RU215861U1 - EXTERNAL TRANSOSSEOUS REPOSITION AND FIXATION DEVICE FOR FOOT OSTEOSYNTHESIS - Google Patents

Abstract

The utility model relates to medicine. The device for external transosseous reposition and fixation for osteosynthesis of the foot contains a base support made in the form of a flat ring and a half-ring with holes connected by threaded rods, on which spokes are fixed with spoke fixation bolts, designed to pass through the bones of the lower leg, a distal support made in the form of a half-ring with holes, on which a needle is fixed, designed to pass through the fragments of the bones of the foot. The distal support is connected to a flat ring with the possibility of moving and fixing a predetermined position. On the flat ring and the distal support cantilever beams are installed, made with longitudinal grooves for accommodating spoke fixing bolts, equipped with transverse through threaded holes designed for installing locking screws. Four cantilever beams are installed on the flat ring, two cantilever beams are designed to fix the spokes inserted into the talus, two cantilever beams are designed to fix the spokes inserted into the calcaneus. On the distal support, two cantilever beams are installed for fixing the spokes, carried out in the foot bone. Mentioned spokes are fixed on the cantilever beams with spoke-fixing bolts, the latter are pressed against the cantilever beam. The flat ring is connected to the distal support by two symmetrically mounted distraction rods equipped with a fixed spherical hinge. Each rod is made in the form of a sleeve, at one end equipped with a telescopically retractable threaded rod and a distraction nut capable of rotation for metered movement of the threaded rod relative to the sleeve, and at the other end - with a fixed spherical hinge with a threaded shank, made with a ball head and a clamping nut for the ability of the threaded shank to change the angular position relative to the longitudinal axis of the threaded rod and fixation. The technical result consists in expanding the arsenal of technical means for treating the foot, with the possibility of fixing the spokes outside the plane of the support in an arbitrary position with the possibility of blocking the position of the spoke fixator bolt, in order to increase the stability of the fixation of bone fragments. 5 ill.

Description

Technical field

The technical solution relates to medical equipment, to traumatology and orthopedics, namely to devices for the treatment of fractures, dislocations or deformities of the bones of the foot by external transosseous reposition and fixation.

State of the art

A device is known for eliminating deformation of the forefoot (source [1] patent RU 122571). Device for elimination of deformation of the forefoot, contains one annular and one arc (half-ring) supports with spokes provided with holes, connected by pairs of threaded rods (rods) pivotally connected to each other, a reposition unit, connecting and fastening elements in the form of spoke-fixing bolts. In the annular support, the holes alternate with through grooves. Each pair of threaded rods is equipped with a drive mechanism made in the form of two L-shaped rods pivotally connected to each other, equipped with moving nuts fixed at opposite ends with the possibility of rotation and connected to the threaded rods, the reposition unit contains a rotation mechanism and a threaded rod fixed to it by means of a guide. a rod equipped at the ends with couplings in which the threaded rods connecting the supports are movably fixed, while the rotation mechanism is made in the form of a threaded bracket, fixed with the possibility of rotation in the hole of the annular support and pivotally fixed with the possibility of displacement in its adjacent groove of the L-shaped rod with a moving the nut connected with the threaded bracket, the guide is provided with an eye, with which it is movably fixed on the threaded bracket, with a through longitudinal groove and a pin installed in it, passing through the threaded rod.

In the device [1], the spoke fixing bolts located in the grooves on the annular support are subject to displacement along the groove. When mounting the device, the spokes are tensioned to a force of 120 to 130 kgf, and external forces are applied to the supports at the entrance of reposition, the spokes are displaced along with the bolts, which leads to unstable fixation of bone fragments. The supports do not contain beams or brackets that allow fixing the spokes outside the support plane, which limits the possibility of fixing the bones of the foot. In addition, the mechanism for connecting the annular support and the distal support is difficult for manual control, it is required to tighten the nuts of the repositioning unit and the nuts of the hinged units, the repositioning is carried out by rotating the moving nut mounted on the threaded bracket with the L-shaped rod mounted on it, which leads to to the rotation of the reposition node. Also, a multidirectional displacement of pairs of rods relative to each other is performed, which is ensured by rotation of the fixing nuts that fix the position of the rods in the couplings at the ends of the threaded rod of the reposition unit. After elimination of the deformation components, the device is transferred to the stable fixation mode.

