RU2801693C1 - Kit for performing lockable intramedullary osteosynthesis in dogs and cats and a method of performing lockable intramedullary osteosynthesis in dogs and cats using the kit - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: set for interlocking intramedullary osteosynthesis in dogs and cats contains an intramedullary nail, locking pins, a key for installing locking pins, an intramedullary nail holder, bone drills, drill bushings, supports made of carbon and metal, connecting monoblocks, adapters for installing supports, insert in the holder of the intramedullary nail, fixing bolt, and adapters for installing supports. The intramedullary nail is made with an external thread along its entire length, with one end rounded for insertion into the bone canal, and the other with an external thread, and with two threaded holes spaced at the ends. The intramedullary nail can also be made smooth with one end rounded for insertion into the bone canal, and the other end with an external thread, and with three threaded holes at both ends of the nail, with the axes of one hole perpendicular to the axes of two adjacent holes, and the other end with an external thread. The diameter of the working part of the bone drill corresponds to the diameter of the threaded holes on the intramedullary nail. The dimensions of the bone drill correspond to the dimensions of the drill sleeve. The holder of the intramedullary nail is made three-stage with an internal through channel for insertion of the liner. Threaded sections are made at both ends of the channel. The threaded section on one side is intended for coaxial connection with the fixing bolt, and the threaded section on the other side is intended for coaxial connection with the external threaded end of the intramedullary nail. The adapter for installation of supports has a threaded shank and a cylindrical body, on which mutually perpendicular smooth holes for the support and a threaded hole for fixing the mounting pin of the support are made. The connecting monoblock is made in the form of a tetrahedral elongated prism with holes: an axial through threaded hole and smooth holes placed on the sides, perpendicular to the axis of the monoblock with an offset. Smooth holes are designed to accommodate drill bushings, supports, the middle step of the holder and the threaded shank of the adapter. Drills and supports are rigidly fixed with fasteners inserted into the threaded holes. The threaded shank of the adapter is fixed with a nut. The key for installing the locking pin is made with the possibility of holding the locking pin. A method of performing blocked intramedullary osteosynthesis in dogs and cats using the above kit includes selection of an intramedullary nail, while a smooth cylindrical intramedullary nail is used in the treatment of diaphyseal fractures of the thoracic and pelvic limbs of animals with a different fracture line and degree of comminutedness, and an intramedullary nail with an external thread is used for treatment of oblique fractures. Before the operation, the intramedullary nail, the holder of the intramedullary nail with the liner are assembled coaxially and fixed with a fixing bolt to press the liner to the intramedullary nail, which are installed in the device using monoblocks, metal supports and holders of metal supports. Then, bushings with drills are installed in the monoblocks — for the bone, so that the drills for the bone pass freely through the threaded holes in the intramedullary nail and rigidly fix all structural elements in the selected position. Drill bushings and drills are removed from the connecting monoblocks. After that, the intramedullary nail is inserted and installed in the previously prepared medullary canal, and the sleeves for the drill are again installed in the connecting monoblocks so that the free end of the sleeve abuts against the outer wall of the bone. After that, the said drills are alternately introduced into the bushings, with which the bone wall is drilled, they fall into the holes in the intramedullary nail, and the opposite bone wall is drilled. Then, the said drills are removed one by one from the prepared holes, successively replaced with locking pins, using a wrench to install the locking pins.

EFFECT: inventions provide accurate comparison of fragments, stable and rigid fixation without the use of expensive technical devices for installing rods and locking screws, universality of the design, which is applicable for the treatment of various diaphyseal fractures of tubular bones, as well as for arthrodesis of large joints, the availability of the kit to a wide range of specialists due to acceptable cost.

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Description

The invention relates to the field of traumatology, orthopedics and veterinary medicine, namely to metal structures for intramedullary osteosynthesis, and can be used in the treatment of fractures of various bones in animals.

