Surgical instruments or methods for treatment of bones or joints and devices specially adapted therefor (A61B17/56)

A   Human necessities(305254)
A61B17        Surgery(21042)
A61B17/56                     Surgical instruments or methods for treatment of bones or joints; devices specially adapted therefor(4288)
Osteosynthesis method for multi-fragment comminuted fracture of patella // 2615665
FIELD: medicine.SUBSTANCE: knee is washed with an antiseptic solution. Small pieces of patella are removed. The patellar defect is filled with hydroxyapatite. Two spokes are directed vertically in the interior of the patella in the longitudinal direction so that the lateral and medial spokes fixed the lateral and medial patellar fragments, and the spokes are tightened with a 8-shape directed wire behind the quadriceps tendon. Two parallel spokes are injected in the horizontal direction in the interior of the patella to secure the proximal and distal fragments of the patella, the wire is directed transversely to the patella, and the spokes are tightened with a 8-shaped drawn wire loop.EFFECT: method increases osteosynthesis stability, reduces the risk of non-union, reduces the risk of contracture.2 dwg
ethod for long tubular bones combined osteosynthesis during deformities correction for children with osteogenesis imperfecta // 2615279
FIELD: medicine.SUBSTANCE: supports of a transosseous distraction device with external fixation are mounted on the bone. The first elastic rod is introduced in the medullary bone cavity through the pineal gland, not reaching the expected osteotomy level. Bone osteotomy is performed. Bone fragments are set in the desired proper position. The set position of bone fragments is fixed with the transosseus external fixation device. The first elastic rod is directed further into the medullary cavity, beyond the osteotomy level, to the opposite metaphysis, and its end is immersed in the metaphysis. The second elastic rod is introduced through the opposite epiphysis towards the first elastic rod into the medullary bone cavity, directed beyond the osteotomy level, and its end is immersed in the metaphysis. During flexible rods introduction, equal bend curvature and opposite direction are provided. At least one flexible rod is directed through the bone growth zone. The free ends of the rods are bent and cut. Transosseous external fixation device provides moderate compression force on the bone fragments. After bone fragments fusion is reached, the transosseous external fixation device is removed.EFFECT: method prevenst re-strain during growth.2 dwg
ethod for bone diaphysis circular defects recovery // 2614888
FIELD: medicine.SUBSTANCE: polypropylene mesh "Lintex" for hernia plastics is applied in the circular bone defect area to the bone fragments limiting the defect, in the form of "clutch". "Collapan" in the form of granules, mixed with endosteum tissue, extracted from the medullary canal is poured into the defect in the mesh edges connection area.EFFECT: method allows to reduce trauma, reduce the time of surgery.1 dwg

ethod for autoplasty of false joints of tubular bones // 2614882
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for autoplasty of false joints of tubular bones. Reposition is performed. Longitudinal osteotomy of ends of bone fragments is realised with double circular saw with formation of two autotransplants of different length that continues each other. Ends of lines of longitudinal osteotomy are connected by means of oscillatory saw to bone surface at angle 45-60 degrees, as a result length of internal surface of autotransplants exceeds length of their external surface. Positions of both autotransplants are interchanged, four holes are drilled: one hole on each closest to each other ends of autotransplants and lateral holes from both sides of bone bed at the level of hole of the larger of the two autotransplants. Thread is passed through holes, tightened and knot is tied up, which is placed above the smaller of the two autotransplants. One of two ends of thread is passed around bone and tied, with placement of final knot near the previous knot.EFFECT: method makes it possible to increase fixation reliability.3 dwg
Treatment method of haematogeneous osteomyelitis of vertebral column // 2614360
FIELD: medicine.SUBSTANCE: invention may be applied for the treatment of the haematogeneous osteomyelitis of the vertebral column. A porous implant, inside which a perforated drainage is mounted, is installed into a bone defect of vertebrae. Elimination of a pyoinflammatory exudate from the affected area is performed by means of vacuum at (-0.1)-(-0.2) mPa within 7-10 days.EFFECT: method allows improving efficiency of the drainage of the bone cavity and epidural space during the treatment of the haematogeneous osteomyelitis of the vertebral column.4 dwg, 1 tbl
ethod of posterior interbody fusion // 2614219
FIELD: medicine.SUBSTANCE: invention refers to the traumatology and orthopedics and may be used for posterior interbody fusion. Channels in the intebody space is formed with maintaining of integrity of the endplates of adjacent vertebral bodies. An autotransplant of bone chip formed during conduction of interlaminectomy, facetectomy, or decompression of spinal cord roots is formed by means of expression of the liquid fraction of a bone mass and compression until formation of a supportable bone column of an intended size. The implant of porous titanium nickelide is installed into the channel in such way to provide maintaining of support ability of the autotransplant.EFFECT: method of posterior interbody fusion allows quickening of formation of a bone and metal block.

