RU2332185C1 - Device for tibia condyle osteosynthesis - Google Patents

Abstract

FIELD: medicine; traumatology.

SUBSTANCE: device includes T-shape plate with holes for cortical and compression screws in the transverse and longitudinal T-sections. One of the holes for compression screw is oblong, holes for compression screws in the transverse section have larger diametre. One end of the transverse section of T-shaped plate is longer and is bent arc-wise. Radius of arc-wise bent curvature corresponds to the contour of rear part of tibia condyle. Internal surface of longer end of the transverse section features resetting fixation tenons.

EFFECT: reduction of surgical dissection with possibility to catch rear end of a condyle fragment with further resetting and fracture compression zone formation in case of rear lateral tibia condyle fractures.

2 dwg

Description

The present invention relates to medicine, namely to traumatology and orthopedics, and can be used for osteosynthesis in fractures of the posterolateral divisions of the tibial condyles.

A device is known, for example, a supporting L-shaped plate containing two strips of larger and smaller sizes, perpendicular to each other, with holes for screws. There are six screw holes on the long bar, two holes (1) on the short bar.

Closest to the proposed is a device for osteosynthesis of tibial condyles fractures, made in the form of a supporting T-shaped plate containing two strips: longitudinal - longer and transverse - shorter. The longitudinal and transverse planks are perpendicular to each other and have screw holes. The middle of the transverse strip of the T-shaped plate coincides with the central axis of the longitudinal strip (2).

However, the known device for the osteosynthesis of the tibial condyles has significant disadvantages:

- it is impossible to perform atraumatic reposition and fixation of bone fragments in the posterolateral tibial condyle due to possible damage to closely located neurovascular structures of the knee joint;

- do not provide sufficient stability during the reposition of bone fragments, since in case of fractures in the posterolateral tibial condyle, known structures fix bone fragments only in one plane - along the lateral surfaces;

- does not allow to achieve a compressive effect, especially with a multi-split fracture;

- early development of movements in the knee joint due to loss of stability and rigidity of fixation of the fracture is excluded.

Based on an analysis of the current level of technology and the identified deficiencies inherent in known devices for osteosynthesis in case of fractures of the posterolateral tibial condyles, the task was posed: to ensure that fractures in the posterolateral tibial condyles reduce the surgical incision if it is possible to hook the condylar fragment and then repon him, as well as the creation of compression of the fracture zone.

The problem is solved as follows.

A device for osteosynthesis of the tibial condyle contains a T-shaped plate with holes for cortical and compression screws on the longitudinal and transverse bars, one of the holes being elongated for the compression screw, holes on the transverse bar have a larger diameter for compression screws. New in solving this problem is that the transverse lath of the T-shaped plate is elongated on one side and curved in an arcuate manner, while the radius of curvature of the arcuate bend corresponds to the contours of the posterior condyle of the tibia, and repairing fixing spikes are made along the inner surface of the elongated part of the transverse lobe .

We explain the essential distinguishing features of the proposed device.

The execution of the transverse bar of a T-shaped plate elongated on one side and curved with a radius of curvature of the arcuate bend corresponding to the contours of the posterior condyle of the tibia is necessary for tight coverage of the entire perimeter of the posterolateral condyle without increasing the invasiveness of the operation.

The presence on the inner surface of the elongated part of the longitudinal bar of fixing, repairing spikes allows to repair fragments during fractures of the condyles of the tibia in the posterolateral sections, create compression in the fracture zone, and perform stable osteosynthesis with the proposed device.

The patent studies on subclasses А61В 17/56, 17/80 and the analysis of scientific and medical literature reflecting the state of the art in the field of devices for osteosynthesis for fractures of the tibial condyles in the posterolateral sections did not reveal identical designs. Thus, the proposed device is new.

The interconnection and interaction of the essential distinguishing features of the proposed technical solution ensures the achievement of a new technical medical result in solving the problem, namely: to ensure that in case of fractures in the posterolateral tibial condyles, the surgical incision is reduced if it is possible to grab the condyle fragment by the posterior region and then repair it, and also creation of compression of the fracture zone.

