RU2692531C1 - Reposition-fixation support ring for operative treatment of displaced fractures of cotyloid cavity - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: reposition-fixing support ring for surgical treatment of displaced acetabular fractures has a concave shape and holes for insertion of screws. Ring has shape of a hemisphere, external and internal surfaces, two rows of holes in a hemisphere and three flanges with holes for introduction of fixing screws. Flanges are located on the external surface of the hemisphere so that when the ring is placed in the cotyloid cavity two of them are located on the same line connecting the middle of the junction point of the ischial bone and the lower edge of the acetabulum and the inferior endostane of the ilium. First of two flanges is located on that part of external surface of hemisphere of ring, which corresponds to place of upper edge of cotyloid cavity. Second of the two flanges is located on that part of external surface of the hemisphere of the ring, which corresponds to the junction of the ischial bone and the lower edge of the cotyloid cavity. Third flange on the ring is located on that part of the outer surface of the hemisphere, which corresponds to the point of confluence of the front edge of the cotyloid cavity and the horizontal branch of pubic bone and is located on the line connecting the middle of the fusion point of the front edge of the cotyloid cavity and the horizontal branch of pubic bone and the posterior lower tip of the iliac bone. Plane of the first flange is at an angle to the plane of the ring inlet. Plane of the second and third flanges of the ring is in the same plane as the plane of the ring inlet. Holes of three flanges allow additionally fixing fragments of cotyloid cavity to reposition-fixing support ring, which enhances fixing capabilities of ring. First row of holes is located on one line along the edge of the ring inlet, from the edge to the center, and the second row of holes is located on one line, from the first row in the direction towards the hemisphere center. Holes of the second row are located relative to holes of the first row in staggered order. Three groups of holes consisting of two holes of the first and from one hole of the second row are located opposite each of three flanges. Holes of the second row of each of three groups of holes are located on one line of location of corresponding flanges.EFFECT: invention provides surgical management of displaced fractures of cotyloid cavity.1 cl, 23 dwg

Description

The reposition-fixation support ring, refers to medicine, namely for the surgical treatment of displaced acetabular fractures, hip joint arthroplasty, experimental medicine, and biomechanics.

Several devices have been proposed that are implanted into the acetabulum in order to restore its support and biomechanics for defects of the acetabulum of various origins, namely, for defects caused by the development of osteolysis after hip arthroplasty, and for traumatic defects (Fig. 1, 2, 3).

The closest solution to the problem of treatment of displaced acetabular fractures can be achieved by using the Muller ring (Fig. 1), which (which - if we are talking about all three rings - Figs 1, 2, 3) allows you to insert screws into the acetabulum fragments. However, these devices do not allow screws to be inserted into the bone mass of the acetabulum at an acute angle, and the arrangement of the screw insertion holes does not allow concentrating the efforts of fixing various fragments of the acetabulum taking into account the classification of acetabular fractures (Fig. 13) (Muller ME, Allgover M., Schneider R., Willinger X. Guidelines for internal osteosynthesis. - M., 1996. - 756 p.).

The technical result is the development of a reposition-fixation support ring, right and left, for the operative treatment of displaced acetabular fractures.

The technical result is ensured by the fact that it has the shape of a hemisphere, an outer and an inner surface, two rows of holes in the hemisphere and three flanges with holes for insertion of fixing screws, while the flanges are located on the outer surface of the hemisphere so that when you install the right ring in the acetabulum two of them are on the same line connecting the middle of the confluence of the ischial bone and the lower edge of the right acetabulum and the anterior lower spine of the right iliac bone,

