RU212395U1 - DEVICE FOR OSTEOSYNTHESIS OF THE CANEAL BONE ASHIROV-URINBAYEV - Google Patents

Abstract

The utility model relates to medical equipment, traumatology and orthopedics, namely to devices for the treatment of calcaneus fractures.

The device comprises a ring 1 and a semi-ring 2 connected by threaded rods 3 with holes 4, on which spokes 6 are fixed with spoke-fixing bolts 5, intended for passing through the bones of the lower leg, one heel support, made in the form of a semi-ring 7 with holes 4, on which spoke-fixing bolts 5 pin 6 is fixed, designed to pass through the distal fragment of the calcaneus. On the ring 1, two cantilever beams 8 are symmetrically installed, equipped with holes 4, on the beams 8, a spoke 6 is fixed with spoke-fixing bolts 5. Two distraction rods 9 are symmetrically installed on the beams 8, the threaded ends of the rods 9 are connected to the heel support 7, and the rods 9 are fixed on beams 8 with the possibility of controlled changes in the angular position. Rod 9 is made in the form of a sleeve 10, through which a pin 11 passes, fixed by nuts 12, while the sleeve 10 contains a threaded shank 13 located perpendicular to the longitudinal axis of the rod 9. The ring 1 and the heel support are connected by a third distraction rod 14 installed in the middle of the half ring 7.

The technical result consists in expanding the arsenal of technical means for minimally invasive treatment of compression fractures of the calcaneus. Moreover, the device provides ease of control of the movement of the fragment, the predictability of the trajectory of movement of the distal fragment of the calcaneus. 8 ill.

Description

The field of technology.

The utility model relates to medical equipment, traumatology and orthopedics, namely to devices for the treatment of calcaneus fractures.

The level of technology.

A device for the treatment of comminuted fractures of the calcaneus is known (source [1]: patent RU 2283628). The device contains a basic annular support for mounting in the lower third of the leg on two intersecting spokes, one of which is passed through both tibia, and the other through the tibia parallel to its inner edge. An arcuate support is attached perpendicularly to the plane of the base annular support, consisting of a half-ring and strips with end threaded ends. On the arcuate support, two intersecting spokes are installed, passing through the anterior part of the calcaneus. At the junctions of the half-ring with the slats, single-plane axial hinges are installed from two interconnected brackets. Threaded rods are attached to the axial hinges, through which a U-shaped support, consisting of a bar and two brackets, is connected to the arcuate support. Through the tubercle of the calcaneus, perpendicular to the long axis of the calcaneus, a spoke with an emphasis was passed and fixed to the brackets on the U-shaped support. By means of a threaded rod with a two-axis hinge, the U-shaped support is connected to a bar mounted on the base annular support in its rear part.

In the device [1], an arcuate support is attached to the plane of the base annular support, consisting of a half-ring and strips with end threaded ends, while the half-ring is placed under the arch of the foot, which does not allow leaning on the foot during treatment. In addition, it is difficult to ensure that distraction forces directed along the longitudinal axis of the calcaneus are applied to the distal fragment of the calcaneus, since to ensure the directed movement of the fragment, it is necessary to sequentially tighten the nuts at six points, which inevitably leads to a broken trajectory of the fragment.

Known apparatus for axial fixation of the calcaneus (source [2]: patent No. RU 119993). It contains a frame with spoke clamps installed on it and regulating elements in which the ends of the spokes are fixed, characterized in that the frame is made closed in the form of a rectangle and is formed by plates located opposite each other, the ends of which are interconnected, with the possibility of movement, guides, in addition, beams of spokes are cantilevered on each of the plates.

The disadvantage of this device is the inability to ensure the stability of the calcaneus, and the inability to apply distraction efforts.

Known apparatus G.A. Ilizarov for transosseous osteosynthesis, which in the variant for the treatment of pathology of the bones of the foot contains supports connected to each other by threaded rods and hinge nodes with spokes that fix the bones of the foot and lower leg (source [3]: A.S. USSR No. 1055499, publ. 23.11.83 , bul. No. 43).

