UA151188U - Fixator for temporary blocking of the growth zone of the long bones - Google Patents

Abstract

The fixator for temporary blocking of the growth zone of the long bones is made in the form of a plate with holes for screws and a hole for a guide rod. The plate is made of thin metal, with the possibility of modeling it to the shape of the bone and inserting it under the soft tissues through a proximal skin incision. The plate on one edge contains a protrusion with recesses for connection with a special device for installation.

Description

The useful model belongs to the field of medicine, namely orthopedics and traumatology, and can be used for the surgical treatment of angular epimetaphyseal deformities of the long bones of the limbs (KEDDC) in children.

The specified KEDDC in children can develop as a result of the action of various pathological factors (dysplasia, infectious lesions of the growth zone, injuries, biomechanical disorders). KEDDC can be noted in different planes: frontal (valgus, varus deformation), sagittal (ante-; recurvation), lumbar (external, internal torsion) and be combined.

KEDDC in children leads to a violation of the biomechanics of the functioning of the affected and adjacent joints, which leads to the progression of deformation, the development of functional and cosmetic disorders, as well as provokes the appearance and progression of degenerative-dystrophic changes in the joints, which may lead to the need to perform disabling operations (endoprosthetics) in the future . Treatment of PKEDDC is carried out surgically. A modern effective and at the same time minimally invasive method used for the treatment of these deformities in children is the blocking of the growth zone with the help of a fixator, which leads to the appearance of asymmetric growth and gradual correction of the deformity. The specified blocking is performed for a certain period, sufficient to achieve correction.

A known device for the treatment of limb deformities caused by impaired growth of long tubular bones, which is a plate for temporary fixation of the bone growth zone. (ZIyemep5

R.M. Sysidey adgouly og apdshag soitesiyop: a rgeiittipagu zepez ivipu a yeepviop bapa riagie. / Reaiai"

Opor. 2007; 27: 253-259).

The disadvantage of this device is that the shape of the plate bend does not match the shape of the epimetaphyseal transition, which has a step-like contour, which greatly complicates the adaptation of the plate to the bone in the place of fixation, and leads to the fact that the metaphyseal screw is located at an angle to the plane of the plate, reducing their contact area.

The closest analogue to the claimed utility model is a plate for temporary fixation of the bone growth zone, which is provided with two holes for screws and a central hole for a guide wire, characterized in that the narrowed central part has a step profile and the peripheral parts are located parallel to each other

INSHO0O00109401 Plate for temporary fixation of the bone growth zone.

The disadvantage of this device is the installation of the plate openly, which leads to traumatization of soft tissues and vessels in the anatomically rich blood supply area of the joints, which leads to complications in the form of subcutaneous hematomas or hemarthroses, which increase the patient's treatment time and hospital stay.

The useful model is based on the task of creating a fixator for temporarily blocking the growth zone of the long bones of the limbs with the ability to simulate the shape of the bone, to introduce it under the soft tissues through a proximal skin incision, which will increase the convenience of spatial manipulation of the plate and its maintenance in the correct position during installation, and the accuracy of installation of the plate.

The task is solved by the fact that the fixator for temporarily blocking the growth zone of long bones is a plate with holes for screws, a hole for a guide rod, according to a useful model, the plate is made of thin metal, with the ability to model it to the shape of the bone and insert it under the 'what tissues through a proximal skin incision, with the plate on one edge containing a protrusion with recesses for connection with a special device for installation.

This development is aimed at increasing the convenience and accuracy when the plate is installed, which will lead to a reduction in the time of surgical intervention and a reduction in the amount of traumatization of soft and bone tissues.

A useful model is explained by drawings that show:

Fig. 1 - general view of the fixator, top view;

Fig. 2 - general view of the retainer, bottom view;

Fig. C - general view of the fixator, side view.

The following are conventionally marked on the drawings: (1) plate, (2) screw holes, (3) protrusion with recesses for connection with a special installation device.

The fixator for temporary blocking of the growth zone of the long bones of the limbs includes a plate 1 with holes for screws 2 and a protrusion with recesses for connection with a special device for installation 3.

A useful model is used as follows.

Installation of the fixator is carried out under spinal anesthesia, through two surgical incisions of 60 skin up to 0.0 cm in length in the projection of the corresponding epimetaphyseal zone of the long bone. With the help of surgical instruments (mosquito) they perform layering of soft tissues in the area of installation of the fixator. The fixator is preliminarily modeled according to the shape of the installation zone, then the device for installation (holder) is attached to the protrusion 3. With the help of the holder, the fixator is introduced under the soft tissues through a proximal skin incision.

