RU2238691C2 - Plate for carrying out osteosynthesis of slipped epiphysis and osteoepiphysiolysis of infantine radial bone - Google Patents

Abstract

FIELD: medical engineering.

SUBSTANCE: device has overlay part and holes for receiving screws. The overlay part is rectangle having two stilettos on one end making an angle of 70° to plate plane, sharp ends of which are directed toward the plate center. Two holes are available on the plate. One of them is round and has diameter of 3.5 mm, the other one being oval with dimensions of 3.5x7.0 mm. The holes are 15 mm far from each other in the case of plate intended for treating 7-11 years old children. The distance is equal to 20 mm in the case of plate intended for treating 12-15 years old children. Stiletto sizes have width equal to 2 mm, thickness to 1.5 mm and length of 8 mm when intended for treating 7-11 years old children. The dimensions are equal to 3mm, 2 mm and 12 mm when intended for treating 12-15 years old children, respectively. The overlay part dimensions are equal to 9mm, 1.5 mm and 30 mm when intended for treating 7-11 years old children and 9 mm, 2 mm and 50.0 mm when intended for treating 12-15 years old children, respectively.

EFFECT: enhanced effectiveness of treatment; stable bone fragments compression conditions.

3 dwg

Description

The invention relates to surgery, in particular to traumatology and orthopedics for the treatment of epiphysiolysis and osteoepiphysiolysis of the radial bone in children and adolescents.

Epiphysiolysis and osteoepiphysiolysis of the distal end of the radial bone take first place among injuries of the forearm in children. With this pathology, reposition should be as gentle and complete as possible, since damage to the epiphyseal cartilage affects the growth of the bone in length and causes deformations, which increase as the child grows. (Traumatology and orthopedics / A guide for doctors. In 3 volumes. T.2 / Edited by Yu.G. Shaposhnikov. - M .: Medicine, 1997. S. 466.). The closest analogue prototype is a T-shaped plate AO (L.N. Ankin, N.L. Ankin. The practice of osteosynthesis and endoprosthetics. - Kiev, 1994. p.144-146). However, this plate requires two to three screws to pass through the pineal gland, which in a child can destroy the cartilaginous tissue of the pineal gland and damage the physical zone (growth zone). The use of a T-shaped plate does not allow stable compression of fragments. The installation of this plate is combined with a wide dissection of the capsule of the wrist joint.

The objective of the invention is the stable compression of fragments without damaging the physical area of the radius by fixing the fragments with a special plate.

The drawings show: figure 1 is a general view of the plate, position 1 is the patch, position 2 is stilettos, position 3 is a round hole, position 4 is an oval hole; figure 2 - laying the plate, position 1 - the introduction of stylet into the pineal gland, position 2 - screwing the screw through the oval hole; figure 3 - fixing the plate, position 1 - screwing the screw through a round hole.

The task is implemented as follows. For an accurate comparison of fragments of the radius, stable fixation and compression of fragments without damaging the physical zone (growth zone), a special plate is used for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radius in children, which consists of a patch made in the form of a rectangle with two stylet on one end , and having holes for screws. The plate has two sizes, corresponding to the ages of 7-11 and 12-15 years:

for 7-11 years old - the overlay of the plate 30 mm long, 1.5 mm thick, 9 mm wide (Fig. 1, Item 1) has stilettos on one edge, located at an angle of 70 ° to the plane of the plate, superimposed on the pineal gland and directed towards its center. The length of the stylet is 8 mm, the thickness is 1.5 mm, the width is 2 mm, their ends are pointed, the distance between the stylet is 5 mm (Fig. 1, item 2). The patch of the plate has 2 holes: one is round in shape, with a diameter of 3.5 mm (Fig. 1, pos. 3) and the other is oval in the form of 3.5 × 7 mm (Fig. 1, pos. 4). The distance between the holes is 15 mm. The distance from the round hole to the base of the stylet is 13 mm;

for 12-15 years - the overlay of the plate 50 mm long, 2 mm thick, 9 mm wide (Fig. 1, Item 1) has stilettos on one edge, located at an angle of 70 ° to the plane of the plate, superimposed on the pineal gland and directed to to its center. The length of the stylet is 12 mm, the thickness is 2 mm, the width is 3 mm, their ends are pointed, the distance between the stylet is 3 mm (Fig. 1, item 2). The patch of the plate has 2 holes: one is round in shape, with a diameter of 3.5 mm (Fig. 1, pos. 3) and the other is oval in the form of 3.5 × 7 mm (Fig. 1, pos. 4). The distance between the holes is 20 mm. The distance from the round hole to the base of the stylet is 20 mm.

