RU2151566C1 - Device for carrying out osteosynthesis of fractured proximal segment of the femur - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has metal bearing fixing member and conductor having aiming member for guiding wire provided with pusher member. Aiming member of the guiding wire is mounted near the upper boundary of the conductor satisfying relation B=0.3A, where A is the conductor length, B is the aiming member length. Pusher working rod length is C=A. EFFECT: enhanced accuracy and stiffness; enhanced effectiveness in setting and fixing wires in treating femur fractures. 2 dwg

Description

 The device relates to medical equipment and can be used to perform osteosynthesis.

 The essence of the invention is that the conductor is equipped with a sight for a guide pin mounted at the upper edge of the conductor so that the ratio B = 0.3 A is fulfilled, where A is the length of the conductor, B is the length of the sight; moreover, said conductor is further provided with a pusher, the length of the working rod of which is C = A, FIG. 2.

 A device for performing osteosynthesis [1], which is an analogue. Its disadvantage is that with the introduction of the spokes they do not provide the necessary accuracy and rigidity of fixation of the spokes made in the form of a hairpin [2].

 As a prototype, a device [3] was selected in which the fixing element is inserted along the back inside the conductor. It also does not provide the required installation accuracy and rigidity of fixation, as well as ease of use in the case of installation of spokes made in the form of a stud.

 The proposed invention solves the problem of increasing accuracy, rigidity and ease of use when installing and fixing the spokes made in the form of a hairpin.

 This goal is solved by the fact that the conductor is equipped with a sight for conducting the guide spokes, mounted at the upper edge of the conductor so that the ratio B = 0.3 A, where A is the length of the conductor, B is the length of the sight; moreover, the indicated conductor is additionally equipped with a pusher, the length of the working rod of which C = A.

List of figures:
FIG. 1 - conductor with a sight;
FIG. 2 - the device assembly.

Designations in the figures:
1 - conductor,
2 - sight,
3 - pusher
4 - supporting knitting needles,
5 - guide pin,
6 - designation of a bone fracture.

Description of the device in statics
The jig 1 is a hollow tube. At the upper edge of the conductor, a sight 2 is fixed, also made in the form of a tube of a smaller diameter and shortened in comparison with the length of the indicated conductor, FIG. 1. The pusher 3 is designed to be held inside the conductor. The metal support latch is a supporting spokes 4 made in the form of pins and directed (see Fig. 2) through the conductor 1 with its free ends forward. The guide pin 5 is selected from surgical traumatological instruments for installation and passing through the bone fracture 6 of the proximal femur. A guide pin 5 is inserted into the sight 2. Support pins 4, made in the form of studs, are installed inside the conductor 1 and their pointed ends are directed towards the bone fracture 6. The pusher 3 is inserted into the conductor 1 after the supporting spokes 5.

Description of the device
The device operates as follows. A patient with a fracture of the proximal femur is prepared for osteosynthesis with a kit containing a conductor 1, sight 2, pusher 3; FIG. 1. Then, under X-ray observation, a guide pin 5 is inserted into the bone fracture 6, FIG. 2. A conductor 1 of length A through the sight 2 of length B = 0.3 A is mounted on the guide pin 5. The ratio B = 0.3 A is convenient for use. In the conductor 1 enter the supporting spokes 4, made in the form of a stud. After the spokes, a pusher 3 of length C = A is introduced into the same conductor 1. By impacts on the site at the free end of the pusher 3, the supporting needles 4 are inserted into the bone fracture 6. The ratio C = A ensures the introduction of the needles 4. The optimal time for performing osteosynthesis for 15-20 minutes was experimentally found. For less than 15 minutes, it is difficult to complete the stage of targeted insertion of the guide needle 5 into the bone fracture 6. Simple insertion of the 4 needles in most surgical interventions is performed qualitatively and the traumatologist does not need more than 20 minutes.

 After 9 to 12 days, the stitches are removed. In the following days, the patient is activated. After 2-3 days, the patient begins to make the first movements on crutches. In the future, after discharge, three months after surgery, the patient moves with a cane. After one year, the movement is fully restored and the patient's needles are removed 4.

Clinical examples
Example 1. Patient St., 76 years. Was admitted to the hospital for a hip fracture on the right 03/21/97. On the morning of March 22, 1997, under local anesthesia with a solution of novocaine from a 1 cm skin incision, a conductor with a sight is installed along the guide needle. The conductor produces osteosynthesis with bunches of spokes made in the form of a hairpin. The duration of the operation is 15 minutes The patient sat down in bed on the day of the operation, 03/23/97 activated on crutches. After 10 days, the sutures were removed from the wound. The patient was discharged 04/01/97 from the hospital, can independently move with crutches. The movement gradually recovered completely and a year later the needles were removed. Almost no anxiety.

 Example 2. Patient Aev, 74 years old. He entered the hospital on 04/14/97 about a fracture of the neck of the left thigh. On the morning of April 15, 1997, under local anesthesia with a solution of novocaine from a 1 cm skin incision, a conductor 1 with a sight 2 was installed along the guide pin 4. Osteosynthesis was performed on the conductor using bundles of supporting spokes 4 made in the form of a hairpin. The duration of the operation is 20 minutes. Patient 04/16/97 activated on crutches. The sutures from the wound were removed 04.25.97. Discharged from the hospital 04/22/97. Pain in the left hip joint does not bother. The patient at discharge independently moved with crutches. After 3.5 months he walked, leaning on a cane, movements in the joint were almost completely restored. After a year, the supporting spokes were removed with a full x-ray joint fusion.

 The proposed invention solves the following problems.

 1. Significantly increased the accuracy of the installation of supporting spokes, made in the form of a hairpin, in the area of a bone fracture, since during the operation the conductor is fixed on the guide needle.

 2. A fixation stiffness is achieved, which is ensured by the introduction of spokes in two mutually perpendicular directions (planes).

 3. There is no return of supporting spokes and dynamic stress in the fixer-bone system due to the elastic divergence of the ends of the spokes made in the form of a hairpin.

 4. The operation time is reduced by 2 times.

Literature:
1. Orthopedics, traumatology, prosthetics, 1988, 3, p. 64 - 66.

 2. Application for invention N 97117250/14 of 10.27.97, the decision to grant a patent of the Russian Federation.

 3. M.E. Muller et al. Guide to internal osteosynthesis. M. 1996.

Claims (1)

 A device for performing osteosynthesis of fractures of the proximal femur containing a metal support retainer and a conductor with a sight for the guide needle, characterized in that the conductor is equipped with a pusher, the sight for the guide needle is installed at the upper edge of the conductor with a ratio of B = 0.3 A, where A is the length of the conductor, and B is the length of the sight, the length of the working rod of the pusher C = A.

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