However, the device in the presented version for the treatment of foot pathology provides for simultaneous fixation of the bones of the lower leg, and the passage of a plurality of spokes, which increases its size and weight. In addition, it is difficult to ensure that distraction forces directed along the longitudinal axis of the calcaneus are applied to the distal fragment of the calcaneus, since to ensure the directed movement of the fragment, it is necessary to sequentially tighten the nuts at six points, which inevitably leads to a broken trajectory of the fragment.

A device for the treatment of pathologies of the hindfoot is known (source [4]: patent No. RU 122013). It contains supports with bone fixators connected to each other by threaded rods and fastening elements. It contains two U-shaped brackets with transverse beams, equipped with figured plates with L-shaped ends, fixed with the possibility of displacement on the threaded rods connecting the ends of the brackets, and an arc located between the brackets, having ball joints at the ends and top, which is connected to figured plates G -shaped threaded rods fixed with the possibility of displacement in ball joints at the ends of the arc, and threaded rods fixed at the ends of the rods, and with one of the rods connecting the ends of the U-shaped brackets - a threaded rod fixed in the hinge at the top of the arc.

The device [4] is bulky, heavy, inconvenient to operate, and does not allow leaning on the foot during treatment. Does not allow for the application of distraction forces directed along the longitudinal axis of the calcaneus to the distal fragment of the calcaneus.

A device is known for eliminating the pathology of the hindfoot (source [5]: patent No. RU 7305), containing a frame made of two annular supports located parallel to each other and connected to each other, knitting needles and a repositioning unit equipped with an arc support connected indirectly to the ability to move from one of the annular supports. The ends of the arc support are connected by single-axis hinges with the threaded ends of a pair of guides, each of which has a second end made flattened and connected to a two-axis hinge mounted on an annular support, in addition, two additional two-axis hinges are installed in the central part of the arc support, connected to the flattened ends of the second pairs of guides interconnected by a coupler, wherein the coupler is connected to the bar, and the latter is connected to the annular supports by means of an additional guide with a flattened end and a screw bar.

The device [5] contains a repositioning unit equipped with an arc support; to control the movement of the repositioning unit, it is required to tighten the nuts in six places on the threaded rods. It is difficult to ensure the application of distraction forces to the distal fragment of the calcaneus with such a node, directed along the longitudinal axis of the calcaneus, since to ensure the directed movement of the fragment, it is necessary to tighten the nuts sequentially at six points, which inevitably leads to a broken trajectory of the fragment.

Thus, existing analogs have disadvantages, which complicates their use and limits the possibility of using them for the treatment of compression fractures of the calcaneus.

The essence of the technical solution.

The present technical solution is aimed at providing the possibility of distraction of the distal fragment of the calcaneus, which was driven in during a fracture, along the longitudinal axis of the calcaneus, the possibility of stable minimally invasive fixation of the achieved position for the treatment of compression fractures of the calcaneus.

The objective of the proposed device is to increase the efficiency and stability of distraction, compression and fixation of the distal fragment of the calcaneus in calcaneus fractures.

The technical result consists in expanding the arsenal of technical means for minimally invasive treatment of compression fractures of the calcaneus. Moreover, the device provides ease of control of the movement of the fragment, the predictability of the trajectory of movement of the distal fragment of the calcaneus.

The technical result is achieved by the fact that the device for osteosynthesis of the calcaneus contains two base supports connected by threaded rods, made in the form of a flat ring and a half ring with holes, on which the spokes are fixed with spoke fixation bolts, designed to pass through the bones of the lower leg, one heel support, made in the form of a semi-ring with holes, on which a spoke is fixed with spoke fixing bolts, designed to be passed through a bone fragment, the heel support is connected to the ring with the possibility of movement. It differs in that two cantilever beams equipped with holes are symmetrically installed on the annular support, a spoke is fixed on the beams with spoke-fixing bolts, two distraction rods are symmetrically installed on the beams, the threaded ends of the rods are connected to the heel support, and the rods are fixed on the beams with the possibility of a controlled change in the angular position , the bar is made in the form of a sleeve through which a pin fixed with nuts passes, while the sleeve contains a threaded shank located perpendicular to the longitudinal axis of the rod, the ring and the heel support are connected by a third distraction bar installed in the middle of the half ring.