Under X-ray control, the growth zone is marked with a needle

Ilizarov, which is introduced through the hole in the center of the plate (not shown in the drawings). At the same time, the plate 1 is fixed in the correct position due to the holder with one of the surgeon's hands (or an assistant), and with the other hand, the installation manipulation is performed. They form two channels in the epiphysis and metaphysis of the corresponding long bone. The growth area is blocked with plate 1, due to its fixation with screws inserted into the holes of plate 2. After confirming the correct installation of the retainer, with the help of X-ray control, the retainer is removed.

An example of a specific use of a utility model.

Patient O., 11 years old, medical history Mo 98271, applied to the pediatric orthopedics clinic of the State University "IPHS named after Prof. M.I. Sitenko of NAMA of Ukraine" on 17.09.2020 with complaints of the presence of shortening of the left leg due to the lower leg against the background of the child's neurological pathology, rapid fatigue of the muscles of the lower limbs and pain in the right knee joint after physical exertion. It is known from the anamnesis that the shortening progressed in 1 year against the background of active growth of the child. The patient underwent a course of conservative physiofunctional and neurological treatment at the place of residence, but the treatment was ineffective, the deformity progressed. Objectively: the patient walks independently with full support on both lower limbs. Shortening of the left lower leg by 2.0 cm is noted. Palpation of the knee joints of both lower extremities is painless. X-rays of the limbs with a ruler revealed a shortening of the left lower leg by 2.2 cm.

The patient underwent surgical intervention in the scope: bilateral blocking of the proximal growth zone of the right lower leg with the applied fixators. The duration of the surgical intervention was 20 min (installation of one plate 10 min.) On the postoperative X-ray control image: the fixator tightly adheres to the tibia and femur, the position of the screws is correct. The patient is allowed a dosed load on the right limb for 2

From the day after the operation, full - after the reduction of the pain syndrome (on the 4th day). Activation of the knee joint on the third day after surgery. The patient was discharged for outpatient treatment on the 4th day after the operation. At the time of the follow-up examination after 12 months: the patient walks with full support on both lower limbs. There is an incomplete correction of the difference in the length of the limbs (the left lower leg is shortened by 0.8 cm). The range of motion in the right knee joint is full. On the control radiograph: the correct position of the plate and screws is noted. A decision was made to continue blocking to achieve full limb length correction.

Patient D., 10 years old, medical history 95019, applied to the Children's Orthopedics Clinic of the "Professor M.I. Sytenka National Academy of Medical Sciences of Ukraine" on May 24, 2020 with complaints of valgus deformity of the tendons/extremities at the level of the knee joint. From the anamnesis, the child suffers from exostosis chondrodysplasia, the deformity has increased over the past 14 months. X-rays of the limbs reveal multiple exostoses of the limbs, several of which are located near the lateral surface of the growth zones of both tibias. Angles of inclination of the articular surface of the femur and tibia, right: those OBA-87"7; MRTA-102"; on the left: those OBA-87"; MRTA-104": (according to the method of 0. Raieu). The patient underwent surgical intervention in the scope: blocking of the medial-proximal growth zone of both lower legs with the applied fixators. Removal of exostoses of the proximal part of both lower legs. The duration of installation of one plate did not exceed 10 minutes. On the postoperative X-ray control image: the fixator fits tightly to the tibia and femur, the position of the screws is correct. The patient is allowed a dosed load on the nerves/extremities on the 4th day after the operation, full - after the reduction of the pain syndrome (on the 7th day). Activation of the knee joints on the 3rd day after surgery. The patient was discharged for outpatient treatment on the 5th day after the operation. At the time of the follow-up examination after 5 months: the patient walks with full support on both lower limbs.

A complete correction of the valgus deformity of both n/extremities is noted. The range of motion in the knee joints is full. On the control radiograph: the correct position of the plate and screws on the right is noted: those OBA-87"; MRTA-87"; from the left: those OEA-87"; MRTA-86"; (according to the method of 0. Raieu).

A decision was made to unblock growth zones.

Thus, the fixator for temporarily blocking the growth zone of the long bones of the limbs, which allows you to insert it under soft tissues through a proximal skin incision of up to 0.6 cm, allows you to increase the convenience of blocking the growth zone, reduce the duration of the surgical intervention and reduce the period stay in a hospital.

Claims (2)

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