RU2143241C1 - Device for osteosynthesis of pelvis bone fractures - Google Patents

Abstract

FIELD: medicine, namely traumatologic and orthopedic engineering. SUBSTANCE: device has metal plates with holes, screws for attachment of plate to bone, bushes and shaped pins with ellipsoidal heads. Plates are of different form and length. Holes serve to receive bushes and have tapered surface. Bushes may be deformed by means of expanding appliance according to plate holes, thereby forming ellipsoidal surface. Shaped pins couple plates to one another forming multi-link fixed connections of different configuration and length created during operation according to pelvis relief. EFFECT: treatment of complicated pelvis fractures. 20 dwg

Description

 The invention relates to medicine, namely to traumatology and orthopedic equipment.

 With unrepaired pelvic fractures, surgical treatment in most patients is inevitable. Until recently, conventional metal plates were used for osteosynthesis of pelvic bone fragments, which are used in traumatology for osteosynthesis of long bones (Ankin AN, Levitsky VB Principles of stable functional osteosynthesis. Monograph, Kiev, 1991).

 However, when used for osteosynthesis in the pelvic region, these plates do not always fit snugly due to the curvature and large relief of the pelvic bones, especially in conditions of post-traumatic deformities. The angle is not changed in these plates - they are straight, there is no way to change their configuration in relation to the treatment of complex pelvic fractures with different orientation of fracture lines.

 To provide various options for directed osteosynthesis on the pelvic bones, we created a multi-link adjustable device - a set of plates of various configurations - previously unknown in traumatology.

 The goal is achieved by the fact that during the operation the plates are interconnected, which provides any necessary length of the device, the configuration necessary along the fracture lines, while ensuring the necessary angles between the individual elements of the device.

 The use of this device provides reliable fixation of fragments of the pelvic bones having an irregular volumetric shape.

 The device consists of a set of plates that are connected using a flare tool. The flaring tool is intended for flaring a part when creating an integral connection of plates. The device is known from the technique and patent protection is not claimed for it.

 The plate set (Fig. 1 - 17) to create a device equipped with bushings 1 with an ellipsoidal groove. During the operation, the plates are interconnected by means of a curly finger with an ellipsoid head.

 In the frame 5 of the device (Fig. 18 - 20) there is a vertical hole in which the punch 4 and the spring 13 are placed. With the help of the punch, the part is deformed, and the spring returns the punch to its upper position and holds it after unloading.

 Fixation of the fastened parts relative to the punch is carried out using a pin 9.

 On the centering belt of the punch there is a threaded hole in which a pin 6 is screwed, which can move in the slot of the plate 7, mounted on the frame 5 with two screws 8. This prevents the punch from turning around its axis during operation.

 To lower the punch and create the necessary amount of force required to deform the part (i.e., flaring) and compress the plates, lever 2 with a handle is intended (the handle is not shown in the drawing). Screw 1 is used to secure the handle to the lever. The lever is movably fixed to the bed using the axis 3.

 In the lower part of the bed there are lobes that are inserted into the grooves formed by the U-shaped pad 11 and the base 12. The U-shaped pad is mounted on the base with 6 screws.

 To eliminate corrosion, all parts of the device are made of stainless steel: parts 1, 5–13 and the handle is made of X18H10T steel, parts 2, 3, 4 are of 2X13 brand, followed by heat treatment and electric polishing.

 The technique of connecting the plates. To create the optimal design shape, the sleeve 1 (Fig. 1) is installed in the hole 0 of the plate 3 (Fig. 2) until it stops. Using a special device having a working surface that repeats the conical shape of the hole 0 of the plate 3 equidistantly, the upper end of the sleeve 1 is deformed (Fig. 1) until it is pressed against the surface of the hole of the plate 3 (Fig. 2) with the formation of the protrusion B (Fig. 13 ) The plate 3 is pressed tightly (Fig. 13) to the plate 2 (Fig. 13) without protruding above its surface (Fig. 13).

 The ellipsoidal surface of the sleeve formed after deformation serves as a seat for the conical part of the head of the screw attaching the structure to the bones of the pelvis.

 In FIG. 17 shows a General view of two connected plates of the final type with a section explaining the principle of operation of the connection.

 Direct fastening of the plates relative to each other is possible at any angle in the joint plane in the range determined by the design of the plates themselves, i.e. the angle (alpha, Fig. 13) can take any values in the specified range and is determined by the needs that arise during the operation.

 The immobility of the connection of the plates relative to each other and the ability of such a connection to withstand significant loads allows after fixing the plates on the fragments of the pelvic bones to reliably fix the latter to each other, ensuring their quick fusion.

 The presence in the set of plates of the final (Fig. 1, 2, 4, 5, 6, 8, 9, 11, 15, 16) and intermediate (Fig. 3, 7) types allows you to create multi-link connections, which ensures maneuverability when performing operations on about the consequences of polyfocal pelvic fractures.

 In a multi-link connection, there can be several intermediate-type plates, and only two of the final-type plates. If necessary, from the plates of the intermediate type, you can create a three-link, four-link.

 On (Fig. 13) shows a variant of a two-link connection consisting of end plates (Fig. 1, 2, 3).

 Methodology of using the device. After exposure of the site of the former fracture, fragments of the pelvic bone are isolated and compared. Next, they select, fit and connect the plates depending on the nature and type of the consequences of the fracture. Using special drills with stops (so as not to fall into the pelvic cavity), having determined the thickness of the bone tissue in advance, a channel is drilled through the holes in the plate to the bone to the required depth and the plate is fixed with a screw. As a result, a stable osteosynthesis of the pelvic bones is created. Layered stitches on the wound with the introduction of antibiotics. Gypsum immobilization in the postoperative period is not used.

 The device found its application in a clinic with positive results in more than 40 patients.

Claims (1)

 A device for osteosynthesis of pelvic fractures containing metal plates with holes and screws for fastening the plate to the bone, characterized in that it is equipped with bushings and curly fingers with ellipsoid heads, plates made of various shapes and lengths and with holes with a conical surface for placement of bushings with the possibility of their deformation by a flaring device along the hole of the plate with the formation of an ellipsoid surface at the bushings, while curly fingers connect the plates with the possibility of azovaniya of fixed plates multilink connections with different configuration and length, generated during the operation, respectively the relief pelvis.

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