at the same time, the first of the two flanges is located on that part of the outer surface of the ring hemisphere, which corresponds to the place of the upper edge of the right acetabulum, and the second of the two flanges is located on that part of the outer surface of the ring hemisphere, which corresponds to the place of confluence of the sciatic bone and the lower edge of the acetabulum right iliac bone, and the third flange on the right ring is located on the part of the outer surface of the hemisphere that corresponds to the confluence of the front edge of the right acetabulum and horiz the ontal branch of the right pubic bone and is located on the line connecting the middle of the confluence of the anterior edge of the right acetabulum and the horizontal branch of the right pubic bone, and the posterior lower spine of the right iliac bone, and the plane of the first flange is at an angle relative to the plane of the ring entrance, the plane the second and third flanges of the ring are in the same plane with the plane of the ring entrance, while the openings of the three flanges make it possible to additionally fix the fragments of the acetabulum to the reposition-fixation support a ring, which enhances the fixation capabilities of the ring,

and for the right ring, the first row of holes is located on one line along the edge of the ring entrance, some distance from the edge to the center, and the second row of holes is located on one line, some distance from the first row towards the center of the hemisphere, and the holes of the second row are located with respect to staggered holes of the first row

moreover, three groups of holes consisting of two holes of the first and one hole of the second row are located opposite each of the three flanges, while the holes of the second row of each of the three groups of holes are located on the same line of the location of the corresponding flanges. The invention is illustrated by the following figures.

FIG. 1. A photo of the acetabular strengthening ring ME. Muller (ME Muller).

FIG. 2. A photo of an acetabular strengthening support ring with a hook from Protek, Switzerland (PROTEK) is presented.

FIG. 3. A photo of the Burkh-Schneider acetabular strengthening ring (N.V. Burch-R. Schneider) is presented.

FIG. 4. A photo of the outer surface of the reposition-fixation support ring for the surgical treatment of displaced acetabular fractures is presented. 1 - outer surface of the ring hemisphere; 3 - the first flange of the support ring; 4 - the second flange of the support ring; 5 - the third flange of the support ring; 6 - openings of the second row located on the longitudinal spine of the corresponding flanges; 7 - openings of the first row; 8 - holes of the second row; 9 - flange holes; 10-technical hole for the manufacture of the ring; 11 - the line of the longitudinal axis of the location of the first and second flanges; 12 - the line of the longitudinal axis of the third flange.

FIG. 5. A photo of the inner surface of the reposition-fixation support ring for the surgical treatment of displaced acetabular fractures is presented. 2 - the inner surface of the ring hemisphere; 3 - the first flange of the support ring; 4 - the second flange of the support ring; 5 - the third flange of the support ring; 6 - openings of the second row located on the longitudinal spine of the corresponding flanges; 7 - openings of the first row; 8 - holes of the second row; 9 - flange holes; 10 - technical hole for the manufacture of the ring; 11 - the line of the longitudinal axis of the first and second flanges; 12 - the line of the longitudinal axis of the third flange; 25 - the plane of the flanges; 31 - edge of the ring wall; 32 - a group of holes consisting

two holes of the first and one hole of the second row, located opposite each of the three flanges.

FIG. 6. Presents a photo of the right Ilium. 13 - right iliac bone; 14 - the line connecting the middle of the place of confluence of the ischial bone and the lower edge of the acetabulum of the right iliac bone, on the one hand, and the anterior lower spine of the right iliac bone, on the other; 15 - ischium; 16 - the middle of the confluence of the sciatic bone and the lower edge (17) of the acetabulum (33); 18 - anterior lower iliac spine; 19 - the upper edge of the acetabulum; 20 - the middle of the confluence of the front edge (21) of the acetabulum and the horizontal branch of the right pubic bone (22); 23 - the line connecting the middle of the confluence of the front edge of the right acetabulum and the horizontal branch of the pubis and the posterior lower spine of the right iliac bone; 24 - posterior lower iliac spine, 33 - acetabulum.