It creates conditions for the early development of movements in the knee joint after surgical treatment, and also prevents the displacement of fragments, which cannot be solved by a simple engineering solution and does not explicitly follow from the existing level of technology. Thus, the proposed technical solution has an inventive step.

The proposed device is industrially applicable in the field of practical health care, since it does not require exceptional and extraordinary means for its implementation. It can be used in traumatology and orthopedics for surgical interventions on the joints, which include the element of reposition and fixation of fragments during fractures of the condyles of the tibia in the posterolateral sections of the tibia.

The essence of the design of the proposed "Device for osteosynthesis of the tibial condyle" is illustrated by drawings, which show:

- figure 1 - General view of the device,

- figure 2 is a device fixed on the posterolateral surface of the condyle of the tibia.

A device for osteosynthesis of the tibial condyle is made in the form of a T-shaped plate having a longitudinal bar 1 and a transverse bar 2 (with respect to the long axis of the tibia). The longitudinal bar 1 is placed in relation to the transverse bar 2 at a right angle and has a bend in the upper part in accordance with the contour of the tibial condyle. On the longitudinal 1 and transverse 2 slats of the T-shaped plate, holes 3 and 4 are made for accommodating screws (not shown). Moreover, one of the holes 5 is made elongated under the compression screw. The holes 3 on the transverse bar 2 have a larger diameter for the compression screws for more rigid fixation in the condyles.

The transverse bar 2 is elongated to the right or left (depending on damage to the inner or outer condyle of the tibia) and has an arcuate end 6, and the radius of curvature of the arcuate bend corresponds to the contours of the posterolateral condyle of the tibia. On the inner surface of the curved end 6 of the arcuate bend of the transverse strip 2 of the T-shaped plate, fixing reponent spikes 7 having a length and diameter of 2 mm are made.

Apply the proposed device as follows.

After processing the surgical field, external projection access to the tibial condyle is performed. When a condyle fracture is detected, a T-shaped plate is placed in the posterolateral part. In this case, the arcuate curved end 6 of the transverse bar 2 is led beyond the posterior condyle under the collateral ligament. Then, under the control of the arthroscope, the bone fragment is repaired with a T-shaped plate using repairing fixing spikes 7 located on the curved end 6 of the transverse plate 2. After reposition of the bone fragments, the transverse 2 and longitudinal 1 plates of the T-shaped plate are fixed with cortical screws and compression screws through the corresponding holes 3, 4 and 5 of the strips 1 and 2. The holes 3 on the transverse bar are made of a larger diameter for introducing compression screws under the articular surface of the condyles.

The wound is sutured in layers, drainage is performed according to Redon.

Thus, the proposed "Device for osteosynthesis of the tibial condyle" allows, in comparison with the known constructions, to provide the most accurate atraumatic, arthroscopic reposition of the fracture in the posterolateral tibial condyle, as well as to create compression of the fracture zone and to prevent re-displacement of fragments during the development of movements in the knee joint .

Information sources

1. L-shaped support plate, catalog “Implants. Instruments. Endoprostheses. External fixation devices. Electromechanical tools. " 2005, NGO DEOST Pushchino-on-Oka, page 32, tool code 24.35.87.

2. T-shaped support plate, catalog “Implants. Instruments. Endoprostheses. External fixation devices. Electromechanical tools. " 2005, NGO DEOST Pushchino-on-Oka, page 32, tool code 24.35.135.

Claims (1)

A device for osteosynthesis of the tibial condyle, containing a T-shaped plate with holes for cortical and compression screws on the longitudinal and transverse bars, one of the holes being elongated under the compression screw, the holes on the cross plate have a larger diameter for compression screws, characterized in that the transverse bar of the T-shaped plate is elongated on one side and curved in an arc, while the radius of curvature of the arc-shaped bend corresponds to the contours of the posterior condyle of the condyle of the tibia, and on the inner surface of the elongated portion of the transverse lath, repairing fixing spikes are made.

Images