RU60345U1 - NEEDLE FIXING DEVICE - Google Patents

Abstract

The proposed utility model relates to medical equipment, namely to medical devices used in traumatology and orthopedics. Its purpose is to increase the effectiveness of the treatment of patients with fractures of long tubular bones by the Ilizarov apparatus. The goal is realized using the proposed device for fixing the spokes with a thrust pad outside the parafracture ring of the outer frame of the Ilizarov apparatus. It consists of the details of a standard set of Ilizarov apparatus, namely brackets, plates, bolts and nuts. The device is distinguished by the multivariance of its layouts - thanks to the included multi-plane hinges from brackets connected to each other, which regulate both its size and shape, and the level and direction of fixing the spokes in it with a thrust pad.

Description

The utility model relates to medical equipment, namely to medical devices used in traumatology and orthopedics.

The Ilizarov method has the optimal combination of atraumatic surgical intervention, the possibility of anatomical reposition and stable fixation of bone fragments, as well as their manipulation during the entire period of wearing the device (Shevtsov V.I., Makushin V.D., Kuftyrev L.M., 1994 ; Barabash A.A., Solomin L.N., 1995; Beidik O.V., 1996; Vvedensky S.P., Vvedensky P.S., 2001; Ciuccarelli S., Cervellati S., Montanari G., 1989 ; Cibo S., 1992, etc.).

To eliminate lateral displacement of bone fragments, a spoke with a persistent pad is usually used, which is described in the Guide to Transosseous Osteosynthesis (Golyakhovsky V., Frenkel V., 1999) and chosen by us as a prototype device. On the side to which there is a displacement of the bone fragment, a spoke with a stop (metal brazing) is carried out, the tip of which is seized with pliers and a sharp pulling and simultaneously tightening movement is carried out until the brazing of the bone stops. The needle is pulled and fixed in the parafracture ring of the outer frame of the apparatus. If the level of its conduct is located outside the plane of the ring - use brackets installed on the external

the frame of the Ilizarov apparatus. The choice of the length of the brackets is determined by the distance to the nearby ring of the device. The greater this distance and, accordingly, the length of the bracket, the technically easier the tension and fixation of the spokes. However, an increase in the length of the bracket (or the rod on which it is installed) directly correlates with a decrease in the possibility of adequate tension of the Kirschner needle, and hence the reduction of bone fragments and the stability of the entire Ilizarov apparatus system. In this case, both brackets are bent, to which the ends of the spokes are fixed with a thrust pad, and even fixing one of them with an additional rod to the other parafracture ring is not always effective (Fig. 1). Therefore, the prototype device has the following significant disadvantages:

1) When removing lateral displacement of bone fragments - the appearance of a curvature of the brackets or rods on which they are fixed to the parafractural external support;

2) The distortion of the tension of the forces of the entire system of the Ilizarov apparatus, which delays the time of fracture fusion and increases the risk of developing its delayed consolidation or false joint.

To prevent the above complications, a device for fixing the knitting needle with a thrust pad outside the parafracture ring of the outer frame of the Ilizarov apparatus is proposed (Fig. 2). It consists of parts of the Ilizarov apparatus set, namely, brackets (1), plate (2), bolts (3), nuts (4) and threaded rods (5). Due to the fact that the brackets connected to each other by nuts, are multi-plane hinges, there is the possibility of a variety of sizes and configurations

devices with the possibility of layout of its most diverse options. More than a twofold advantage of rigidity and the ability to choose a rational form of the device, can completely prevent the curvature of the brackets and threaded rods of the Ilizarov apparatus (figure 3). A knitting needle with a thrust pad can be tensioned and fixed both with the help of a fixator and with a “pull-rod” (a threaded rod with a longitudinal slot in which the front end of the spoke is attached).

An example of the clinical application of the proposed device is the following observation.

Patient P., 65 years old, was admitted to the Republican Orthopedic and Traumatology Center (RTC) in Makhachkala on September 7, 04 with a diagnosis of Closed comminuted fracture of the distal metaepiphysis of the radial and lower third of the left ulnar diaphysis with displacement and separation of the styloid process of the ulna . From the anamnesis: a household injury (falling from a ladder), two weeks before admission, in Khasavyurt, where an attempt was made to close the fracture and apply a plaster cast from the shoulder joint to the fingers of the hand. Due to the failure of the closed fracture reduction and the danger of developing Sudeck's syndrome (the patient had edema, soreness and burning of the fingers), an extra focal osteosynthesis of bones of the left forearm was performed on September 8, 2004 using an Ilizarov apparatus of two rings and one half ring. Distraction along the longitudinal threaded rods of the apparatus eliminated the displacement of the comminuted fracture of the radius, and to eliminate the displacement of fragments of the ulna along the width and axis, a spoke was held through the distal bone fragment with a persistent

platform. When the spokes were tensioned, both rods bent connecting the arms and the distal ring of the apparatus. One of the brackets was even strengthened by an additional rod fixed to the half-ring, but to no avail (Fig. 1). Therefore, the apparatus was re-installed with the installation of the proposed device (Fig. 3), consisting of brackets, plates, bolts, nuts and threaded rods. A knitting needle with a thrust pad was stretched and fixed to the device plate using a spoke fixator, which completely eliminated the displacement of bone fragments and ensured adequate rigidity of the Ilizarov apparatus system. Swelling and soreness of the fingers completely disappeared a day after the operation. After X-ray monitoring with verification of the satisfactory position of the bone fragments September 14, 04, the patient was discharged for outpatient treatment. Ilizarov’s apparatus was removed after complete fracture of the forearm bones after 2.5 months. The result of treatment is regarded by us as good.

Thus, the advantages of the device are as follows:

1) Due to the fact that the brackets connected to each other are multi-plane hinges, there is the possibility of a wide variation in the size and configuration of the device with the possibility of layout of its various options. This increases the manipulative properties of the Ilizarov apparatus in a wide variety of conditions, with all sorts of fractures and types of displacements;

2) A spoke with a thrust pad can be tensioned and fixed both with the help of a spoke fixator and with a “pull-rod”: a threaded rod with a longitudinal slot;

3) When eliminating lateral displacement of bone fragments - the exception of the curvature of the brackets or rods on which they are fixed to the parafractural external support;

4) Prevention of distortion of the voltage of the system forces of the Ilizarov apparatus;

5) The simplicity and cost-effectiveness of manufacturing the device with no need to search for parts for it.

Thus, the proposed device is efficient, simple and economical, and its use can increase the handling properties of the Ilizarov method.

Claims (1)

A device for fixing a knitting needle with a thrust pad outside the parafracture ring of the outer frame of the Ilizarov apparatus, consisting of parts of the Ilizarov apparatus kit, namely brackets, plates, bolts and nuts, characterized in that its size and shape, level and direction of the knob with the emphasis are adjusted included in it with multi-plane hinges represented by brackets connected to each other.