FIG. 7. A photo of the right repositional-fixation support ring mounted on the acetabulum of the right ilium is presented. 3 - the first flange of the support ring; 4 - the second flange of the support ring; 5 - the third flange of the support ring; 13 - right iliac bone; 14 - the line connecting the middle of the place of confluence of the ischial bone and the lower edge of the acetabulum of the right iliac bone, on the one hand, and the anterior lower spine of the right iliac bone, on the other; 15 - ischium; 16 - the middle of the confluence of the sciatic bone and the lower edge (17) of the acetabulum (33); 18 - anterior lower iliac spine; 19 - the upper edge of the acetabulum; 20 - the middle of the confluence of the front edge (21) of the acetabulum and the horizontal branch of the right pubic bone (22); 23 - the line connecting the middle of the confluence of the front edge of the right acetabulum and the horizontal branch of the pubis and the posterior lower spine of the right iliac bone; 24 - posterior lower spine of the ilium; 31 - edge of the ring wall; 33 - acetabulum; 32 - a group of holes consisting of two holes of the first and one hole of the second row, located opposite each of the three flanges.

FIG. 8. A photo of one of the lateral external surfaces of the reposition-fixation support ring for the operative treatment of displaced acetabular fractures is presented, with the deviation of the deflection angle of the plane of the first flange relative to the plane of the ring entrance. 6 - openings of the second row located on the longitudinal spine of the corresponding flanges; 7 - openings of the first row; 8 - holes of the second row; 25-plane flanges; 26 - line indicating the deviation of the plane of the first flange relative to the plane of the ring entrance - 28; 27 - the deflection angle of the plane of the first flange relative to the plane of the entrance ring; 28 - the line denoting the plane of the ring entrance; 31- edge of the ring wall.

FIG. 9. A photo of one of the lateral external surfaces of the reposition-fixation support ring for the operative treatment of displaced acetabular fractures is presented, with the deviation of the deflection angle of the plane of the first flange relative to the outer surface of the ring. 25-plane flanges; 26 - line indicating the deviation of the plane of the first flange relative to the plane of the ring entrance - 28; 29 - the deflection angle of the plane of the first flange relative to the outer surface of the ring; 30 is a line indicating the angle of inclination of the outer surface of the ring.

FIG. 10. A photo of one of the lateral external surfaces of the reposition-fixation support ring for the operative treatment of displaced acetabular fractures is presented, with the location of the third flange plane relative to the ring entrance plane. 4 - the second flange of the support ring; 5 - the third flange of the support ring; 28 - the line designating the plane of an entrance of a ring.

FIG. 11. A photo of the acetabulum fracture scheme B2.2 according to the international classification AO / ASIF is presented. Transverse fracture of the acetabulum. Fracture of the posterior colony pelvis. Fracture of the anterior colony pelvis. 34 - the main fragment of the damaged acetabulum associated with the ileum - 13; 35 - part of the articular surface of the acetabulum (33); 36 is the transverse acetabular fracture line; 37 - the rear pelvis column; 38 - the line of fracture of the pelvic posterior column; 39 - front pelvic column; 40 - the line of fracture of the anterior column of the pelvis.

FIG. 12. A photo of a mock-up of the right iliac bone with modeling of acetabular fracture B2.2 according to the AO / ASIF international classification with a diastasis between fragments is presented. 34 - the main fragment of the damaged acetabulum associated with the ileum - 13; 35 - part of the articular surface of the acetabulum; 37 - the rear pelvis column; 39 - front pelvic column.

FIG. 13. A photo of the model with repaired acetabular fragments is presented. 34 - the main fragment of the damaged acetabulum associated with the ileum - 13; 35 - part of the articular surface of the acetabulum; 37 - the rear pelvis column; 39 - front pelvic column.

FIG. 14. A photo of the model with repaired acetabular fragments and an established reposition-fixation support ring is presented. 3 - the first flange of the support ring; 4 - the second flange of the support ring; 5 - the third flange of the support ring; 13 - right iliac bone; 15 - ischium; 17 - the place of confluence of the sciatic bone and the posterior edge of the right acetabulum; 18 - anterior lower iliac spine; 20 - the middle of the confluence of the front edge (21) of the acetabulum and the horizontal branch of the right pubic bone (22);

34- the main fragment of the damaged acetabulum associated with the ileum; 37 - the rear pelvis column; 39 - front pelvic column.

