RU2150248C1 - Device for performing vertebrae fractures reposition and fixation - Google Patents

Abstract

FIELD: medicine. SUBSTANCE: device has uprights joining four plates. The uprights are connected by hinged joints in the middle part between two of the plates to enable posterior angle to be fixed for making reposition. Each plate is provided with a pair of rods set into opening in the screw body introduced into the holes in the plates. The plates are graded into 360 deg for adjusting the angle of rod to be introduced into the vertebra body. Rod lineal is introduced through the outer holes in the plates, its end being fixed on the outer plate and ring-shaped protrusions are spaced all over its whole length with 5 mm spacing interval for determining the place the rods are to be introduced. EFFECT: reduced risk of traumatic complications; stable fixation. 2 cl, 3 dwg

Description

 The invention relates to medicine, namely to traumatology and orthopedics.

 Depending on the mechanism of injury, spinal fractures account for up to 20.3% of all skeleton fractures, second only to long tubular bones. Despite the improvement of methods for treating spinal fractures, the number of unsatisfactory results remains high and ranges from 8% to 58.3%. The initial disability rate is 54.3% - 100%, depending on the type of fracture. The problem of treating spinal fractures remains relevant, especially for the Kuzbass, where a significant part of the able-bodied population is employed in the coal industry and in heavy industries characterized by a high level of injuries. Clinical observations show that conservative treatment does not provide correction of deformation and reliable fixation of a broken vertebra, so in recent years, most traumatologists began to prefer surgical methods of treating these injuries, in particular, external fixation devices.

A fixing device for reposition of the spine is known, which contains two screws located on both sides of the vertebra, and two elements parallel to the spine, connecting the screws and adjusting the screws relative to the vertebra, the position of which is restored, (US Pat. EP N 0499037, class A 61 B 17/60, published 92.08.19 "The fixing device for reposition of the spine")
The disadvantages of this device:
- massive structure;
- fixation only adjacent to the damaged vertebrae, which leads to a decrease in stiffness;
- high risk of secondary displacements;
- the possibility of adequate reposition is difficult.

A device for the treatment of the spine, containing nodes of fixation of the vertebrae with central plates and a shear mechanism of these nodes, characterized in that, in order to provide spatial displacement of the vertebrae, the shear mechanism is made in the form of a multi-axis hinge with the possibility of fixation in different positions formed by two crank brackets mounted on central plates and interconnected by a L-shaped threaded rod. (ed. St. N 1237194, class A 61 B 17/60 publ. 86.06.15. BI N 15 "Device for the treatment of the spine")
The disadvantages of this device:
- massive structure;
- fixation for the spinous processes, which leads to a decrease in stiffness;
- the possibility of adequate reposition is difficult.

The closest device to the claimed, selected as a prototype, is a device for the treatment of vertebral fractures. It is used to treat vertebral fractures with displacement of fragments in width in the frontal plane. In order to prevent creasing of the surfaces of damaged vertebrae during reposition, the device contains support nodes interconnected by repositional and centering blocks. The support unit is made of a plate on which a central rod with a U-shaped plug, screws and two spokes are mounted. The reposition unit contains four rods, one ends of which are fixed on each of the plates, on the other, a mounting plate and a guide are connected in pairs, connected by an arm. The centering unit contains a centering rod, which is passed into the holes of two brackets mounted on the central rods of each support node. (ed. St. N 1711860, class A 61 B 17/60, publ. 92.02.15, BI N 06, "Device for the treatment of vertebral fractures")
The disadvantages of this device:
- massive structure;
- an open stage of fixation for the spinous processes, which increases the invasiveness of the operation, increases the risk of purulent postoperative complications;
- fixation only adjacent to the damaged vertebrae, which leads to a decrease in stiffness.

 The objective of the invention is to create a reliable device that would allow to perform a slightly traumatic, completely closed operation, with the possibility of adequate reposition and subsequent rigid, stable fixation, both during planned and emergency surgical interventions.

 This object is achieved in that the racks connecting the four plates in the middle part, between the two plates, are hinged with the possibility of fixing a given angle for reposition, while each plate is equipped with a pair of rods installed in the holes of the screw body inserted into the holes of the plates, which are equipped 360 degree marking to adjust the angle of the rod in the vertebral body; through all the extreme holes of the plates, a ruler-rod is drawn, the end of which is fixed to the extreme plate, and annular protrusions are made along its entire length with a step of 5 millimeters to calculate the place of introduction of the rods.

The novelty of the device:
1. Four plates are selected based on the fact that a given number of elements achieves adequate reclamation, rigidity and stability of the device.

 2. The connection of their rods with hinges allows you to give a metered reclamation with subsequent fixation of the achieved angle.

 3. The rods are installed two on each plate in the body of the screws inserted into the holes of the plate in order to achieve stability and to prevent the eruption of the vertebral body.

 4. Graduation of the holes of the plates by 360 degrees to adjust the angle of installation of the rod in the body of the vertebra.