The proposed plate for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radial bone in children is used as follows. After identifying the site of fracture of the radius and comparing its fragments, plate stilettos are introduced into the pineal gland (figure 2, position 1). After that, through the oval hole of the plate at the proximal edge of the hole screw the cortical screw (figure 2, position 2) to the full length, thereby achieving compression of the fragments. The next step is to screw a cortical screw (Fig. 3, item 1) through a round hole in the plate, thereby achieving rigid fixation of fragments of the radius.

Advantages of the plate for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radial bone in children:

- eliminates the possibility of damage to the distal radius of the radius;

- achieved stable compression of fragments of the radial bone, which eliminates additional trauma to the growth zone in the process of postoperative treatment;

- the terms of external immobilization are reduced, since the compressive stability of the fragments allows them to be reduced and early functional recovery treatment to begin;

- eliminates the possibility of damage to the articular cartilage of the wrist joint.

Example 1. Vladimir 3., 10 years old (IB No. 4119), was admitted to the children's traumatology department of the Children's Clinical Hospital of Khabarovsk No. 27.08.01 with a diagnosis of closed distal osteoepiphysiolysis of the right radius with displacement of fragments; closed fracture of the right ulnar bone in the lower third with the displacement of fragments; Closed transcondylar fracture of the right humerus with displacement of fragments. Under general anesthesia, an operation was performed - open reduction and fixation of fragments of the radial bone with a plate for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radial bone in children. The postoperative period was uneventful, wound healing occurred by primary intention. The child was discharged from the hospital on the 14th day for outpatient treatment by a traumatologist. Examined 1.5 months after surgery: no complaints, range of motion in the wrist joint is complete, the anatomical axis of the limb is correct. X-ray: the fusion of fragments of the radius, the ratio of the bone anatomical formations of the wrist joint is correct.

Example 2. Kirill L., 10 years old (IB No. 431), was admitted to the children's traumatology department of Children's Clinical Hospital No. 2 of Khabarovsk on 08.20.01 with a diagnosis of closed distal osteoepiphysiolysis of the left radial bone with fragment displacement. Under general anesthesia, an operation was performed - open reduction and fixation of fragments of the radial bone with a plate for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radial bone. The postoperative period was uneventful, wound healing occurred by primary intention. The child was discharged for outpatient treatment on the 17th day after surgery. Examined 2 months after surgery: no complaints, range of motion in the wrist joint is complete, the anatomical axis of the limb is correct. Radiological: complete fusion of fragments of the radius, the ratio of the bone anatomical formations of the wrist joint is correct.

Claims (1)

A plate for osteosynthesis of epiphysiolysis and osteoepiphysiolysis of the radial bone in children, consisting of an overlay part and having holes for screws, characterized in that the overlay part is made in the form of a rectangle, at one end of which two stylet are made at an angle of 70 ° to the plane of the plate, the tips of which are directed to the center of the plate, on the plate there are two holes: one is round in shape with a diameter of 3.5 mm and the other is oval with dimensions of 3.5 × 7.0 mm, the distance between the holes is 15 mm for the plate for children 7-11 years old, and for plates for For 12-15 years, this distance is 20 mm, while the size of the stylet is: width 2 mm, thickness 1.5 mm, length 8 mm for children 7-11 years old, and for children 12-15 years old these dimensions are 3 mm, 2 mm, 12 mm, the surface of the plate has a width of 9 mm, a thickness of 1.5 mm, a length of 30.0 mm for children 7-11 years old, and for children 12-15 years old a width of 9 mm, a thickness of 2 mm, a length of 50, 0 mm

Images