RU2767897C1 - Set of tools for subtalar arthroeresis - Google Patents

Abstract

FIELD: medical technology.

SUBSTANCE: invention relates to medical technology, namely to surgical instruments used in operations for the installation of a subtalar implant. The tool kit includes four multi-purpose tools: impactor, patterns of eight standard sizes, elevator, hexagonal screwdriver. At the end of the impactor cylinder, there is a groove with a thread for installing probes made in the form of a truncated cone, in the larger base of which a threaded mount is made. The working part of the elevator is made of metal in the form of a curved lever. The metal cylinder of the impactor and the working part of the elevator are connected to the silicone handle in a single unit. The hexagonal screwdriver is a 3.5 mm metal cannulated screwdriver with a through hole in the center with a diameter of 1.6 mm for a conductor pin.
EFFECT: invention is aimed at increasing the service life of tools that are simple and easy to use.

1 cl, 5 dwg

Description

Technical field

The invention relates to medical equipment, namely to surgical instruments used in operations for the installation of a subtalar implant. State of the art

Known tools for performing subtalar implant surgery are the Kalix 2 subtalar implant tool kit from Integra (http://mercuryme.ru/images/cms_otdely_stopy.pdf). The kit includes the Viladot arm, trial implant holder, impactor for implanting the final subtalar implant, a set of trial implants in various sizes (from size 9 to size 17). The instruments are made of medical steel. The handles of the trial implant holder and the Viladot retractor are made of plastic.

The disadvantages of the instrument kit are that it can only be used for the implantation of the Kalike 2 endorthesis and cannot be used for the implantation of subtalar implants from other manufacturers, and there is also no instrument for removing the subtalar implant from the subtalar sinus if necessary or due to possible postoperative complications.

In addition, the sufficiently large width and height of the tip of the Wilodot lever often presents a technical problem for passing the subtalar sinus under the talus in children of younger and middle age groups, as well as in adults with small foot sizes.

Also, the disadvantage of this set of instruments is that the impactor is used to perform the final implantation, which is a complex structure with a large number of levers and moving parts, which makes it difficult to manufacture this instrument, financially expensive for the manufacturing process and repair in case of breakage of this instrument.

A set of tools for the operation of subtalar arthroeresis by Footdoctor is also known (https://footdoctor.ru/upload/uf/238/podtaranniy_nabor%20blr.pdf). The set consists of a metal case for sterilization with reamers from size 6 to 13 and one starting reamer, a universal quick-release handle, a set of subtalar implants from size 6 to 13, 3 pieces of each size.

The disadvantages of the above set of tools is that the implants and reamers are of the same size, which does not allow tight fixation of the implant in the sinus and, accordingly, there is no tendency for it to migrate. In addition, it is impossible to remove them from the subtalar sinus during pronation tests with trial sweeps, which makes it difficult to determine the degree of mobility of the foot after deformity repair with the definitive subtalar implant. The trial implant reamers of this set of instruments are also available in sizes 6 to 13. Size 13 may not be sufficient for arthroeresis in adults with large feet.

The essence of the technical solution

The technical task is to create a set of tools that makes it possible to perform surgical intervention with various subtalar implants and provides the surgeon with convenient tools that facilitate the process of surgical intervention and improve the quality of patient treatment results.

The technical result is to increase the service life of tools that are simple and easy to use.

The technical result is achieved by the fact that the set of tools for subtalar arthroeresis includes four multi-purpose tools:

- an impactor made in the form of a metal cylinder connected to a silicone handle as a whole, while at the end of the cylinder there is a recess with a thread for installing probes of eight standard sizes;

- probes made in the form of a truncated cone, in the larger base of which a threaded fastening is made, while the smaller bases of the truncated cone are 7.2 mm and 9.2 mm, and the largest bases of the truncated cone are 15.2 mm and 17.2 mm , while the step between the standard sizes is 1.0 mm;

- an elevator designed to eliminate subluxation of the talus in relation to the calcaneus, consisting of a working part made of metal in the form of a curved lever connected to a silicone handle as a whole;

- a hexagonal screwdriver designed to screw the subtalar implant into the implantation site, which is a metal cannulated screwdriver 3.5 mm with a through hole in the center with a diameter of 1.6 mm for the conductor wire.

The invention is illustrated by drawings:

In FIG. 1 shows a general view of the impactor in section, in Fig. 2 - section A-A, in Fig. 3 is a general view of the probe, in Fig. 4 is a general view of the elevator, in Fig. 5 - hexagonal cannulated screwdriver.

The subtalar arthroeresis instrument set includes four multi-purpose instruments, namely: impactor, 8-size probe set, elevator, hex cannulated screwdriver.

