RU64503U1 - DEVICE FOR REMOTE LOCKING OF INTRAMEDOLLAR PINS - Google Patents

Abstract

The utility model relates to medicine, namely to traumatology, orthopedics, and is intended for distal blocking of intramedullary pins with closed blocking osteosynthesis of tubular bones. A device for distally locking intramedullary pins is made of a movable conductor with guide holes for installing the locking screws in the distal part of the pin, the conductor is connected by two guide rods with a L-shaped beam fixed to the handle of a standard guide device, and a fixing plate is installed in the distal part of the guide rods . The proposed model allows to exclude radiation exposure of patients during the operation, reduce the composition of the operating team for one surgeon and gives an economic effect when conducting 100 operations in the amount of 1,200,000 rubles.

Description

The utility model relates to medicine, namely to traumatology, orthopedics, and is intended for distal blocking of intramedullary pins with closed blocking osteosynthesis of tubular bones.

In traumatology, blocking of intramedullary nails is widely used in osteosynthesis of the femur and tibia. Proximal blocking is extremely simple since the handle of the guiding device is simultaneously used to insert intramedullary nails. Distal blocking is not possible without the electron-optical transducer of the x-ray image, since using mechanical guiding devices it is impossible to accurately determine the insertion point of the locking screws.

Known devices for distal blocking of intramedullary rods during osteosynthesis of long tubular bones [RF patent No. 2253397 from 10.06.2005; RF patent No.2000125961 dated 08/20/2002].

Significant disadvantages of these devices is the need to use an electron-optical converter of the x-ray image in the blocking process, the large size of the structure and their inconvenience in operation, the devices are not suitable

under all types of blocked intramedullary pins and require significant time costs for the operation.

As a prototype, a distal guide device consisting of a handle with a movable removable nozzle, a direction finder made of X-ray negative artificial material [M.E. Muller et al. Guidelines for internal osteosynthesis. M .: Ad Marginem, 1996, p. 310-316. SU].

This device has the following disadvantages: the need to use an electron-optical converter of the x-ray image in the process of inserting the locking screws, the device is not fixed, which requires the participation of an additional assistant during the operation, significant exposure of the patient to x-rays and the duration of the operation.

The objective of the present invention is to provide a reliable device for distally locking intramedullary pins with closed intramedullary blocking osteosynthesis, which allows to reduce the level of x-ray radiation of the patient and to reduce the composition of the operating team.

The solution to this problem is achieved by the fact that by using a movable jig with guide holes for installing the locking screws, it is possible to project the insertion point of the locking screws into the pin, which eliminates the use of an electron-optical X-ray image converter during the operation, and the L-shaped beam is fixed on the handle of a standard guide device and a fixing plate on the distal part of the guide rods allow butting from the work of one surgeon performing work on fixing the device.

The technical result is achieved due to the fact that the device is made of a movable conductor with guide holes for installing the locking screws in the distal part of the pin, the conductor is connected by two guiding rods with a L-shaped beam fixed on the handle of a standard guide device, a fixing bracket is installed in the distal part of the guide rods plate.

The essence of the utility model is illustrated by graphic material. Figure 1 shows a standard guiding device consisting of a handle (1) that allows the insertion of an intramedullary nail (2) into the tubular bone (3) and the fracture site of the tubular bone (4). Figure 2 presents the diagram of the device of the utility model "Device for distal locking of the intramedullary pins", where 8 is the handle of a standard guide device, 2 is an L-shaped beam that is attached with bolts and nuts (1) to the handle of a standard guide device , 3 - two guide rods parallel to each other, on the distal ends of which a fixing plate is installed (6), 5 - a movable jig with guide holes (4) for installing the locking screws (7) in the distal part of the pin (9).

