RU201990U1 - DEVICE FOR OSTEOSYNTHESIS OF LONG TUBULAR BONES - Google Patents

Abstract

The utility model relates to medical technology, namely to surgical instruments for osteosynthesis, in particular to traumatology and orthopedics for the treatment of diseases of long bones. A technical problem is the expansion of means intended for the implementation of transosseous osteosynthesis, the solution of which achieves a technical result in the prevention of displacement of fragments during treatment, the ability to control movement, ease of use. The specified technical result is achieved by the fact that in the device each of the supports is made in the form of a sector, equipped with two rows of staggered through holes. At least three bone screws are attached to each of the supports, with one bone screw attached to both sides of the support. In addition, one bone screw is cantilevered to each support. The supports are interconnected by threaded rods, two of which are fixed in the extreme holes located in the second row, the third threaded rod is fixed cantilever. Threaded rods and nuts are marked.

Description

The utility model relates to medical technology, namely to surgical instruments for osteosynthesis, in particular to traumatology and orthopedics for the treatment of injuries and diseases of long tubular bones.

Known transosseous device, consisting of a pair of rings and rods fixed to the arched support, the device is made so that the pairs of rings and the arched support are installed and interconnected with the possibility of sequential movement by means of connecting nodes, each connecting node has a spring-loaded stopper and a bushing having an inner concave part connected thereto (Patent No. JP2002522145A. Publ. · 2002-07-23).

However, the known device, in spite of the fact that it is intended for osteosynthesis of long tubular bones, has a complex structure, including annular supports, which increases the cost of treatment and is justified for its use not in all cases of treatment. In addition, the known device is cumbersome to use on both limbs, and also significantly complicates the view during X-ray examination.

There is a known method of reposition and osteosynthesis of a segmental fracture of the humerus with a rod apparatus for transosseous osteosynthesis, in which transosseous rods are used to fix bone fragments, fixed in fixation blocks and fixation blocks of reposition nodes, and fixed to the inner surface of the arches using brackets, while the arcs are connected between are threaded rods (Patent No. RU2363407. Publ. 10.08.2009).

However, the known apparatus for transosseous osteosynthesis has a complex design, the presence of additional reduction nodes reduces the rigidity of fixation of bone fragments, and, if necessary, lengthening the segment, does not prevent the appearance of unwanted deformities.

A device for transosseous osteosynthesis of fractures of long tubular bones is known, including parallel support beams with holes and rods with fixation elements, which is additionally equipped with reposition nodes, consisting of a housing with a hinge and a central hole in the latter, fixing and external threaded screws, while the repositioning node is located between parallel support beams and is fixed with fixing screws, and the rods with a repositioning hinge are rigidly fixed with external screws passing through the central hole of the hinge, and the hinge is installed with the possibility of rotation in any direction to fix the rods at different angles (Patent No. RU62795. Publ. 10.05. 2007).

However, the known device has a complex design of repositioning units, which are difficult to assemble between parallel support beams, in addition, it requires a long time to apply it to the limb. In addition, when the segment is lengthened, the known device is difficult for the patient to perform distraction.

Known apparatus for the treatment of comminuted fractures of long tubular bones, containing intraosseous rods, rod-fixators, connected by threaded rods by means of spherical support nuts in the form of plates, curved radially in their own plane and bent in this plane in the form of protrusions from the end sections of the plate towards its bulge. The tabs and end sections of the plates are equipped with double-sided countersink holes. Along the plates, there are square holes located along the radius for the fixing rods (Patent No. RU2271168. Publ. 10.03.2006).

However, the known device has a complex design, is intended for the treatment of comminuted fractures of long bones, and is not intended for the treatment of tubular bones with no more than two bone fragments, since it cannot provide reliable, rigid fixation of the fragments.

