RU44933U1 - DEVICE FOR REPOSITION AND FIXATION AT ACROMIAL DISLOCATIONS OF THE KEY - Google Patents

Abstract

The utility model relates to medicine, in particular to traumatology and orthopedics. The proposed device for reposition and fixation of the acromial end of the clavicle contains two external semicircular support apparatus G.A. Ilizarov, connected by three threaded distraction rods. On one semicircular support of the apparatus of G.A. Ilizarov, two Kirschner spokes with thrust pads are fixed in brackets in brackets. On the other semicircular support of the apparatus of G.A. Ilizarov, two cantilever osteofixer rods are fixed to the brackets. The spokes are drawn through the acromial end of the clavicle in the sagittal plane, one cantilever rod is installed in the acromial process of the scapula in the sagittal plane, front to back, and the second to the spine of the scapula at the level of its upper third in the sagittal plane in the direction back to front. The proposed device allows you to reliably hold the acromial end of the clavicle in a repaired position, to provide high rigidity and stability of fixation, which is necessary for a favorable course of reparative processes in the area of damaged clavicular-acromial joint.

Description

The utility model relates to medicine, in particular to traumatology and orthopedics, and is intended for transosseous fixation in case of damage to the clavicle-acromial joint.

A device is known for reposition and fixation of the acromial end of the clavicle, used in the treatment of ruptures of the acromial-clavicular joint using external transosseous osteosynthesis (Urazgildeev, R.Z. Urazgildeev // Bulletin of Traumatology and Orthopedics named after N.N. Priorov. - 1998. - No. 4. - P.44-48). This device contains an external support on which the base is fixed by means of bolts and nuts. On the base are threaded stands, the free ends of which are distraction special fixators. When fastening knitting needles with thrust pads through the acromial and coracoid processes of the scapula, the acromial end of the clavicle, the sharp ends of the spokes, they are fixed in the distraction spoke fixators of the device, and the shanks in simple spoke fixators. Reposition of the dislocated end of the clavicle is carried out by moving the spokes along the distraction special fixators.

The disadvantages of such a device for the treatment of dislocations of the acromial end of the clavicle are:

- insufficient rigidity of fixation and stability of osteosynthesis when using three spokes fixed in external supports, which makes it difficult to firmly hold the adjusted acromial end of the clavicle, and also leads to trauma to the bones and soft tissues of the shoulder girdle with the risk of developing local inflammatory complications.

- For the reposition of the dislocation, distraction special fixators of a special design are required, which are not included in the set of commercially available parts of the apparatus of G. A. Ilizarov.

To eliminate these shortcomings, we proposed a useful model for the treatment of dislocations of the acromial end of the clavicle, consisting of an external support made by two semicircular arches of G.A. Ilizarov’s apparatus connected by distraction rods, and osteofixers — two Kirschner spokes and two cantilevered Shantz rods. The spokes are fixed on the external support using brackets in the spoke fixers, the cantilever rods are also fixed using brackets and nuts that are part of the standard set of parts of G.A. Ilizarov's apparatus. Figure 1 shows the proposed device, where

1, 2 - semicircular support apparatus G.A. Ilizarov;

3 - threaded distraction rod;

4, 5 - Kirchner spokes with thrust pads;

6 - special fixators;

7 - bracket;

8 - rod installed in the acromial process of the scapula;

9 - a rod installed in the spine of the scapula;

10 - acromial end of the clavicle;

11 - acromial process of the scapula;

12 - spine of the scapula.

The proposed device for reposition and fixation of the acromial end of the clavicle contains two external semicircular support apparatus G.A. Ilizarov (1, 2), connected by three threaded distraction rods (3). On the semicircular support of the apparatus of G.A. Ilizarov (1) on the brackets (7) two Kirschner spokes with thrust pads are fixed in the fixators (6) (4, 5). On the semicircular support of the apparatus of G.A. Ilizarov (2), on the brackets (7), two cantilever osteofixer rods are fixed (8, 9). The spokes are drawn through the acromial end of the clavicle in the sagittal plane, one cantilever rod is installed in the acromial process of the scapula in the sagittal plane, front to back, and the second to the spine of the scapula at the level of its upper third in the sagittal plane in the direction back to front.

Osteofixers are installed in anatomically and functionally safe areas of the shoulder girdle, therefore damage to the subclavian vessels and nerve plexuses is excluded (Ostroverkhov, G.E. Surgical surgery and topographic anatomy / G.E. Ostroverkhov, Yu.M. Bomash, D.N. Lubotsky. - Kursk, Moscow: CJSC Litera, 1996. - 720 p.).

The device is as follows. The patient is placed on the operating table on his back closer to the edge, so that the shoulder joint on the side of the injury hangs somewhat. Between the shoulder blades stack

roller. Under general intravenous anesthesia after treatment of the surgical field, the skin is punctured in the area of the acromial process of the scapula at the site of the proposed introduction of the osteofixer, the cantilever shaft (8) is installed, in the sagittal plane in the direction from front to back. Then, the skin is punctured in the region of the spine of the scapula at the level of its upper third, at the site of the proposed introduction of the rod, and the second cantilever rod (9) is introduced in the sagittal plane, in the direction from front to back. Two Kirschner spokes (4, 5) are drawn through the acromial end of the clavicle (4, 5) in the sagittal plane, parallel to each other. The spokes (4, 5) are fixed in the spoke fixators (6) on the brackets (7) to the semicircular support of the apparatus of G.A. Ilizarov (1). The rod (8), inserted into the acromial process of the scapula, and the rod (8), inserted into the spine of the scapula, are attached to the semicircular support of G.A. Ilizarov’s apparatus using brackets (7) (2). Then, a closed reduction of the dislocation of the acromial end of the clavicle is carried out by manipulating the semicircular support (1) under manual control. After reposition of the dislocation, two semicircular supports (1, 2) are rigidly connected by three distraction rods (3). The spokes (4, 5) pull and carry out the final stabilization of the apparatus. If necessary, by drawing together the semicircular supports (1, 2) along the distraction connecting rods (3), a metered compression is created in the damage zone.

The proposed device for the treatment of dislocations of the acromial end of the clavicle allows:

- reliably hold the acromial end of the clavicle in a repaired position, providing high rigidity and stability of fixation, and, therefore, eliminate the risk of developing relaxation and local inflammatory complications;

- do not use special devices for reposition and fixation of the dislocated acromial end of the clavicle and use a standard set of parts of G.A. Ilizarov’s apparatus when completing the model;

- increase the safety of surgical intervention, reducing the risk of damage to neurovascular formations;

- to simplify the installation technique of the apparatus due to the use of transosseous fixators (cantilever rods) in its layout, which do not require tension before fixing on an external support.

- create additional compression in the area of damaged clavicular-acromial joint for a more favorable course of reparative processes.

Claims (1)

A device for reposition and fixation during acromial dislocation of the clavicle, containing an external support, spokes with thrust pads mounted on it, characterized in that it additionally contains two osteofixer rods rigidly connected to the external support.