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

A   Human necessities(308424)
A61B17        Surgery(21508)
A61B17/56                     Surgical instruments or methods for treatment of bones or joints; devices specially adapted therefor(4383)
ethod for heterotopic ossification surgical treatment with local neural simulation of spastic syndrome // 2628370
FIELD: medicine.SUBSTANCE: for surgical treatment of heterotopic ossification with local neural simulation of the patient spastic syndrome, preliminary multilayer spiral computerized tomography (CT) is used to ptovide spatial imaging of bone structures and ossificates. The method of magnetic resonance imaging reveals the ossificate soft tissue component which is not visualized by MSCT. Then the heterotopic ossificate maturity stage is determine by calcium-phosphorus metabolism indices - alkaline phosphatase, osteocalcin, and bone matrix formation marker PINP - N-terminal pro-peptide of type 1 procollagen in patient's venous blood. If the measured parameters of N-terminal propeptide of type 1 procollagen - PINP are less than 76 ng/ml, even in case of an isolated lesion of one elbow or knee joint, alkaline phosphatase level is in the range 40-150 U/l and osteocalcin level is within 11-46 ng/mL, completion of osteoid formation and mineralization with formation and maturation of newly formed cancellous bone is concluded. In this case, surgical ossificates removal from the affected joint is prescribed. At that, local neural simulation of spastic syndrom is performed prior to surgical removal of ossificates, until it a stable decrease to the level of 0 to 1 on Ashworth scale is reached. Next, surgical treatment is performed involving ossificate resection or removal of an adequate volume of heterogeneous bone to restore the functionally adequate range of motion in the affected joint.EFFECT: possibility of surgical treatment of heterotopic ossification in patients with spastic syndrome, minimizing the risk of complications during surgical treatment, and pathological process recurrence.3 cl, 5 ex
ethod for low invasive surgical stimulation of reparative osteogenesis of slowly consolidated distraction regenerates in combination with false connection of limbs long bones of limbs in case of soft scar tissues // 2628368
FIELD: medicine.SUBSTANCE: under the control of electron-optical transducer, a guiding drill rod is introduced through the slow-consolidating distraction regenerate area and the false joint area, through which a cutting tool in the form of a cannulated flexible shaft with a drill is then introduced, and a hole of a specified diameter is formed in the medullary canal of the long tubular bone using a replaceable cutting tools set with drills of increasing diameter. A nanostructured composite implant is inserted into the formed internal cavities through a hole of a predetermined diameter formed in the medullary canal of the long tubular bone in slowly consolidating distraction regenerate and the false joint area.EFFECT: method allows to reduce the time of distraction regenerate reconstruction into a full bone.2 cl
ethod for hyaline cartilage production // 2627817
FIELD: medicine.SUBSTANCE: hyaline cartilage from the articular surfaces of the phalanx of additional fingers or toes of healthy children, removed intraoperatively in case of polydactyly. Some fragments of hyaline cartilage are used to carry out control studies, and the other part is used to obtain cell cultures.EFFECT: method provides high regenerative potential of the hyaline cartilage.1 cl
ethod for achilles tendon plasty // 2627293
FIELD: medicine.SUBSTANCE: in the thickness of the proximal and distal ends of a ruptured Achilles tendon, sagittal incisions are made into which a fine-celled lavsan band is laid, which is sutured to the sides of the convergent ends of the ruptured tendon side to side, and the preserved parathyon and ruptured tendon filaments are stitched with thin lavsan threads.EFFECT: method allows to create favorable conditions for tendon regeneration, reduce the risk of relapse.1 cl
ethod for correction of combined flexion contracture of three-phalangeal fingers and adduction contracture of first finger in case of spastic paralysis // 2627291
FIELD: medicine.SUBSTANCE: tendons of the superficial finger flexor is cut off at the level of the main phalanges, and the tendons of the deep finger flexor - 1 cm proximally to the wrist canal origin, followed by movement of the distal ends of the deep flexor tendons to the proximal ends of the superficial flexor tendons with elongation. The proximal ends of the tendons of this deep finger flexor are transposed, suturig them to the structures of the first ray of the hand, and the distal ends of the tendon of the superficial finger flexor are used to form the tenodes of proximal interphalangeal joints of II-V fingers.EFFECT: method allows to provide active removal and opposition of the first finger, prevent hyperextension in the proximal interphalangeal joints.4 cl, 7 dwg