FIG. 15. Presented a photo of the model with a fixed fixed repositional - fixation support ring. 3 - the first flange of the support ring; 4 - the second flange of the support ring; 5 - the third flange of the support ring; 9 - flange holes; 13 - right iliac bone; 15 - ischium; 18 - anterior lower iliac spine; 22 - the horizontal branch of the right pubic bone; 32- ring hole group; 34- the main fragment of the damaged acetabulum associated with the ileum; 37 - the rear pelvis column; 39 - front pelvic column; 41 - screws; 42 - awn sciatic bone.

FIG. 16. A photo is presented with outlines of the cut and contour of the large skewer.

FIG. 17. Presents a photo of the skin incision and muscle tensioning the fascia of the thigh along the outer surface of the left spit area.

FIG. 18. A photo of modeling on the cadaveric material of the acetabular fracture B2.2 according to the AO / ASIF international classification by means of the acetabulum osteotomy is presented. 34- the main fragment of the damaged acetabulum associated with the ileum; 36 is the transverse acetabular fracture line; 37 - the rear pelvis column; 38 - the line of fracture of the pelvic posterior column; 39 - front pelvic column; 40 - fracture line of the anterior column of the pelvis; 43 - the big spit.

FIG. 19. A photo of the installation of the repositioning-fixation support ring in the acetabulum is presented with the introduction of a screw into the main fragment of the acetabulum through one of the group of holes in the first flange of the ring. 3 - the first flange of the support ring; 5 - the third flange of the support ring; 32 — a group of holes in the region of the first and second flanges; 34- the main fragment of the damaged acetabulum associated with the ileum; 41 - screw; 43 - the big spit.

FIG. 20. Presents a photo of the introduction of the screw into the posterior column of the acetabulum through one of the group of holes in the second flange of the ring. 32 — a group of holes in the region of the second flange; 32 — a group of holes in the region of the first and second flanges; 34- the main fragment of the damaged acetabulum associated with the ileum; 39 - pelvic posterior column; 41 - screw; 43 - the big spit.

FIG. 21. Presents a photo of the introduction of the screw into the anterior column of the pelvis of the acetabulum through one of the group of holes of the third ring flange. 3 - the first flange of the support ring; 5 - the third flange of the support ring; 32 — a group of holes in the region of the third flange; 34- the main fragment of the damaged acetabulum associated with the ileum; 41 - screw; 43 - the big spit.

FIG. 22. A photo of the screwed screws is presented, with simultaneous tightening of the rear and front columns to the ring. 3 - the first flange of the support ring; 32 — a group of holes in the region of the first second and third flanges; 34- the main fragment of the damaged acetabulum associated with the ileum; 41 - screw; 43 - the big spit.

FIG. 23. Presents a photo of the inserted screws through the holes of the flanges. 3 - the first flange of the support ring; 5 - the third flange of the support ring; 34- the main fragment of the damaged acetabulum associated with the ileum; 41 - screws; 43 - the big spit.

