RU2187260C1 - Zygomatic arch and bone repositioning instrument - Google Patents

Abstract

FIELD: medicine, in particular, maxillofacial surgery, reconstruction surgery and traumatology. SUBSTANCE: repositioning instrument has handle and working part composed of rod and two projections. Working part is made from titanium nickelide producing thermal memory effect and is composed of stable rod and part defined by projections and having variable shape. Stable rod is bent at an angle of 20 deg with respect to handle and part defined by projections. Projections are positioned at rear part, are diverging at an angle of 30 deg and oriented at an angle of 60 deg with respect to stable rod. Method provides reliable repositioning of zygomatic arches and bones to correct anatomical position without substantial injury to said arches and bones. EFFECT: increased efficiency by enabling advantageous functional and aesthetic results or surgery. 2 cl, 2 dwg

Description

 The invention relates to medicine, namely to maxillofacial surgery, and can be used in reconstructive surgery and traumatology.

 Reposition of displaced zygomatic bones and zygomatic arches after their fracture is a prerequisite for achieving normal architectonics of the lateral section of the middle zone of the facial skeleton, serves to restore functional and aesthetic parameters.

 The well-known elevator of Karapetyan (B.A. Smirnov, I.S. zygomatic arches, consisting of a handle and bayonet-shaped part.

 Such an elevator has a number of disadvantages, such as: the inability to displace bone fragments at the time of setting in all directions. It does not provide reposition of bone fragments during comminuted fractures to the correct anatomical position, it has a destructive effect on the surrounding tissue.

 Known perforating, cutting, exfoliating and scalping tools designed to remove pathological tissues from the nasal cavity and paranasal sinuses. The tools are made of an alloy based on titanium nickelide grade TN-20. The main advantage of the tools is the sufficient plasticity of the working part, which makes it possible to give it the form necessary for surgical intervention with high cutting properties and wear resistance. The tools consist of a handle, a neck and a working part in the form of a crescent-shaped cutting part or a loop-shaped knife (the book. Medical materials and implants with shape memory. - Publishing house of Tomsk University, Tomsk, 1998. - P. 401-404).

 The disadvantage of these tools is the inability to use them to reposition bone fragments.

 Closest to the claimed is a tool for A. with. USSR 736971, A 61 B 17/24, 1980, B.I. 20, p. 20 for repositioning the zygomatic bone.

 The tool contains a handle and a working part in the form of a rod and two teeth.

Tool disadvantages:
- does not provide reposition of 2 or more bone fragments;
- its use causes significant trauma to the operated tissues;
- the difficulty of aseptic processing before surgery.

 The objective of the invention is low-invasive and reliable reposition of the zygomatic bones and arches in the correct anatomical position, creating the conditions for obtaining favorable functional and aesthetic results of treatment.

 This goal is achieved in that the device is made in the form of a tool containing a handle and a working part. The working part is made of titanium nickelide, which has the effect of thermal memory. It consists of a stable rod bent at an angle of 20 degrees relative to the handle, and a part that changes shape in the form of two awl-shaped teeth diverging at an angle of 30 degrees and oriented towards a stable rod at an angle of 60 degrees. At the ends of the awl-shaped teeth there are through holes for ligatures.

The conformity of the claimed technical solution to the criterion of "novelty" is confirmed by the presence of signs that the prototype does not have:
1. The working part of the device is made of titanium nickelide with the effect of thermal memory and consists of a stable rod and a part capable of changing shape.

 2. The changing part of the device is made of two awl-shaped teeth.

 3. The stable core is bent at an angle of 20 degrees with respect to the handle in accordance with the contours of the face in this area, which makes it convenient for insertion under bone fragments.

 4. Two awl-shaped teeth diverging at an angle of 30 degrees, take a V-shape in the wound, providing a large area of contact with the bone, capture simultaneously two or more bone fragments.

 5. The introduction of the instrument occurs through a puncture on the skin or mucous membrane, since at this moment the awl-shaped teeth are reduced and take the form of an awl.

 6. The variable geometry of the shape of the working part and the orientation of its awl-shaped teeth at an angle of 60 degrees with respect to the stable core allows a force sufficient to displace the bone fragments to the correct anatomical position.

 7. At the ends of the awl-shaped teeth there are through holes for ligatures.

 The significance of the differences of the claimed device to achieve the task is confirmed by the absence in the patent and scientific literature of information about similar devices with the same set of features.

The device is illustrated by drawings, presented on
figure 1:
a). General view of the tool from the side,
b) Front view;
figure 2. General view of the instrument at the time of thermomechanical action:
a). Side view,
b) Front view.

 The tool consists of a handle 1 and a working part. The working part is made of titanium nickelide with the effect of thermal memory and includes a stable part 2, made in the form of a rod bent at an angle of 20 degrees with respect to the handle, and a part that changes shape, in the form of two awl-shaped teeth 3, diverging at an angle of 30 degrees and oriented to a stable rod at an angle of 60 degrees. At the ends of the awl-shaped teeth there are through holes 4 for ligatures.

 The device operates as follows. Before reposition of bone fragments, the device is cooled with a solution of chloroethyl or liquid nitrogen. Two awl-shaped teeth 3 are deformed, they are given an awl-shaped shape, which makes it easy to enter the instrument through one puncture, thereby avoiding unnecessary damage to the surrounding soft tissues. The device is then inserted under the bone to be repositioned. In the process of heating due to the transfer of heat by the surrounding tissues, the effect of thermal memory is realized .. Two awl-shaped teeth 3, diverging at an angle of 30 degrees, take a V-shape in the wound, which provides a large area of contact with the bone, simultaneously capture two or more bone fragments, working the part takes its initial position, providing reposition of bone fragments up to 1.5 cm, which allows you to set bone fragments in the anatomical position. At the ends of the styloid processes there are through holes for ligatures.

 Thus, a tool for reposition of the zygomatic bones and zygomatic arches allows you to achieve good aesthetic and functional results due to low trauma and reliability of reposition of bone fragments.

Claims (2)

1. A tool for repositioning the zygomatic arches and bones, containing a handle and a working part in the form of a rod and two teeth, characterized in that the working part is made of titanium nickelide with the effect of thermal memory and consists of a stable rod bent at an angle of 20 ^o relative to the handle and a part that changes shape in the form of teeth that are awl-shaped, diverging at an angle of 30 ^o and oriented towards a stable shaft at an angle of 60 ^o .  2. The tool according to claim 1, characterized in that at the ends of the awl-shaped teeth there are through holes for ligatures.

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