RU2344783C1 - Method of calcaneal spur removal and device for method implementation - Google Patents

Abstract

FIELD: medicine; orthopedics and traumatology.

SUBSTANCE: anatomic position of calcaneal spur is defined by electronic optical converter, then a cut at the sole side of foot is made. Trocar is set against apical part of calcaneal spur, head is removed off trocar, a plug is screwed in, and trocar is planter onto the spur by a hit on the plug. Afterwards the plug is removed, a cutter is inserted into the trocar, and spur is cut at the base by drill. To implement the method, a device including cutter, holder and case with through threaded hole, where trocar for soft tissue passage is fixated by nut and thread shank, is used. Trocar features threaded shock plug and threaded sharp head with shock bushing. Sharp head inserted into trocar is removable, and cutter can be installed into trocar.

EFFECT: reduced injury rate of operation, ensured treatment efficiency.

2 cl, 1 ex, 1 dwg

Description

The invention relates to medicine and can be used to eliminate heel spurs.

Ossifying periostitis (calcaneal spur) in the area of attachment of the plantar aponeurosis to the calcaneal tuber is more common in middle-aged people suffering from flatfoot, and is manifested by pain along the medial-plantar surface of the calcaneal tuber due to inflammation of soft tissues surrounding the spur, injured by bone exostosis under stress on the foot.

Known are traditional methods of treating heel spurs - limiting physical activity, physiotherapy (ed. Certificate. USSR # 889016), heat. With the ineffectiveness of these types of treatment, x-ray therapy, local administration of steroids is prescribed. However, against the background of such therapy, the pain syndrome can persist for many months, and sometimes years, which sharply worsens the quality of life of patients.

To ensure unloading of the foot and relieving pain in the heel, in the presence of spurs, special insoles are offered (auth. Certificate. ССС No. 1637793).

To relieve pain, the use of foot baths from celandine is known (US Pat. RF No. 1790411).

To reduce the treatment time for calcaneal bursitis, a cryoapplicator is introduced into the pathological bursitis lesion through a previously drawn needle and cryotherapy is performed until the temperature decreases at the border of the pathological lesion (-7) - (- 12) ° С. In this case, the cannula is inserted all the way into the calcaneus, after which it is pulled 3-5 mm into the bursa tissue (ed. Certificate. USSR # 1491481). The treatment period has been reduced to 5 days.

In medicine and cosmetology, a tool for the treatment of heel spurs in the form of the PLANTAPROSAN balm is used, which has increased penetrating activity and the ability to soften, as well as anti-inflammatory, regenerating, analgesic and resolving effects (Patent RF №2139075). PLANTAPROSAN consists of extract of propolis decoction of white cabbage, chopped beef bones, garlic, alcohol.

There is a method of treating degenerative and destructive diseases of the joints and, for example, calcaneal spurs by introducing subcutaneously, gaseously nitrous oxide in the gaseous state into the area of the affected joint or segment, the volume of injected gas is 700-1000 ml for large joints, and 300-600 ml for small joints ( Pat. of the Russian Federation No. 2239381).

All these measures do not eliminate spurs, they only relieve pain.

A closed compression of the heel spur is known (Shaposhnikov V.I. Materials of the 6th congress of orthopedic traumatologists of the CIS, Yaroslavl - 1993. - p. 418), when under the intravenous anesthesia a closed compression of the calcaneal spur is performed with three to four hammer blows on a metal nozzle (diameter at the end 2 cm), which is tightly pressed to the skin at a painful point in the position of maximum plantar flexion and extension of the fingers. After the manipulation, a fracture of the spur is detected on the radiograph, more often at the sharp end of it. However, such an intervention is traumatic. Due to the fact that the manipulation is closed, softening of the soft tissues between the spur and the metal nozzle softens, as well as damage to the bone structure of the spur (fracture), which increases the duration of rehabilitation treatment.

