WO2013095193A2 - Fixateur pour l'ostéosynthèse des fractures de la partie distale du radius - Google Patents

Fixateur pour l'ostéosynthèse des fractures de la partie distale du radius Download PDF

Info

Publication number
WO2013095193A2
WO2013095193A2 PCT/RU2012/001010 RU2012001010W WO2013095193A2 WO 2013095193 A2 WO2013095193 A2 WO 2013095193A2 RU 2012001010 W RU2012001010 W RU 2012001010W WO 2013095193 A2 WO2013095193 A2 WO 2013095193A2
Authority
WO
WIPO (PCT)
Prior art keywords
screws
radius
diaphysial
distal
diaphyseal
Prior art date
Application number
PCT/RU2012/001010
Other languages
English (en)
Russian (ru)
Other versions
WO2013095193A3 (fr
Inventor
Алексей Валерьевич БАБОВНИКОВ
Original Assignee
Общество С Ограниченной Ответственностью "Азбука Технологий"
РУБЕКИНА, Людмила Николаевна
РУБЕКИН, Дмитрий Николаевич
АЛТУХОВ, Алексей Владимирович
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Общество С Ограниченной Ответственностью "Азбука Технологий", РУБЕКИНА, Людмила Николаевна, РУБЕКИН, Дмитрий Николаевич, АЛТУХОВ, Алексей Владимирович filed Critical Общество С Ограниченной Ответственностью "Азбука Технологий"
Publication of WO2013095193A2 publication Critical patent/WO2013095193A2/fr
Publication of WO2013095193A3 publication Critical patent/WO2013095193A3/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones

