SU1197658A1 - Arrangement for stretching thigh - Google Patents

Abstract

1. DEVICE FOR EXTENDING THE HIP, containing outer and inner hollow telescopically connected housings with fixing screws, made with a protrusion and a groove, a ratchet mechanism with a lead screw that interacts with a threaded part of the inner casing and installed inside the housings, a telescopic drive associated with a fork Ratchet mechanism, characterized in that, in order to enable installation of the device to the child, starting from an early age, between the walls of the outer case and the inner case, made with a latch , intermediate housings are installed, made with the possibility of sequential extension and fixation with the help of latches and windows. 2. A device according to claim 1, characterized in that, in order to prevent the intermediate cases from spontaneously protruding, their walls are interconnected with each other and with the wall of the outer case with polyamide or polyethylene puffs. (L

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The invention relates to medical technology, in particular to traumatology and orthopedics.

The aim of the invention is the possibility of installing the device to a child, starting from an early age.

FIG. 1 shows a device for extending the thigh, an incision; on „fig. 2 - internal case, section; in fig. 3 is a view A of FIG. 2; in fig. 4 shows a section BB in FIG. 2; in fig. 5 shows a section B-B in FIG. 2; in fig. 6 - one of the intermediate buildings, the cut; in fig. 7 - another intermediate case, section; in fig. 8 - outer casing, incision; in fig. 9 - lead ratchet, slit; in fig. 10 - the same, right view; in fig. 11 - spindle; in fig. 12 - sleeve; in fig. 13 - the same side view; in fig. 14 is a section of YYY in FIG. 13; in fig. 15 - the initial stage of the expansion of the device; in fig. 16 is an intermediate step of expanding a device superimposed on the thigh at the initial stage of treatment; in fig. 17 and 18 — a device applied to the thigh on the final ethane of the treatment. The device can be made of three or more housings (in this case, a device with four telescopically connected housings is shown).

The device contains an outer case 1, made with ratchet teeth 2, interacting with locking ratchet latches 3 (Fig. 1 and 14) of the sleeve 4, on which also made a ratchet latch 5, interacting with the ratchet teeth 6 (Fig. 1 and 12 ) leading ratchet 7. The latter is made with a threaded hole 8 in which the threaded end 9 of the lead screw 10 with an annular protrusion 11, a groove 12 and a threaded part 13 is placed. The leading ratchet 7 has a fork 14 at the end (Fig. 1 and 9), which can be rotated on axis 15 The second housing 16 of the telescopic actuator 17, in a slot 18 of which, on axis 19, is screwed a screw 20, a nut 21 of a protrusion 22 and a nut 23. The underside screw 10 has an orifice 24 through which the sleeve 4 is attached to it with a pin 25 26 with a threaded hole 27 for a fixing screw 28 with an opening 29 for a locking screw 30. Its threaded part 31 (FIG. 1) passes through the opening 32 of the housing 1. In the shifted position of all the housing the threaded part 33 of the housing 34 (FIG. 1 and 2) is located on the threaded part 13 of the driving screw 10. The housing 34 has a threaded hole 35 for the fixing screw 36, a latch 37 and a groove 38 of the protrusion 39 (Figs. 1 and 6) of the housing 40 with the threaded part 41 located on the bore 12 of the running screw 10, the window 42, the hole 43 and the latch 44. The housing 40 also has a groove 45, in which the protrusion 46 of the housing 47 is located (Fig. 7,

15 and 16) with a threaded part 48, a window 49 and openings 50 and 51 for a pinch 53 made of nylon, monolithic lavsan or polyamide - twelve materials permitted for implantation. The housing 47 is also provided with a longitudinal groove 54, in which the protrusion 55 of the housing 1 is placed, in the wall of which there is a hole 56 for the pin 53 and the hole 57 for the pin 52.

The device works and is applied as follows.

