RU2228723C1 - Method for fixing metaepiphysial osseous fractures - Google Patents

Abstract

FIELD: medicine, traumatology, orthopedics. SUBSTANCE: one should introduce external screw rod into osseous fragments, moreover, with its threaded part it should be introduced into proximal fragment. One should introduce short diverging needles into distal fragment to be fixed them all in fixation knots. EFFECT: increased strength of fixation. 1 dwg, 1 ex

Description

The present invention relates to the field of surgery, traumatology, orthopedics, in particular to methods for external fixation of bone fragments.

A known method of fixing bone fragments with external screws of the Shants (Schanz screw) after reposition of the fracture as a whole. The screws are fixed in a device that represents a modular frame in which the necessary action of compressive forces is created (M.E. Muller, M. Algover, R. Schneider, X. Willinegger // Guide to internal osteosynthesis. Method recommended by the AO-Springer - Verlag group - 1996 - Berlin. S. 80).

The disadvantage of this method is that biasing forces acting on the fragments due to muscle traction lead to loosening and, as a result, to a decrease in the rigidity of fixation of fragments, which creates conditions for inflammation of soft tissues and bones. In addition, the use of one Shants screw for each of the fragments does not provide the possibility of repositioning the fracture in the apparatus in all planes due to the rod turning in the bone, in which the Shants screws are fixed, holding the fragments in a repaired state.

Closest to our proposed invention is a method for fixing bone fragments using systems with short diverging spokes. After reposition, short knitting needles are inserted into the fragments with a diverging beam. Then they are assembled in fixation nodes and fixed. At the same time, the spokes are slightly bent, which creates their mutual tension and ensures fixation stiffness (Yu.B. Kashansky et al. Hardware fixation of fractures is the method of choice in the treatment of patients with polytrauma. // Traumatology and Orthopedics of Russia. - 1994. - No. 6 - S. 51-58).

The disadvantages of the method selected as a prototype include the use for fixing smooth knitting needles, the rigidity of which is insufficient, and maximum compression between fragments cannot be achieved.

The objective of the invention is to increase the efficiency of fixation of fragments of metaepiphyseal zones of bones by increasing stiffness in the bone-device system and creating compression between the fragments for the entire treatment period.

In the method of fixing metaepiphyseal bone fractures, including the introduction of short diverging spokes into the fragments and fixing them in the fixation unit, an external screw shaft is inserted, with the threaded part thereof into the proximal fragment, and the spokes are inserted into the distal fragment.

The introduction through the fragments of the outer rod-screw provides compression between them due to the emphasis of diverging spokes, which increases the strength of fixation and makes it possible to carry out compression in dosage.

According to the scientific, technical and patent literature, the introduction of a screw rod and diverging spokes fixed in a fixation unit for fixing fragments of metaepiphyseal areas of bones is unknown.

The implementation of the method is shown in the drawing. Under general anesthesia, an open reduction of the fracture is performed. In the repaired position, an external screw-rod 2 is passed through the fragments 1 and diverging spokes 3 are screwed in the same plane on both sides of the screw-rod 3. The screw-rod and knitting needles are fixed in the fixing unit 4, in which, as the rod-screw continues to be inserted into the fragments, they come closer as much as possible , the necessary compression is created between them. With nuts 5, the rod-screw is fixed in a node in a predetermined position. The wound is sutured in layers, and alcohol wipes are applied around the knitting needles and the core.

Example, Patient Volkov A.Yu. 50 years old, No. 6680 disease history, was treated at the Scientific Research Institute of the joint venture from 02/27/02 to 02/10/02 with a diagnosis of Auto Trauma. Closed head injury. Brain concussion. Closed oblique fracture of the left clavicle. He was urgently operated on: an open reduction was performed, osteosynthesis of a clavicle fracture in the described manner. After the operation, the course went smoothly. From the first week, movements in the upper shoulder girdle are allowed. After 6 weeks, radiologically complete consolidation of the clavicle fracture. The device is dismantled. At the control examination after 2 months, the function of the upper limb is within normal limits.

The proposed method for fixing bone fragments allows you to treat metaepiphyseal fractures physiologically justified. An effective compression between bone fragments is created, which ensures optimal conditions for the consolidation of fractures.

Claims (1)

A method for fixing metaepiphyseal bone fractures, including the introduction of short diverging spokes into the fragments and fixing them in the fixation nodes, characterized in that the outer screw shaft is inserted into the fragments, with the threaded part being inserted into the proximal fragment, and the spokes are inserted into the distal fragment.