Definitions

  • the proposed technical solution relates to the field of medicine, and more specifically to traumatology and orthopedics, and is an innovative universal fixative for osteosynthesis of fractures of the distal radial metaepiphysis and corrective osteotomies of incorrectly fused fractures of the distal radial metaepiphysis.
  • the latch is designed for installation on the front-inner surface of the distal radial metaepiphysis.
  • Fractures of the distal radial metaepiphysis are the most common injuries of the upper limb and make up about 20% of all fractures of the tubular bones and about 70% of fractures of the forearm bones (Z.M. Ataev and D.U. Rusakova 1974; L.P. Sokov 1985; Miller R . 1985; Scharplatz et al, 1986).
  • Great interest in fractures of this localization is caused not only by its frequency, but also by a high percentage of unsatisfactory results.
  • a significantly high percentage of errors and complications in the near and distant periods are the result of prolonged immobilization, as the basis of conservative treatment, which is still the generally accepted method for this contingent of victims.
  • a prerequisite for ensuring the full fusion of the damaged bone and the speedy rehabilitation of the patient is the most accurate comparison of fragments and fragments, restoration of normal bone anatomy, stable fixation and compression between the fragments, as well as the shortest time for immobilization of the damaged limb.
  • a device for fixing fragments in fractures of the distal metaepiphysis of the radius, containing arcs with spokes connected by threaded rods (F.Kh. Katushev, B.M. Prokin "Herald of Surgery named after Grekova", 1973, t.Z, N212, p. 72-76).
  • the disadvantage of this device is the increased invasiveness and the possibility of infection of tissues with a significant number of points of the spokes.
  • a device for fractures of the radius in a "typical place", containing a tire and a spoke, equipped with a spring-loaded bracket with a sleeve (Auth. Certificate. USSR N ° 10506693).
  • the disadvantage of this device are: limited use (only for non-split fractures), cumbersome design, the risk of contracture of the elbow joint and poor fixation of fragments.
  • M ° 58334 in which a radiography of the damaged bone is preliminarily performed to determine the nature of the displacement of the fragments.
  • a bone fracture of a limb is exposed, for example, the distal radius of the radius.
  • the supporting hook is brought under the diaphyseal fragment of the bone, proximal to the fracture site.
  • the overlay, together with the osteosynthesis plate, is placed above the supporting hook so that the bent liner of the overlay falls into the oval hole of the hook. After that, the reposition element of the device is fixed to the bone using a clamping clamp and a screw.
  • the osteosynthesis plate is set so that the holes in its transverse part are located above the distal bone fragment. Through holes in the transverse part of the plate, screws are passed into the epiphyseal fragment of the bone. The spokes are removed. Using the traction screw, the plate is moved in the distal direction to eliminate displacement along the length. After the final reposition is achieved, screws are inserted into the diaphyseal fragment of the bone. The reposition element is removed.
  • the disadvantage of this device is the complexity of the design, as well as the impossibility of dosing the magnitude of the compression, insufficient accuracy of the reposition.
  • a device for treating radial fractures comprising a proximal, middle and distal ring, rod, nut.
  • the latter fasten the rings and rods and are located on the rods from opposite ends of the rings, ⁇ brackets with holes along the longitudinal axis, spokes, spokes holders, restrictive emphasis on the spokes, while the diametrically opposite sides of the middle and proximal rings are connected by the corresponding spokes with the formation of the radial bone support (see the book by L.N. Solomin, “Fundamentals of transosseous osteosynthesis of G. A. Ilizarova ”, published by MORSAR, St. Moscow; 2005, p.205-206).
  • T-shaped plate AO L.N. Ankin, N.L. Ankin. The practice of osteosynthesis and endoprosthetics. - Kiev, 1994. p.144-146.
  • this plate fixes the fracture in only one plane and requires two to three screws to pass through the pineal gland, which, for example, in a child can destroy the cartilaginous tissue of the pineal gland and damage the zone (growth zone).
  • the use of a T-shaped plate does not allow stable compression of fragments. The installation of this plate is combined with a wide dissection of the capsule of the wrist joint.
  • a known plate consisting of an overhead part and having holes for screws (US Pat. RF 2238691).
  • the patch is made in the form of a rectangle, at the bottom of which two stylet are made at an angle of 70 ° to the plane of the plate, the tips of which are directed to the center of the plate.
  • the closest prototype is a fixator for treating a fracture of the distal metaepiphysis of the radius, consisting of a L-shaped perforated plate having an epiphyseal and diaphyseal parts with lockable screws (LCP Distal Radius System 2.4 from Synthes).
  • this device like all of the above analogues, cannot provide stable fixation of complex comminuted unstable fractures of the radial bone, nor can it treat chronic, non-healing or non-healing fractures of this bone. In addition, this device cannot provide early mobility in the wrist and wrist joints.
  • the goal of the proposed technical solution is to create a device for the treatment of all types of unstable fractures of the distal part of the radial bone, as well as to eliminate chronic displacements, as a consequence of conservative treatment, in the case of abnormally fused or fused fractures, providing conditions for early postoperative functional rehabilitation of the wrist joint and hand .
  • the objectives of the proposed technical solution are: reducing the time of surgery and treatment time, ensuring stable osteosynthesis, improving the convenience of the operation due the absence of the need for additional modeling of the latch and the low cost of the device.
  • a fixative for the treatment of a fracture of the distal metaepiphysis of the radius consisting of a perforated plate having an epiphyseal and diaphyseal parts with lockable screws.
  • the epiphyseal and diaphyseal parts have additional lateral branches directed perpendicular to the main part of the plate towards the center of the diaphyseal part of the radius.
  • the latch additionally has a metaphysical part located at an angle with respect to the diaphyseal part.
  • the retainer forms an “F-shaped” shape with bends that anatomically repeat the shape of the radius in the distal part; the screws in the lateral branches are inserted perpendicular to the screws in the diaphyseal part, and the screws of the metaphysical part are inserted at an angle with respect to the diaphyseal part. All holes are made of different diameters and have directional threads to block the screws in a strictly defined direction.
  • the proposed fixer has holes of different diameters for fixing the subchondral site, metaepiphysis and diaphysis of the radius.
  • the connectedness of the plate branches, the use of crossing screws of different diameters provides greater stability compared to the prototype, and the universality of the arrangement of the fixing elements provides the possibility of osteosynthesis of almost any type of fracture in this area.
  • the proposed technical solution is a fixative for osteosynthesis of fractures and corrective osteotomies of abnormally fused fractures of the distal radial bone metaepiphysis.
  • the clamp is designed for installation on the palmar and outer surfaces of the distal radial metaepiphysis.
  • the latch can be used for the right and left radius (specular).
  • figure 1, 2, 3 presents a front view, side view and top view, respectively.
  • the latch consists of 3 interconnected parts - the upper epiphyseal part (1); the middle one is the metaphyseal part (2) and the lower diaphyseal part (3) and 2 branches — the epiphyseal lateral branch (4) and the diaphyseal lateral branch (5).
  • the metaphyseal part is made in the form of a plate and is perpendicular to the diaphyseal part (3).
  • the general view of the fixator has an “F-shaped” shape with bends anatomically repeating the shape of the radius in the distal part.
  • the latch is designed for the right and left radius (mirror symmetric) and is equipped with locking screws of different diameters. Drilling of channels for screws is carried out using a guide, which is screwed into the plate (not shown in Fig.).
  • the total length of the plate is from 50 to 100 mm, depending on the length of the diaphyseal part.
  • the diaphyseal part (3) has holes (6) for introducing lockable screws with a diameter of 3.5 mm.
  • the metaphyseal part (2) has 3 holes (7), the epiphyseal part (1) has 4 holes (7) and the side branches (4) and (5) have 4 and 2 holes (7), for the introduction of lockable screws with a diameter of 2.4 mm
  • the screws in the lateral branches (4) and (5) are inserted perpendicular to the screws in the diaphyseal part (3).
  • the screws of the metaphysical row (2) are inserted at an angle with respect to the diaphyseal part (3). All holes in the plate have directional threads to lock the screws in a strictly defined direction.
  • the proposed latch has 3 rows of holes of different diameters (1.5 mm; 2.4 mm and 3.5 mm) for fixing the subchondral pad, metaepiphysis and diaphysis.
  • the connectedness of the plate branches, the use of crossing screws of different diameters provides greater stability compared to the prototype, and the universality of the arrangement of the fixing elements provides the possibility of osteosynthesis of almost any type of fracture in this area.
  • the next step is the osteosynthesis of fragments of the epiphyseal part (4) and the diaphyseal part (5) with the introduction of screws into the holes (7).
  • the proposed technical solution can be used to treat all types of unstable fractures of the distal part of the radius, as well as for elimination of long-standing displacements, as the consequences of conservative treatment, in the case of improperly fused or fused fractures, providing conditions for early postoperative functional rehabilitation of the wrist joint and hand.
  • the positive properties of this technical solution are the reduction of the operation time and treatment time, ensuring stable osteosynthesis, as well as improving the convenience of the operation due to the absence of the need for additional modeling of the fixator, as well as the low cost of the device.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