The closest technical solution to the claimed method is a method of treating a heel spur with a surgical laser (US Pat. RF 2206285). To relieve the pain syndrome, after local anesthesia, a spur, a paraspur box and partially plantar aponeurosis in the area of its attachment to the spur are perforated with a laser for intraosseous anesthesia through a needle. The course of treatment consists of three manipulations (one per week). After each manipulation, the limb is immobilized by a removable plaster cast in the position of plantar flexion. Patients during the treatment period (3 weeks) use crutches. The thermal effect on the tissues surrounding the spur causes their destruction and aseptic inflammation, the outcome of which is obliteration of the bursa and cicatricial-sclerotic degeneration of the tissues surrounding the spur. In addition, during the destruction of sensitive nerve endings die, which leads to the disappearance of pain in the spur immediately after manipulation. Anesthetics are therefore not prescribed.

The aim of the invention is an effective and low-traumatic method for removing heel spurs and a convenient and efficient device for implementing the method.

This goal is achieved by using the method of removing the heel spur by accessing the spur, its destruction and subsequent removal, while first determining the anatomical location of the heel spur using an electron-optical transducer (EOP), then making an incision along the plantar surface of the foot, bringing the trocar to the apical part of the calcaneal spur, remove the tip from the trocar, screw in the plug, due to the impact on which the trocar is placed on the spur, then the cap is removed, the cutter is inserted into the trocar and Using a drill, cut the spur to the base.

To implement the method, a device is used that contains a milling cutter, a holder and a body with a through threaded hole, in which, due to the nut and threaded shank, a trocar is installed for passage in soft tissues, and the trocar is equipped with a threaded plug for impact and a pointed tip with thread and with an impact sleeve, while the pointed tip is inserted into the trocar with the possibility of impact, and the cutter is made for installation in the trocar.

The drawing shows: a) a general view of the device, b) a plug, c) a mill.

The device consists of a holder 1 and a housing 2 with a through threaded hole 3. A trocar 6 is installed in the hole due to a nut 4 and a threaded shank 5. A tip 7 with a threaded shank 8, an impact sleeve 9 and a tip 10 is inserted inside the trocar 6. The device is equipped with a threaded plug 11 with thread 12 and cutter 13.

The method is as follows:

Under the control of the electron-optical transducer "EOP" the anatomical location of the heel spur is determined. Using colored knitting needles affixed beacons. An incision is made along the plantar surface of the foot, depending on the diameter of the selected trocar 6. Trocar 6 is brought to the apical part of the calcaneal spur. The tip 7 is removed from the trocar, the plug 11 is screwed in and under the control of the image intensifier due to the impact on the plug 11, the trocar 6 is mounted on the spur. Then the plug is removed, the cutter 13 is inserted and under the control of the image intensifier with the help of a drill, the spur is cut off. The spur is removed with the milling cutter. The wound was treated and sutured.

According to this technique, 9 patients were treated. The observation period is 1.5 years. No disease recurrence was observed throughout the observation period.

Example 1. Patient I., 49 years old, was admitted to hospital No. 49 on 08.12.05 with a diagnosis of Calcaneal spur on the left. According to the above scheme, markers were marked and spurs were removed according to the claimed method. Against the background of treatment, pain cider was stopped, the patient was discharged to work in satisfactory condition.

The method allows to reduce the morbidity and ensure the effectiveness of the treatment.

Claims (2)

1. The method of removing the heel spur by accessing the spur, its destruction and subsequent removal, characterized in that the anatomical location of the heel spur is first determined using an electron-optical transducer, then an incision is made along the plantar surface of the foot, a trocar is brought to the apical part of the heel spur, the tip is removed from the trocar, the cap is screwed in, due to the impact on which the trocar is mounted on the spur, then the cap is removed, the cutter is inserted into the trocar and the spur is cut to the base with a drill. 2. The device for implementing the method according to claim 1, containing a milling cutter, a holder and a body with a through threaded hole, in which, due to a nut and a threaded shank, a trocar is installed, made for passage in soft tissues, the trocar being equipped with a threaded plug for impact and a pointed tip threaded and with a shock sleeve, while the pointed tip is inserted into the trocar with the possibility of removal, and the cutter is made for installation in the trocar.