Anchor for legiment and muscles reinsetion in case of their separation from bones and key for installation and removal // 2614208
FIELD: medicine.SUBSTANCE: anchor for legiments and muscles reinsertion in case of separation from the bone comprises a threaded cylindrical portion and a head for the anchor installation and removal key, with hole and slots in the thread on both sides. Grooves are made along the entire length of the thread, a suture hole extends perpendicularly to the side surface and connects slots in the middle part, the key head has a cylindrical shape with flats at the grooves in the thread. The key for installation and removal of the above anchor is T-shaped and includes a handle and a rod. The working end of the rod is a stepwise cup, two opposing recesses are arranged on the lower step, coming from the edges of the rod to the handle. The recess height exceeds the anchor head height by 1 mm, while the walls of the lower cup step are flat from the inside at anchor head flats. The side wall of the rod contains an inclined channel extending to the upper step of the cup for suture withdrawal from the rod cavity, the channel outlet opening is located in a plane perpendicular to the side recesses plane.EFFECT: structural strength to secure the suture, suturing without any contact with the cutting edge of the anchor.2 cl, 6 dwg

ethod of treating chronic elbow and prepatellar brusitis // 2614207
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to traumatology-orthopedics and surgery, and can be applied for treatment of chronic elbow and prepatellar brusitis. For this purpose puncture of bursa, its content aspiration, introduction of medication in its cavity, drainage of bursa with constant active aspiration are realised. As medication 2 ml of heparin 10000 IU are introduced in bursa cavity. After 24 hours aspiration of content is carried out and 2 ml of heparin 10000 IU and 10 mg of trypsin are introduced. 3 hours after this vacuum system of active aspiration is placed in bursa cavity. Further, in a day removal of aspiration liquid from system is realised in the process of bandaging. System of active aspiration is applied until exudate extraction from bursa stops.EFFECT: method ensures improvement of treatment effects as a result of reduction of pain reaction to medicinal procedure, reduction of quantity of recurrences as a result of active influence on synovial envelope of bursa, thorough evacuation of its content and activation of regeneration processes.1 dwg, 2 ex

ethod of surgical management of congenital hip dislocated in adolescence // 2614101
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for surgical management of congenital hip dislocated in adolescence. Gigli saw is brought around femoral bone. Hip is transected by half its diameter. Osteotomy of external cortical thighs is made with vibration saw oblique downwards and from outside inwards to contact with previous line of corticotomy to make two fragments of hip with oblique fracture line in intertrochanteric and subtrochanteric areas. Behind lesser trochanter groove is made with grooved chisel, where proximal end of distal bone fragment is embedded. And proximal end of femur is shifted downward and forward as much as possible. Biomechanical axis of extremity is restored by bringing distal part of hip. Preset position of extremity is fixed on plate.EFFECT: method enables reducing length of staying in hospital, reducing risk of deformation in remote period.1 cl, 1 dwg
ethod for neck of radius intramedullary osteosynthesis for children // 2614099
FIELD: medicine.SUBSTANCE: two needles are passed: one through the styloid process of the distal radius, the other - through the distal radius over the ulna notch to the proximal fragment of the neck of radius. The needles are introduced into the proximal fragment without entering the joint cavity. The needles are bent and cut in the distal section. The limb is fixed by a plaster cast.EFFECT: method allows to reduce trauma and increase the stability of fixation, prevent elbow joint contracture.1 dwg

ethod for fibula autoplastic properties optimisation // 2614095
FIELD: medicine.SUBSTANCE: fibula is sawed longitudinally into two parts, multiple perforations are applied to each half and stacked on the defect with cortical walls rotated towards each other.EFFECT: method allows to optimize the plastic properties of the fibula.1 dwg
ethod of radiation dose reduction in transcutaneous-open installation of transpedicular screws under paraspinal mini-access // 2613601
FIELD: medicine.SUBSTANCE: invention relates to traumatology and neuro-orthopaedic surgery and can be applicable for dose reduction in transcutaneous-open installation of transpedicular screws in terms of paraspinal mini-access. Perform mid-paraspinal mini-access and percutaneous punctures. Perform under the control of the x-ray images an installation of the navigating spokes, cutting of internal thread by cannulated taps, installation of transpedicular screws. Installation starts on the left side of the patient, first install the right rostral navigating spoke which is guided via a separate skin puncture, then install the left caudal navigating spoke directly through mini-access, thus set navigating spokes are in miscellaneous position. Perform first 2–3 fluoroscopic images in the frontal and sagittal projections. Then by navigating spokes perform cutting with cannulated taps of pediculo-corporal bone channels and set transpedicular screws, and exercise this in the reverse order, namely first perform cutting with cannulated taps of pediculo-corporal bone channels along the set left caudal navigating spoke and introduce left caudal transpedicular screw, wherein the navigating spoke is removed in the moment of the initial introduction of the screw, then perform cutting with cannulated taps of pediculo-corporal bone channels along the set right rostral navigating spoke and introduce right rostral transpedicular screw, wherein the navigating spoke is removed in the moment of the initial introduction of the screw. Then install the next pair of navigating spokes and transpedicular screws wherein the installation is performed at the right side from the patient, first introduce the left rostral navigating spoke which is guided via a separate skin puncture, then install the right caudal navigating spoke directly through mini-access, Perform next 2-3 fluoroscopic images in the frontal and sagittal projections. Then along the installed right caudal navigating spoke perform cutting with cannulated taps of pediculo-corporal bone channel and install right caudal transpedicular screw, then along the installed left rostral navigating spoke perform cutting with cannulated taps of pediculo-corporal bone channel and install left rostral transpedicular screw.EFFECT: method allows to reduce the number of intraoperative images to reduce x-ray exposure dose affecting the patient and medical staff.3 cl, 1 tbl, 6 dwg
Device for orbital floor defects and deformations plastics and method for its application // 2613443
FIELD: medicine.SUBSTANCE: device for orbital floor defects and deformations plastics includes a trivalve plate, and also includes an additional plate with through holes all over its surface; the central valve of the trivalve plate is trapezoidal with rounded sides and corners, outer valve pairs are symmetrical, have a bean shape with an outward convex and is connected to Ѕ of its length by the concave side surface to the convex side surface of the central valve, starting from its center towards its larger base to form slit spaces between the valves, the central valve is longer than the outer valves and projects more from the lower base; at that, the trivalve plate has through holes all over the outer valves surface along the larger base and side surfaces of the central valve, as well as from its center to the smaller base, except the central portion, at that, the additional plate is inserted under the lower base of the central valve and on the outer valves of the plate and is fixed by two U-shaped sutures on the trivalve plate through the through holes located along the additional plate edges and holes in the outer valves of the plate facing the lower base of the central valve. For implementation of the method for orbital floor defects and deformations plastics, a device with one additional plate with smaller base of the central valve directed towards the eye socket top is installed, and the exophthalmometer is used to determine the eye level relative to the fellow eye, and when the eye position symmetry is achieved, the device is fixed through the holes along the larger base of the central valve to the periosteum of the lower orbital edge by U-shaped sutures.EFFECT: group of inventions allows to achieve eye symmetry eye, prevent the formation of adhesions with the bottom eye muscles, reduce the risk of infectious complications.4 cl, 3 ex, 3 dwg
ethod for prevention of interspinous retainer instability development // 2613419
FIELD: medicine.SUBSTANCE: retainer is installed at intraoperative monitoring of spinous processbone tissue saturation indicators. Prior to retainer installation, base saturation is determined in % by means of a laser flowmetry sensor, which is mounted on the top of the spinous process. Transosteal fixation is performed using a digital torque wrench, changing efforts to achieve secure locking while maintaining the core value of the saturation parameters within acceptable limits.EFFECT: method avoids excessive compression, reduces the risk of retainer instability.1 dwg

