in the form of a pin on which the corresponding external thread is made;

- the detachable connection of the wedge-shaped element and the tie is made in the form of a threaded connection, and the retainer of the wedge-shaped element is made in the form of a pin on which an external thread is made, and the tie retainer is made in the form of a grip with a hole and has a corresponding internal thread;

- the screed contains a bone thread;

- the wedge-shaped element contains bone threads.

In the context of the present description, the term "wedge-shaped element" is understood as an element that allows interlocking with the tie through a detachable connection. By itself, the "wedge-shaped element" can have a blade-like shape, for example in the case of a blade plate with a removable blade or made as a single unit, or another shape, for example, essentially a rod shape. As the skilled person will understand, the term "wedge-shaped element" is not limiting, but only serves to provide an understanding of the difference between this element and other structural elements.

BRIEF DESCRIPTION OF DRAWINGS

FIG. 1 shows the appearance of a known design for osteosynthesis and bone screws:

1 - plate for osteosynthesis according to the prior art;

2 - bone screws according to the prior art;

FIG. 2 shows the inventive device for osteosynthesis, where:

3 - plate;

4 - wedge-shaped element;

5 - screed;

FIG. 3 shows the inventive device for osteosynthesis, where:

6 - screed head;

7 - the head of the wedge-shaped element;

8 - additional mounting hole for the screed head;

9 - additional mounting hole for the head of the wedge-shaped element;

10 - retainer of the wedge-shaped element;

11 - tie clamp;

12 - fastener hole;

13 - the middle part of the screed;

14 - the middle part of the wedge-shaped element;

FIG. 4 shows a variant of connecting a wedge-shaped element and a tie using a threaded connection, where:

15 - external thread;

16 - internal thread;

FIG. 5 shows a variant of a screed with a variable angle of connection, where:

17 - tie rod;

18 - tie sleeve;

19 - rotary grip;

20 - the tip of the tie rod;

FIG. 6 shows a variant of connecting a sleeve with a grip, where:

21 - groove;

22 - ledge;

23 - the axis of the hinge joint;

24 - transverse hole;

25 - hole for the pivot axis

FIG. 7 shows a variant of connecting a tie rod with a tie sleeve, where:

26 - external thread;

27 - internal thread;

FIG. 8 shows a variant of connecting a screed to a plate, where:

28 - small spherical insert;

29 - screed threaded hole;

FIG. 9 shows a variant of connecting a wedge-shaped element with a plate, where:

30 - spherical insert;

31 - threaded hole for a wedge-shaped element;

FIG. 10 shows a variant of a bone-threaded rod:

32 - bone carving;

FIG. 11 shows a through groove on spherical inserts:

33 - through groove.

FIG. 12 shows a variant of the connection of a wedge-shaped element and a tie, where

34 - pin;

35 - grip with a hole;

FIG. 13 shows a variant of connecting a screed with a blade plate, where:

36 - blade plate.

FIG. 14 shows options for the cross-section of a wedge-shaped element, where:

37 - rectangular;

38 - H-shaped;

39 - L-shaped;

40 - U-shaped;

41 - oval;

42 - four-bladed;

43 - three-bladed;

44 - flat;

45 - triangular;

IMPLEMENTATION

The proposed design for osteosynthesis can be used for the surgical treatment of fractures and deformities of human bones.

The structure consists of plate 3, screws 2, at least one wedge-shaped element 4 and the corresponding tie 5. The wedge-shaped element 4 is connected at one end to the plate 3, and contains a head 7, and at the opposite end has at least one retainer of the wedge-shaped element 10, as well as the middle part 14.

The plate 3 and the wedge-shaped element 4 can be detachable, as shown in FIG. 2-5

The plate 3 and the wedge-shaped element 4 can be formed as a single element and be a blade plate 36, as shown in FIG. 13.

The wedge-shaped element can have a circular cross-section in the transverse plane as shown in Figures 2-5, or: rectangular 37, H-shaped 38, L-shaped 39, U-shaped 40, oval 41, four-bladed 42, three-bladed 43, flat 44, triangular 45 as shown in FIG. fourteen.

