RU2299697C1 - Tendon passer - Google Patents

Abstract

FIELD: traumatic surgery; orthopedics.

SUBSTANCE: tendon passer can be used for putting tendon or tendon transplant through bone-fibrous channel. Tendon passer has handle, operation plate and through opening for putting thread through. Operation plate is made flexible and it has external thread at its end for connecting removable tip-bougie and tip-stop. Tip-bougie is made in form of olive provided with internal thread. Tip-stop is made in form of hollow truncated cone provided with internal thread at area of vertex of cone. Through opening for passing thread through is disposed at area of cone's base and it is made lateral. Tendon passer provides smooth bouginage of walls of bone-fibrous channel and section of tendon when putting tendon through bone-fibrous channel.

EFFECT: improved efficiency f operation.

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Description

The invention relates to medicine, in particular to traumatology and orthopedics, and can be used to conduct a tendon or tendon graft through a bone-fibrous canal.

Known conductors for conducting tendons through the bone-fibrous canal [1, 2], including a handle, a working plate with a rounded end and a retainer.

The disadvantages of these conductors is significant trauma to the walls of the bone-fibrous canal and a cut of the tendon when the latter is passed through the bone-fibrous canal.

A tendon conductor is proposed that provides smooth bougienage of the walls of the bone-fibrous canal and protection of the tendon slice when passing it through the bone-fibrous canal.

The tendon conductor consists of a handle 1 and a flexible working plate 2. At the end 3 of the working plate 2, an external thread 4 is applied to attach a replaceable tip of the bougie 5 and the tip of the retainer 6. The tip of the bougie 5 is made in the form of a metal olive with an internal thread 7 on one from the ends for connecting to the external thread 4 of the end 3 of the working plate 2. The tip-retainer 6 is made in the form of a hollow metal truncated cone with an internal thread 8 in the region of the top of the cone for connecting to the external thread 4 of the end 3 of the working plate 2. Nak the end-fixer 6 in the area of the base of the cone further comprises a through transverse hole 9 for fixing the cut of the tendon.

Figure 1 shows the conductor of the tendon, a General view. Figure 2 shows the tip of the bougie, side view. Figure 3 shows the tip-retainer, side view.

The tendon conductor works as follows. The tip-bougie 5 is attached to the external thread 4 of the end 3 of the working plate 2 by means of an internal thread 7. After that, the manipulation of the handle 1 through the distal wound retrogradely conducts the tendon conductor through the bone-fibrous canal. Moreover, thanks to the flexible plate 2, repeating the bends of the bone-fibrous canal, the tip-bougie 5 provides smooth bougieument of the bone-fibrous canal. After removing the end 3 of the working plate 2 into the proximal wound, the tip-bougie 5 is removed, and the tip-clamp 6 is attached to the external thread 4 of the end 3 of the working plate 2 by means of the internal thread 8. A type of tendon suture is applied to the end of the tendon and the threads are carried a through transverse hole 9 of the retainer-tip 6. By pulling on the threads, make sure that the tendon cut is located inside the retainer-tip 6, after which, by pulling on the handles 1, the tendon is carried out through the bone discord channel.

Example. Patient K., 22 years old, received a cut wound on the flexion surface of the main phalanx of the first finger of the right hand with damage to the tendon of the long flexor of the finger. Taken to the operating room after 2 hours from the moment of injury. On the operation: in the wound area of the main phalanx, the distal end of the damaged tendon was found, the proximal fragment of the wound could not be found. An additional incision bordering the elevation of the thumb, the synovial canal of the tendon of the long flexor I p. Is exposed on the hand; after opening the canal, a proximal fragment of the damaged tendon was found at the level of the middle third of the metacarpal bone, stitched, taken to the holder. Through a wound on a finger, a tendon conductor with an attached bougie tip was drawn into the synovial canal of the tendon of the long flexor I p., The end of the working plate was brought out into the wound in the palm of the hand. The tip-bougie is replaced by a tip-retainer, in the openings of which hollow threads are passed, fixing the proximal segment of the tendon. A tendon slice was placed inside the latch, after which, pulling the handle of the conductor, the proximal fragment of the tendon of the long flexor I p. Was smoothly inserted into the wound on the finger. A microsurgical suture according to Kuneo was applied between the fragments of the tendon, the wounds were sutured in layers tightly. The postoperative period without complications, the wounds healed, the sutures were removed. The function of flexion of the first finger of the right hand fully recovered 5 weeks after surgery.

Literature:

1. Rozov V.I. Damage to the tendons of the hand and fingers and their treatment. - L .: MEDGIZ, 1952. - P.148.

2. Z. 20033119087 (Russia). Tendon conductor / A.V. Fedoseev, V.V. Lapin, D.S. Lobanov. - Declared. 06/24/2003. No. 2003119087/14. Publ. 01/10/2005. IPC А61В 17/00.

Claims (1)

A tendon conductor containing a handle, a working plate and a through hole for conducting the thread, characterized in that the working plate is flexible and has an external thread at the end for attaching a replaceable bougie tip and latch tip, and the bougie tip is made in the form of olive from the inside thread, and the tip-clamp is made in the form of a hollow truncated cone with an internal thread in the region of the apex of the cone, while the through hole for holding the thread is located in the region of the base of the cone and made transverse m

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