 5. The ruler-rod is used to calculate the place of introduction of the rods under the control of the image intensifier tube.

 The invention is illustrated by drawings, where in FIG. 1 shows a general view of the device; in FIG. 2 - node mounting the rod in the screw; in FIG. 3 - part of the ruler-rod with annular protrusions.

 A device for reposition and fixation of vertebral fractures consists of four rectangular plates 1, along the long side of which a series of holes 2 are made, equally oriented relative to each other. The plates are interconnected by four racks 3, which pass through the corresponding holes of the plates 2, with a thread along their entire length. Racks 3 in their middle part, between two plates 1, are connected by hinges 4. In the other holes of all four plates, for example, to the right and left of the columns 3, screws 5 with nut 6 are screwed in, holes 7 are made in the body of the screws, into which are inserted , two on each plate 1, rods 8 for introducing them into the body of the vertebrae. In the extreme holes 9 of the plates 1, a ruler 10 is installed in the form of a rod, at one end of which a thread 11 is made for installation and fixing it with a nut 12 in the extreme plate, and annular projections 13 are made along the entire length of the rod-rod with a step of 5 millimeters for calculation places of introduction of the rods 8. Around each hole 2 in the plates there is a marking of 14 by 360 degrees, one division is equal to 10 degrees in order to accurately calculate the angle of introduction of the rods 8 into the vertebral body. The divisions are plotted around all holes 2, since the posts 3 and the rods 8 can be installed in any desired combination. The posts 3 can form a functional angle with the help of hinges 4 and are fixed in this state with the screw 15.

 The device operates as follows: the patient lies on the operating table in a position on his stomach. Under the control of the image intensifier tube (electron-optical transducer), in the second, counting from the damaged, the overlying vertebra is transpedicularly inserted from both sides along the rod 8. Plate 1.1 is fastened to the rods by means of screws 5 and nuts 6. A ruler-rod 10 is attached to the hole 9 of the plate 1.1 with a thread 11, is fixed by nuts 6. Two posts 3 are attached to the holes 2 of the plate 1.1, and the plate 1.2 is fixed to the opposite ends of the posts by nuts 6 in the corresponding holes 2. Under the control of the tube and the ruler-rod 10 along the annular protrusions 13, the points of introduction of the rods 8 into the adjacent vertebra from the damaged vertebra are calculated. The angle of introduction is determined on a scale plotted around each hole 2 on the plate 1, the value of the angle of introduction of all the rods 8 is calculated before surgery, based on computed tomography data. Transpedicularly, one rod 8 from each side is inserted into the vertebral body. The rods 8 are attached to the plate 1.2 in the holes 2 by means of screws 5 and nuts 6. Two hinges are attached to the ends of the racks 3. Two racks 3 are screwed onto the opposite ends of the hinges 4. Above the lower vertex adjacent to the damaged vertebra on the racks 3 in the corresponding holes 2 with the help of nuts 6, the plate 1.3 is attached. Under the control of the image intensifier tube and the ruler-rod 10, the points of introduction of the rods are calculated from the annular projections 13. The angle of introduction is determined by the scale around each hole 2 on the plate 1. The rods 8 are transpedicularly inserted into the vertebral body and attached to the plate 1.3 into the holes 2 by means of screws 5 and nuts 6. On the opposite ends of the uprights 3 in the corresponding holes 2 with the help of nuts 6 is attached a plate 1.4. Under the control of the tube’s rod-rod 10, the points of insertion of the rods 8 are calculated from the annular projections 13. The insertion angle is determined according to the scale plotted around each hole 2 on the plate 1. The rods 8 are transpedicularly inserted into the vertebral body and attached to the plate 1.4 into the holes 2 by means of screws 5 and nuts 6. The ruler-rod 10 is removed from the holes 9 of the plate 1. Reclination is made, and the hinges 4 are fixed in the reached position by means of screws 15.

 The device for reposition and fixation of vertebral fractures is simple and effective in operation, compact. When using it, operations are less traumatic, bloodless, the risk of infectious complications is minimized. The device allows for adequate reposition, rigid, stable fixation and early activation of patients. Being a fully collapsible device is easy to sterilize. It is used in the department of traumatology and orthopedics for emergency and planned surgical interventions. This device has been used in two patients.

Claims (2)

1. A device for reposition and fixation of vertebral fractures, consisting of plates with holes, rods and racks, characterized in that the racks connecting the four plates in the middle part between the two plates are hinged with the possibility of fixing a given angle for reposition, with each plate equipped with a pair of rods installed in the holes of the body of the screws inserted into the holes of the plates, which are provided with a marking of 360 ^o to adjust the angle of installation of the rods in the body of the vertebra.  2. The device according to claim 1, characterized in that through all the extreme holes of the plates a ruler-rod is drawn, the end of which is fixed to the extreme plate, and annular protrusions are made along its entire length with a step of 5 mm to calculate the place of introduction of the rods.

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