Blocked intramedullary osteosynthesis is a method of treating bone fractures, which involves fixing fragments by inserting a rod into the formed bone marrow canal, the stability of which is ensured by locking screws installed in certain holes in the rod. The technique for performing such operations involves the use of various devices to perform these manipulations. Improvement of metal structures for intramedullary osteosynthesis is an urgent task in the treatment of bone fractures.

It is known to block the intramedullary nail using a guide (see Intramedullary osteosynthesis of the tibia https://chm.eu/uploads/ST_CHARFIX_TIBIAL-NAIL_40.5000.600_RU_25C.pdf - 06/18/2022), where a set of metal structures is proposed containing intramedullary rods, blocking elements and an instrumentation consisting of a guide arm, guides (distal and proximal), etc. The main disadvantage of the existing kit is its high cost, which hinders the widespread use of this system.

A known Method for distal blocking of intramedullary locking rods (see Pat. 2749839, RU, IPC A61V 17/72, 2019), for which the following tools are used: a distal target for installing locking screws, a rod length gauge, a Kirschner wire, a protective guide, drill guide, trocar, screw length gauge, drill with a measuring scale, guide needle, wire needle holder, as well as a screwdriver and a curved awl. In the method, a lockable rod is installed, then a check is made to get the spoke into the distal locking hole using a guide wire. If the lockable nail is cannulated, the guidewire for inserting the lockable nail is passed distally along the nail channel and meets the resistance of the pin at the level of the lower distal locking hole. If the lockable nail is non-cannulated, the pin hit check is performed using an X-ray image intensifier tube. Then the opposite cortical plate is drilled, and only after that the pin is replaced with a drill of the required diameter, with which a hole for the distal locking screw is drilled through the channel formed earlier by the pin, and after checking that the drill hits the distal locking hole in the manner described above. The protective guide is left in the hole of the target. Through the protective guide, a screw length gauge is inserted into the hole drilled in the bone so that the hook of the gauge reaches the plane of the "exit" of the hole. Remove the screw gauge. Using a screwdriver, a blocking screw is screwed into the formed channel so that the screw head reaches the cortical layer of the bone. The disadvantage is that during installation, it is possible to shift the axes of the holes in the bone relative to the blocking holes in the rod, which leads to instability of the fixation of fragments, their slow consolidation. The disadvantage is also the use of a special guide handle, which complicates the technique of manipulation when installing the locking screws.

A device for closed osteosynthesis in complex fractures of the femur (see Pat. 2262321, RU, IPC A61B 17/72, 2004) is known, which contains: a cylindrical intramedullary pin, on which blocking holes are made from the end and from the side of the tip proximal fragments, and a coaxial threaded hole is made in the end; trocar for coaxial location of the working instrument or blocking screws in it; a guide made with holes for the trocar corresponding to the blocking holes in the pin. The guide is made in the form of a console with monolithically connected support and bent ends. The axes of the blocking holes in the pin and the axes of the corresponding holes for the trocar in the guide are located in planes perpendicular to the axis of the pin and equidistant from the base plane passing through the end of the pin. The disadvantages are the complexity of the technique of blocking the rods, the complexity of the exact centering of the axes of the blocking holes and the axes of the guide, and this increases the time of the operation.

The closest in technical essence to the claimed invention is a Device for inserting an intramedullary nail into the bone (see Pat. . The device is made in the form of a single figured base with five levers, on which there are holes for stabilizing bushings. The base is provided with a handle for connection with the intramedullary nail, at both ends of which there are holes for locking screws. Bushings designed to accommodate the drill are inserted into the selected holes on the levers. In section, the bushings can have a square or any polygonal shape. The disadvantages include the complexity of centering the holes of the intramedullary nail and locking fixators, limited possibilities for adjusting the position of the bushings, design complexity, and high cost.

The objective of the invention is to develop a device for the installation of intramedullary rods and locking screws in closed intramedullary locking osteosynthesis.