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 [2]: A.S. USSR No. 1055499, publ.: 23.11. 83., bul. No. 43).

In the apparatus [1], the brackets (beams) do not contain grooves that allow fixing the spokes on the bracket in an arbitrary position along its length, which limits the possibility of fixing the bones of the foot. In addition, the support connection mechanism is difficult for manual control during one-stage reposition.

A device for osteosynthesis of the calcaneus is known (source [3]: patent RU 212395). It contains two base supports, connected by threaded rods, made in the form of a flat ring and a semi-ring with holes, on which 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 semi-ring with holes, on which spoke fixing bolts a pin is fixed, designed to pass through the bone fragment, the heel support is connected to the ring with the possibility of movement. Two cantilever beams equipped with holes are symmetrically mounted 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 rod is made in the form of a sleeve through which the pin passes, fixed with nuts, 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 rod installed in the middle of the half-ring.

The device [3] does not allow fixing the spokes outside the plane of the distal and annular support. The spoke is fixed with spoke fixing bolts in the holes on the beams, the beams are mounted on the ring. Since the design of the beam does not allow to displace the spoke bolt along the beam body, when installing the spokes, it is impossible to choose an arbitrary position for them, it is necessary to displace the spokes and deviate their position from the optimal one. When mounting the device, the wires are tensioned from 120 to 130 kgf, and external forces are applied to the supports at the repositioning inlet, the wires deflected during mounting on the beam are displaced, which reduces the stability of fixation of bone fragments. The supports do not contain beams or brackets that allow fixing the spokes outside the support plane, which limits the possibility of fixing the bones of the foot.

Thus, existing analogues have disadvantages, which complicates their use and limits the possibility of using them for foot treatment.

The essence of the technical solution.

The technical result consists in expanding the arsenal of technical means for treating the foot, with the possibility of fixing the spokes outside the plane of the support in an arbitrary position with the possibility of blocking the position of the spoke fixator bolt, to increase the stability of fixing bone fragments.

The technical result is achieved by the fact that the device for external transosseous reposition and fixation for osteosynthesis of the foot contains a base support, made in the form of a flat ring and a semi-ring with holes, connected by threaded rods, on which spokes are fixed with spoke fixation bolts, designed to pass through the bones of the lower leg, the distal support , made in the form of a semi-ring with holes, on which a spoke is fixed, designed to pass through the fragments of the bones of the foot, the distal support is connected to a flat ring with the possibility of moving and fixing a given position. It differs in that cantilever beams are installed on the flat ring and the distal support, made with longitudinal grooves for accommodating spoke-fixing bolts, equipped with transverse through threaded holes designed for installing locking screws, four cantilever beams are installed on the flat ring, and two cantilever beams are designed for fixation of the spokes inserted into the talus, two cantilever beams are designed to fix the spokes inserted into the calcaneus, two cantilever beams are installed on the distal support for fixing the spokes inserted into the foot bone, the mentioned spokes are fixed on the cantilever beams with spoke fixing bolts, the latter are pressed to the cantilever beam, the flat ring is connected to the distal support by two symmetrically mounted distraction rods, equipped with a fixed spherical hinge, each rod is made in the form of a sleeve, at one end equipped with a telescopically retractable threaded rod and a distraction nut, which has the ability to the possibility of rotation for metered movement of the threaded rod relative to the bushing, and at the other end - with a fixed spherical hinge with a threaded shank, made with a ball head and a clamping nut to enable the threaded shank to change the angular position relative to the longitudinal axis of the threaded rod and fixation.

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

Figure 1 - device, General view;

figure 2 - device, view of the beams, made with grooves and transverse holes;

figure 3 - device mounted on the limb, general view from the front;

figure 4 - device mounted on the limb, rear view; rotated relative to the beams and the base ring, general view;

figure 5 - device mounted on the limb, side view.