The tie is represented by a head 6, a middle part 13 and a tie lock 11. The tie lock 11 has a hole 12. The plate has additional mounting holes: hole 8 for the head 6 of the tie 5 and a hole 9 for the head 7 of the wedge-shaped element 4. The wedge-shaped element 4 and the tie 5 are made with the possibility of interlocking by means of a detachable connection formed by the tie retainer 11 and the wedge-shaped element retainer 10 For example, due to the fact that the tie-down retainer 11 is a grip with a hole in which the internal thread 16 is made, and the retainer of the wedge-shaped element 10 is a pin, on which has a corresponding external thread 15. Moreover, the pin of the clamp of the wedge-shaped element 10 is made with the possibility of locking in the mentioned hole of the clamp of the tie 11.

Alternatively, the wedge retainer 10 may be a gripper with an opening 35 and the tie retainer 11 may be a pin 34 configured to lock in said opening of the wedge retainer 10, as shown in FIG. 12.

FIG. 5 shows an embodiment of a tie 5 with a variable angle of connection. In such an embodiment, the tie can be made detachable in the middle part and includes a tie screw 17 with a tip 23 having an external thread 26, which is threadedly connected to the tie sleeve 18.

The catch 19, located at the end of the tie 5, is pivotally connected to the tie sleeve 18, which has an internal thread 27 along its length. At the other end, the tie sleeve 18 contains a groove 21 containing a transverse hole 24. The catch 19 may have a protrusion 22, a hole for the axle 25 and be rotatable due to the connection with the bushing through the axle 23 to form a hinge joint.

The locking of the head 6 of the tie 5 in the corresponding additional mounting hole of the plate 3 is shown in FIG. 8 can be realized by means of a small spherical insert 28 having a threaded tie hole 29. The blocking of the head 7 of the wedge-shaped element with the corresponding additional mounting hole of the plate is shown in FIG. 9 can be implemented by a spherical insert 30 having a threaded rod hole 31. The spherical inserts have a through groove 33.

The middle part and the tip of the wedge-shaped element can have a bone thread 32. Similarly, the tie 5 can have a bone thread.

The wedge-shaped element 4 can be made in the form of a wedge with a substantially rectangular cross-section with a head at one end and a wedge-shaped element retainer at the opposite end, the head being detachable with a hole for installing the wedge-shaped element made in plate 3.

Alternatively, the wedge-shaped element may have a substantially different cross-section, for example, oval, triangular, L-shaped, H-shaped, U-shaped, etc. in this case, as will be understood by a person skilled in the art, the hole for installing the wedge-shaped element 4 in the plate 3 must have a corresponding shape.

The wedge-shaped element 4 can be made detachable similarly to the embodiment of the tie 5 described above.

The functional purpose of the osteosynthesis device according to the present invention is described below. When treating a bone fracture, using an open (through a soft tissue incision and access to the fracture) or closed (under fluoroscopy control) method, the displacement of bone fragments is eliminated, the so-called. reposition. Bone fragments are held in the position of reduction manually or by temporarily fixing them using special bone forceps, clamps, distractors, or temporarily connected with needles. Then, through one or several incisions of the soft tissues, an extra-bone installation of the plate is performed. Through standard mounting holes, along the guides, channels are formed in the bone using a drill of the appropriate size, then a tap is used, after which, using a screwdriver, bone screws 2 are inserted above and below the fracture (at least 1 screw each), which fix the plate to the bone. The length of the screws should be such that the end of the screw protrudes 1–2 mm beyond the distal cortex. Then, according to the guide, as an option, or under fluoroscopy control, through the hole in the small spherical insert 28, previously installed in the additional mounting hole of the plate tie head 8 with a drill of the appropriate diameter, a channel is formed in the bone. A tie 5 is inserted into the formed channel using a screwdriver. After that, a channel is formed in the bone through the hole in the spherical insert 30, previously installed in the additional mounting hole of the head of the plate rod 9 with a drill of the appropriate diameter. In this case, it is necessary to conduct the drill not only through the bone, but also through the hole in the fastener of the coupler 12. This manipulation is performed using guides or under fluoroscopy control. A rod 4 is inserted into the formed channel using a screwdriver. The correctness of the installation of the wedge-shaped element 4 is controlled by means of fluoroscopy. When properly installed, the tip of the rod 10 should be visualized in the hole of the tie-down retainer 12. Then block the wedge-shaped element 4 in the plate 3, tightening the connection of the head of the wedge-shaped element 7 with a screwdriver by means of a spherical insert 30 in the additional mounting hole of the head of the rod 9. Then block the tie 5 in the plate 3 tightening with a screwdriver the connection of the tie head 6 by means of a small spherical insert 28 in the additional mounting hole of the tie head 8. If necessary, in the proposed design, two or more couples of the tie-wedge-shaped element can be used. Mandatory for osteosynthesis is the use of at least one pair of tie-wedge-shaped element. After installing the tie and the wedge-shaped element, the device is strengthened by passing additional bone screws 2 into the corresponding mounting holes of the plate 3. In this case, the number of standard screws should not be less than six: three are placed above the fracture, three below.