A device for fixing and repositioning the tibial condyle is known, containing supports in the form of arcs with holes, with bone screws fixed on them, connected by a telescopic bar fixed on the supports by means of hinge nodes, made in the form of a sleeve, in which a distraction nut is installed, connected to a threaded thrust, fasteners, nuts, in which the hinge assemblies contain a bracket equipped with a threaded shank located in the hole on the support, a shoulder contacting the end surface of the support, a fork made with a cylindrical edge and a hole in which, by means of an axis, a threaded rod , equipped with an eyelet at one end and a radial threaded hole at the other, while the threaded rod of one of the hinge units with the end with a radial threaded hole is located in the hole of the threaded rod of the telescopic rod and fixed with a screw, and the threaded rod of the other hinge unit with the end with a radial threaded hole a hole is installed in the bore of the telescopic rod bushing and is fixed with a screw, in addition, a nut and a washer are located on the threaded rod, contacting the cylindrical edge of the bracket fork, and the distraction nut of the telescopic rod is installed on the bushing in a radial groove (Patent No. RU124139. Publ. 20.01.2013).

However, the known device allows the fixation of the bone rods in only one plane, which reduces the rigidity of fixation of the fragments, during treatment, possibly, their displacement relative to the longitudinal axis. In addition, it is not intended to eliminate congenital deformities of long bones due to limited repositioning capabilities.

Known rod apparatus for transosseous osteosynthesis, containing arcs with holes, threaded rods connecting the arcs to each other, and repositioning elements in the form of brackets fixed on arcs and equipped with transosseous rods, which is equipped with repositioning units, each of which is made in the form of a threaded rod with a cylindrical the middle part of a large diameter, on the surface of which parallel flats are made, connected by a through hole passing perpendicular to their axis, transosseous rods are installed in the holes with the possibility of rotational and axial movements and fixing with nuts, and the threaded ends of the repositioning units are placed with the possibility of movement and fixation with nuts in the holes of the brackets located on the inner surfaces of the arches (Patent No. 2272593 C2. Publ. 27.03.2006).

However, the known rod apparatus for transosseous osteosynthesis does not allow to prevent displacement of fragments during treatment and to exercise convenient control over the movement. In addition, it has a rather complex layout, including the fixation of the rods outside the end planes of the supports, the repositioning units have a large number of connecting elements, the above mentioned does not allow to achieve rigid fixation of the fragments, has an error in the movement and is difficult to control during the movement. The absence of a third threaded rod does not allow the fragments to move without their angular displacement. In addition, it should be noted that the two transosseous rods are fixed on each arch cantilever by means of brackets, and not on the end plane of the corresponding arch. The third transosseous rod is fixed on the cylindrical part of each of the repositioning units by means of a flat. This fixation creates an error in the movement of fragments when eliminating their displacement. In the aforementioned invention, a full-fledged arc is used as a support, which, despite the execution of through holes in two rows and staggered, has a sufficiently large angle of limitation in relation to the sector, in the claimed solution, and a greater number of said holes.

The task (technical problem) of the present utility model is to expand the means intended for the implementation of transosseous osteosynthesis.

The technical result is the prevention of displacement of fragments during treatment, through the convenience of visual monitoring of their movement

The stated technical result is achieved by the fact that in a device for osteosynthesis of long tubular bones, containing supports with bone screws fixed on them, while the supports are interconnected by threaded rods equipped with nuts, with the ability to move, each of the supports is equipped with two rows located in staggered, through holes, on each of the supports are fixed at least three bone screws, while one of them is fixed in a cantilever, each of the supports is made in the form of a sector, the supports are interconnected by three threaded rods, two of which are fixed in the extreme holes located in the second row, and one is fixed by means of strips fixed on the outer end plane of each sector, two bone screws are fixed on the end plane of each of the supports on both sides, the third threaded rod is fixed cantilever, by means of strips fixed in the central holes of the second row of each of supports, on console elements The instructions are marked.

It is advisable to apply red marks on the support and one of the nuts to increase the convenience of using the device, mark arrows in the form of arrows on the threaded rods.

This useful model is explained with a detailed description, diagrams, on which:

fig. 1 - shows a general view of the assembled device according to the invention;

fig. 2 shows a general view of an assembled device with installed telescopic rods, located on a long tubular bone;

fig. 3 - shows a support made in the form of a sector;

fig. 4 shows a hinge assembly;

fig. 5 is a photo of the device superimposed on a long tubular bone.