On the graphic materials marked

1- flat ring;

2- half ring;

3- threaded rods;

4 holes;

5- bolt-spoke fixer;

6- knitting needle;

7- distal support;

8- cantilever beam;

9- groove;

10- threaded holes;

11- locking screws;

12 - talus;

13 - calcaneus;

14 - bones of the foot;

15- rod;

16- spherical hinge;

17- bushing;

18- threaded rod;

19- distraction nut;

20 - threaded shank;

21 - ball head;

22 - clamping nut.

Device implementation

Example 1 (Fig.1;2;3;4;5).

The device for foot osteosynthesis contains a base support made in the form of a flat ring 1 and a half ring 2 with holes 4 connected by threaded rods 3, a distal support 7 made in the form of a half ring with holes 4.

On the flat ring 1 and the distal support 7, cantilever beams 8 are installed, made with longitudinal grooves 9, designed to accommodate spoke-fixing bolts 5, equipped with transverse through threaded holes 10, designed to install locking screws 11.

On the flat ring 1, four cantilever beams 8 are installed, two cantilever beams 8 are designed to fix the spokes 6 inserted into the talus 12, and two cantilever beams 8 to fix the spokes 6 inserted into the calcaneus 13.

On the distal support 7, two cantilever beams 8 are installed for fixing the spokes 6, carried out in the foot bone 14.

On the cantilever beams 8 spokes 6 are fixed with spoke fixing bolts 5. On the flat ring 1 and the half ring 2 spokes 6 are fixed with spoke fixing bolts 5, which are intended for passing through the bones of the lower leg. A needle 6 is fixed on the distal support and is intended for passing through fragments of the foot bones. When this spokes 6 fixed on the distal support 1 can be carried out in the wedge-shaped, cuboid bones, metatarsus, phalanges.

Bolts-speakers 5 are pressed against the beam by locking screws 11 screwed into holes 10, which prevents their displacement during reposition and operation of the device during fixation. The rods 15 are fixed on the flat ring 1 with the possibility of changing the angular position.

The distal support 7 is connected to the flat ring 1 with the possibility of movement to ensure simultaneous reposition and fixation of the position achieved during the reposition due to the rods 15. The flat ring 1 is connected to the distal support 7 by two symmetrically mounted distraction rods 15, equipped with a fixed spherical hinge 16. Threaded ends the rods 15 are connected to the distal support 7. The rod 15 is made in the form of a sleeve 17, equipped with a telescopically retractable threaded rod 18 and a distraction nut 19, the rotation of which ensures the measured movement of the threaded rod 18 relative to the sleeve 17. At the opposite end, the rod 15 is equipped with a spherical fixed hinge 16 , containing a threaded shank 20, made with a ball head 21 and a clamping nut 22. When loosening the nut 22, the threaded shank 20 is able to change the angular position relative to the longitudinal axis of the threaded rod 18, which allows the distal support 7 to be displaced relative to the ring 1 in an arbitrary position, when tightening the nuts 22 on the hinges 16, the mutual position of the supports is fixed.

The device is used as follows.

