RU2269964C2 - Device for introducing two-rod holders into bone - Google Patents

Abstract

FIELD: medicine; traumatic surgery; orthopedics.

SUBSTANCE: device has tube with sharpened working end and pusher. Tube has handle at thickened end. Sharpened end of tube is slanting. Gleam of tube is made in form of four cross-shaped longitudinal channels communicating with each other through longitudinal slots along center. Longitudinal channels are intended for passing guiding and drilling needles through, as well as pusher and rods of two-rod holder. Width of any slot is smaller than diameter of needle but larger than thickness of rod. Rods of two-rod holders can be directed into bone in more precise manner.

EFFECT: improved quality of paracentetic osteosynthesis.

2 cl, 5 dwg

Description

The invention relates to medicine, namely to traumatology and orthopedics, and is intended for surgical treatment of patients mainly with fractures of the femoral neck.

Known guide needle to improve the accuracy of the direction of insertion of the retainer-three-lobed nail into the head of the femur, containing a rod with a pointed working end and with flattening on the sides at the other end (Kaplan A.V. Closed injuries of bones and joints. Second supplemented and revised edition. M .: Medicine, 1967, p. 318-320).

The disadvantage of this device is the impossibility of passing through it a two-rod retainer, and when introduced nearby, the divergence or convergence of its rods and the insufficiently controlled direction of their entry into the bone, which does not contribute to improving the quality of puncture osteosithesis by more accurately directing the rods of the double rod clamps into the bone.

A device is known for guiding the introduction of knitting needles into bone fragments, including two parallel tubes connected to each other at a certain distance and placed outside the wound without immersion in soft tissue (Kaplan A.V., ibid., P. 54, Fig. 13).

The disadvantage of this device is the low accuracy of conducting a double-rod retainer through it, the possibility of divergence or convergence of its rods in the cavity of the guide and the insufficiently controlled direction of their entry into the bone, which does not improve the quality of puncture osteosynthesis by more accurately directing the rods of the double-rod fixators into the bone.

Known according to the patent of the Russian Federation No. 1826873 a hollow guide in the form of a tube with an obliquely pointed working end for introducing it into soft tissues and through it osteosynthesis with a single rod retainer.

The disadvantage of this device is the low accuracy of passing through it a two-rod retainer, the possibility of divergence or convergence of its rods in the cavity of the guide and the insufficiently controlled direction of their entry into the bone, which does not contribute to improving the quality of puncture osteositis by more accurately directing the rods of the two-rod clamps into the bone.

Known hollow needle according to the patent of the Russian Federation 12159591 for the sequential insertion through it into the bone of several single-rod clamps, including a tube with an obliquely pointed working end for insertion into soft tissues, and through the lumen of the tube, the introduction of several single-rod clamps into the bone tissue.

The disadvantage of this device is the low accuracy of the passage through it of a two-rod retainer with pointed working ends and rods fastened with a gap between them. In the cavity of such a guide, the rods can diverge or converge without a sufficiently controlled direction of their entry into the bone, which does not contribute to improving the quality of puncture osteosynthesis by more accurately directing the rods of the two-rod fixators into the bone.

A device according to the patent of the Russian Federation No. 2210331 is known, which includes knitting needles, a tube with a pointed working end for introducing through it a two-rod retainer containing two pointed rods connected to each other at the other end.

The disadvantage of this device is the low accuracy of holding a latch through it with two pointed rods fastened with a gap between them. In the cavity of such a guide, the rods can diverge or converge without a sufficiently controlled direction of their entry into the bone, which does not contribute to improving the quality of puncture osteosynthesis by more accurately directing the rods of the two-rod fixators into the bone.

The closest in technical essence to the proposed device is a device according to the patent of the Russian Federation No. 2210331, which we take as a prototype, and its disadvantages are described above.

The technical result consists in improving the quality of puncture osteosynthesis by more accurately directing the rods of the two-rod fixators into the bone.

The technical result is achieved by the fact that the device for introducing double-rod fixators into the bone includes a tube with a pointed working end. Moreover, it is equipped with a pusher, the tube is made with a handle at the thickened end, the pointed end of the tube is oblique, and the tube lumen is made in the form of four crosswise placed longitudinal channels communicating in the center through the longitudinal slots. At the same time, the longitudinal channels are intended for guiding and drilling knitting needles, pusher and rods of a double-rod retainer, the width of each of the slots is less than the diameter of the spoke, but more than the thickness of the rod.

