SU938958A1 - Method and apparatus for osteosynthesis - Google Patents

Description

one

This invention relates to medicine, namely to traumatology and orthopedics, and is intended for the treatment of injuries and diseases of bones and joints.

The known method of osteosynthesis, which includes the imposition of a compression-distraction apparatus on the area of the fracture.

A device for compression-diffraction osteosiitis, which contains a bracket and a needle 1, is known.

However, the known method and device for its implementation makes it difficult to reposition the fragments in the proximal femur, as they require complex manipulations with the structural elements of the device. In addition, the reposition is hampered by the anatomical features of the fracture area, i.e. the small size of the bone fragment, which does not allow to carry out parallel needles through his horizontal needles or to perform their complex intersections.

The purpose of the invention is to simplify the process of reposition of fragments by increasing the mobility of the proximal fragment.

The goal is achieved by the fact that during the process of ostersynthesis, including the imposition of a compression-distraction apparatus on the fracture area, the needle is held in the sagittal plane through a needle and fixed in a semicircle of the compression-distraction apparatus, then on both sides of the needle into a cortical bone Two separate rods are placed at a distance of) from the other, equal to 2.0-2.5 diameters of the bone.

For implementing the method, devices are proposed that are interconnected by a single inventive concept.

15 At the same time, in a device for compression-distraction osteosynthesis, containing a bracket and a needle, that the bracket is made in the form of an arc, on which the stop is mounted. 1. Thread the threaded rods by means of clamps,

20 and the needle is attached to the ends of the arc.

Claims (2)

FIG. 1 shows an osteosynthesis device, general view; in fig. 2 - the same kind of drill. 3 The device contains a bracket in the form of an arc 1 on which thrust threaded rods 2 are installed by means of clamps 3. A 4-pin is fixed on the arc hooks and nuts 5 are placed on the rods x 2 for fixing the rod in the clamps. The method of osteosntesa fracture in the proximal part of the femur is carried out in a healing manner. After appropriate preparation of the skin for anesthesia at the prescribed levels of the limb, transossal spokes are carried out. In this case, cross-spoke spokes are passed through the distal fragments, which after tension are fixed with clamps and rings. Through the proximal bone fragment 6, the needle 4 is held in the sagittal plane, which in a free state is fixed to the arc 1 of the compression-distraction apparatus. On both sides of the passage through the bone of the needle 4 on the lateral side, threaded rods 2 are inserted into the cortical bone layer at a distance of 2.0-2.5 bone diameters. the ends of the rods 2 are brought together and fixed to the arc 1 with the help of clamps 3 in a common area. By moving the nuts 5, the pins 2 are brought closer or separated from the bone simultaneously by the tension of the relaxed needle. Thus, they create a dynamic and sufficiently stable fixation node, effectively included in the general system of the compression-distraction apparatus. To arc 1 using. clamps fix the rods of the apparatus. Further, the distal ring of the apparatus is repositioned of the bone fragments, after which the rods are fixed to it in a similar way. With the help of the middle ring, the necessary detachable repositioning manipulations are carried out and fixed in the same way. Correction of the proximal fragment in the course of treatment is carried out with the help of rods 2, the screwing-up of the system L increases with the additional screwing. The stability of the system L increases the stability of the bone fragments. After consolidation of the bone fragments, the apparatus is removed. The dismantling of the apparatus, as well as its relaxation during the correction of fragments, is carried out in the reverse order. Example. Patient G., 26 years old, was admitted with a diagnosis: fracture of both femur bones, on the right podvitelny with displacement of fragments, on the left transverse fracture in cf. / C with displacement of fragments. When entering shock III. After withdrawal from a severe general condition of the patient, operative accommodation was performed: the imposition of a compression-distraction apparatus of V.K. Kalnberz on a rigid system on the right. Skeletal traction through the femoral condyles (temporarily) imposed on the left. The operation of the compression-distraction apparatus was performed under intratracheal anesthesia. The reposition of the bone fragments was closed with subsequent fixation using a compression-distraction apparatus. In this case, at the level of the lower and middle third, two intersections of the spokes are made and fixed in the rings of the compression-distraction apparatus. Fixation of the proximal fragment was carried out according to the described method with the help of knitting needles and rods. In the sagittal plane, a spoke is drawn through the center of the proximal fragment, the ends of which, after stretching, are fixed in symmetrical places of the arc. Along the lateral surface of the femur, 2 cm above and below the line of the spokes make incisions of the skin 1 cm long, through which rods are inserted into the bone, the free ends of which are fixed on an arc in a common angle at the level of the spoke. The rings of the apparatus are interconnected by four rods. Further, by carrying out manual pull for the distal rings, the limb length is leveled and the fragments are corrected in length, the reposition of the proximal fragment is carried out by moving the proximal arc of the apparatus — angular and rotational displacements are eliminated. After that, the arc is installed in the overall design of the apparatus, fixing it to three rods of the apparatus. The final reposition is performed by increasing the length of the rods, as well as by moving the proximal arc and the distal rings. Reposition is practically completed on the operating table. In the further treatment process, only periodic tension of the spokes was required and slight correction of the position of the proximal fragment was required. The postoperative period is uneventful. After 7 days, movements in the hip and knee joints began. Thus, the proposed method and device provide a reduction in the morbidity of accommodation. With this method, instead of two transosseous crosses of the spokes, fixation is carried out with a needle and two wipers, which injures the bone janny significantly less and reduces the number of entrance gates for infection to penetrate. In addition, fragment handling is facilitated. Changing the position of the bone fragment in a wide range during the treatment process is accomplished by redistributing the tension in the spoke-rod system, angular, are eliminated. transverse n rotational displacements. Convenience is provided in the process of treating a patient's dp. The use of a lateralized arc in the proximal femur, if possible, does not threaten to give the limb a position of permanent abduction, and the stability of fixation allows early movements in the hip joint. All of the above is confirmed by the results of clinical observations. In all 25 cases of the use of the proposed method, it was possible to achieve complete reposition of the bony sites, fracture fusion, and full restoration of the hip function. Claim 1. Osteosynthesis method, which includes compression and distraction apparatus on the fracture area, which also, in order to simplify reposition by increasing the mobility of the proximal fragment, through the latter in the sagittal plane, hold the needle and fix it in the half-ring of the compression-dnsstrackioi apparatus, then on either side of the needle into the cortical layer of the bone are inserted two stop rods at a distance of 2.0-2.5 diameters of the bone., 2. Device dp of osteosynthesis, containing a bracket and a shaft, characterized in that, in order to simplify the process of reposting fragments, the bracket is made in the form of arcs, on which the stop threaded rods are mounted by means of clamps, aspits zakresh1 "{a) at the ends of the arc. Sources of information taken into account during the examination 1. USSR author's certificate N 611612, cl. A 61 B 17/18, 1975. I