The technical result of solving the problem is to ensure accurate matching of fragments, stable and rigid fixation without the use of expensive technical devices for installing rods and blocking screws. The technical result is the versatility of the design, which is applicable for the treatment of various diaphyseal fractures of tubular bones, as well as for arthrodesis of large joints. The technical result is the availability of the kit to a wide range of specialists due to an acceptable cost.

The claimed technical result is achieved due to the fact that a kit is proposed for performing lockable intramedullary osteosynthesis in dogs and cats, containing an intramedullary nail, locking pins, a key for installing locking pins, an intramedullary nail holder, bone drills, drill bushings, supports made of carbon and metal , connecting monoblocks, adapters for the installation of supports, an insert in the holder of the intramedullary nail, a fixing bolt, adapters for the installation of supports. The intramedullary nail is made with an external thread along its entire length with one end rounded for insertion into the bone canal, and the other with an external thread, and with two threaded holes spaced at the ends. Or the intramedullary nail is made smooth, with one end rounded for insertion into the bone canal, and the other end with an external thread, and with three threaded holes at both ends of the nail, the axes of one hole being perpendicular to the axes of two adjacent holes, and the other end with an external thread. The diameter of the working part of the bone drill corresponds to the diameter of the threaded holes on the intramedullary nail, and the dimensions of the bone drill correspond to the dimensions of the drill sleeve. The holder of the intramedullary nail is made three-stage with an internal through channel for insertion of the liner, threaded sections are made at both ends of the channel, and the threaded section on one side is intended for coaxial connection with the mounting bolt, and the threaded section on the other side is intended for coaxial connection with the end with external thread intramedullary nail, The adapter for mounting the supports has a threaded shank and a cylindrical body, on which a smooth hole for the support and a threaded hole for fixing the fixing pin of the support are made mutually perpendicular. The connecting monoblock is made in the form of a tetrahedral elongated prism with holes: an axial through threaded hole and smooth holes placed on the sides, perpendicular to the axis of the monoblock with an offset, smooth holes are designed to accommodate bushings for drills, supports, the middle stage of the holder and the threaded shank of the adapter , while the drills and supports are rigidly fixed with fasteners inserted into the threaded holes, and the threaded shank of the adapter is fixed with a nut. The key for installing the locking pin is made with the possibility of holding the locking pin. In addition, the blocking pin consists of threaded parts of larger and smaller diameters, with the threaded part of the larger diameter placed between the threaded parts of the smaller diameter. Trihedral sharpening is performed at the ends of the studs. The key for installing the locking pin is made to be able to hold the locking pin with an internal threaded recess.

To perform blocked intramedullary osteosynthesis in dogs and cats using the kit, a Method for performing blocked intramedullary osteosynthesis in dogs and cats is proposed, including the selection of an intramedullary nail, while a smooth cylindrical intramedullary nail is used in the treatment of diaphyseal fractures of the thoracic and pelvic limbs of animals with different fracture lines and degrees comminuted, and an intramedullary nail with an external thread is used in the treatment of oblique fractures, before the operation, the intramedullary nail, the holder of the intramedullary nail with the liner are assembled coaxially and fixed with a fixing bolt to press the liner to the intramedullary nail, which are installed in the device using monoblocks, metal supports and metal holders supports, then bushings with drills for the bone are installed in the monoblocks, so that the drills for the bone pass freely through the threaded holes in the intramedullary nail and rigidly fix all the structural elements in the selected position, and the drills for the drill and the drill are removed from the connecting monoblocks, after which, the intramedullary the rod is inserted and installed in a previously prepared medullary canal, and bushings for the drill are again installed in the connecting monoblocks so that the free end of the bushing abuts against the outer wall of the bone, after which the said drills are alternately inserted into the bushings, which drill the bone wall, fall into the holes in intramedullary nail, the opposite wall of the bone is drilled, then the mentioned drills are alternately removed from the prepared holes, successively replaced with locking pins, using a key to install the locking pins

The difference between the claimed invention and the prototype is that:

