RU2752032C1 - Device for open, sparing reduction of columns and acetabular fragments - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine. The device for open, sparing reduction of columns and acetabular fragments consists of a main wire, its fixing part, a second wire and a guide tube. The main wire has a fixing part at one end. The fixing part is permanently connected by a wire in such a way that it can move relative to the wire and assume a position parallel to the wire. A second wire is attached to one end of the fixing part, which can change the position of the fixing part relative to the main wire. The conductor tube is double and consists of two conductor tubes, an outer conductor tube that has an inner diameter for passing the inner conductor tube and a section of a rough outer surface, and the inner conductor tube has an inner diameter for passing a wire with a fixing part.

EFFECT: invention ensures the implementation of all the necessary manipulation elements for the most accurate open reduction of the columns and fragments of the acetabulum precisely from the side of the acetabulum, which meets the requirements of sparing reduction, prevents trauma to soft tissues associated with fragments and columns of the acetabulum, allowing reliable fixation of the columns and fragments of the acetabulum precisely from the side of the acetabulum, preventing secondary displacement of the columns and fragments of the acetabulum, contributing to the early activation of the patient in the postoperative period with a simultaneous sufficient increase in the quality of his life.

1 cl, 18 dwg

Description

A device for open, sparing reduction of columns and acetabular fragments refers to medicine, namely, for the surgical treatment of displaced acetabular fractures, hip arthroplasty, experimental medicine, and biomechanics.

For the reposition of fragments and columns of the acetabulum, a device is proposed [Buachidze O.Sh. and other Surgery of the hip joint, M., Medicine, 2002, 15-20.].

However, this device does not allow effectively and minimally traumatic to perform open reduction and fixation of columns and fragments of the acetabulum and has the following disadvantages:

- does not allow performing the necessary elements of manipulation for the most accurate reduction of the columns and fragments of the acetabulum exactly from the side of the acetabulum,

- injures soft tissues associated with fragments and columns of the acetabulum,

- does not meet the requirements of sparing reduction,

- does not allow fixation of the columns and fragments of the acetabulum exactly from the side of the acetabulum.

The objective of the invention is to develop a device for open, sparing reduction of columns and acetabular fragments.

The technical result of the invention is to ensure the implementation of all the necessary manipulation elements for the most accurate open reduction of the columns and fragments of the acetabulum exactly from the side of the acetabulum, which meets the requirements of a gentle reduction, preventing trauma to the soft tissues associated with fragments and columns of the acetabulum, allowing reliable fixation of the columns fragments of the acetabulum exactly from the side of the acetabulum, preventing secondary displacement of the columns and fragments of the acetabulum, contributing to the early activation of the patient in the postoperative period with a simultaneous sufficient increase in the quality of his life.

The technical result is achieved by the fact that the proposed device for open sparing reduction of columns and fragments of the acetabulum, characterized by the fact that it consists of a main wire, its fixing part, a second wire and a guide tube, while the main wire has a fixing part at one end, and , the fixing part is permanently connected with a wire in such a way that it can easily move relative to the wire and take a position parallel to the wire, and a second wire is attached to one end of the fixing part, which can change the position of the fixing part, and the conductor tube is double, and consists of two conductor tubes, an outer conductor tube that has an inner diameter for passing a wire with a fixing part and an inner conductor tube, and a section of a rough outer surface, and an inner conductor tube has an inner diameter for passing a wire with a fixing part.

Among the essential features that characterize the proposed device for open, sparing reduction of columns and acetabular fragments, the distinguishing features are:

- the device consists of a main wire and its fixing part,

- the second wire and the conductor tube,

- in this case, the main wire has a fixing part at one end, - moreover, the fixing part is permanently connected by a wire in such a way that it can easily move relative to the wire and take a position parallel to the wire,

- a second wire is attached to one end of the fixing part, which can change the position of the fixing part,

- the conductor tube is double, and consists of two conductor tubes, an outer conductor tube, which has an inner diameter for conducting a wire with a fixing part and an inner conductor tube, and a section of a rough outer surface,

- the inner conductor tube has an inner diameter for conducting the wire with a fixing part.