ethod for surgical correction of funnel chest deformity and device for realisation thereof // 2612825
FIELD: medicine.SUBSTANCE: group of the inventions relates to thoracic surgery and can be applied for surgical correction of funnel chest deformity. In order to pass correcting plate successively its proximal end is connected with distal end of tunneliser-guide by means of 5 mm thick and 10 mm long Kevlar cord and then plate is moved by pulling in from right to left direction by handle of tunneliser-guide with simultaneous application of translator efforts to distal end of correcting plate in the same direction.EFFECT: group of the inventions makes it possible to reduce trauma.2 cl, 10 dwg
ethod for combined osteosynthesis of intraarticular humerus block fractures using submersible compression screws and swivel-distraction external fixation device // 2612812
FIELD: medicine.SUBSTANCE: wedge osteotomy of the olecranon with mobilization and diverting up of the tendon and the lower third of the shoulder triceps with access to intra-articular fractures of the humerus block. Fracture site reposition is performed, and guide spokes are passed perpendicular to the fracture lines of, along which channels are drilled, and fractures are fixed by introduction of cannulated compression screws into the channels with screw head immersion down the subchondral plate to ensure complete intraosseous location. Then osteosynthesis is performed on the pre-fixed osteotomised olecranon by means of wire and Weber spokes, followed by hemostasis. The surgical wound is sutured by layers tightly to form a bed for the ulnar nerve. Then a modeled hinge-distraction Oganesyan device is imposed on the elbow joint, and spokes are passed through the condyle of the humerus along the motion axis of the elbow joint through the middle third of the humerus, and also through the upper third and middle third of the ulna, along the motion axis of the elbow joint in the frontal plane through the locking fittings of the hinge-distraction device. The spokes are fixed in the hinge-distraction device locks, pulled, and the ends are removed. The hinge-distraction apparatus is fixed by the rear bar with moderate elbow distraction in the average physiological position ensuring the creation of an enlarged joint space. Active development of elbow movements in a hinge-distraction device starts from the third day after surgery. The hinge-distraction device is removed after 4-9 weeks. Removal of wire and spokes locking the olecranon is performed 8-12 months after surgery.EFFECT: method allows to start early development of operated joint movements, reduces the risk of postoperative contractures and arthrosis.13 cl

