RU74797U1 - DEVICE FOR TREATMENT OF MULTI-SHORT FRACKS OF THE PROXIMAL DEPARTMENT OF THE HUMER BONE - Google Patents

Abstract

A device for the treatment of multi-fragmented fractures of the proximal humerus containing a diaphysis part made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus, through the body of the plate there are made through rounded holes and one hole of oblong shape - an installation, diaphysis part is connected through an intermediate part with an epiphyseal part, at the distal end of which an awl-shaped fixing protrusion is made, installed at right angles to the plane of the epiphyseal part Characterized in that the epiphyseal portion is formed as a pad, the envelope contour of the front of the head of the humerus, and comprises through holes for fixing screws.

Description

The utility model relates to the field of medicine, namely to traumatology and orthopedics, and can be used for bone osteosynthesis of bone fragments in multi-fragmented four-fragment fractures of the proximal humerus.

A device for bone osteosynthesis of fractures of the proximal humerus containing a profiled "T" -shaped plate, cortical and spongy screws. It consists of an open reposition of fragments, fixation of fragments by a “T” -shaped plate, laid in the proximal part on the region of a large tubercle, and screws. Cortical screws 4.5 are screwed into the diaphysis of the humerus, spongy screws 6.5 are screwed into the head of the humerus (Müller M.E., Allgover M., Schneider R., Willinger H. Manual on internal fixation. 3rd edition. )

The disadvantages of this device are: the inability to ensure stable fixation of fragments, the inability to fix this design of a small tubercle in the case of a four-fragment fracture of the surgical neck of the humerus.

A device for bone osteosynthesis is known - LPHP plate with angular stability. The device comprises a plate in the body of which threaded holes are made. The screw heads are fixed in the plate due to the existing thread, which ensures stable fixation of fragments (Plate with angular stability for the proximal shoulder LPHP // Margo Anterior. - 2001. - No. 5-6.).

The disadvantage of this device is the inability to adequately fix a multi-fragmented fracture of the proximal shoulder with its help.

The closest in technical essence and the achieved result to the proposed device is a profiled "fork-shaped" Voronkevich plate for bone osteosynthesis (Application for the grant of a patent of the Russian Federation No. 2002127430/14). The device comprises a diaphyseal part made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus. Through the body of the plate, through round holes are made and one oblong-shaped hole is an installation hole. The diaphyseal part is connected through the intermediate part to the epiphyseal part, at the distal end of which two awl-shaped fixing protrusions are made, installed at right angles to the plane of the diaphyseal part.

Fixation of fragments by this design is carried out by introducing into the head of the humerus two awl-shaped guide projections

4.0 cm long. The diaphyseal part of the plate is fixed with 4.5 cortical screws to the diaphysis of the humerus. For additional fixation, a 6.5 screw can be inserted into the head of the humerus through a special hole in the plate.

The disadvantages of this device are: the impossibility of simultaneous fixation of a multi-fragmented fracture of the head of the humerus, the risk of migration of the metal structure.

The purpose of the utility model is to increase the reliability of osteosynthesis in the treatment of multi-fragmented fractures of the proximal humerus,

The goal is achieved in that the device comprises a diaphyseal part made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus. Through the body of the plate, through round holes are made and one oblong-shaped hole is an installation hole. The diaphyseal part is connected through the intermediate part to the epiphyseal part, at the distal end of which an awl-shaped fixing protrusion is made, which is installed at right angles to the plane of the diaphyseal part, and the epiphyseal part is made in the form of a platform enveloping the front contour of the humerus head and contains through holes for fixing screws.

Figure 1 shows a general view of the device.

The device comprises a diaphyseal part (1) made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus. Through the body of the plate, through round holes (2) are made and one oblong-shaped hole (3) is an installation hole. The diaphyseal part (1) is connected through the intermediate part (4) with the epiphyseal part (5), at the distal end of which an awl-shaped fixing protrusion (6) is made, installed at right angles to the plane of the diaphyseal part (5), and the epiphyseal part (5) is made in the form of a platform enveloping the front contour of the head of the humerus and contains through holes (7) for the fixing screws.

The device is used as follows. The result is achieved by introducing into the head of the humerus through the region of a large tubercle an awl-shaped fixing protrusion (6), extending from the plate at an angle of 90 degrees, and the epiphyseal part (5), which is a monolithic part of the structure, enveloping the head contour in front, having openings (7) , allows you to fix fragments of a small tubercle by inserting through the holes of the screws. The diaphyseal part (1), made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus, through the installation hole (3) is first fixed with a screw to the shoulder bone and, after achieving a sufficient reposition of bone fragments, is finally fixed to the bone by introducing through the plate body into the through rounded holes (2) of the screws. Associated through the intermediate part (4) with the diaphyseal part (1), the epiphyseal part (5) provides the most physiological placement of the device on the injured bone.

Thus, the reason for creating the proposed device was the need to solve the following problems:

- improving the quality of surgical treatment of multi-fragmented fractures of the proximal humerus;

- providing the possibility of stable fixation of multi-fragmented fractures of the proximal humerus;

- reduce the risk of metalwork migration and secondary displacement of fragments;

- reducing the risk of impingement syndrome.

After solving the above problems, a design was created that provides a technical result consisting in the possibility of stable fixation of bone fragments during multi-fragmented fractures, ease of installation, eliminating the possibility of migration of metal structures, secondary displacement of fragments, and reducing the risk of impingement syndrome.

The device exists in 2 versions: right and left.

The specified device is used for surgical treatment of multi-fragmented 4-fragmented fractures of the proximal shoulder, and can also be used to treat 2- and 3-fragmented fractures.

The plate installation procedure is as follows. After performing open reposition of the fragments, the fragments are temporarily fixed with knitting needles and transossal sutures. Then in the large tubercle of the humerus with a narrow awl or drill 3.2 a channel is formed for the guide protrusion of the plate. The plate is anatomically pre-bent, therefore, additional modeling is not required. The guide plate is introduced into the formed channel, brought by a nailing to a snug fit with the plate. An additional rail is laid on the front surface of the head of the humerus, on the region of the small tubercle. Through the holes in this rail, a small tubercle is fixed with 6.5 spongy screws. Next, the diaphyseal part of the plate is fixed to the diaphysis of the humerus with cortical screws 4,5.

Claims (1)

A device for the treatment of multi-fragmented fractures of the proximal humerus containing a diaphysis part made in the form of a plate bent along the length in accordance with the external curvature of the diaphysis of the humerus, through the body of the plate there are made through rounded holes and one hole of oblong shape - an installation, diaphysis part is connected through an intermediate part with an epiphyseal part, at the distal end of which an awl-shaped fixing protrusion is made, installed at right angles to the plane of the epiphyseal part Characterized in that the epiphyseal portion is formed as a pad, the envelope contour of the front of the head of the humerus, and comprises through holes for fixing screws.