RU2361533C1 - Method of bone fragment fixation - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to traumatology and orthopedics. Fragment fixation is performed by means of one flexible fixer, which is successively passed through two crossing at different levels channels, on leaving each of the channels it is additionally fixed with possibility of tightening on support of compression- distraction apparatus. Method ensures enhancing fixation rigidity and ability to control bone fragments position, reduction of number of applied fixing elements and possibility to support their even tightening in course of whole period of osteosynthesis.

EFFECT: enhancing fixation rigidity and ability to control bone fragments position, reduction of number of applied fixing elements and possibility to support their even tightening in course of whole period of osteosynthesis.

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Description

The invention relates to medicine and can be used in the treatment of patients with an orthopedic and traumatic profile.

A known method of osteosynthesis, providing transosseous, cross-conducting the spokes through the fixed bone fragments with their subsequent tension and fixation on the support of the compression-distraction apparatus (Simultaneous lengthening of both legs by double partial compactotomy of the tibia according to G.A.Ilizarov as the first stage of growth growth in patients achondroplasia. Method. Recommendations. - Kurgan, 1988. - 26 p.).

However, with this method of osteosynthesis, it is impossible to uniformly tension the spokes, which can negatively affect the stiffness of fixation. In addition, the fixing elements often injure the patient himself and the hands of surgeons, exposing them to the risk of infection with a number of diseases.

A known method of osteosynthesis using an external fixation apparatus, in which rods with threaded cutting of working ends are inserted into bone fragments (Montichelli G., Spinelli R. Limb lengthening by epiphyseal distraction. // International Orthopedics, vol. No. 5, No. 2, 1981 )

However, the disadvantage of this method of osteosynthesis is increased trauma and insufficient rigidity of fixation of fragments, which is due to the cantilever fastening of the fixation rods, as well as the possibility of development of bone resorption in the places of their introduction.

A known method of osteosynthesis, providing for the fixation of bone fragments by forming intraosseous channels and introducing flexible fixators into them, the ends of which are tensionably mounted on the support of the compression and distraction apparatus (AS USSR No. 1138142, publ. 07.02.85, bull. No. 5 )

However, this method is intended primarily for the longitudinal movement of the fragment selected for defect replacement and does not provide sufficient stability of the position of the bone fragments during their multi-plane movement.

The objective of the invention is to develop a method that increases the rigidity of fixation and controllability of the position of bone fragments by reducing the number of used locking elements and the ability to maintain their uniform tension during the entire period of osteosynthesis.

This problem is solved by the fact that in the method of fixing a bone fragment, including the formation of transosseous channels, introducing flexible fixators into them and securing them with the possibility of tensioning on the support of a compression-distraction apparatus, the fixation of the fragment is carried out with one flexible fixator, sequentially conducted through at least two intersecting at different channel levels, and at the output of each channel it is additionally fixed on a support with the possibility of sliding.

The method is illustrated by the description and the drawing, which shows a diagram of the fixation of a bone fragment.

The method is as follows.

After anesthesia and treatment of the surgical field, in a segment of a limb, at each of its fixation levels, with the help of an electric drill and a smooth needle with a sharpening with a diameter of 1.0-1.5 mm, at least two channels intersecting at different levels are simultaneously formed with simultaneous passage through them flexible retainer. For this, after insertion into the bone and exit from the soft tissues on the opposite side of the segment of the sharpened part of the spoke, one of the ends of the flexible retainer is attached to its opposite end and, removing the spoke in the course of its introduction, it is passed through the formed channel. The end of the latch is rigidly mounted on the support of the compression-distraction apparatus, and its transversely held part is fixed to the same support with the possibility of sliding, for example, by means of one or more guide rollers. After that, in a similar way, somewhat more distal or proximal to the first, cross to it, the second channel is formed and the free part of the flexible retainer is passed through it. The number of channels formed through which the flexible fixture is passed can be more than two - three, four - depending on the size of the fragment, the level of fixation, the treatment problem to be solved, etc. Upon leaving the last channel, the flexible retainer is pulled, stabilizing the position of the fragment, and its second end is fixed on the support with the possibility of additional tension during osteosynthesis.

In a similar manner, the fragment is fixed at a different level with the flexible retainer fastened to the second support.

The method can be used both for fixing bone fragments due to their traumatic damage, and for fixing bone fragments isolated as a result of an osteotomy for orthopedic reconstruction of pathologically altered limb segments.

Using the proposed method in the clinic RSC "WTO" them. Acad. G.A. Ilizarova shows that its use in the treatment of orthopedic and traumatological patients provides an increase in the rigidity of fixation and controllability of the position of bone fragments.

Claims (1)

A method of fixing a bone fragment, including the formation of transosseous channels, introducing flexible fixators into them and securing them with the possibility of tensioning on the support of a compression-distraction apparatus, characterized in that the fixation of the fragment is carried out with one flexible fixer, sequentially conducted through at least two channels crossing at different levels, moreover, after exiting from each channel, it is additionally fixed on the support with the possibility of sliding.