RU2232555C2 - Method for lengthening tubular bone - Google Patents

Abstract

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should destroy the integrity of patient's tubular bone. Then one should introduce precurved needle and additional one into medullary canal through metaphysis. One should apply curved ends of needles at opposite sides of medullary canal. External ends of every needle should be fixed to a support of perosseous apparatus. Osseous fragments should be replaced. In peculiar case, needles are made of shape-memory material. The method enables to stimulate osteogenesis and prevent the shift of fragments.

EFFECT: higher efficiency of operation.

1 cl, 2 dwg, 1 ex

Description

The invention relates to medicine, in particular to orthopedics, in particular, is used to align the length of the lower extremities in the treatment of the musculoskeletal system of a person using devices with external fixation.

A known method of replacing defects of long tubular bones by lengthening one of the fragments according to Ilizarov, in which to increase the rigidity of fixation in the reduced fragment, additionally carry out spokes and periodically support compression between the ends of the fragment (V. I. Zarubin. Replacing defects of long tubular bones by lengthening one of fragments according to Ilizarov. Kurgan Regional Scientific Society of Traumatologists and Orthopedists. Publ. 26.12.75).

A known method of lengthening the tubular bone, including the use of an intramedullary needle, violation of the integrity and distraction of bone fragments using a transosseous device, in which intramedullary stimulation of bone formation is carried out using an additional spoke, which is introduced through the metaphysis into the bone marrow canal to the required depth, then a partial corticotomy is performed (RF Application No. 99106052/14, Method for lengthening the tubular bone. Publ. 10.01.2001).

However, the known method does not allow the prevention of secondary displacements of bone fragments and the stimulation of reparative osteogenesis from the bone marrow cavity.

The present invention is to develop a method for lengthening the tubular bone, which allows stimulation and to prevent secondary displacement of fragments when moving due to elastic deformation of the spokes.

The problem is solved in that in the method of lengthening the tubular bone, including the violation of its integrity, the imposition of the transosseous apparatus, the introduction of the knitting needle into the bone marrow canal through the metaphysis and the movement of bone fragments, use an additional spoke, while the spoke and additional spoke are pre-bent, after which injected into the bone marrow canal, having the curved ends of the spokes on opposite sides of the bone marrow canal, and the outer ends of each spoke attached to the support of the transosseous apparatus.

It is advisable for ease of use knitting needles made of material with shape memory.

The patented invention is illustrated by a detailed description, an example of its implementation and illustrative materials on which:

Figure 1 - arrangement of curved knitting needles, namely knitting needles and additional knitting needles in the bone marrow cavity.

Figure 2 is a copy of the x-ray of the patient during treatment.

The method is as follows.

In the operating room, the transosseous device is applied to lengthen the segment according to the standard method. Perform an osteotomy.

Through the metaphysis closest to the osteotomy, from the inner and outer sides, through pre-drilled holes with a diameter of 3-4 mm, pre-uniformly curved 1 / 2-3 / 4 circles are introduced along the entire length of the spoke and an additional spoke, the diameter of which is 1.5-1 , 8 mm.

After immersing to the required depth along the bone marrow canal with the help of a special handle, to which the free end of each of the spokes is fixed, they are turned so that the curved ends of the knitting needles and additional knitting needles are bent in opposite directions within the elastic deformations. Thus, they carry out elastic stable fixation of bone fragments due to oppositely directed bending moments.

The free ends of each of the spokes bite and bend so that during distraction the spokes do not completely sink into the bone, or their ends are fixed to the supports of the transosseous apparatus.

For ease of use, the needles can be made of material with shape memory.

The proposed method allows to prevent secondary displacements of bone fragments in the process of elongation due to counter-bent spokes within the elastic deformations and, sliding in the marrow canal and passing through the regenerate, stimulate reparative osteogenesis.

An example of a method for lengthening a tubular bone.

The history of the disease is 2145. Patient B., 16 years old. Diagnosis: congenital shortening of the left lower limb.

The operation was performed: osteotomy of the left thigh in the lower third, application of the Ilizarov apparatus.

Through the metaphysis closest to the osteotomy, from the inside and outside, through pre-drilled holes with a diameter of 3-4 mm, pre-uniformly curved 1/2 to 3/4 circle circles were introduced along the entire length of the spoke with a diameter of 1.5-1.8 mm.

After immersion to the required depth along the marrow canal using a special handle to which the free ends of the spokes were fixed, they were turned so that they were bent in opposite directions within the elastic deformations. Elastic stable fixation of bone fragments is carried out due to oppositely directed bending moments. The free ends of the spokes were fixed to the supports of the transosseous apparatus. In addition, knitting needles made of a material with shape memory can maintain an elastically stressed state during the entire treatment period.

Claims (2)

1. A method of lengthening the tubular bone, including a violation of its integrity, the imposition of a transosseous apparatus, the introduction of a spoke into the bone marrow canal through the metaphysis and the movement of bone fragments, characterized in that they use an additional spoke, while the spoke and additional spoke are pre-bent, and then introduced into the bone marrow canal, having the curved ends of the spokes on opposite sides of the bone marrow canal, and the outer ends of each spoke attached to the support of the transosseous apparatus. 2. The method according to claim 1, characterized in that the spokes are made of material with shape memory.

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