The device contains the following elements

has the shape of a hemisphere (Fig. 4), an outer (Fig. 4-1) and inner (Fig. 5-2) surface, two rows of holes in the hemisphere (Fig. 4 - 6, 7, 8; Fig. 5 - 6, 7, 8) and three flanges on the outer surface of the hemisphere (Fig. 4 - 3, 4, 5; Fig. 5 - 3, 4, 5) with holes for insertion of fixing screws (Fig. 4 - 9; Fig. 5 - 9 ) and technical hole (Fig. 4 - 10; Fig. 5 - 10), while the flanges are located on the outer surface of the hemisphere so that when you install the right ring in the acetabulum (Fig. 6 - 33) right (Fig. 6, 7-13) Ilium bone, two of them, the first and second (Fig. 4 - 3, 4, Fig. 5 - 3, 4), are on the same line (Fig. 6, 7 - 14), connecting the middle of the confluence (Fig. 6, 7 - 16) of the ischial bone (Fig. 6, 7 - 15) and the lower edge (Fig. 6, 7 - 17) of the acetabulum (Fig. 6 - 33) of the right iliac bone (Fig. 6, 7 - 13) the anterior lower spine (Fig. 6, 7 - 18) of the right iliac bone (Fig. 6, 7 - 13 ), at the same time, the first (fig. 4, 5 - 3) of two flanges is located on that part of the outer surface of the ring hemisphere, which corresponds to the place of the upper edge (fig. 6, 7 - 19) of the acetabulum (Fig. 6 - 33), and the second (Fig. 6, 7 - 4) of two flanges is located on that part of the outer surface of the hemisphere of the ring, which corresponds to the place of confluence of the ischial bone (Fig. 6, 7 - 15) and the lower edge (Fig. 6, 7 - 15) of the acetabulum (Fig. 6 - 33), and the third flange (Fig. 6, 7 - 5) on the right ring is located on that part of the outer surface of the hemisphere, which corresponds to the middle of the confluence (Fig. 6, 7 - 20) of the front edge (Fig. 6, 7 - 21) of the acetabulum and the horizontal branch of the right pubic bone (Fig. 6, 7 - 22) and is on the line (f ig. 6, 7–23) connecting the middle of the confluence site (Fig. 6, 7–20) of the front edge (Fig. 6, 7–21) of the right acetabulum (Fig. 6–33) and the horizontal branch of the right pubic bone ( Fig. 6 - 22), and the posterior lower spine of the right ilium (Fig. 6, 7 - 24), and the plane of the first flange (Fig. 4, 5, 9 - 25), is at an angle (Fig. 8 - 27) , indicated by a line (26 - fig. 8) with respect to the plane of the ring entrance (FIG. 8 - 28), and the plane of the first flange (Fig. 4, 5, 9 - 25) is at an angle (Fig. 9 - 29) to the outer surface of the ring hemisphere (Fig. 9 - 30), the plane of the second (Fig. 10 - 4, 5) and the third (Fig. 10 - 4, 5) ring flanges are in the same plane with the entrance plane (Fig. 10 - 28) rings, besides the flanges can be bent using tools to adapt to the surface of the corresponding bone , with the holes of the three flanges (Fig. 4, 5 - 9) allow you to additionally fix the acetabular fragments to the reposition - fixation support ring, which forces the fixation possibilities of the ring, while in the right ring the first row of holes (Fig. 4, 5, 7, 9 - 7) is located on one line along the edge (Fig. 5 - 31) of the ring entrance, some mm from the edge to the center , and the second row of holes (Fig. 4, 5, 7, 9 - 8) is located on the same line (Fig. 4, 5, 7, 9 - 8), departing from the first row towards the center of the hemisphere (in the direction of the technical hole) a few mm, and the holes of the second row are located with respect to the holes of the first row in a checkerboard pattern (Fig. 4, 5, 7, 9 - 7, 8), with a group of holes (Fig. 5, 7 - 32) consisting of two holes of the first and one hole of the second row located opposite each of the three flanges (Fig. 4, 5 - 7, 8), with the holes of the second row (Fig. 4, 5 - 6) of each of the three groups of holes, corresponding to the three flanges, located on the same line (Fig. 4, 5 - 11) the location of the corresponding flanges (Fig. 4, five).

The device works as follows

The operation of the device is described on the example of acetabular fracture B2.2 according to the international classification AO / ASIF (Fig. 11-11).