ethod for surgical treatment of palmar digital nerves damages // 2612122
FIELD: medicine.SUBSTANCE: rear digital nerve is crossed at the level of damage to the own palmar digital nerve. The central end of the rear digital nerve is moved to the palmar surface and sutured with the peripheral end of the own palmar digital nerve.EFFECT: method reduces postoperative complications, which is achieved by direct suturing of the peripheral end of the palmar digital nerve to the central end of the rear digital nerve.5 dwg, 1 ex
ethod for flat-valgus foot deformities treatment for children and adolescents // 2612097
FIELD: medicine.SUBSTANCE: method involves imposition of external fixation unit on the foot and lower leg, peroneal muscle group tendon and Achilles tendon lengthening, foot joints resection followed by distraction on the unit, with bringing down of calcaneus and forefoot. Semicircular supports of the unit are applied parallel to the plantar surface of the calcaneus and the metatarsal bones and perpendicular to the side surface of the forefoot in relation to the rear department. Talonavicular arthrodesis is created by taking out the scaphoid from the subluxation position, which is fixed by a longitudinal needle drawn through the first metatarsal, first wedge, and scaphoid bones to the normal correction position. Valgus deformity of the forefoot is eliminated by cuboid bone osteotomy in the middle third. Pronation and equinus installation of calcaneus is corrected by calcaneus body osteotomy made outside inwards, in a plane parallel to the talo-calcaneal joint space. The rear and front semicircular supports are connected in a closed elliptical frame, which is connected to the annular support, superimposed on the middle third of the tibia by means of rods and joints, control which forms a multiplanar reclaim of the calcaneus. Sphenoid-distraction regenerate of the cuboid bone is form by connecting rods between the front and rear of semicircular support.EFFECT: method prevents development of shortened foot.5 dwg
ethod for radial bone defect and ulna head luxation treatment // 2612094
FIELD: medicine.SUBSTANCE: ulna bone transplant is placed to the radial bone defect, the transplant is fed from the square forearm pronator, supplied by ulnar artery branches. The second metacarpal bone, ulna transplant and the lower third of the radial bone are fixed by a plate.EFFECT: method allows to reduce the risk of trophic disorders, reduce the risk of pathologic fracture.5 dwg
ethod for determination of channel center during tibia anatomical single-beam plastic of anterior cruciate knee ligament // 2611958
FIELD: medicine.SUBSTANCE: guide end is mounted on the rear edge of the intercondylar eminence, with a retreat at a distance of no more than 13 mm to the front along the perpendicular to the line connecting the tops of the intercondylar eminence inner and outer bumps, which crosses it at a distance of 1/3 from the top of the intercondylar eminence outer bump to provide the center of the anterior cruciate ligament attachment to the tibia.EFFECT: method provides anatomical location of the transplant, its natural functional tension.1 dwg
ethod for arthro-medullary shunt installation in case of knee joint degenerative-dystrophic diseases // 2611950
FIELD: medicine.SUBSTANCE: invention can be applied to install an arthro-medullary shunt in case of knee joint degenerative-dystrohpic diseases. A channel is formed in the femur with an awl 4.5 mm in diameter without drilling, 0.5 cm anterior to the intercondylar arch. The arthro-medullary shunt is screwed "flush" with the cartilage.EFFECT: method allowes to reduce trauma, to prevent shunt blockage with bone chips.2 tbl
Osteoplastic laminotomy method for selective dorsal rhizotomy // 2611927
FIELD: medicine.SUBSTANCE: single non-free bone and ligamentous blocks of two adjacent vertebrae are formed in the spinal cord cone localization projection, where the dorsal roots of caudal segments are located at the point of entry into the dorsolateral sulcus. Plates of adjacent vertebrae aches in the upper portion thereof for the proximal vertebra, and the lower portion thereof for the distal vertebra are not dissected along the entire thickness, but only to the cancellous bone level. Thus formed single non-free bone and ligamentous blocks are folded and fixed by a rack retractor opening the operative field.EFFECT: method provides a clear view for intrachannel manipulation, can reduce the risk of trophic loss and bone and ligamentous unit separation.6 dwg
ethod for treatment and prevention of deforming osteoarthritis of ankle joint // 2611913
FIELD: medicine.SUBSTANCE: under the EOC control a K-wire is conducted intramedullary and a cannulated drill is used to form a channel where an artromedullar shunt is installed flush with an internal channel under the cartilage until total immersion flush with the bone front edge of the tibia, linking the intraosseous space, forming the medullary cavity of the tubular bone with joint cavity. After K-wire removal, the shunt channel is cleaned from possible bone chips contamination and the cartilage is treated in the outlet area by a countersink.EFFECT: accelerated recovery of joint cartilage to prevent their deterioration.2 cl, 3 dwg, 1 ex
ethod for check-out and complex primary endoprosthetics of knee joint in case of defects of articular surfaces // 2611911
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for check-out and complex primary endoprosthetics of knee joint in case of defects of articular surfaces. In the process of preoperative planning, radiograms of knee joint are used to determine position and length of supracondylar line of femur in direct projection, by connection of apexes of medial and lateral epicondyles. After that, position of initial line of articular surfaces of femur is determined by connection of medial segment, drawn towards joint space, perpendicular to supracondylar line of femur, from the point of attachment of major adductor muscle of thigh for distance, constituting 0.50 of supracondylar line, and end of lateral segment, drawn towards joint space, perpendicular to supracondylar line of femur, from apex of lateral epicondyle for distance, constituting 0.27 of supracondylar line length. In the process of endoprosthesis implantation its femoral component is placed in femur in such a way that in direct projection line of articular surface of femoral component coincides with initial line of articular surface of femur. Thigh component is fixed in specified position. Implantation of tibial component of endoprosthesis is performed.EFFECT: method makes it possible to recover normal ligament balance in knee joint.5 dwg
ethod of rear access to acetabulum // 2611898
FIELD: medicine.SUBSTANCE: cut is made from the back-upper iliac bone towards the femur greater trochanter with transition to the front outer surface of the hip. Access to the rear roof structures of the acetabulum is provded through the large gluteal muscle. The ligaments of pyrimorm muscle, internal obturator muscle and twin muscles are mobilized and crossed. Muscle ligaments are cut off at the point of attachment to the femur, two bores are pre-formed therein, according to the long coaxial lines of the pyriform and the internal sphincter. The ligaments are sutured. The free ends of sutures from the ligamnts are passed through the formed channels respectively. Ligaments are pulled up to the level of their anatomic attachment to the femur. The free ends of the suture are fixed by means of fasteners.EFFECT: method allows prevention of circulatory disorders and functional disorders.2 cl, 10 dwg
ethod of excision of femoral component of hip joint endoprosthesis // 2611897
FIELD: medicine.SUBSTANCE: invention refers to traumatology and orthopaedics and is applicable for removal of the femoral component of the hip joint endoprosthesis. A burr hole is made in the femur at the level of 2-3 cm from the level of the endoprosthesis leg end, by means of a 5-7 mm drill. A guide channel is formed along the endoprosthesis leg on the outer surface between the endoprosthesis and bone. A guide wire is inserted from the proximal side and brought out through the burr hole and cerclage system conductor, and fixed to the Gigli saw, which is passed in the opposite direction through the cerclage conductor, placed in the burr hole, and along the femoral component of the endoprosthesis within the femoral canal through the guide channel. A saw cut is made between the endoprosthesis component and femur along the entire circumference of the femoral canal by progressive pendulum-like movements of the Gigli saw. The femoral prosthesis component is removed from the femoral canal.EFFECT: invention preserves bone tissue.4 cl
ethod for treating defects of shoulder girdle soft tissues, complicated by humeral head osteomyelitis // 2611893
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for treating defects of shoulder girdle area soft tissues, complicated by humeral head osteomyelitis. Necro- , sequestrectomy are performed. Trilateral foramen with located in it vessels, running towards latissimus dorsi muscle, skin and fascia, is exposed. Skin-fascial-muscle transplant, including skin, fascia of scapula area and part of latissimus dorsi muscle, blood supply of which is realised by thoraco-dorsal artery (athoraco-dorsalis), which is a branch of subscapular artery (asubscapularis), is formed. Formed transplant is moved in frontal plane at 170° in direction of shoulder joint, rolled into tube, passed through skin-fascial tunnel, formed in posterior part of shoulder joint, and transplanted into the area of defect of shoulder girdle soft tissues and humeral head.EFFECT: invention makes it possible to treat defects of shoulder girdle soft tissues.5 dwg
ethod for treating bone tumour of popliteal region // 2611889
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for treatment of bone tumour of popliteal region. Access is realised on posterior surface of shin. Gastrocnemius and soleus muscles are separated. Motor branches of posterior tibial nerve and posterior neurovascular bundle are exposed. Tumour base is dissected from fibula by external access. Tumour is cut into parts with excision of tumour between posterior neurovascular bundle and its branches through access on anterior surface of shin.EFFECT: method makes it possible to ablate tumour in case of location of large vessels and nerves on it.1 ex, 3 dwg
ethod for pathological hip dislocation treatment // 2611884
FIELD: medicine.SUBSTANCE: acetabulum is made free from scar tissues. Transtrochanteric osteotomy of the femur is performed at the level of the lower pole of the cervix with simultaneous cutting of the greater trochanter with the cervix. Holding the proximal fragment of the femur, lateral displacement and valgus deviation of the distal fragment of the femur is carried out. The femur fragments are fixed in the specified position using the external fixation device and connected by means of an extramedullary plate. The external fixation device is secured to the wing of the ilium and the distal end of the femur, freeing the proximal end of the femur from external fixation device. Open reduction of the proximal end of the femur in the acetabulum is performed, providing alignment of the bearing surface of the proximal end of the femur in the acetabulum. The achieved position is stabilized, and the hip joint is unloaded by the external fixation device. Postoperatively, development of passive movements in the hip joint is performed. The external fixation device is dismantled after consolidation of the femur fragments and stabilization of the hip joint. The hip joint is fixed by a removable plaster cast.EFFECT: method allows creation a favorable geometric relations in the hip joint, shortened patient's stay in the external fixation device.5 dwg, 1 ex