In a preferred embodiment, the pusher is made longer than the tube and with a width that allows it to be introduced simultaneously through two opposite channels in the tube.

The essence of the technical solution and a specific example of the device is illustrated by drawings. Figure 1 shows the device, side view. Figure 2 is the same, top view. Figure 3 is the same, rear view. Figure 4 is an enlarged detail of the device is a tube, rear view. Figure 5 is the same with the spokes and the retainer inserted into the device.

Figure 1-5 marked: 1 - tube; 2 - thickening on the tube; 3 - the sharp end of the tube; 4 - a blunt edge of a cut of a tube; 5 - oblique slice of the working end of the tube; 6 - pen; 7 - a lateral groove in the thickening of the tube; 8 - upper groove in the thickening of the tube; 9 - upper longitudinal channel in the tube; 10 - the right longitudinal channel in the tube; 11 - lower longitudinal channel in the tube; 12 - left longitudinal channel in the tube; 13 - restrictive left upper protrusion; 14 - restrictive right upper protrusion; 15 - restrictive right lower protrusion; 16 - restrictive left lower protrusion; 17 - left knitting needle; 18 - the right knitting needle; 19 - latch.

They work like this. Through the designated area, guide needles are transdermally inserted into the bone and radiography is performed. From the pictures determine the more appropriate needle located in the bone, for example 17, the remaining needles are removed. The transdermally located end of the spokes 17 is passed into the channel 12 of the device, leaving its blunt end outside, and the soft tissue is pierced with a tube 1 until it stops in the bone. A second spoke 18 is introduced through channel 10. A cortical bone layer is drilled through the channels 9 and 11 with a needle and this drilling needle is removed. One rod of the two-rod retainer is inserted through the channel 11 of the tube, and the other through the channel 9 into the holes drilled in the bones. The pusher hammer the two-rod retainer into the bone. The spokes 17 and 18 are removed. The rods of the second two-rod retainer, which are also additionally clogged with a pusher, are inserted into the holes remaining from them in the cortical bone layer. If necessary, one suture is applied to the wound.

The significance of the differences of the invented device is as follows. The implementation of the lumen of the tube in the form of four crosswise placed longitudinal channels allows four rods of guide spokes and retainers to be inserted through one tube. The presence of a message in the center of the four channels in the tube through the longitudinal slots provides the possibility of introducing two double-rod clamps through one tube without changing its position on the bone, which increases the accuracy of their insertion and eliminates the divergence of the rods when they pass through the tube. Performing the width of each of the slots less than the diameter of the spokes eliminates its exit beyond the channel. The implementation of the width of each of the slots more than the thickness of the rod provides the possibility of passing through them part of the retainer connecting the rods, and passing during insertion of the retainer into the bone simultaneously through two channels in the tube and through two slots. Performing a channel diameter greater than the thickness of the spoke does not prevent its passage through the channel. In a preferred embodiment of the device, the execution of the pusher longer than the tube provides the possibility of striking it when driving the retainer without longitudinal impact on the tube. The thickness of the pusher is less than the distance between the limiting protrusions allows him to pass between them. The implementation of the width of the pusher is less than the distance between the opposite walls of the channels in the tube allows you to enter it simultaneously through two opposite channels in the tube. Thus, the claimed device in the aggregate of its features provides an increase in the quality of puncture osteosynthesis by more accurately directing the rods of the two-rod fixators into the bone. Using the invented device reduces the time spent on staff and creates an economic effect.

The application of the invention is possible in pediatric and field surgery.

Claims (2)

1. A device for introducing double-rod retainers into the bone, including a tube with a pointed working end, characterized in that it is equipped with a pusher, the tube is made with a handle on the thickened end, the pointed end of the tube is oblique, and the tube lumen is made in the form of four crosswise placed longitudinal channels communicating in the center through the longitudinal slots, while the longitudinal channels are designed to guide and drill the spokes, pusher and rods of the two-rod retainer, the width of each and slits smaller diameter needles, but greater web thickness. 2. The device according to claim 1, characterized in that the pusher is made longer than the tube and with a width that allows it to be introduced simultaneously through two opposite channels in the tube.

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