All distinguishing features from the prototype are devices for open, sparing reduction of columns and acetabular fragments are necessary and sufficient to achieve the technical result.

Experimental studies of the proposed device for open, sparing reduction of columns and acetabular fragments have shown its high efficiency.

It was found that the proposed device for open, sparing reduction of the columns and fragments of the acetabulum during its use provided a necessary and sufficient degree of reliable fixation of the columns and fragments of the acetabulum; secondary displacement of the columns and fragments of the acetabulum.

The device for open sparing reduction of columns and fragments of the acetabulum, characterized by the described set of essential features, possesses an inventive step, is new and industrially applicable.

The essence of the proposed device for open, sparing reduction of columns and acetabular fragments is illustrated by the following figures:

FIG. 1. Photo of bone holders Olier and Farabef is presented.

FIG. 2. Photo of Olier bone holder is presented

FIG. 3. Shown is a photo of the permanently connected main wire and the fixing part, and the second wire. 1 - main wire; 2 - fixing part in the reduced position; 3 - second wire.

FIG. 4. Shown is a photo of the permanently connected main wire and the fixing part, and the second wire in another projection. 1 - main wire; 2 - fixing part in the retracted position; 3 - second wire.

FIG. 5. A photo of the guide tube is presented. 4 - outer conductor tube; 5 - inner tube - conductor; 6 - a section of the outer rough surface of the conductor tube.

FIG. 6. Presented is a photo of the assembled conductor tube. 4 - outer conductor tube; 5 - inner tube - conductor; 6 - a section of the outer rough surface of the conductor tube.

FIG. 7. Shown is a photo of a conductor tube with a wire passed through it. 1 - main wire; 2 - fixing part in the reduced position; 3 - the second wire; 4 - outer conductor tube; 5 - inner tube - conductor.

FIG. 8. Shown is a photo of a conductor tube with a wire passed through it. 1 - main wire; 2 - fixing part in the retracted position; 3 - the second wire; 4 - outer conductor tube; 5 - inner tube - conductor.

FIG. 9. Shown is a photo with a repositioning-fixation ring installed in the acetabulum. 7 - reposition-fixation ring; 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 10 - drilled channel in the rear column.

FIG. 10. Shown is a photo with a repositioning-fixation ring and a guide tube installed in the acetabulum. 4 - a conductor tube introduced into the drilled channel; 7 - reposition-fixation ring; 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 10 - drilled channel in the rear column.

FIG. 11. Shown is a photo of the inner surface of the ischium (inner surface of the posterior column). 1 - main wire; 2 - fixing part in the reduced position; 3 - the second wire; 4 - outer conductor tube; 5 - inner tube - conductor; 10 - drilled channel in the rear column; 11 - the inner surface of the ischium (inner surface of the posterior column).

FIG. 12. Shown is a photo of the inner surface of the ischium (inner surface of the posterior column). 1 - main wire; 2 - fixing part in the retracted position; 3 - the second wire; 4 - outer conductor tube; 5 - inner tube - conductor; 10 - drilled channel in the rear column; 11 - the inner surface of the ischium (inner surface of the posterior column).

FIG. 13. Shown is a photo of the inner surface of the ischium (inner surface of the posterior column) with wire and fixing part. 1 - main wire; 2 - fixing part in the retracted position; 3 - the second wire; 10 - drilled channel in the rear column; 11 - the inner surface of the ischium (inner surface of the posterior column).

FIG. 14. Shown is a photo of the inner surface of the ischium (inner surface of the posterior column) with the fixing part of the wire. 2 - fixing part in the retracted position; 10 - drilled channel in the rear column; 11 - the inner surface of the ischium (inner surface of the posterior column).

FIG. 15. A photo of a diagram of a type B2.2 acetabular fracture according to the international classification AO / ASIF is presented. 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 12 - pelvic bone; 13 - the main fragment of the acetabulum associated with the ilium.