Percutaneous methods of treating spinal canal and foraminal stenosis // 2610882
FIELD: medicine.SUBSTANCE: group of inventions can be used for treating spinal stenosis. Device for treating spinal stenosis comprises first percutaneous needle with first opening, near end and far end, wherein far end is configured to be placed into epidural space in first position relative to selected plate; second percutaneous needle with second opening, near end and far end, wherein far end of second percutaneous needle is configured to be placed into epidural space in second position relative to selected plate; wire tool made with possibility of displacement within first and second gaps; and clamping tool with near end and far end, wherein said clamping tool can displace within first and second gaps, and its far end is configured for temporary connection with wire tool inside epidural space of selected plate and pushing of said wire tool through appropriate opening of epidural space. Method of percutaneous laminoplasty includes steps of: introduction of first needle percutaneously into epidural space above specified plate; introduction of second needle percutaneously into epidural space under selected plate; introduction of wire tool in first opening and moving of wire tool into epidural space above selected plate; introduction of clamping tool in second opening and moving of clamping tool into epidural space under selected plate; deployment of clamping tool for temporary connection with wire tool and retraction of clamping tool and wire tool for their approach; and manipulation of wire tool to modify selected plate.EFFECT: group of inventions enables reducing invasiveness of intervention.19 cl, 16 dwg