- the execution of threaded holes of intramedullary rods from different sides provides an accurate comparison of bone fragments and increases the rigidity of fixation of the operated bone, in addition, a rod with an external thread, intended for the treatment of oblique fractures, increases the stability of fixation;

- making the working part of the drill for the bone corresponding to the diameter of the threaded holes on the intramedullary nail, and the dimensions of the drill for the bone, corresponding to the size of the sleeve, ensure the accuracy of centering relative to the axes of the holes in the intramedullary nail;

- the execution of the pointed end of the intramedullary rods facilitates the introduction of the rod into the bone marrow canal of the bone, and the external thread on the other end facilitates the assembly of the structure;

- an adapter for installing metal supports with a threaded shank and a cylindrical body, on which mutually perpendicular smooth and threaded holes are placed, allowing for perpendicular construction of the structure, increasing the potential of the device;

- making the holder of the intramedullary nail stepped and containing an internal channel for insertion of the liner, and the inner channel is provided with threaded sections allows you to make a coaxial connection with the intramedullary nail on one side and the bolt on the opposite side of the holder, allows you to assemble a device that is strictly oriented relative to the holes in the intramedullary nail.

the introduction of bone drills, polyfunctional monoblocks, adapters for installing metal supports, an intramedullary nail holder, locking pins, a key for installing locking pins, metal supports, inserts in the intramedullary nail holder allows using these parts to build a device for blocking intramedullary osteosynthesis .

The set of distinguishing features of the described device ensures the achievement of the task. These distinctive features allow us to conclude that there is novelty in the proposed technical solution, and their implementation ensures the achievement of results in solving the problem. The conducted patent search did not reveal solutions that have features similar to the claimed invention, which indicates an inventive step. The description and drawings demonstrate the possibility of implementing the inventions, which gives the right to conclude that the criterion of "industrial applicability" is met.

The claimed invention is explained by the description and illustrations:

Fig. 1 - smooth intramedullary nail;

Fig. 2 - holes in the smooth intramedullary nail;

Fig. 3 - threaded intramedullary nail;

Fig. 4 - holes in the threaded intramedullary nail;

Fig. 5 - bushing;

Fig. 6 - drill;

Fig. 7 - connecting monoblock;

Fig. 8 - adapter for installing metal supports;

Fig. 9 - holder of the intramedullary rod;

Fig. 10 - blocking pin, option 1;

Fig. 11 - blocking pin, option 2;

Fig. 12 - a key for installing a blocking pin;

Fig. 13 - - assembly scheme;

Fig. 14 - set for blocked osteosynthesis;

Fig. 15 - set for blocked osteosynthesis using all holes in the intramedullary nail;

Fig. 16 - X-ray image of the right pelvic limb of the cat: a - before surgery; 6 - osteosynthesis of a bone fracture with an intramedullary nail with blocking using the proposed device.

In accordance with the invention, a kit for lockable intramedullary osteosynthesis in cats contains intramedullary nails 1,2, bushings 3, bone drills 4, a polyfunctional monoblock 5, an adapter for installing metal supports 6, an intramedullary nail holder 7, locking pins 8,9, a key 10 for the installation of locking pins, metal supports 11, insert 12 in the holder of the intramedullary nail, various fasteners.

The intramedullary nail is a cylindrical nail with a solid cross section. The smooth rod 1 (Fig. 1) can be made of titanium, stainless steel, designed to be inserted into the bone and blocked by blocking elements. The distal end of the rod 1 is rounded for ease of installation. The proximal end of the rod 1 contains a section 13 with an external thread for coaxial connection with the holder of the rod 7. At both ends of the rod 1, 3 threaded holes 14, 15, 16 (Fig. 2) and 17, 18, 19 are made for blocking pins. The axes of the holes 15 and 18 are made perpendicular to the axes of the pair of holes 14, 16 and 17, 19. The rods can be of different lengths (from 5 to 40 cm) and different diameters (4+10 mm). Smooth rod 1 is widely used in the treatment of diaphyseal fractures of the thoracic and pelvic limbs of animals with different fracture lines and degrees of comminutedness.