La solution technique concerne le domaine de la médecine et, plus particulièrement, la traumatologie et l'orthopédie. L'invention a pour objet un fixateur destiné au traitement d'une fracture de la méta-épiphyse distale du radius, ce fixateur comprenant une plaque perforée présentant une partie épiphysaire et une partie diaphysaire pourvues de vis de blocage. Les parties épiphysaire et diaphysaire comportent des branches latérales additionnelles orientées vers la partie diaphysaire du radius, et une partie métaphysaire disposée perpendiculairement à la partie diaphysaire. Le fixateur se présente sous la forme d'un F présentant des courbures qui rappellent la forme anatomique du radius dans la partie distale, des vis dans les branches latérales étant introduites perpendiculairement aux vis de la partie diaphysaire, et des vis de la partie métaphysaire étant introduites au niveau d'un angle par rapport à la partie diaphysaire. L'utilisation de la solution technique permet de réduire la durée d'une intervention et la période de traitement, et garantit une ostéosynthèse stable, ainsi qu'une plus grande facilité de réalisation d'une intervention du fait qu'une modélisation additionnelle du fixateur n'est pas nécessaire.
PCT/RU2012/001010 2011-12-23 2012-12-03 Fixateur pour l'ostéosynthèse des fractures de la partie distale du radius WO2013095193A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
RU2011152545 2011-12-23
RU2011152545 2011-12-23

Publications (2)

Publication Number Publication Date
WO2013095193A2 true WO2013095193A2 (fr) 2013-06-27
WO2013095193A3 WO2013095193A3 (fr) 2013-10-24