ethod of fixation of bone fragments during endoprosthesis replacement of transtrochanteric femoral fractures // 2610861
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be used for fixation of bone fragments during endoprosthesis replacement of transtrochanteric femoral fractures. Through fragments of greater trochanter channel is made, in which wire cerclage is introduced. End of wire is driven round rear surface of proximal femur and moved at front above lesser trochanter. Loop of 8-suture is made with help of the same end of the wire around lesser trochanter. On front surface of proximal femoral bone final node is made with initial end wire cerclage applying compression at femoral diaphysis.EFFECT: method enables increasing fixation stability.1 cl, 1 dwg
ethod of surgical treatment of heterotopic ossification in the background of the patient's spastic syndrome // 2610538
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be applicable for surgical treatment of heterotopic ossification in the background of the spastic syndrome of the patient. Determine the stage of maturity of heterotopic ossification on indicators of calcium-phosphorus metabolism in venous blood of the patient, at the same time determine the contents in the venous blood of the patient of alkaline phosphatase in U/l and osteocalcin, ng/ml as well as marker characteristics of formation of bone matrix (PINP) - N-terminal propeptide of procollagen type 1 in ng/ml. In the presence of passage of active regenerative processes testifying to the incompleteness of the process of osteoid generation, its mineralization with the maturation of spongy bone tissue of newly formed bone, then the surgical removal of the formed heterotopic ossification is considered premature. In the presence of completeness of the osteoid formation process and its mineralization with formation and ageing of spongy bone tissue of newly formed bone, adequacy of metabolic maturity of heterotopic ossification of patient surgical removal of the formed heterotopic ossification in the affected joint is performed.EFFECT: method allows to reduce the risk of complications in surgery and reduce the risk of relapse.1 cl
ethod of surgical treatment of heterotopic ossification in background of patient's spastic syndrome // 2610537
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be applicable for surgical treatment of heterotopic ossification at spastic syndrome in patient. Stage of maturity of heterotopic ossification is determined by indicators of calcium-phosphorus metabolism in venous blood of patient, wherein content of alkaline phosphatase in patient's venous blood in units/l, osteocalcin in ng/ml are determined, as well as characteristics of bone matrix formation marker (PINP)-N-terminal procollagen propeptide type 1 ng/ml. In case, if fact of presence of active regeneration processes is stated, testifying incompleteness of process of osteoid generation, conclusion is made on prematurity of stages of surgical removal of formed heterotopic ossificates. In case, if fact of completeness of osteoid formation processes is stated, surgical removal of formed heterotopic ossificates in involved joint is made.EFFECT: method reduces risk of recurrence.1 cl, 3 ex
ethod of surgical treatment of heterotopic ossification with the implementation of neural network modeling of the spastic syndrome of patient // 2610532
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be applicable for surgical treatment of heterotopic ossification with the implementation of neural network modeling of spastic syndrome of the patient. Determine the stage of maturity of heterotopic ossification on indicators of calcium-phosphorus metabolism in venous blood of the patient, at the same time determine the contents in the venous blood of the patient of alkaline phosphatase in U/l and osteocalcin, ng/ml as well as marker characteristics of formation of bone matrix (PINP) - N-terminal propeptide of procollagen type 1 in ng/ml. If the fact of passage of active regeneration processes, testifying to the incompleteness of the process of osteoid generation, its mineralization with the maturation of spongy bone tissue of newly formed bone, surgical removal of the formed heterotopic ossifications is considered premature. In case if the fact of completeness of osteoid formation processes and its mineralization with the formation and maturation of spongy bone tissue of newly formed bone, the adequacy of stage of metabolic maturity of heterotopic ossification of patient in relieving the active metabolic processes in the pathological focus and it is considered appropriate to conduct stage of surgical removal of the formed heterotopic ossification in the affected joint.EFFECT: method allows to reduce the risk of complications in surgery and reduce the risk of relapse.1 cl
ethod of choosing a tactic of treatment of complications of knee joint arthroplasty that can not be conservative treatment // 2609624
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be applied for choosing a tactic of treatment of complications of knee arthroplasty, is not amenable to conservative treatment. In the absence of the patient signs of septic instability and reliable x-ray signs of aseptic instability of endoprosthesis is performed arthroscopy of prosthetic joint. Performing lateral arthroscopic port in a projection of the slot of the knee joint, placing it into 15 mm above the level of cutting of the tibia at the outer edge of the patellar ligament, that is approximately corresponds to the upper edge of the polyethylene insert joint. Front upper-medial instrumental port is performed after test puncture of a joint capsule by the injection needle, it should correspond to the upper edge of the polyethylene insert of endoprosthesis along a medial border of the patellar ligament. Carry out diagnostic arthroscopy, in which inspected: anterior chamber of the knee joint, medial facet of polyethylene insert, medial, upper carcass of knee joint, articular surface of the patella, a balance of the patellar is evaluated, inspected lateral inversion of the knee joint, lateral facet of polyethylene insert, intercondylar notch, “spike” of polyethylene insert, contact area of the tibial component of the prosthesis and a tibia. By means of arthroscopic hook, blunt obturator of arthroscopic mine is estimated stability of the tibial and femoral endoprosthesis components. If in the joint cavity detecting pathological changes, such as a joint fibrosis, synovitis, hemarthrosis, fragments of the bone cement, cartilage flaps, pinching of joint capsule by components of the endoprosthesis, imbalance of the patella, they are eliminated during conducted arthroscopy. If observing the instability of one or more components of the endoprosthesis is set absolute indications for performing revision endoprosthesis replacement of knee joint.EFFECT: method allows to reduce the number of unjustified operations of revision arthroplasty.1 cl