We model a fracture of the right acetabulum B2.2 according to the international classification AO / ASIF by osteotomy of the acetabulum with the creation of a diastasis between the fragments (Fig. 12 - 11). At the next stage, we use the toolkit to bring the displaced fragments closer to each other, achieving the most accurate reposition (Fig. 12 - 11). Next, the right repositional-fixation support ring is installed in the right acetabulum so that the first flange is above the upper edge of the right acetabulum (Fig. 14-4) directly on the anterior lower spine (Fig. 14-18) of the right iliac bone (Fig. 14). 6 - 11). The second flange is placed at the place of confluence (Fig. 14 - 17) of the ischial bone (Fig. 14 - 15) and the posterior edge of the right acetabulum. The third flange (fig. 14 - 5) is installed at the confluence (fig. 14 - 20) of the front edge (fig. 14 - 21) of the right acetabulum and the horizontal branch of the right pubic bone (fig. 14 - 22). After this chisel we adapt the edges of the acetabulum to the plane of the flanges. Then the ring is fixed to the part of the articular surface of the main fragment (Fig. 15-34) of the acetabulum, which is connected by the iliac bone by inserting screws (Fig. 15-41) through a group of holes (Fig. 15-32) of the support ring (Fig. 15-32 , 41). Next, we consistently introduce screws (Fig. 15-41) into the articular surface of the fragment of the posterior colons of the pelvis (Fig. 15-37) and the anterior columns of the pelvis (Fig. 15-39) through the corresponding holes of the first and second row of the ring. Screwing the screws alternately, we tighten the fragments of the posterior and anterior columns to the ring and thus, we first fix them and at the same time fix them to the ring. After that, we fix the ring with screws to the ilium by inserting screws through the holes of three flanges (Fig. 15-9), while the middle screw of the second flange (Fig. 15-9) must be screwed into the sciatic bone (Fig. 15-42) .

Experimental example

The operation of the device is described using the example of modeling acetabular fracture B2.2 according to the AO / ASIF international classification on corpse material with reposition and fixation of fragments by reposition-fixation support ring for surgical treatment of displaced acetabular fractures.

The corpse is laid on the right side. We perform the classic external-anterior access (Fig. 16) used for endoprosthesis replacement to the hip joint (Fig. 17). We carry out an osteotomy of the femoral neck, we remove the head of the femur, and remove the pinnacle region posteriorly.

We model acetabular fracture B2.2 according to the AO / ASIF international classification by osteotomy of the acetabulum (Fig. 18) with a diastasis between fragments. We perform using the toolkit to bring the displaced fragments closer to each other, seeking the most accurate reposition.

The left repositionally fixation support ring is installed in the left acetabulum so (Fig. 19), so that the first flange is above the upper edge of the left acetabulum, directly on the anterior lower spine of the left iliac bone. The second flange is located at the confluence (Fig. 19) of the ischium and the posterior edge of the left acetabulum. The third flange (fig. 19) is installed at the place of confluence of the front edge of the left acetabulum and the horizontal branch of the right pubic bone.

Then the ring is fixed to the articular surface of the main fragment of the acetabulum by inserting screws (Fig. 19-41) through a group of holes (Fig. 19-32) of the support ring.

After that, we consistently insert screws through the articular surface of the fragment of the posterior column of the pelvis (Fig. 20-32, 41) and the anterior column of the pelvis (Fig. 21-32, 41) through the corresponding holes of the first and second row of the ring. Twisting the screws alternately, we tighten the back and front columns to the ring and thus perform the final reposition of fragments and at the same time fix to the ring (Fig. 22).

At the next stage, we introduce screws through all the free holes in the ring, thus fixing the reduction and strengthening the fixation of the fragments. Then the ring is fixed to the pelvis by inserting screws through the holes of the three flanges (Fig. 23). In this case, the middle screw of the second flange (Fig. 15-9) is inserted with the direction to the top of the sciatic spine.

Thus, the reposition-fixation support ring, right and left, for the surgical treatment of displaced acetabular fractures allows:

выполнять репозицию отломков вертлужной впадины;

perform reposition of acetabular fragments;

окончательную фиксацию отломков вертлужной впадины;

final fixation of acetabular fragments;

надежную фиксацию отломков вертлужной впадины к опорному кольцу за счет введения фиксирующих винтов в костную массу стенок вертлужной впадины под разными углами;

reliable fixation of fragments of the acetabulum to the support ring due to the introduction of fixing screws into the bone mass of the walls of the acetabulum at different angles;