Before the operation, the housings 34, 40 and 47 slide together with the sleeve 4 into the inside of the housing 1. The leading ratchet 7 is screwed onto the threaded end 9 of the lead screw 10, and the studs 52 and 53 are coaxially positioned in the coaxial holes 43 and 52. The patient is placed on side so that the operated limb was bent at the knee and hip joints. Soft tissue incisions are made above the greater skewer and above the wing of the ileal bone. A drill, the diameter of which is equal to the outer diameter of the housing 1, in the bone-marrow channel of the femur is drilled through the large spit hole (channel) to the depth necessary to install the entire device. An osteotomy is made by any known method, after which bone fragments 58 and 59 are obtained. Using a conductor device (not shown), fragment 59 is drilled and fixed to the body 34 with a fixing screw 36, and in fragment 58, two mutually perpendicular holes are drilled for the fixing screws 28 and 30. The device is inserted inside the femur until the holes in the bone coincide with the opening 32 of the housing 1, the fixing screw 28 is screwed in, and then the fixing screw 30. The fragments 58 and 59 (bone fragments) are rigidly fixed according to Telescopic drive 17 is then carried out bluntly through the body and portions of the average annual muscle muscles. The hole in the wing of the ileum bone 60 is drilled and a nut 21 is fixed into it, which is fixed by a nut 23. and axis 15 is screwed down. The wounds are layer by layer protected. In the postoperative period, in order to carry out distraction, the patient rotates the operated limb first in one direction and then in the other until the clicks appear in both directions. The rotation angle depends on the number of ratchet teeth (at 24, rotation is required by at least 15 ° in both directions). First, the drive ratchet 7 teeth mi 6 rotates by 15-20 ° through the latches 5 the lead screw 10 (in this case, the left-hand thread) and it advances the body 34 by 0.05 mm. In this case, the housings 40 and 47 remain fixed to the housing 1. The housing 34 extends out of the housing 1 until the latch 37 enters the window 42 of the housing 40 (Fig. 15). Since the threaded part 33 of the housing 34 has not yet come from the threaded part 13 of the lead screw 10, the housing 34 begins to carry away the housing 40, cutting the puff 52 during movement, since its fixation to hulls 47 and 1 is the weakest — one flute 52 while housings 1 and 47 are fixed to each other by two pins - the remaining part of the pin 52 and the pin 53 (Fig. 16). The threaded portion 41 of the housing 40 is moved along the groove 12 of the lead screw 10 and is screwed gradually onto the threaded portion 13 of the lead screw 10 (Fig. 16). With further operation of the apparatus, the threaded part 33 of the housing 34 comes off the lead screw 10, and the latch 34, abutting the side parts against the walls of the window 42, takes all the axial load, closes the telescopic pair consisting of the housings 34 and 40, and the joint the extension of these housings is already carried out by the interaction of the threaded portion 41 of the housing 40 with the threaded portion 13 of the drive screw 10. After the latch 41 of the housing 40 is aligned with the window 49 of the housing 47 and enters it, the threaded portion 41 will continue to move along the drive screw 10, carried along the housing 47, at the same time, both the shafts 52 and 53 will first be cut, the threaded part 48 of the housing 47 will move along the groove 12 of the lead screw 10, will engage with the threaded part 13 of the screw screw 10 and the housing 47 will begin to slide out together with the housing 40. Once the threaded part 41 will come off the end of the threaded part 13 of the lead screw 10, the latch 44 in the window 49 will close the housings 40 and 47 and thus create a single telescopic rod consisting already of their three cases - 34, 40 and 47. The case 47 is the last retractable case from the housing 1. If necessary, the number in Sliding housings can be increased, but each time the same lead screw will push all the other housings in turn. Housing 47 with further distraction can extend out of housing 1 almost to its full length. The axial load is then placed on the lead screw 10. After the end of the distraction (Figs. 1-18), the drive 17 is promptly removed and the distraction apparatus is converted into a conventional intramedullary fixator, on which the final maturation of the regenerate occurs.

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Claims (2)

1. DEVICE FOR EXTENSION OF THE HIP, containing the outer and inner hollow telescopically connected housings with fixing screws, made with a protrusion and a groove, a ratchet mechanism with a lead screw interacting with the threaded part of the inner case and installed inside the housings, a telescopic drive connected to the ratchet plug mechanism, characterized in that, in order to install the device to the child, from an early age, between the walls of the outer casing and the inner casing, made with a latch, installed The intermediate casings are made, with the possibility of sequential extension and fixation using latches and windows. 2. The device according to π. 1, characterized in that, in order to exclude the possibility of spontaneous extension of the intermediate housings, their walls are connected with each other and with the wall of the outer casing by polyamide or polyethylene pins. “ S U .. „1197658