ethod for correction of combined flexion contracture of three-phalangeal fingers and forearm pronation contracture // 2627290
FIELD: medicine.SUBSTANCE: tendons of the superficial and deep finger flexors are intersected, followed by the movement of distal ends of the tendons of the deep finger flexor to the proximal ends of the tendons of the superficial flexor with elongation. Tendons of the superficial finger flexor are cut off at the level of main phalanges, and the tendons of the deep finger flexor - 1 cm proximally to the wrist canal origin. The proximal ends of the tendons of the deep finger flexor are transposed in the subcutaneous tunnel through the ulnar side to the rear forearm and fixed to the distal metaepiphysis of the radius at the place where the brachial muscle tendon is attached, to obtain active supination, and the distal endsof the superficial flexor tendon are used to form the tenodes of proximal interphalangeal joints of II-V fingers.EFFECT: method allows to strengthen active supination, prevent hyperextension in proximal interphalangeal joints.10 dwg

Adjustable devices for knee arthritis treatment // 2626961
FIELD: medicine.SUBSTANCE: system for tibia angle changing for patient having knee osteoarthritis comprises an adjustable non-invasive implant and a drive member. The adjustable non-invasive implant comprises an adjustable actuator configured to fit inside the tibia longitudinal cavity and having an outer housing and an inner rod telescopically arranged in the outer housing. The outer housing is connectable to the first part of the tibia, and the inner rod is configured to be connected to the second part of the tibia. The second part of the tibia is at least partially separated from the first part of the tibia by means of osteotomy. The drive element comprises a permanent magnet and is adapted to remote actuation, in order to telescopically displace the inner rod relative to the outer housing. The system for bone angle changing includes an adjustable non-invasive implant and a drive member. The adjustable non-invasive implant comprises an adjustable actuator having an outer housing and an inner rod telescopically arranged in the outer housing. The outer housing is connected to the first anchor hole, and the inner rod is connected to the second anchor hole. The first anchor hole is configured to pass the first anchor to connect the adjustable actuator to the first part of the bone. The second anchor hole is configured to pass the second anchor to connect the adjustable actuator with the second part of the bone. The second part of the bone is at least partially separated from the first part of the bone by means of osteotomy. The drive element is adapted to remote actuation, in order to telescopically displace the inner rod relative to the outer housing. The adjustable non-invasive implant is adapted to be indefinite in angle relatively to at least one of the first or the second part of the bone when connected to both the first part and the second part of the bone.EFFECT: prevention of adjustment angle loss.20 cl, 69 dwg
ethod for acceleration of tubular bones distraction regenerate formation // 2626250
FIELD: medicine.SUBSTANCE: immediately after receipt of the required segment length, the bone is extended by another 4 mm. A carbon nanostructure cylindrical implant with ends having the form of truncated cone is placed into the bone regenerate, diameter of the implant is 30% of the bone diameter, and its length exceeds the required value of elongation by 4 mm. After implant insertion the bone fragments are brought together to the required value of elongation so that the ends of the implant were introduced into the medullary channels of proximal and distal bone fragments (2 mm for each piece). Fixing is performed using the device to form a strong supporting ability of the bone-carbon unit.EFFECT: method can shorten the life of hardware fixation, duration of treatment.2 cl, 10 dwg

ethod of treatment of front shoulder dislocation in patients with erbe's paresis // 2626197
FIELD: medicine.SUBSTANCE: moving the tendon of the long head of the biceps arm muscle to the inside and sew it into the fold of the capsule of the shoulder joint. Z-shaped lengthen the tendon of the subscapular muscle. Move a large round muscle on the vascular-neural bundle through the subcutaneous canal, formed in the armpit, onto the anterior surface of the shoulder joint and fix it to the beak-like process of the scapula and anterior portion of the deltoid muscle.EFFECT: method reduces the risk of relapse of the dislocation.11 dwg