наличие трех групп отверстий кольца, находящихся на линии продольной оси трех фланцев позволяет вводить как минимум по три винта в основную массу отломков, образованную слиянием стенок вертлужной впадины с подвздошной костью, горизонтальной ветвью лонной и седалищной костей, и надежно фиксировать все фрагменты вертлужной впадины;

the presence of three groups of ring holes located on the line of the longitudinal axis of the three flanges allows inserting at least three screws into the main mass of fragments formed by merging the walls of the acetabulum with the iliac bone, the horizontal branch of the pubic and sciatic bones, and reliably fix all fragments of the acetabulum;

наличие фланцев позволяет выполнять дополнительную вне вертлужной впадины фиксацию отломков вертлужной впадины к опорному кольцу, что повышает стабильность фиксации;

the presence of flanges allows additional fixation of acetabular fragments outside the acetabulum to the support ring, which increases the stability of fixation;

выполнить последующее эндопротезирование тазобедренного сустава.

perform subsequent hip arthroplasty.

в ранние сроки начинать активное восстановление движений в оперированном суставе объективно имеет место положительный лечебный эффект, заключающийся:

early to begin active recovery of movements in the operated joint objectively there is a positive therapeutic effect, which consists of:

- to reduce the time of surgery, because only one external access to the hip joint is used, consequently, in reducing blood loss;

- reducing tissue trauma by optimizing the performance of surgical intervention;

наличие раннего экономического эффекта, заключающегося в сокращении стоимости лечения за счет использования только одного наружно - переднего доступа к тазобедренному суставу, следовательно, и уменьшения расходного операционного материала.

the presence of an early economic effect, which consists in reducing the cost of treatment due to the use of only one external - anterior access to the hip joint, therefore, and reducing the expendable surgical material.

наличие долгосрочного экономического эффекта, заключающегося в ранней реабилитации пациента, сокращении времени нетрудоспособности, следовательно, и затрат на лечение.

the presence of long-term economic effect, consisting in the early rehabilitation of the patient, reducing the time of disability, and hence the cost of treatment.

присутствует социальный эффект за счет восстановления качества жизни пациента.

there is a social effect by restoring the patient’s quality of life.

Claims (3)

Repositional-fixation support ring for surgical treatment of displaced acetabular fractures, having a concave shape and screw insertion holes, characterized in that it has the shape of a hemisphere, an outer and an inner surface, two rows of holes in the hemisphere and three flanges with holes for insertion of fixing screws, at the same time, the flanges are located on the outer surface of the hemisphere in such a way that when the ring is installed in the acetabulum, two of them are on the same line connecting the middle of the place of fusion of the sciatic to the awn and lower edge of the acetabulum and the anterior lower spine of the ilium, the first of the two flanges is located on that part of the outer surface of the hemisphere of the ring, which corresponds to the place of the upper edge of the acetabulum, and the second of the two flanges is located on that part of the outer surface of the hemisphere of the ring, which corresponds to the place of confluence of the ischial bone and the lower edge of the acetabulum and the third flange on the ring is located on that part of the outer surface of the hemisphere, which corresponds to the confluence of the front edge of the acetabulum and the horizontal branch of the pubic bone and is located on the line connecting the middle of the confluence of the anterior edge of the acetabulum and the horizontal branch of the pubic bone and the posterior lower spine of the Ilium, and the plane of the first flange is at an angle with respect to the plane of the ring entrance, the plane of the second and third flanges of the ring is in the same plane with the plane of the ring entrance, and the holes of the three flanges additionally allow fixing fragments of the acetabulum to the reposition-fixation support ring, which enhances the fixation ring, and the first row of holes is located on the same line along the edge of the ring entrance, some distance from the edge to the center, and the second row of holes is located on one line, some distance from the first about a row in the direction of the center of the hemisphere, and the holes of the second row are located with respect to the holes of the first row in a staggered manner, with three groups of holes consisting of two holes of the first and one hole of the second row located opposite each of the three flanges, and the holes The second row of each of the three groups of holes are located on one line of the location of the corresponding flanges.

Images