Options for the implementation of the technical solution is illustrated by graphic materials:

Fig.1 - device, General view;

Fig.2 - device, side view;

Fig.3 - the device is mounted on the limb, General view;

Fig.4 - device, distraction bar with heel support rotated relative to the beams and the base ring, General view;

Figure 5 - distraction bar, showing the place of attachment to the beam, using a swivel with spherical washers, exploded view;

Fig.6 - device, variant with distraction rods placed at a distance of 30 mm from the beams, on the bushings of the distraction rods there are viewing windows with a scale to control the amount of movement of the pin, general view;

Fig.7 - the device is mounted on a limb, a variant with distraction rods placed at a distance of 30 mm from the beams, viewing windows with a scale to control the amount of movement of the pin are made on the sleeves of the distraction rods, a photograph from the side;

Fig.8 - the device is mounted on the extremity, a variant with distraction rods placed at a distance of 30 mm from the beams, observation windows with a scale to control the amount of movement of the pin are made on the sleeves of the distraction rods, front photo.

Graphic materials indicate:

1 - ring;

2 - half ring;

3 - threaded rods;

4 - holes;

5 - spoke bolt;

6 - knitting needle;

7 - half ring;

8 - beam;

9 - distraction bar;

10 - bushing;

11 - hairpin;

12 - nut;

13 - threaded shank;

14 - distraction bar;

15 - corner marks;

16 - spherical washers;

17 - window;

18 - scale;

Device implementation

Example 1 (Fig.1-5).

The device for osteosynthesis of the calcaneus contains two base supports, connected by threaded rods 3, made in the form of a flat ring 1 and a semi-ring 2 with holes 4, on which spokes 6 are fixed with spoke fixation bolts 5, intended for passing through the bones of the lower leg, one heel support, made in the form of a semi-ring 7 with holes 4, on which the spoke 6 is fixed with spoke-fixing bolts 5, which is intended for passing through the distal fragment of the calcaneus. The heel support 7 is connected with the ring 1 for movement. Two cantilever beams 8 equipped with holes 4 are symmetrically installed on the ring 1, a spoke 6 is fixed on the beams 8 with spoke-fixing bolts 5. Two distraction rods 9 are symmetrically installed on the beams 8, the threaded ends of the rods 9 are connected to the heel support 7, and the rods 9 are fixed on the beams 8 with the possibility of a controlled change in the angular position. Rod 9 is made in the form of a sleeve 10, through which a pin 11 passes, fixed by nuts 12, while the sleeve 10 contains a threaded shank 13 located perpendicular to the longitudinal axis of the rod 9. The ring 1 and the heel support are connected by a third distraction rod 14 installed in the middle of the half ring 7. Angular marks 15 (0, 45, 90 degrees) are made on the distraction rods 9 to control the angular position of the rod 9. The threaded shanks 13 are fixed on the beams 8 using a swivel joint on spherical washers 16, which makes it possible to deviate the position of the stay 9 relative to the beam 8.

Example 2 (Fig.6-8).

The device for osteosynthesis of the calcaneus contains two base supports, connected by threaded rods 3, made in the form of a flat ring 1 and a semi-ring 2 with holes 4, on which spokes 6 are fixed with spoke fixation bolts 5, intended for passing through the bones of the lower leg, one heel support, made in the form of a semi-ring 7 with holes 4, on which the spoke 6 is fixed with spoke-fixing bolts 5, which is intended for passing through the distal fragment of the calcaneus. The heel support 7 is connected with the ring 1 for movement. Two cantilever beams 8 equipped with holes 4 are symmetrically installed on the ring 1, a spoke 6 is fixed on the beams 8 with spoke-fixing bolts 5. Two distraction rods 9 are symmetrically installed on the beams 8, the threaded ends of the rods 9 are connected to the heel support 7, and the rods 9 are fixed on the beams 8 with the possibility of a controlled change in the angular position. The rod 9 is made in the form of a sleeve 10, through which the pin 11 passes, fixed by nuts 12, while the sleeve 10 contains a threaded shank 13 located perpendicular to the longitudinal axis of the rod 9. The distraction rods 9 are placed at a distance of 30 mm from the beams 8, on the sleeves 10 distract rods 9, viewing windows 17 with a scale 18 on the studs 11 are made to control the amount of movement of the stud 11 relative to the sleeve 10. The ring 1 and the heel support are connected by a third distraction rod 14 installed in the middle of the semi-ring 7, made in the form of a curved stud.