ethod for substitution of post-traumatic tibia defect // 2626146
FIELD: medicine.SUBSTANCE: tibia osteotomy is performed at one level or fibular osteotomy is performed at the level of the tibia fracture. When the bone fragments are stretched for three to five centimeters, a dosed distraction is carried out along the inner rods of the apparatus until valgus deformation of the formed regenerate of 25-30 degrees appears. Subsequent distraction is performed along all rods. Pressure is used by an external clamping member of the compression-distraction apparatus designed to be superimposed on the tibia surface in the bone regenerates projection.EFFECT: method allows to prevent blood supply violations, reduce the risk of purulent complications.7 dwg

ethod for external nose and nasal cavity septum fixation // 2626125
FIELD: medicine.SUBSTANCE: manual or instrumental reposition of bones, external nose cartilage and nasal septum is performed. At that, a nasal mirror is introduced into the nasal cavity, stainless steel cerclage wire needles 1 mm in diameter are used, which are introduced percutaneously after final repositioning of bone fragments. The first needle is introduced into the back of the nose, at 10 mm and 4 mm distance from the frontonasal suture, outwards from the internasal suture in the sagittal plane, the needle in the frontal plane is introduced parallel to the outer wall of the nasal cavity, so that the side nasal wall was lateral, and the outer surface of the nasal mirror lateral sponge was medial, the needle is passed through the inferior turbinate 4 mm short to the rear edge of the hard palate. Then the second needle is introduce, retreating 10 mm downwards, parallel to the first needle. The third needle is introduced 10 mm below the second one, parallel in the frontal plane, and in the direction of the upper jaw sixth tooth crown in the sagittal plane. The fourth needle is introduced parallel to the third one, but 10 mm below. The fifth needle is introduced, at 2 mm distance outwards from the internasal suture, parallel to the first needle in the sagittal plane, and parallel to the nasal septum in the frontal plane, so that the nasal mirror medial sponge outer wall was lateral. The sixth needle is introduced in the frontal plane as the fifth needle, and in the sagittal plane - parallel to the second needle. Then the seventh needle is introduced parallel to the sixth needle in the frontal plane and parallel to the third needle in the sagittal plane. The eighth needle is introduced parallel to the seventh needle in the frontal plane and parallel to the fourth needle in the sagittal plane. The outer ends of needles are bent over the integuments at a distance of 10 mm, needle excess is removed, leaving up to 2 mm of a needle to lock the monoblock. A similar operation is carried out on the second side of the nose. After the repeated final repositioning of bone fragments, a monoblock made from self-hardening plastic is imposed on the bent ends of needles. If a repeated delayed bone fragments repositioning is required, the monomlock is destroyed after anesthesia, bone fragments are repositionied to their correct position, and then a monoblock is imposed again.EFFECT: method is simple and low-traumatic, allows redressing during treatment without needles removal.2 cl, 3 dwg
Device for pelvic bones reconstruction // 2626122
FIELD: medicine.SUBSTANCE: device for pelvic bones reconstruction includes a spatial structure consisting of: beams designed for location of pelvic bones, connecting screws in the direction between the saw-lines, at least a couple of extra pair of beams, one of which is designed for fixation to at least one bone saw-line with orientation at least along it, and the other is for fixation of at least to the adjacent bone saw-line with orientation at least along it. Beams designed to be positioned in the direction between the bone saw-lines of the pelvis to be joined, are connected to the extra beams. Each extra beam is connected to the corresponding beam designed to be positioned in the direction between the pelvic bones saw-lines, split connection with a possibility of rigid fixation. Screws for bone connection are mounted on the extra beams by means of detachable joints with a possibility of rigid fixation.EFFECT: invention allows to perform an adequate more reliable and stable fixation in case of massive resection of pelvic bones.14 cl, 31 dwg

ethod for pelvic bones reconstruction // 2625986