Utility Model Case Studies

Example 1

A 37-year-old patient R. was admitted to the traumatology and orthopedics department of the regional clinical hospital No. 2 of Tyumen on 1.02.2006 with the diagnosis: “Closed, transverse fracture of the femur at the border of the middle and lower third of the left thigh. After preoperative preparation, an operation was performed: closed intramedullary osteosynthesis of the left thigh with a Kuncher nail with proximal and distal blocking. A closed reposition of fragments was performed by traction along the axis of the limb. Skin incision 5-7 cm. Proximal from the apex

a large skewer and slightly posterior to it. The length of the skin incision is 5 cm. After dissection of adipose tissue, all the muscular-fascial layers to the greater trochanter of the femur were separated by blunt and sharp paths. Using a hand drill, the bone marrow canal was opened. The assembly of tools for the installation of the pin has been completed. On the handle for introducing the pin, a device for distal locking is fixed. The location of the moving conductor is set. After the device is disconnected from the handle, a pin was inserted into the medullary canal of the femur. On the handle for introducing the pin, a device for distal locking is fixed. Distal blocking was carried out using a device for distal blocking with two screws with a diameter of 3.5 mm and a length of 30 mm. Removed distal locking device. Proximal blocking was performed according to the standard method. Removed pin insertion tools. A dummy screw is installed. X-ray control performed. The operation culminated in wound closure. The duration of the operation for distal blocking of the intramedullary pins was 20 minutes.

The postoperative period was uneventful. The patient was discharged from the hospital on February 18, 2006. He started to work 2.7 months after the operation.

Example 2

Patient G., 40 years old, was admitted to the traumatology and orthopedic department of the Design Bureau No. 2 of Tyumen with a diagnosis: "A closed double fracture of the right thigh, transversely comminuted in the middle third with a shift." After preoperative preparation, an operation was performed: closed intramedullary osteosynthesis of the right thigh with a Kuncher nail with proximal and distal blocking. A closed reposition of fragments was performed by traction along the axis of the limb. Skin incision in

5-7 cm. Proximal from the apex of the greater trochanter and slightly posterior to it. The skin incision is 4 cm long. After dissection of adipose tissue, all the muscular-fascial layers to the greater trochanter of the femur were separated by blunt and sharp paths. Using a hand drill, the bone marrow canal was opened. The assembly of tools for the installation of the pin has been completed. On the handle for introducing the pin, a device for distal locking is fixed. The location of the moving conductor is determined. After the device is disconnected from the handle, a pin was inserted into the medullary canal of the femur. On the handle for introducing the pin, a device for distal locking is fixed. Distal blocking was carried out using a device for distal blocking with two screws with a diameter of 3.5 mm and a length of 30 mm. Removed distal locking device. Proximal blocking was performed according to the standard method. Removed pin insertion tools. A dummy screw is installed. X-ray control performed. The operation culminated in wound closure. The duration of the operation for distal blocking of the intramedullary pins was 15 minutes.

The postoperative period was uneventful. The patient was discharged from the hospital on June 22, 2006. He began work 3 months after the operation.

The utility model is implemented on the basis of the traumatology and orthopedic center of Design Bureau No. 2 of Tyumen. Using this device, 7 closed intramedullary blocked osteosynthesis operations were performed. Assessment of the economic and positive effect of the proposed utility model is carried out in comparison with the prototype and is presented in the table. A total of 7 patients were operated on in each group. The proposed utility model allows to exclude irradiation of patients during the operation, reduces the time of the operation,

allows you to reduce the composition of the operating team per surgeon and gives an economic effect when conducting 100 operations in the amount of 1,200,000 rubles.

Table Sign Prototype Device for distally locking intramedullary pins Using an Optical Converter Used during operation Not used during operation The number of surgeons involved in the operation Minimum two One Time-consuming installation and distal blocking 20-30 minutes From 10-20 minutes Traumatism Moderate Minimum Device cost 17,000 rubles 5000 rubles

Claims (1)

A device for distally locking intramedullary pins, characterized in that the device is made of a movable conductor with guide holes for installing the locking screws in the distal part of the pin, the conductor is connected by two guide rods with a L-shaped beam fixed on the handle of a standard guide device, and in the distal parts of the guide rods mounted fixing plate.