RU35591U1 - Device for osteosynthesis of fractures and pseudoarthrosis of the scaphoid - Google Patents

Description

DEVICE FOR OSTEOSYNTHESIS OF FRACTURES AND FALSE JOINT JAWS

The utility model relates to medicine, namely to surgery, traumatology, orthopedics, hand surgery.

The problem of treating injuries of the hand among all injuries of the musculoskeletal annqjara has been gaining more and more interest recently. A large number of bones, their small size, complex structure, the relationship of the latter, the greater functional significance of the hand requires a more accurate, stable comparison of bone fragments when they are damaged. Non-invasive immobilization, even for short periods, leads to contractures, ankyloses. Pfeyaoma of the Ladovica stew constitute more than 70% of all fractures of the wrist bones and about half of them do not heal. Numerous information has been cited in the literature on Poddrich on the low effectiveness of many methods of treatment for scaphoid fractures (A.M. Volkova, "Hand Surgery, 1991.- T.Z. - P.23; V.V. Klyuchevsky" Surgery of injuries, 1999. - S. 413).

Various devices for scaphoid osteosynthesis are known. For reposition and fusion of fragments of the scaphoid bone, Malygin G.D., 1979, Korshunov V.F., Kozlov I.A., 1980 and others used external fixation devices (A.M. Volkova, Hand Surgery, 1991.- T.Z. - S.32).

In order to achieve compression between the cleft of the scaphoid M.JE. Müller, M. Allgover, RSHneider, HWishshngf, 19% “Guidelines for osgeosynthesis for osgeosingesis were used by Vichy.

HGeisel, APuhringer in 1986 (Old Fractures and psmd-itop of the Hand, E phenases with the Ender Implant Plate for the Akt. Traumatol. 16: 149) and P.Stankovic, H-Buriiardt in 1993 () eriences with the Ender Scaphoid Plate for the Non-Uni (m, Handchir. Mikrochir. PlasL Chir. 25 (1993) 217-222) and for the osgeosynthesis of eelomas and pseudoarthrosis of the palate 5 of the oblique braid we used a device consisting of a screw and a brace that was aggravated and bent the distal fragment of the scaphoid, and the screw passing through the hole in the bracket recorded ttroksimaltty fragment

The described device is the closest in technical essence to the proposed one.

However, this device does not provide reliable fixation of fragments of the navicular bone for the entire period of non-fracture fusion, as well as the impossibility of distributing a uniform load on the fragments during fixation of the fracture and simultaneous longitudinal and transverse constant compression between the fragments of the scaphoid for the entire treatment period. Moreover, this device is difficult to use.

The objective of the proposed utility model is 11 to ensure reliable fixation, uniform load, simultaneous longitudinal and transverse constant compression between fragments of the scaphoid for the entire period

treatment, as well as ease of use.

This result is achieved due to the fact that the device is made of a wire of material with shape memory in the form of a U-shaped bracket with a bend in the middle of the shelf and with legs slanted inward at an angle of 70-80, pointed at the ends, while the diameter of the wire is 1.5-1.75 mm. The wire is made of titanium nickelide. The legs of the bracket are inserted into the holes on the proximal and distal fragments of the scaphoid. In this case, the longitudinal force (0.6 kg) is created due to the shape memory after plastic deformation of the bending of the bracket back, and the transverse force (0.6 kg) is created due to the shape memory after plastic deformation of the angle by the plane of the bracket back and the plane of the legs.

The utility model is illustrated by the graphic material, where in FIG. 1 shows a side view of the device, and FIG. 2 is a top view of it, and FIG. 3 is an example of a clinical application of the device.

The device for osteosynthesis of fractures and pseudoarthrosis of the scaphoid is made of titanium nickelide alloy wire with a diameter of 1.5 - 1.75 mm, the length of the bracket flange is selected depending on the size of the scaphoid bone according to x-rays and the size of the fragments and can have three types of sizes to accelerate preparation to the operation.

3 This device provides reliable fixation and simultaneous

longitudinal and transverse continuous compression between the fragments of the scaphoid and the transverse line of fracture and comparable oblique fractures, for the entire period of fracture fusion, which makes it possible for functional postoperative treatment of patients with fractures and false joints of the scaphoid, to begin early active controlled movements in the joints of the wrist and wrist joint operated limbs and early dosed load, reduce immobilization time.

Indications for use of the device are fractures of the joints of the scaphoid, with a transverse line of fracture and comparable oblique fractures.

The device is used as follows. During the operation, fragments of the scaphoid are compared, and then holes are drilled perpendicular to the plane of the fracture with a drill in each fragment, departing from the fracture line by 5-8 mm. Then the clamp is irrigated with chloroethyl for 10-15 seconds. The needle holder unbends the half-ring of the back and the fixing legs to an angle between the plane of the back of the bracket and the plane of the legs of 90 degrees, for insertion into the bone. The bracket is transferred to the surgical wound, its legs are immersed in the holes in the bone fragments and fixed with a finger or tool for 20-30 seconds. In connection with the effect of the form restoration that occurs upon contact heating of titanium nickelide to +35 C, the bracket

4

takes a given (i.e., initial) form. In this case, longitudinal compression is created due to shape memory after deformation of the half ring, and lateral compression due to shape memory after deformation of the angle between the plane of the half ring and the plane of the fixing legs.

We give an example of the use of the proposed device: patient M., 32 years old, was operated on for a scaphoid fracture of the right hand, he was performed an open reposition of fixation of fragments by the proposed device of fig.Z.

Claims (2)

1. The device for osteosynthesis of fractures and false joints of the scaphoid is made of a wire of material with shape memory in the form of a U-shaped bracket with a shelf, smoothly curved along the circumference, and with legs tapered inward at an angle α = 70-80 °, pointed at the ends while the diameter of the wire is 1.5-1.75 mm 2. The device according to claim 1, characterized in that the wire is made of titanium nickelide.