Family

ID=48669672

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/RU2012/001010 WO2013095193A2 (fr) 2011-12-23 2012-12-03 Fixateur pour l'ostéosynthèse des fractures de la partie distale du radius

Country Status (1)

Country Link
WO (1) WO2013095193A2 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107007338A (zh) * 2017-03-30 2017-08-04 天津天好医疗器械有限公司 桡骨远端骨折外固定系统
CN109480993A (zh) * 2018-12-25 2019-03-19 吉林大学第医院 组合式胫骨平台后外侧解剖钢板

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6096040A (en) * 1996-06-14 2000-08-01 Depuy Ace Medical Company Upper extremity bone plates
RU2238693C1 (ru) * 2003-02-19 2004-10-27 Закрытое акционерное общество "Ключевский" Устройство для накостного остеосинтеза

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6096040A (en) * 1996-06-14 2000-08-01 Depuy Ace Medical Company Upper extremity bone plates
RU2238693C1 (ru) * 2003-02-19 2004-10-27 Закрытое акционерное общество "Ключевский" Устройство для накостного остеосинтеза

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
'LCP Distal Radius System 2. 4. Dorsal and volar plates for fractures and osteotomies of the distal radius.' SYNTHES., [Online] 2006, Retrieved from the Internet: <URL:http://www.synthes.com/sites/intl/IntIContent/Files/036.000.130.pdf> *

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107007338A (zh) * 2017-03-30 2017-08-04 天津天好医疗器械有限公司 桡骨远端骨折外固定系统
CN109480993A (zh) * 2018-12-25 2019-03-19 吉林大学第医院 组合式胫骨平台后外侧解剖钢板

Also Published As

Publication number Publication date
WO2013095193A3 (fr) 2013-10-24

Similar Documents

Publication Publication Date Title
US6712073B2 (en) Extramedullary rod implant for long bones
US7828801B2 (en) External fixation device for fractures
US6488685B1 (en) Extramedullary rod fixateur for bones
US7479142B2 (en) Method of fracture fixation
US20030225405A1 (en) Fixator with outrigger
JPH08266562A (ja) 植込み可能な装置
JPH03501092A (ja) 骨接合用圧迫‐伸延装置
Iacobellis et al. Plating in diaphyseal fractures of the forearm
WO2013095193A2 (fr) Fixateur pour l&#39;ostéosynthèse des fractures de la partie distale du radius
WO2017037733A1 (fr) Fixateur externe pour gestion du traumatisme d&#39;un membre
RU116335U1 (ru) Фиксатор для лечения переломов дистального метаэпифиза лучевой кости
RU2353321C1 (ru) Устройство для лечения переломов лучевой кости
JPH0312145A (ja) 骨プレート
RU2762481C1 (ru) Ладонное (волярное) фиксирующее устройство для остеосинтеза при лечении переломов дистального отдела лучевой кости
RU116340U1 (ru) Фиксатор для остеосинтеза переломов проксимальной части большеберцовой кости
RU2740529C1 (ru) Аппарат для лечения диафизарных переломов костей голени у детей
RU2454963C1 (ru) Аппарат для лечения повреждений и заболеваний длинных трубчатых костей у детей
RU162568U1 (ru) Направитель для спиц при предварительной фиксации проксимальных переломов плечевой кости
WO2013073994A1 (fr) Fixateur pour l&#39;ostéosynthèse de fragments de l&#39;extrémité proximale de l&#39;humérus
CN220423949U (zh) 一种用于胫骨骨折的外固定架
RU2208413C2 (ru) Устройство для лечения переломов дистального отдела плечевой кости
Bhattacharyya et al. Principles and Usage of Ilizarov Techniques in the Management of Fractures
RU2816627C1 (ru) Способ остеосинтеза проксимального отдела плечевой кости путем периимплантной дистракции и фиксации
RU2423945C1 (ru) Направитель для спиц для фиксации отломков при лечении переломов хирургической шейки плеча
RU2750518C1 (ru) Устройство для зажима чрескостных элементов

Legal Events

Date Code Title Description
122 Ep: pct application non-entry in european phase

Ref document number: 12858745

Country of ref document: EP

Kind code of ref document: A2