Osteosynthesis by the proposed design in the treatment of deformities differs from that in the treatment of fractures only in that osteotomy and deformity correction are performed. At the same time, as will be clear to a specialist, the inventive device significantly increases the stability of fixation of bone fragments.

Claims (19)

1. A device for osteosynthesis, comprising a plate with a plurality of mounting holes and bone screws, into which at least one wedge-shaped element and at least one tie are additionally inserted, the wedge-shaped element is connected to the plate at one end, and at the opposite end has at least one retainer of the wedge-shaped element; the tie includes a head at one end, configured to be inserted into at least one additional hole made in the plate, and a tie retainer at the opposite; the wedge-shaped element and the tie are made with the possibility of interlocking by means of a detachable connection formed by the tie lock and the wedge-shaped element lock. 2. The device of claim. 1, in which the plate and the wedge-shaped element are made as a single element and represent a blade plate. 3. The device according to claim. 1, in which the wedge-shaped element retainer is a gripper with an opening, and the tie-down retainer is a pin made with the possibility of locking in said opening of the wedge-shaped element retainer. 4. The device according to claim. 1, in which the tie retainer is a gripper with an opening, and the wedge-shaped element retainer is a pin adapted to lock in said opening of the tie retainer. 5. The device of claim. 1, wherein the plate and the wedge-shaped element are detachable. 6. The apparatus of claim 5, wherein the plate includes at least one hole for receiving the wedge-shaped element. 7. The device according to claim 6, in which the wedge-shaped element is made in the form of a rod with a head at one end and a wedge-shaped element retainer at the opposite, and the head is made with the possibility of detachable connection with the hole for installing the wedge-shaped element. 8. The device according to claim. 7, in which the hole for installing the wedge-shaped element contains a spherical insert, which, in turn, has a through groove and an internal threaded hole, and the head of the wedge-shaped element is made with the possibility of locking in the spherical insert of the corresponding hole for installing the wedge-shaped element by means of a threaded connection with said internal threaded hole. 9. The device according to claim. 6, in which the wedge-shaped element is made in the form of a wedge of substantially rectangular section with a head at one end and a wedge-shaped retainer at the opposite, and the head is made detachable to the hole for installing the wedge-shaped element. 10. The device according to claim. 1, in which the additional mounting hole contains a spherical insert, which, in turn, has a through groove and an internal threaded hole, and the head of the tie is made with the possibility of locking in the spherical insert of the corresponding additional mounting hole by means of a threaded connection with said internal threaded hole. 11. The device according to claim 1, in which the tie is split in the middle and includes a tie screw and a tie sleeve, 12. The apparatus of claim. 11, wherein the tie retainer located at the end of the tie is pivotally connected to the tie sleeve. 13. The device according to claim 1, in which the detachable connection of the wedge-shaped element and the tie is made in the form of a threaded connection, and the retainer of the wedge-shaped element is made in the form of a grip with a hole and has an internal thread, and the retainer of the tie is made in the form of a pin on which the corresponding external thread. 14. The device according to claim. 7, in which the detachable connection of the wedge-shaped element and the tie is made in the form of a threaded connection, and the retainer of the wedge-shaped element is made in the form of a pin on which an external thread is made, and the retainer of the tie is made in the form of a grip with a hole and has a corresponding internal thread. 15. The device of claim 1, wherein the tie comprises a bone thread. 16. The device of claim. 7, wherein the wedge-shaped element comprises bone threads.

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