The device is used as follows.

On the day of the operation, in the operating room under anesthesia, the transverse displacement of the bone fragments is eliminated by manual reposition. After confirming the success of the reposition on the control radiographs, they proceed to the closed imposition of supports, you can use the supports of the Ilizarov apparatus and its other details, supplementing with distraction rods 9 and 14.

Example 1

The spokes 6 are passed into the leg bone, and they are fixed to the ring 1 and the half-ring 2 with spoke fixation bolts 5 in the holes 4. The base supports are connected with threaded rods 3. The spoke 6 is passed into the proximal fragment of the broken calcaneus, and the spoke 6 is fixed with spoke fixation bolts 5 in holes 4 on the beams 8, the beams 8 are installed on the ring 1. The needle 6 is passed into the distal fragment of the calcaneus and fixed on the half ring 7. The rods 9 are installed on the beams 8, fixing the threaded tails 13, while the rods 9 are set at an angle of 45 degrees to planes of ring 1. Semi-ring 7 is connected to ring 1 by distraction rods 9 and rod 14. When mounting the device, rod 9 is set at an angle of 45 degrees (with a tolerance of 5 degrees) to the plane of ring 1. To ensure application to the distal fragment of the calcaneus, distraction efforts (or compression) directed along the longitudinal axis of the calcaneus to ensure directed movement of the fragment in a straight line The trajectories sequentially tighten the nuts 12 at three points, on the rods 9 and 14 (in one direction for distraction, in the other direction for compression). Distraction in a compression fracture is performed until the longitudinal arch is removed.

Example 2. A patient with a fracture of the calcaneus is placed under general anesthesia with a device. The position of the patient on the back, on the orthopedic table. In the lower third of the lower leg, two knitting needles 6 are carried out and fixed on the ring 1 with the help of spoke-fixing bolts 5. In the middle third of the lower leg, a transverse knitting needle 6 is carried out and fixed on the semi-ring 2 with the help of spoke-fixing bolts 5. The semi-ring 2 is connected to the support ring 1 using threaded rods 3. Beams 8 are installed on the support ring 1, connected to the bushings 10, at an angle of 45 degrees, a needle 6 is passed through the talus, fixed in the holes 4 of the beams 8 with the help of spoke-fixing bolts 5. The bushings 10 are connected with the heel support 7. Two spokes 6 are passed through the calcaneus and fixed on the calcaneal support 7 with the help of spoke-fixing bolts 5. X-ray control is carried out by tightening the nuts 12 of the rods 9, and distraction is carried out. After that, the pores are fixed with a barbell 14. The places where the needles come out of the skin are covered with alcohol balls. The device is installed for a period of 2 months, after which it is removed.

The device was used for the treatment of calcaneal fractures using distraction osteosynthesis with the Ilizarov apparatus in the Samarkand Regional Hospital of Orthopedics and Traumatology, on the basis of the Department of Orthopedics and Traumatology of the Samarkand State Medical Institute.

The device is convenient and easy to use, allows to treat patients with fractures of the calcaneus, is recommended for widespread use in practical medicine.

Claims (1)

A device for osteosynthesis of the calcaneus, containing two base supports connected by threaded rods, made in the form of a flat ring and a half ring with holes, on which the spokes are fixed with spoke fixing bolts, designed to pass through the bones of the lower leg, one heel support, made in the form of a half ring with holes , on which a spoke is fixed with spoke fixing bolts, designed to pass through a bone fragment, the heel support is connected to a ring with the possibility of movement, characterized in that two cantilever beams equipped with holes are symmetrically mounted on the annular support, a spoke is fixed on the beams with spoke fixing bolts, on two distraction rods are symmetrically installed on the beams, the threaded ends of the rods are connected to the heel support, and the rods are fixed on the beams with the possibility of a controlled change in the angular position, the rod is made in the form of a sleeve through which a stud passes, fixed with nuts, while the sleeve contains there is a threaded shank located perpendicular to the longitudinal axis of the rod, the ring and the heel support are connected by a third distraction rod installed in the middle of the half ring.

Images