The threaded intramedullary nail 2 (Fig. 3) is made with an external thread along its entire length, and also has a threaded section 13 for connection with the nail holder 7, and a rounded tip for insertion into the bone canal. At both ends of the rod 2, one threaded hole 20 and 21 (Fig. 4) is made for locking pins. Threaded rod 2 is effective in the treatment of oblique fractures.

The sleeve 3 (Fig. 5) is designed to install a bone drill 4 in it and determines the position of the bone drill 4 relative to the threaded hole on the rod 1.2. In the assembled structure, the position of the axis of the hole in the sleeve 3 corresponds to the position of the axis of the threaded hole in the intramedullary nail. The diameter of the hole of the sleeve 3 corresponds to the diameter of the shank of the bone drill 4, the length of the sleeve 3 is 10-15 cm.

The bone drill 4 (Fig. 6) is designed to make a hole in the bone. The length of the working surface of the bone drill 4 corresponds to the size of the operated bone, the diameter of the working part corresponds to the diameter of the holes on the intramedullary nail 1.2, and the shank used for fixation in the drill chuck corresponds to the length of the sleeve 3. When assembling the structure, from 2 to 6 bone drills according to the number of holes in the 1 or 2 intramedullary nail used in the operation. Each drill inserted into the sleeve 3, fixed in the polyfunctional monoblock 5, after drilling holes in the bone and hitting the corresponding hole in the intramedullary nail, is left in the nail, so each drill plays the role of a guide for the subsequent installation of the blocking element.

Connecting monoblocks 5 (Fig. 5) are elements for connecting parts into a single structure. Connecting monoblocks are made in accordance with RF patent No. 2739266 - in the form of a tetrahedral elongated prism with three holes: an axial through threaded hole and smooth holes placed on the sides perpendicular to the axis of the monoblock with offset, but without cruciform notches on the ends of the monoblock. Smooth holes are designed to accommodate bushings, supports, which are rigidly fixed with fasteners inserted into the threaded holes. For example, the sleeve 3 inserted into the smooth hole of the monoblock 5 is rigidly fixed with a fastener from the end of the monoblock (Fig. 14, 15). The diameters of the holes in the monoblock 5 correspond to the diameters of the bushings 3 and metal supports. Monoblock 5, mounted on a support, allows for axial, linear movement and rotational displacement of structural elements fixed in it.

The adapter 6 (Fig. 8) is intended for the installation of metal supports, on which the assembly of the structure of the device for the introduction of locking pins 8.9 (Fig. 14) through the perpendicular holes 15 and 18 in the intramedullary nail 1 is carried out. The adapter 6 has a threaded shank 22 and a cylindrical a body on which mutually perpendicular smooth hole 23 and a threaded hole 24 are made. The shank 22 is inserted into a smooth hole in the monoblock 5 and fixed with a threaded nut, and a metal support is inserted into the hole 23, which is fixed with a fixing pin through the threaded hole 24.

The holder of the intramedullary rod 7 (Fig. 9) has a three-stage cylindrical body with an internal through channel 25 of constant diameter. Threaded sections are made at both ends of the channel 25. The proximal threaded section 26 of the channel 25 is intended for leading the fixing bolt, the distal threaded section 27 is intended for mating the rod holder 7 with the threaded ends of 13 intramedullary rods 1 or 2. For connection with intramedullary rods of different diameters, the holder of the intramedullary rod 7 is performed in three sizes corresponding to rods with a diameter of 4 mm and 5 mm, 6 mm and 7 mm, 8 mm and 10 mm. In the design, the rod holder 7 is installed in a polyfunctional monoblock 5, for which the middle stage of the holder 7 is made mating with a smooth hole of the monoblock 5.