ethod of dysplastic cotyloid cavity reconstruction // 2609283
FIELD: medicine.SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. Osteotomy of iliac bone isthmus above acetabular area is made with subsequent rotational transposition of cotyloid cavity down, forward and laterally. Wherein internal and external cortical plates of acetabular fragment are split stopping at Y-shaped cartilage, followed by bending of external cortical plate, which is roof of cotyloid cavity. Formed diastases above roof of cotyloid cavity are filled with grafts of relevant shape and volume with subsequent fixation of achieved position with Kirschner wires.EFFECT: method provides higher clinical effectiveness by stabilizing of hip joint, by improving congruence of cotyloid cavity and femoral head.1 cl, 2 dwg
ethod of surgical treatment of fractures of proximal part of shoulder bone in children and teenagers // 2609058
FIELD: medicine.SUBSTANCE: two wires are introduced in criss-cross manner towards distal part through minor and major tubercles. Wires are clipped off from tubercle side. Distal end of wire is pulled until submergence into shoulder bone head and bent.EFFECT: method makes it possible to increase osteosynthesis stability, reduce risk of development of contracture of shoulder and elbow joints.6 dwg, 1 ex

Surgical fixator // 2608434
FIELD: medicine.SUBSTANCE: group of inventions relates to traumatology and orthopedics and can be used for surgical fixation. Device for surgical fixation comprises first fixing element with flat profile, second fixing element with curvature along its longitudinal axis, ligature, connected with first and second fixing elements, to be able to adjust distance between first and second fixing elements. Method of treating damage of acromial-clavicle joint includes formation of channels on one axis through patient’s clavicle and coracoid process, driving of fixing element, which has concave surface, through channels at concave surface of fixing element in immediate vicinity of upper surface of patient’s clavicle with longitudinal axis of fixing element located perpendicular to longitudinal axis of clavicle, placing of fixing element with flat profile, under patient's coracoid process, control with ligature, which connects fixing elements, to reduce distance between fixing elements.EFFECT: group of inventions provides anatomically correct recovery of damaged joint.28 cl, 30 dwg
ethod of radial bone distal end plastics // 2607567
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be used for repair of distal end of radial bone. Autograft is taken from fibular bone, including section of thumb flexor muscle of foot, which is sutured to muscle long flexor muscle of thumb. Distal end of autograft is modelled with rasp for congruence with semilunar bone of wrist, which is fixed to it with transosseous capron suture at level of dissected transverse carpal ligament. Autograft and ulnar bone are clamp type covered and fixed with lavsan tape. Autograft is fixed to radial bone with reconstructive plate with angular stability.EFFECT: method enables creating conditions for reparative osteogenesis, restore congruence of articular surfaces.1 cl, 2 dwg
ethod for bone defect replacement in tibial condyle in total knee replacement // 2607189
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for bone defect replacement in tibial condyle in total knee replacement. Tibial and femoral condyles are resected, autograft is formed. During resecting tibial condyle trapezoidal support platform corresponding to the bone defect is formed. During resecting femoral condyle trapezoidal autograft, corresponding to the support platform is formed. Repairing bone defect is performed so that the autograft is tightly adjoined to the support platform.EFFECT: method enables eliminating the risk of early endoprosthesis component instability.1 cl, 9 dwg

ethod of treating open and complicated fractures of distal shin // 2605647
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for treatment of open and complicated fractures of distal shin at location of wound outside its outer surface. Skeletal traction is applied. Reposition and fixation of fibular bone is performed in one stage with shinbone, fixing both fractures with one plate with screws. Plate is placed on outer surface of fibular bone, and screws are introduced from outside inwards at angle of 45° to frontal plane. Skeletal traction is removed.EFFECT: method enables osteosynthesis by plate in case if it is impossible to locate it on shinbone.1 cl, 3 dwg

ethod of long bone diaphyseal area fragments fusion in case of osteomyelitis damage // 2604769
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for diaphyseal area long bones fragments fusion in case of osteomyelitis damage. Intramedullary canal at fragments ends is opened, on one of which cylindrical shaped receiving bed is formed, and second fragment end is treated congruently for its size in form of plug. Elastic perforated tube is introduced on receiving bed side via opening drilled in medullary canal. With matching of bone fragments tube is also immersed into intramedullary canal of opposite bone fragment. After formation of bone soldering rigid fixation is transferred into elastic by installation of springs on external fixation device threaded rods until complete fusion of bone fragments.EFFECT: method enables reducing injuries, improve intramedullary canal drainage, improve blood supply.1 cl, 8 dwg

ethod of corrective femoral osteotomy in youth femoral head epiphysiolysis // 2604039
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopedics and can be used for corrective osteotomy of femoral bone. Channel is formed for subsequent introduction of blade with angled plate at front-side surface of femur towards center of femoral head epiphysis. Intertrochanteric femur osteotomy is made perpendicular to axis of femoral diaphysis at distance from created channel. Distal fragment is rotated inside by value of required femoral neck anteversion. Fragments are fixed with angled plate with introduction of its blade from front-side surface of femoral bone towards center of femoral head epiphysis.EFFECT: method enables preventing of subluxation, varus deformation of femoral neck, delaying of arthrosis progression.1 cl