FIG. 16. A photo of modeling an acetabular fracture of type B2.2 according to the international classification AO / ASIF by osteotomy of the acetabulum of a pelvic bone dummy with the creation of diastasis between the columns is presented. 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 12 - pelvic bone; 13 - the main fragment of the acetabulum associated with the ilium.

FIG. 17. A photo of modeling a acetabular fracture of type B2.2 according to the international classification AO / ASIF with an installed reposition-fixation ring for the treatment of acetabular fractures is presented. 1 - main wire; 7 - reposition-fixation ring; 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 10 - drilled channel in the rear column; 13 - the main fragment of the acetabulum associated with the ilium.

FIG. 18. A photo of modeling a fracture of the acetabulum of type B2.2 according to the international classification AO / ASIF with an installed repositioning-fixation ring with fixing screws inserted into the acetabulum columns through all free holes in the ring is presented. 1 - main wire; 7 - reposition-fixation ring; 8 - anterior column of the acetabulum; 9 - posterior column of the acetabulum; 10 - drilled channel in the rear column; 13 - the main fragment of the acetabulum associated with the ilium; 14 - fixing screws.

The device for open, sparing reduction of columns and acetabular fragments contains the following elements

The device consists of a main wire (Fig. 3-1, Fig. 4-1, Fig. 7-1, Fig. 8-1, Fig. 11-14-1, Fig. 17-1), its fixing part (Fig. Fig. 3-2, Fig. 4-2, Fig. 7-2, Fig. 8-2, Fig. 11-14-2), the second wire (Fig. 3-3, Fig. 4-3, Fig. 7 -3, Fig. 8-3, Fig. 11 - 13-3) and a conductor tube (Fig. 5, 6, 7, 8-4, Fig. 10-12-4), while the main wire has on one end of the fixing part (Fig. 3-2, Fig. 4-2, Fig. 7-2, Fig. 8-2, Fig. 11-14-2), moreover, the fixing part is permanently connected with a wire in such a way that it is easy to move relative to the wire, and take a position parallel to the wire (Fig. 3-4, Fig. 7, Fig. 8, Fig. 11-14), and a second wire is attached to one end of the fixing part (Fig. 3-3, Fig. 4-3, Fig. 7-3, Fig. 8-3, Fig. 11-13-3), which can change the position of the fixing part of the main wire (Fig. 3-4, Fig. 7-8, Fig. 11 -14), and the conductor tube is double, and consists of two conductor tubes (Fig. 5-8, Fig. 10-12), the outer conductor tube a (Fig. 5-8 - 4, fig. 10-13-4), which has an inner diameter for conducting a wire with a fixing part, and an inner conductor tube (Fig. 5-8 - 5, Fig. 10-13-5), and a section of a rough outer surface (Fig. 5 -6 - 6), and the inner conductor tube (Fig. 5-8 - 5, Fig. 10-13-5) has an inner diameter for conducting the wire with the fixing part (Fig. 7-8, Fig. 11-12) ... The device for open sparing reduction of columns and acetabular fragments works as follows. We present the operation of the device using the example of a fracture of the acetabulum B2.2 according to the international classification AO / ASIF (Fig. 15-16). We simulate the fracture of the acetabulum B2.2 of the right pelvic bone (Fig. 15-16-12) according to the international classification AO / ASIF by osteotomy of the acetabulum with the creation of diastasis between the posterior column (Fig. 15-16-9) and the anterior column (Fig. 15-16-8). At the next stage, we bring the displaced columns closer to each other, achieving the most accurate reposition (Fig. 9). Next, we install in the acetabulum a repositioning and fixation support ring (Fig. 9-7) corresponding to the acetabulum size and fix it with fixing screws to the main fragment (Fig. 9-13) of the acetabulum associated with the ilium. Then, after the achieved reduction, we drill a through channel (Fig. 9-10) through the articular surface and the entire thickness of the bone wall of the posterior column (Fig. 9-10), and, if necessary, the anterior column. Next, guide tubes (Fig. 10, 11-13-4) with threaded wires (Fig. 11-12-1) are inserted into the drilled channel so that their ends stand out of the drilled channel from the side of the inner surface of the ischium (Fig. 11- 14-11). Then the inner tube-guide (Fig. 11-12-5). we press on the fixing part of the wire (Fig. 11-12-2) and transfer the fixing part of the wire (Fig. 3-2, Fig. 4-2, Fig. 7-2, Fig. 8-2, Fig. 11-14- 2) in the retracted position (Fig. 4-2, Fig. 7-2, Fig. 12-14-2), due to which the fixing part is hooked onto the inner surface of the acetabulum column from the side of the small pelvis (Fig. 13-14 -2). After that, we pull the main wire (Fig. 17-1) and achieve the maximum approach of the column to the adjacent ring wall, after which we drill the channel through the adjacent ring hole in relation to the hole through which the wire is passed and screw the fastening screw into the channel (Fig. 18-14) until it stops and fix the column to the ring (Fig. 18). At the next stage, we introduce screws at different angles into the acetabular columns through all free holes in the ring, and thus we strengthen the fixation of the repositioned columns to the ring (Figs. 18-14).