The locking pins, intended for insertion into the holes on the intramedullary nails 1 and 2, are made in two versions: the locking pin 8 (Fig. 10) with a thread along the entire length of the pin 8, for example, M3, and the locking pin 9 (Fig. 11) combined , which consists of threaded sections of larger and smaller diameters, and the threaded section of the larger diameter is placed between the threaded sections of the smaller diameter. On sections that differ in diameter, for example, threads M3 and M5 or M4 and M6 are applied. Pin 9 is advisable to use in cases of formation of arthrodesis of the shoulder-scapular joint, when attaching a part of the rod to the posterior part of the scapula. The pins 8,9 are installed in the intramedullary nail using the key 10, therefore, at the ends of the pins, a trihedral sharpening is performed, which limits the excessive immersion of the pin into the key, which contributes to the convenience of removing the key 10 after the pins are installed.

The key 10 for installing pins (Fig. 12) is designed to install the locking pins 8, 9 in the holes of the intramedullary rods 1 or 2. The key 10 has a cylindrical body, at the end of which there is a longitudinal-axial internal threaded recess 28 for the pin. The pin 8 or 9 is installed in the key 10, making two or three turns along the thread of the notch 28, and with the help of the key 10 is inserted into the hole of the rod 1, 2, and after installing the pin, turning the key 10 counterclockwise, the key is removed, leaving the pin in rod. The kit includes its own key of the proposed design for each type of hairpin.

The insert 12 in the holder of the intramedullary nail (Fig. 13) is a piece of metal cylindrical rod, installed in the inner channel 25 of the holder of the nail 7 to prevent unwinding of the threaded connection between the nail holder 7 and the intramedullary nail 1.

The proposed device works as follows.

The intramedullary nail is selected before surgery depending on the size of the operated bone, the choice is determined by the thickness of the bone and its length. Before the operation (Fig. 13), the intramedullary nail 1 or 2 is coaxially connected to the nail holder 7, in the channel 25 of which the liner 12 is placed, then the bolt 29 is installed in the open end of the nail holder 7, which, pressing the liner 12 to the rod 1 or 2, allows rigidly fix the intramedullary nail, eliminating the possibility of rotational, linear displacement. Also, before the operation, the device is assembled using polyfunctional monoblocks, metal supports. To do this, the resulting assembly (intramedullary nail 1, nail holder 7, bolt 29) is installed in a polyfunctional monoblock 5. In the same monoblock 5, a metal support 11 is installed perpendicular to the assembly (Fig. 14, 15), at the free end of which another polyfunctional monoblock is installed 5, in which, in parallel with the assembly with the intramedullary nail 1, a metal support 11 is installed and a U-shaped frame is obtained, consisting of an assembly and two metal supports (Fig. 14).

If during the operation it is supposed to block all the holes in the intramedullary nail 1, then 6 more polyfunctional monoblocks 5 (Fig. 15) are installed on the support 11 in addition, so that the axes of the holes in the intramedullary nail correspond to the axes of the holes in the corresponding monoblocks. If only 4 holes of the rod 1 are used, then 4 polyfunctional monoblocks 5 are installed on the carbon support (Fig. 14). This case of structural construction can be considered a special case and, using its example, we will consider further construction of the structure. On the structure assembled before the operation as described above, in each of 4 monoblocks 5 mounted on a metal support 11, bushings 3 are placed, into which drills for bone 4 are inserted and, moving monoblocks 5 along the metal support, drills for bone 4 are oriented along the threaded holes of the intramedullary nail 1 so that they pass through a pre-selected threaded hole in the intramedullary nail, for which they use the ability to move the monoblocks 5 along the metal support 11. After the final alignment of the blocking holes on the intramedullary nail 1 and bone drills 4, all monoblocks 5 is rigidly fixed in the selected position. Then, bone drills 4 are removed from monoblocks 5, then bushings 3. The device for blocked osteosynthesis is ready for use in the operation, and monoblocks 5, installed and fixed in the selected position, will be guides for further manipulations: drilling holes in the bone, installing pins blocking 8 or 9. After preparing the medullary canal, the intramedullary rod, rigidly fixed in the prepared device, is immersed in the medullary canal, connecting bone fragments.

