RU2340304C2 - Device for reposition of pelvic bones - Google Patents

Abstract

FIELD: medicine; orthopedy and traumatology.

SUBSTANCE: device contains a horizontal rack where the screw couplers are established. On one extremity of a horizontal rack, on screw couplers, adjustable laths are established, and on other the mobile lath, with possibility of its movement along a horizontal rack and its bracing by means of a bolt-clamp and the small cavities executed along a horizontal rack is located. On regulated and mobile laths perpendicularly to horizontal rack fixatives for pubic bones in the form of hairpins with lodgments are established on their extremities. The working surface of lodgments is executed on a curve, and from an opposite side of a working surface there is a through groove.

EFFECT: reduction of time for operation, design simplification, convenience in use without additional traumatic result to pelvic bones.

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Description

The invention relates to medicine, namely to traumatology and orthopedics, field surgery.

A device is known, described in the patent of the Russian Federation, No. 2180533, IPC A61B 17/56, dated 02/14/2000, published on 03/20/02, "A method for treating fractures and ruptures of the anterior and posterior pelvic rings with a vertical displacement of the half of the pelvis," ed. Afaunov A.I., Blazhenko A.Ya., Afaunov A.A., Kurinniy S.N. / analogue, where reposition and fixation of fragments of the ileum, and reposition is carried out by applying anchor-spoke blocks to the iliac crests in front in the sagittal plane, additionally fixing the ileal bodies with rods held horizontally in the frontal plane with subsequent connection into a single spatially rigid system screw bars for distraction with a ring fixing the knitting needles drawn through the distal metaphysis of the thigh on the side of the displaced half of the pelvis.

Disadvantages: the bulkiness of the structure, additional trauma to the bones of the pelvis and femur, the permanent fixation of the device on the injured area until recovery.

The closest technical solution known is the description of the patent of the Russian Federation, No. 2153859 C2, IPC A61B 17/60, with a priority of 07/07/1998, publ. 08/10/2000, "Device for repositioning the pelvic bones", ed. Agadzhanyan V.V., Pronskikh A.A., Milyukov A.Yu., Alymov S.V. / prototype /, which consists of movable racks connected by screw ties, where the movable vertical external racks and additional racks installed between them are parallel to each other, the distal ends of the external vertical racks are made with the possibility of attachment to the operating table, the racks are connected by a horizontal rack, with the help of bushings having a reciprocating movement along the aforementioned vertical struts, forming a rigid L-shaped structure while maintaining the mobility of the vertical racks in two x planes, and at the distal ends of the additional racks, perpendicular to them, bushings are rigidly fixed, in which rods with holes for rods implanted in the pelvic bone are mounted on the thread with the possibility of axial three-plane movement, and all bushings on both sides are equipped with locknuts for fixing the racks and rods in position.

Disadvantages: the disadvantage is that the device is attached to the operating table, which increases the operation time, there is an additional destruction of the pelvic bones due to the introduction of the rods of the device, low maneuverability during the operation due to attachment to the operating table, cumbersome design.

EFFECT: shortening the operation time, simplifying the design, ease of use without additional trauma to the pelvic bones, which is achieved by means of the device for repositioning the pelvic bones that contains a horizontal stack on which screw ties are installed, where screw ties are installed on one end of the horizontal rack adjustable straps, and on the other there is a movable strap with the possibility of its movement along the horizontal rack and fixing it by means of a fixing bolt and holes latches made along a horizontal stand, and on adjustable and movable strips, perpendicular to the horizontal stand, fixators for the pubic bones are installed in the form of pins with lodgements at their ends, and the working surface of the lodgement is made in a curve, and there is a through groove on the opposite side of the working surface of the lodgement. Thus, the operation time is significantly reduced due to the rapid reposition of the pelvic bones by laying lodges on them, the working surface of which is made along a curve, further by capturing the upper branches of the pubic bones by adjusting the movable and adjustable trims and clamps, setting them in a predetermined position, as well as due to the simplification and maneuverability of the design. Ease of use is achieved due to the simplicity of the design and the relationship of structural elements. The working surface of the lodgement of the latch reliably rests on the upper branches of the pubic bones due to the working surface made along a curve having the shape of a through curved groove.