The impactor 1 consists of a metal cylinder 2, on the end of which there is a recess with a thread (Fig. 2) for installing a probe, and a silicone handle 3. The probe 4 is made in the form of a truncated cone, in the larger base of which a fastening 5 with a thread is made. The diameter of the smaller base and the larger base of probe 4 is 0.3 mm less than the dimensions of the final subtalar implant and, accordingly, the dimensions of the upper and lower bases of the truncated cone of the smallest probe size are 7.2 mm by 9.2 mm, and the largest probe size is 15, 2mm by 17.2mm. There are 8 probes in total in the set (with the size of the larger base of the cone - 9.2 mm, 10.2 mm, 11.2 mm, 12.2 mm, 13.2 mm, 14.2 mm, 15.2 mm, 17, 2 mm.). The probe 4 is made of a biologically safe material, for example, titanium alloy Ti6Al4V. Elevator 6 consists of a working part 7 made in the form of a curved lever made of stainless steel, for example, SS 17-4, and a handle 8. The handle of impactor 1 and elevator 6 are made of silicone, for example, brand KE-971T-U. The hexagonal screwdriver 9 is a 3.5 mm cannulated metal screwdriver with a 1.6 mm through hole in the center for the guide wire.

Implementation of the technical solution

After performing a surgical approach to the subtalar sinus of the foot in an oblique direction from front to back, from top to bottom, an elevator is started to eliminate subluxation of the talus in relation to the calcaneus, moderate pressure is applied downwards on the handle of the instrument to obtain elevation of the neck and head of the talus, the foot at this moment moderately rotates inward second hand. An assistant performs excessive inward rotation of the forefoot to stretch the metatarsophenoid ligament and increase forefoot mobility. The elevator is removed from the foot. The foot is brought into the normocorrection position. In the area of the subtalar joint, using the impactor and the probe installed on it, the implant size is selected, starting with a probe of 9.2 mm and in turn reaching the desired size, while the probe of 9.2 mm and each subsequent probe is removed from the impactor and left in the subtalar sinus, and test movements are performed with the foot to assess the degree of deformity correction and determine the required size of the final implant. After selecting the optimally sized implant of a conical shape with the highest possible degree of correction of the foot deformity, a metal pin 4 with a diameter of 1.5 mm is installed in the subtalar joint from bottom to top from front to back, passed through the entire subtalar sinus to the opposite side of the foot with the needle coming out to the opposite side of the foot through the skin, on the final implant of the required size is put on the pin through the central through hole with a diameter of 1.6 mm, a cannulated screwdriver (hexagonal screwdriver) 3.5 mm with a hole 1.6 mm in the center is put on the pin behind the implant. The diameter of the central through hole in the implant and in the screwdriver, equal to 1.6 mm, was selected based on the closest contact between the implant and the guide wire, screwdriver and guide wire to reduce possible play to a minimum and achieve the most accurate placement of the implant in the subtalar sinus of the foot . The implant is rotated clockwise into the cavity of the subtalar sinus with a narrow oval base inward, and a wide base facing outward of the foot at an angle of up to 10-15 degrees to the frontal plane, until it stops. The screwdriver is removed from the spoke, the spoke is removed.

The application of the invention makes it possible to pass through the subtalar sinus without any special technical difficulties, both in children and adults, and to eliminate the collapse of the talus due to the fact that the probes have individual sizes, the handles of the impactor for the probe, screwdriver and repositioning tool are made of high-quality medical silicone, which is convenient in use, the material does not crumble, does not deform, and does not corrode;

A comparative analysis of the claimed invention showed that the totality of the essential features of the claimed invention is unknown from the prior art, therefore, it meets the condition of patentability "novelty" for inventions.

The declared set of essential features makes it possible to achieve non-obvious technical results that were not achieved by known technical solutions at the filing date of this application, therefore the claimed invention meets the condition of patentability "inventive step".

Claims (1)

A set of tools for subtalar arthroeresis, characterized in that it includes an impactor made in the form of a metal cylinder connected to a silicone handle as a whole, while at the end of the cylinder there is a recess with a thread for installing probes of eight sizes, made in the form of a truncated cone, in a larger the base of which is threaded, while the smaller bases of the truncated cone are 7.2 mm and 9.2 mm, and the largest bases of the truncated cone are 15.2 mm and 17.2 mm, while the step between the sizes is 1.0 mm ; an elevator designed to eliminate subluxation of the talus in relation to the calcaneus, consisting of a working part made of metal in the form of a curved lever connected to a silicone handle as a whole; a hexagonal screwdriver designed to screw the subtalar implant into the implantation site, which is a 3.5 mm metal cannulated screwdriver with a through hole in the center with a diameter of 1.6 mm for the conductor wire.

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