After installing the intramedullary nail 1 in the canal of the operated bone, the sleeves 3 are reinstalled in the monoblocks 5 fixed on the metal support 11 of the device so that their free end rests against the outer wall of the bone. Drills for the bone 4 are alternately inserted into the bushings 3, each one drills the bone wall, falls into the corresponding hole in the intramedullary nail, and drills the opposite wall of the bone. After all drills for bone 4 are installed in all the holes in the intramedullary nail necessary for the operation, each drill for bone 4 is removed one by one from the prepared hole and is also sequentially replaced with a blocking pin, for example, 8, using key 10 for installation. After blocking all the holes in the intramedullary nail, the structure, including the nail holder 7, monoblocks 5 and supports 11, is removed by unscrewing the bolt 29.

To carry out the operation with blocking all 6 holes in the intramedullary nail 1, the structure is also assembled before the operation. Out of 6 polyfunctional monoblocks 5 installed on a metal support 11, similarly to the case considered earlier, bushings 3 with bone drills 4 are also installed in four polyfunctional monoblocks 5. 1 Adapters 6 are inserted into two unused monoblocks 5 for installing metal supports 11 (Fig. 15) , on each of which, using monoblocks 5, it is possible to place bushings 3 with bone drills 4 for installing locking pins in perpendicular holes 15, 18 in the intramedullary nail 1. Subsequent manipulations are similar to those described earlier. Pins 3 and bone drills 4 are removed from the assembled structure (Fig. 15). The intramedullary nail 1 is installed in a previously prepared medullary canal. Drills for bone 4 are inserted through pre-oriented bushings 3, the bone is reamed, they fall into the holes on the intramedullary nail 1 and the opposite wall of the bone is reamed. Then, the bone drills 4 are taken out one by one from the prepared holes and also successively replaced with blocking pins, using the key 10 for installation. After blocking all 6 holes in the rod 1 with pins, the structure, including the rod holder 7, monoblocks 5 and metal supports 11, is removed.

An example of an operation.

A five-year-old cat was admitted to the veterinary clinic BION+g Sevastopol with complaints from the owners about the lack of support for the animal on the right pelvic limb. After an x-ray examination, the animal was found to have a comminuted fracture of the proximal part of the right femur, resulting from a bullet wound to the bone, inflicted with a pneumatic weapon. The bullet lodged in soft tissues. After selecting the appropriate intramedullary nail according to the size of the bone and subsequent sterilization of the equipment, the intramedullary nail 1 was connected to the nail holder 7, in the channel 25 of which the insert 12 was placed. 4 monoblocks on metal supports, oriented along the holes of the intramedullary nail 1. Then, all the knots in the structure were tightened and drills for bone 4 and bushings 3 were removed. the diameter of the intramedullary nail 1 and from the side of the greater trochanter of the femur, an intramedullary nail 1 was inserted into the medullary canal, installed in the previously prepared device. Having connected both fragments on the intramedullary nail 1, incisions were made in the bones and muscles to insert the orienting sleeves 3 into the installed monoblocks, the sleeves 3 were introduced into the proximal and distal sections. After that, they were fixed in monoblocks 5, and a bone drill 4 was inserted into each sleeve 3 in the proximal section of the rod, drilling the first cortical layer, then passing the threaded hole of the intramedullary rod, drilling the second cortical layer. After that, a bone drill 4 was removed from the proximal part of the bone with the intramedullary nail 1 installed, and a pin 8 was installed in its place using the key 10. Pins 8 were installed similarly in the remaining threaded holes of the intramedullary nail 1 (Fig. 16). In the distal part of the intramedullary nail 1, based on clinical need, only one pin 8 was installed. After that, the structure was dismantled and the surgical wounds, originally formed for the installation of pins, were sutured. X-ray images taken after the operation showed the exact hit of the locking pins in the holes of the intramedullary nail, the exact matching of the fragments of the operated bone. The proposed design and method of its use ensured stable and rigid fixation of bone fragments without the use of expensive technical devices for installing rods and locking screws in lockable intramedullary osteosynthesis.