The device for osteosynthesis of long tubular bones contains supports 1 and 2, interconnected with the possibility of movement (Fig. 1, 3). Each of the supports 1 and 2 is made in the form of a sector equipped with two rows of staggered through holes. On the support 1 are fixed bone screws 3 and 4, equipped with threads and located on opposite sides of the support 1. On the support 2, bone screws 5 and 6 are fixed, located on opposite sides of the support 2. In addition, one bone screw 7 and 8, respectively, fixed cantilever on each of the supports 1 and 2. Bone screws 7 and 8 are cantilevered using brackets, respectively, 9, 10, equipped with holes. Supports 1 and 2 are interconnected by threaded rods 11, 12, 13. In this case, two of the threaded rods 11 and 12 are fixed in the extreme holes located in the second row of supports 1 and 2. The third threaded rod 13 is cantilevered by means of strips 14 and 15 , one end of each of which is fixed in the corresponding central hole of the second row of each of the supports 1 and 2.

In the device, the threaded rods are made telescopic 16, 17, 18 (Fig. 2, 3).

In addition, in the device, one of the ends of each of the threaded rods 11, 12, 13 or telescopic rods 16, 17, 18 is connected to the support 1 by means of the hinge nodes 19, 20, 21 (Fig. 4).

The support 1 has a mark 20 for counting the amount of movement (Fig. 5). An additional mark 22 is applied to the nut 21 located on the threaded rod 12 or telescopic rod 16. In addition, a pointer 23, 24, 25 in the form of an arrow is placed on each of the threaded rods 11, 12, 13 or telescopic rods 16, 17, 18 for control behind the direction of rotation.

The device is used as follows.

Patient L. was hospitalized for surgical treatment with a diagnosis of congenital shortening of the right hip. The operation was performed under spinal anesthesia: lengthening osteotomy of n / 3 of the right thigh. Performed osteosynthesis with a device for osteosynthesis of long bones (Fig. 1-5). Bone screws 3, 4 were introduced into the long tubular bone above the osteotomy area, which were fixed on the opposite surfaces of the support 1 in the form of a sector. The bone screw 7 was fixed using the bracket 9. The latter was fixed on the surface of the support 1 by means of connecting elements. Then, bone screws 5, 6 were inserted below the osteotomy area, which were fixed on opposite surfaces. After insertion, the bone screw 8 was fixed in the bracket 10. The latter was fixed on the surface of the support 2. The supports 1 and 2 were connected either with threaded rods 11, 12, 13, or telescopic rods 16, 17, 18 using connection elements in the form of nuts. If it is necessary to eliminate the angular displacement, some ends of both threaded rods and telescopic rods can be connected using articulated joints 19, 20, 21. An extension osteotomy was performed in n / 3 of the right thigh. The device was stabilized by tightening the connecting elements in the form of nuts.

Then, on the seventh day from the date of the operation, distraction of 0.25 mm was started 4 times a day (1 mm per day) of bone fragments in the area of the lengthening osteotomy by screwing and tightening the nuts. Mark for control 22 on nut 21 coincides with mark 20 for control on support 1. Marks 20 and 22 are made in red. Move in the direction of the marks in the form of arrows 23, 24, 25, which are performed on the threaded rods 11, 12, 13. The presence of red marks 20 and 22 is positioned so that the patient can see them.

The proposed useful model makes it possible to expand the range of simple tools intended for the implementation of transosseous osteosynthesis.

In addition, it allows you to prevent displacement of fragments during treatment, to control the movement of fragments, while being convenient to use.

Claims (2)

1. A device for osteosynthesis of long tubular bones, containing supports with bone screws fixed to them, while the supports are interconnected by threaded rods equipped with nuts, with the ability to move, each of the supports is equipped with two rows of staggered through holes, on each of supports at least three bone screws are fixed, with one of them fixed cantilever, characterized in that each of the supports is made in the form of a sector, the supports are interconnected by three threaded rods, two of which are fixed in the extreme holes located in the second row, and one is fixed by means of strips fixed on the outer end plane of each sector, two bone screws are fixed on the end plane of each of the supports on both sides, the third threaded rod is fixed cantilever, by means of strips fixed in the central holes of the second row of each of the supports, to the structural elements marks are applied. 2. The device according to claim 1, characterized in that red marks are applied to the support and one of the nuts, marks in the form of arrows are made on the threaded rods.

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