inimally invasive method of treating hushed limited destructive forms of tuberculosis and nonspecific spondylitis in patients of senior age groups // 2603722
FIELD: medicine.SUBSTANCE: invention refers to medicine, namely to spine orthopaedics. After X-ray determination of destruction center trocar is inserted in zone of damage along paravertebral line from the right at an angle of 35-45° to the vertebral body and then microirrigator is introduced through trocar. Extrafocal fixation of damaged spine section by spinous processes above and below the center of destruction is also made with the device. Postoperative period involves antibacterial therapy and after completion of the process of vertebral bodies' consolidation the device of external fixation is removed. Wherein necrotic tissue is destroyed with cutter and removed, then microirrigator is introduced through trocar into center of vertebrae destruction. After introduction of microirrigator through trocar it is used for introduction into the damaged area mixture of preparations of calcium sulphate, demineralized bone matrix with addition of patient's bone marrow aspirate taken from wing of ilium, after which trocar and microirrigator are removed.EFFECT: method allows to considerably reduce length of staying in hospital, increase percentage of positive results of treatment and reduce the number of postoperative complications.1 cl, 7 dwg, 3 ex

Device for activation of reparative osteogenesis // 2603325
FIELD: medicine.SUBSTANCE: invention relates to medicine. Device for activation of reparative osteogenesis comprises cannulated rod-screw, including self-taping and thread-forming parts on one side, threaded part on other side and threadless section between them, as well as through hole and rubber cap. Device additionally comprises ultrasonic generator, piezoceramic ultrasonic emitter, connected to output of ultrasonic generator, waveguide with contact platform and threaded section in upper part, as well as working part, which is straight rod with diameter smaller than through hole in cannulated rod-screw with self-taping and thread-forming parts in its lower section, threadless and threaded parts on other side, and exceeding its length by 5-15 mm, connected to end of piezoceramic ultrasonic emitter with threaded section with contact platform.EFFECT: invention provides optimum conditions for activation of reparative osteogenesis, reduced number of complications and reduced length of fracture consolidation.1 cl, 4 dwg

ethod of treating soft tissue prolapses in area of achilles tendon and calcaneal tuberosity // 2601859
FIELD: medicine.SUBSTANCE: invention relates to medicine, particularly to traumatology and orthopedics. End of the achilles tendon is stitch with the heel bone. Skin-fascial transplant of back surface of the leg with a fragment of the tendon of the medial head gastrocnemius muscle is replaced in defect of soft tissues.EFFECT: method allows to restore function of walking by simultaneous recovery of integrity of the achilles tendon and completion of soft tissue prolapse area of achilles tendon and calcaneal tuberosity.1 cl, 9 dwg, 1 ex

Reparative osteogenesis activation method // 2601858
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for activation of reparative osteogenesis. External fixation apparatus with a bracket-fixed hollow rod-screw is being installed. Said hollow rods-screw is being introduced into the proximal and distal fragments at a distance of 20-40 mm from the fracture point. Ultrasonic waveguide is being introduced through the rod cavity so, that said waveguide projects from the inner edge of said hollow rod by 3-15 mm. Damage area is being insonified by low-frequency ultrasonic vibrations with simultaneous supply of medicinal solution into the impact area.EFFECT: method allows reducing the length of fracture consolidation, reducing infectious complication risk.1 cl

ethod of treating defects of achilles tendon // 2601857
FIELD: medicine.SUBSTANCE: invention relates to medicine, namely to traumatology and orthopaedics, and can be used for treating defects of achilles tendon. Tendon of a long flexor muscle of hallux is transected at the level of a foot arch. Distal end of the tendon is fixed to a short flexor muscle of hallux. Proximal end of the tendon is moved through tunnels formed in the distal and proximal ends of achilles tendon. Proximal end of the tendon of long plantar muscle is placed between ascending and descending portions of the tendon of a long flexor muscle of hallux. After H-shaped vaginal fasciotomy, a back tibial muscle is delivered to transplanted tendons, its fascial leaves are also fixed to side surfaces of achilles tendon and transplanted tendons.EFFECT: method enables recovering the complete functionality of the tendon.1 cl, 7 dwg, 1 ex

ethod of posterior spinal-fusion care // 2601855
FIELD: medicine.SUBSTANCE: invention relates to traumatology, orthopaedics, neurosurgery, and it can be used for posterior spinal-fusion care. Support implant is placed between acanthas of two adjacent vertebrae for unloading posterior support system. Contractor is installed in the form of titanium implant with shape memory at the level of middle one-third of vertebra spinous processes for creating dynamic fixation of VMS.EFFECT: method enables to reduce injury rate and length of the surgery, to decrease the length of rehabilitation.1 cl, 2 dwg

ethod of open reduction and osteosynthesis of distal radius fractures // 2601850
FIELD: medicine.SUBSTANCE: invention relates to traumatology and orthopaedics and can be used for open reduction and osteosynthesis of distal radius fractures. Surgical aid is being performed in conditions of a module of the distraction external fixation apparatus. Distraction external fixation apparatus consists of two circular supports, when attached one pin is being inserted on the hand so that it passes in direction from the proximal II metacarpal bone to the distal V metacarpal bone, proximal pin is being inserted through the olecranon. Under the control of the EOP distraction is being performed between supports, the correct axial interrelation in the distal radial bone and length of the latter are being recovered, biomechanically correct reduction fracture level is being provided due to ligamentotaxis. Extra-cortical metal osteosynthesis of the fracture is being performed by a plate in the achieved position. Distraction external fixation apparatus is being removed. Final x-ray control is being performed.EFFECT: method enables recovering the painless movement in the wrist joint.1 cl, 5 dwg
 
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