Figure 1 shows the device, a top view.

Figure 2 is a side view of the device on page A.

Figure 3 shows the latch with a stud and tool tray, view on page B.

Figure 4 shows a view on page G.

Statics

The device for repositioning the pelvic bones contains a horizontal stand 1, on which are installed screw ties 2, where at one end of the horizontal stands 1 on the screw ties 2 are installed adjustable straps 3, and at its other end is a movable strap 4 with the possibility of its movement along the horizontal strut 1 and fixing it by means of a fixing bolt 5 and holes 6, made along the horizontal strut 1, on adjustable and movable strips 3, 4 perpendicular to the horizontal strut 1, fixators 7 for bones are installed in the form of a spy a nut 8 with lodgements 9 at their ends, the working surface 10 of the lodgement 9 being made in a curve, and on the opposite side of the working surface 10 there is a through groove 11. The handle 12 is located behind the movable film 4 and is connected to a horizontal rack, and on screw ties 2 nuts 13 are installed at their edges, with the help of which the adjustable strips 3 are regulated.

Device operation

In the projection of the discrepancy of the pubic bones, a skin incision is made. The latches 7 mounted on the adjustable strips 3 are superimposed by the working surfaces 10 of the tool holders 9 on the upper branch of the stable pubic bone and are fixed on both sides by adjusting the adjustable strips 3 mounted on the screw ties 2 and clamped by the nuts 13, as well as the adjustment of the latches 7. Movable the strip 4, on which the latch 7 is installed, with the working surface 10 of the lodgement 9 is installed on the upper branch of the pubic bone from the unstable side and is adjusted, and then fixed with the fixing bolt 5 in the hole 6 umbrella stand 1.

The repositioning of the pelvic bones is done by adjusting in the horizontal plane 1 manually, and the elimination of minor displacements is eliminated by means of adjustable and movable straps 3, 4. If the reposition is satisfactory, then after the x-ray examination, the latches 7, which are not located in the locking holes, are rotated 180 ° the pelvic bones, and the fixing plate / not shown /, modeled on the surface of the upper branches of the pubic bones, press it to the pubic bones, while inserting it into the through groove s 11, located on the lodges 9 of the clamps 7. Then, the locking plate is attached to the bones of the pelvis with screws / not shown /. Next, the device is removed and stitched in layers, an aseptic dressing is applied. The device during operation is held by the handle 12.

Example

Patient A., medical history No. 5356/3, was admitted to the trauma department with a diagnosis of concomitant injury, craniocerebral injury, symphysis rupture, closed fracture of the middle third of the left leg with displacement of fragments. Eight days after the relief of nontrological symptoms, osteosynthesis of the lower leg and rupture of the symphysis was performed. Reposition of the pubic bones and their fixation was carried out using the device we proposed for 13-14 minutes. The fixing plate is fixed by six screws. Wounds are washed, sutured in layers, aseptic dressing applied. Result: healing time compared to the prototype at the usual time. However, as a result of the absence of additional devices damaging the skin and ilium, the conditions for patient care were optimized, the volume of dressings decreased and, accordingly, the economic costs of treating the patient decreased, and the quality of his life improved.

Technical and economic indicators

As a result of using the device, the time for repositioning the pelvic bones was reduced by 3-4 times, compared with the prototype, the design was greatly simplified and the usability was improved.

1 - horizontal stand

2 - screw ties

3 - adjustable bar

4 - movable bar

5 - fixing bolt

6 - hole

7 - clamp

8 - hairpin

9 - lodgment under the pubic bones

10 - the working surface of the tool tray 9

11 - through groove under the fixing plate

12 - pen

13 - nut

Claims (1)

A device for repositioning pelvic bones, comprising a horizontal strut on which screw ties are installed, characterized in that adjustable straps are installed on one end of the horizontal strut on screw ties, and a movable strap is located on the other end with the possibility of its movement along the horizontal strut and fixing it by means of a bolt -fixer and holes made along the horizontal strut, and on the adjustable and movable slats perpendicular to the horizontal strut, fixators for the pubic bones are installed in the form of pins with lodges at their ends, the working surface of the lodges made in a curve, and on the opposite side of the working surface there is a through groove.

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