RU2022535C1 - Apparatus for osteosynthesis of neck of femur - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: apparatus has cylindrical body with longitudinal groove, made of interperpendicular slits, that form longitudinal rods, and fixing member on support end of body. Osterous spongy transplant is brought in groove of body. Length of transplant is chosen so, that it will cross line of fracture. EFFECT: apparatus is used to cure breaks of neck of femur. 3 dwg

Description

 The invention relates to medicine, namely to traumatology.

 Known Smith-Petersen three-lobed nail in the modification of Johanson.

 The disadvantages of using this device include the complications arising in the early and late postoperative period after osteosynthesis, frequent nonunion due to secondary displacements, fixative migrations, and its fractures.

 Compression screws are known which compress fragments, causing a cancellous bone compression zone exceeding the diameter of the device.

 Known fixative for osteosynthesis of Seppo, the disadvantages of which include the inability to place the graft to stimulate osteogenesis.

 Also known is a fixator for osteosynthesis of femoral neck fractures, comprising a body with channels and swallowtail rods located in them, between which a wedge is placed. The housing is installed in a tube equipped with a longitudinal recess, which, together with a window made at one end of the housing, is filled with a pasty or solid autograft.

 The disadvantage of this device is the one-way contact of the bone graft with the fracture zone, the absence of a rigid connection between the bone graft and the device body, crushing of the spongy bone, its resorption, which leads to a loss of joint stiffness, slowing of adhesion and impaired blood circulation, as well as aseptic necrosis.

 The aim of the invention is to increase the reliability of adhesion and rigidity of osteosynthesis without compression of fragments in the fracture zone.

 The goal is achieved by the fact that in the device for osteosynthesis of femoral neck fractures containing a cylindrical body with a longitudinal recess under the graft, a fixing element on the supporting end of the body, the recess is made in the form of mutually perpendicular slots with the formation of longitudinal rods.

 New features of the invention include the implementation of the recess in the form of mutually perpendicular slots with the formation of longitudinal rods.

 Figure 1 shows a device for osteosynthesis of femoral neck fractures, General view; figure 2 is a device with a graft placed in it, fixed in the proximal femur; figure 3 is a section aa of figure 2.

 A device for osteosynthesis of fractures of the femoral neck contains a cylindrical body 1, longitudinal rods 2, a recess 3 under the graft, made in the form of mutually perpendicular slots. The supporting end of the device housing contains a flange 4 and a through hole 5 perpendicular to it for a locking screw 6, which fixes this device to the bone; the through hole 7 along the axis of the housing is intended for the guide pin and the locking screw 8. The through hole 7 intersects with the through hole 5, and until it intersects with it, has a thread for the locking screw 8.

 A device for osteosynthesis is used as follows. A bone spongy transplant of a cross-shaped cross-section, the dimensions of which are equal to the size of the cross-section of the recess between the rods, taken by a special device and having a wall parallel to the length, is inserted into the cross-shaped recess of the osteosynthesis device. The length of the graft is chosen so as to overlap the line of fracture (figure 2). Due to the identical transverse dimensions of the graft and the intercostal cross-shaped recess of the device, tight contact occurs between them. In this case, the rods of the device evenly diverge to the sides by several degrees, while remaining straight. Through the longitudinal axis of the neck, a central guide pin is drawn into the head. In parallel around and at a distance from the central guide spokes four more spokes are held to prevent displacement of the femoral head. A hollow drill with a diameter equal to the diameter of the device for osteosynthesis drills a tunnel along the central guide pin through the neck and 0.5-1 cm beyond the fracture line. The center guide pin is removed. The ends of the rods of the device for osteosynthesis approach each other and are introduced into the tunnel. Two adjacent device rods are oriented caudally, and the other two, along with the flat on the body, are cranial so that the axis of the hole 5 for the locking screw 6 coincides with the longitudinal axis of the outer wall of the upper metadiaphysis of the thigh. With the help of a hammer, the device is driven into the tunnel until the entrance to the hole 5 from the side of the flat 4 comes close to the outer cortical wall of the thigh. After drilling the inner cortical wall of the upper third of the thigh through the hole 5, a locking screw 6 is screwed into the drilled channel (Fig. 2). To prevent its self-twisting, the locking screw 8 is screwed into the threaded part of the hole 7 flush. The four retaining spokes are removed.

 Straight rods of the locking device are located in the femoral head at an angle to the axis equal to the angle of their breeding, which prevents all types of displacement (in width, at an angle, in length and circumference) of the femoral head relative to the device. All types of displacements between the device with the femoral head mounted on it and the distal femur fragment along the fracture line are prevented by a blocking screw. This excludes compression between fragments along the fracture line.

The device can be used without a bone graft. To do this, a tunnel with a length of 0.5 cm less than the length of the housing 1 of the device is drilled with a hollow drill along the central guide pin. Direct rods of the device are bent to the sides at equal angles of up to 5 ^° to the axis. Through the central longitudinal tunnel along the central guide pin, the device is inserted into the fragments and fixed with a blocking screw.

 After osteosynthesis, the proposed device does not require gypsum immobilization, standing with full support on both legs is possible, walking with partial load on the leg and support on crutches is allowed.

Claims (1)

 DEVICE FOR OSTEOSYNTHESIS OF THE HIP NECK, containing a cylindrical body with a longitudinal recess under the graft and a fixing element on the supporting end of the body, characterized in that the recess is made in the form of mutually perpendicular slots with the formation of longitudinal rods.

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