After anesthesia and treatment of the surgical field, a base support is applied to the shin, a needle 6 is inserted into the shin bone and fixed on a flat ring 1 and a half ring 2, a flat ring 1 and a half ring 2 are connected with threaded rods 3. The needles 6 are inserted into the calcaneus 13 and the talus 12 , fix the spokes 6 with spoke fixing bolts 5 in a predetermined position, installing them in the grooves 9 of the cantilever beams 8. At the same time, the spokes 6 are tightened, the nuts are tightened on the spoke fixing bolts 5, and the locking screws 11 are screwed into the holes 10 of the cantilever beams 8, preventing the rotation of the bolts - spoke fixators 5 and their displacement together with the spokes in the grooves 9. This ensures a strong connection of the base support with the limb and fixation of the talus and calcaneus, in the presence of fragments in these bones, the spokes 6 allow fixing the fragments and ensuring bone fusion. Next, osteosynthesis of the affected bones of the foot 14 is performed by holding the fixing pins 6 through the metatarsal bones, or the cuboid bone, or the scaphoid bones, or the phalanges. The needle 6 is passed into the bone of the foot and fixed on the distal support 7 by means of cantilever beams 8 and spoke bolts 5. In this case, the spokes 6 are tightened, the nuts are tightened on the spoke bolts 5, and locking screws 11 are screwed into the holes 10 of the cantilever beams 8, preventing rotation bolts-speakers 5 and their displacement together with the spokes in the grooves 9. This ensures a strong connection of the distal support with the bones of the foot and fixation of the bones and bone fragments in the presence of fragments. The flat ring 1 and the distal support 7 are connected with rods 15 without tightening the clamping nuts 22. The distal support 7 is displaced together with the bones fixed in it relative to the base support and a simultaneous reposition of the relative position of the bones is performed. The distal support 7 is fixed by tightening the clamping nuts 22 of the hinges 16 in the achieved position. Due to the free movement of the distal support 7 relative to the base support with the clamping nuts 22 loose, it is possible to simultaneously eliminate valgus or varus deformity, pronation and supination deviation of the forefoot by repositioning behind the distal support 7. At the same time, the spoke 6 fixed on the cantilever beams 8 does not move, since the spoke fixing bolt 5, in addition to being clamped with a nut, is fixed with locking screws 11. After repositioning, the device is switched to a stable fixation mode, which is maintained for the required time.

The spoke fixing bolts 5, located in the grooves 9 on the cantilever beams 8, do not move along the groove 9 when repositioned by the pull of the support and when the spokes are tensioned to a force of 130 kgf, since the locking screws 11 prevent displacement. Moreover, the spokes 6 can be passed through the holes 10 through the cantilever beam 8 so that the free end after bending is pressed against the beam 8 by the head of the spoke fixator bolt 5, this option allows you to tighten the spokes 6 with great effort, without fear that the spoke fixator bolt 5 will not hold spoke 6. Supports containing cantilever beams 8 with grooves 9 allow you to fix the spokes 5 outside the plane of the support, in various positions, which expands the possibilities of fixing the bones of the foot. The mechanism for connecting the base support and the distal support 7, consisting of two rods 15 with a fixed ball joint 16, makes it easy to manipulate the supports and fix them in a predetermined position by tightening two nuts 22, i.e. the device is convenient for manual elimination of displacements and deformations with subsequent stabilization of the achieved position.

Claims (1)

A device for external transosseous reposition and fixation for osteosynthesis of the foot, containing a base support made in the form of a flat ring and a half ring with holes connected by threaded rods, on which spokes are fixed with spoke fixing bolts, designed to pass through the bones of the lower leg, a distal support made in the form of a half ring with holes, on which a pin is fixed, designed to pass through the fragments of the bones of the foot, the distal support is connected to a flat ring with the possibility of moving and fixing a predetermined position, characterized in that cantilever beams are installed on the flat ring and the distal support, made with longitudinal grooves for placing bolts-spoke fixators, equipped with transverse through threaded holes designed for the installation of locking screws, four cantilever beams are installed on the flat ring, and two cantilever beams are designed to fix the spokes inserted into the talus, two cantilever beams are intended designed to fix the spokes inserted into the calcaneus, two cantilever beams are installed on the distal support for fixing the spokes inserted into the foot bone, the mentioned spokes are fixed on the cantilever beams with spoke fixing bolts, the latter are pressed against the cantilever beam, the flat ring is connected to the distal support by two symmetrically installed distraction rods, equipped with a fixed spherical hinge, each rod is made in the form of a sleeve, at one end equipped with a telescopically retractable threaded rod and a distraction nut that can be rotated for measured movement of the threaded rod relative to the sleeve, and at the other end - with a fixed spherical hinge with a threaded shank , made with a ball head and a clamping nut to enable the threaded shank to change the angular position relative to the longitudinal axis of the threaded rod and fix it.

Images