The implementation of the proposed device for open sparing reduction of columns and acetabular fragments is illustrated by the following experimental example.

An experimental example of the operation of the device is presented on the example of a fracture of the acetabulum B2.2 according to the international classification AO / ASIF (Fig. 15-16). We simulate the fracture of the acetabulum B2.2 of the right pelvic bone (Fig. 15-16-12) according to the international classification AO / ASIF by osteotomy of the acetabulum with the creation of diastasis between the posterior column (Fig. 15-16-9) and the anterior column (Fig. 15-16-8). At the next stage, we bring the displaced columns closer to each other, achieving the most accurate reposition (Fig. 9). Next, we install in the acetabulum a repositioning and fixation support ring (Fig. 17-7) corresponding to the acetabulum size and fix it with fixing screws to the main fragment (Fig. 9-13) of the acetabulum associated with the ilium. Then, after the achieved reduction, we drill a through channel (Fig. 9-10) through the articular surface and the entire thickness of the bone wall of the posterior column (Fig. 9-10), and, if necessary, the anterior column. Next, guide tubes (Fig. 10, 11-13-4) with threaded wires (Fig. 11-12-1) are inserted into the drilled channel so that their ends stand out of the drilled channel from the side of the inner surface of the ischium (Fig. 11- 14-11). Then the inner tube-guide (Fig. 11-12-5). we press on the fixing part of the wire and transfer the fixing part of the wire (Fig. 3-2, Fig. 4-2, Fig. 7-2, Fig. 8-2, Fig. 11-14-2) into the retracted position (Fig. 4 -2, Fig. 7-2, Fig. 12 - 14-2), due to which the fixing part is hooked onto the inner surface of the acetabular column from the side of the small pelvis (Fig. 13 - 14-2). After that, we pull the main wire (Fig. 17-1) and achieve the maximum approach of the column to the adjacent ring wall, after which we drill the channel through the adjacent ring hole in relation to the hole through which the wire is passed and screw the fastening screw into the channel (Fig. 18-14) until it stops and fix the column to the ring (Fig. 18). At the next stage, we introduce screws at different angles into the acetabular columns through all free holes in the ring, and thus we strengthen the fixation of the repositioned columns to the ring (Figs. 18-14).

Claims (1)

A device for open, gentle reduction of columns and fragments of the acetabulum, consisting of a main wire, its fixing part, a second wire and a guide tube, while the main wire has a fixing part at one end, and the fixing part is permanently connected by a wire so that it can move relative to the wire and take a position parallel to the wire, and a second wire is attached to one end of the fixing part, which can change the position of the fixing part relative to the main wire, and the conductor tube is double and consists of two conductor tubes, an outer conductor tube that has an inner diameter for passing the inner conductor tube and a portion of a rough outer surface, and the inner conductor tube has an inner diameter for passing a wire with a fixing part.

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