Claims (5)

1. Set for locking intramedullary osteosynthesis in dogs and cats, containing an intramedullary nail, locking pins, a key for installing locking pins, an intramedullary nail holder, bone drills, drill bushings, supports made of carbon and metal, connecting monoblocks, adapters for installation of supports, an insert in the holder of the intramedullary nail, a fixing bolt, adapters for installing supports, the intramedullary nail is made with an external thread along its entire length with one end rounded for insertion into the bone canal, and the other with an external thread, and with two threaded threads spaced apart at the ends holes, or the intramedullary nail is made smooth, with one end rounded for insertion into the bone canal, and the other end with an external thread, and with three threaded holes at both ends of the nail, with the axes of one hole perpendicular to the axes of two adjacent holes, and the other end with external thread, the diameter of the working part of the drill for the bone corresponds to the diameter of the threaded holes on the intramedullary nail, and the dimensions of the drill for the bone correspond to the dimensions of the sleeve for the drill, the holder of the intramedullary nail is made three-stage with an internal through channel for inserting the liner, threaded sections are made at both ends of the channel, and the threaded section on one side is intended for coaxial connection with the fixing bolt, and the threaded section on the other side is intended for coaxial connection with the end with external thread of the intramedullary nail, the adapter for installing supports has a threaded shank and a cylindrical body, on which mutually perpendicular smooth holes are made for supports and a threaded hole for fixing the mounting pin of the support, the connecting monoblock is made in the form of a tetrahedral elongated prism with holes: an axial through threaded hole and smooth holes placed on the sides, perpendicular to the monoblock axis with offset, smooth holes are designed to accommodate drill bushings in them , supports, the middle stage of the holder and the threaded shank of the adapter, while the drills and supports are rigidly fixed with fasteners inserted into the threaded holes, and the threaded shank of the adapter is fixed with a nut, and the key for installing the blocking stud is made with the possibility of holding the blocking stud. 2. The kit according to claim 1, characterized in that the locking pin consists of threaded parts of larger and smaller diameters, and the threaded part of the larger diameter is placed between the threaded parts of the smaller diameter. 3. A set according to claim 1, characterized in that trihedral sharpening is performed at the ends of the studs. 4. The kit according to claim 1, characterized in that the key for installing the locking pin is made to be able to hold the locking pin with an internal threaded recess. 5. A method for performing blocked intramedullary osteosynthesis in dogs and cats using the kit according to claim 1, including the selection of an intramedullary nail, while the intramedullary smooth cylindrical nail is used in the treatment of diaphyseal fractures of the thoracic and pelvic limbs of animals with different fracture lines and degrees of comminutedness, and the intramedullary a rod with an external thread is used in the treatment of oblique fractures, before the operation, the intramedullary nail, the holder of the intramedullary nail with the liner are assembled coaxially and fixed with a fixing bolt to press the liner to the intramedullary nail, which are installed in the device using monoblocks, metal supports and holders of metal supports, then in in monoblocks, bushings with drills are installed - for the bone, so that the drills for the bone pass freely through the threaded holes in the intramedullary nail and rigidly fix all structural elements in the selected position, and the bushings for the drill and drill are removed from the connecting monoblocks, after which the intramedullary nail is inserted and installed in a pre-prepared medullary canal, and the drill bushings are again installed in the connecting monoblocks so that the free end of the bush rests against the outer wall of the bone, after which the said drills are alternately inserted into the bushings, which drill the bone wall, fall into the holes in the intramedullary nail, drill the opposite wall of the bone, then the said drills are alternately removed from the prepared holes, successively replaced with locking pins, using a key to install the locking pins.