FIELD: medicine.SUBSTANCE: bone saw-lines are formed as a result of pelvic bones resection. The device is installed consisting of: beams designed for location of pelvic bones, connecting screws in the direction between the saw-lines, at least a couple of extra pairs of beams for fixing them to the bone saw-lines, one of which is designed for fixation to at least one bone saw-line with orientation at least along it, and the other is for fixation of at least to the adjacent bone saw-line with orientation at least along it. Each extra beam is connected with the corresponding beam designed to be positioned in the direction between the connected pelvic bones saw-lines, split connection with a possibility of rigid fixation, screws for bone connection are mounted on the extra beams by means of detachable joints with a possibility of rigid fixation.EFFECT: method allows to recover the supporting and biomechanical function of the skeleton.7 cl, 31 dwg
ethod of surgical treatment of osteochondrosis of lumbarian spine division in instability of originally-motor segment // 2625776
FIELD: medicine.SUBSTANCE: cutting the skin from the posterior medial access in the projection of spinous processes one level above and below the identified zone of the unstable segment of the lumbar spine, followed by dissection of the subcutaneous tissue and its fascia, perform the skeletonization of the spinous processes, arcuate joints and arcs to the base of the transverse processes. Introducing into the adjacent vertebrae of the unstable segment of the lumbar spine two pairs of transpedicular screws. Stacking in any order on the heads of two pairs of unstable segment of transpedicular screws located in adjacent vertebrae, two metal fixing bars of metal fixation with length of 50 mm each, made of non-deformed material with a thermomechanical shape memory based on titanium nickeled intermetallide or from a copper system alloy of 14 wt % of aluminium - 4 wt % of nickel. They fix two metal fixing rods of metal fixation with nuts pre-placed on the head of the transpedicular screws. Perform layer-by-layer suturing of dissected muscles, fascia and skin of the postoperative wound.EFFECT: method allows you to keep the mobility of the lumbar spine, provide early rehabilitation of the patient.1 cl
ethod of surgical treatment of osteochondrosis of lumbary spine of spine with multi-level stenosis of spinal canal // 2625775
FIELD: medicine.SUBSTANCE: cut the skin from the posterior middle access in the projection of the spinous processes of the revealed segment of the lumbar spine, followed by dissection of the subcutaneous tissue and its own fascia. Perform skeletonization of spinous processes, arcuate articulations and arcs to the base of the transverse processes. Perform a revision and decompression of the vertebral canal in the identified segment of the lumbar spine with excision of the yellow ligament. A disk is approached by displacing a dural sac and root, which is followed by dissecting the disk and removing it with using scoops, discotomy and laminotomy instruments. Place two pairs of transpedicular screws in the adjacent vertebrae of the previously identified segment of the lumbar spine, with the correctness of their placement being controlled by the image intensifier. Stacking in any order on the heads of two pairs of unstable segment of transpedicular screws located in adjacent vertebrae, two metal fixing bars of metal fixation with length of 50 mm each, made of non-deformed material with a thermomechanical shape memory based on titanium nickelide intermetallide or from a copper system alloy of 14 wt % of aluminium - 4 wt % of nickel. They fix two metal fixing rods of metal fixation with nuts pre-placed on the head of the transpedicular screws.EFFECT: method allows to restore the configuration of the spinal canal, provide early rehabilitation.1 cl
ethod of closed reposition of bone distractions with intraarticular fractures of condyles of tibia // 2625651
FIELD: medicine.SUBSTANCE: injured limb is placed on the pedestal when the knee joint is bent at an angle of 165 and the position of the tibia is parallel to the surface of the operating table. Two fixing elements are introduced into each bone fragment, between the outer ends of which a different fixing element is transversely arranged and fixed by universal clamps of the rod fixation device. The X-ray source is oriented centrally to the knee joint slit from front to back at an angle of 7 to 10 with respect to the perpendicular of the long axis of the tibia in such a way that the conditional plane of the articular surface of intact segments of the tibial condyles coincides with the direction of the x-ray radiation. Manipulating the assembled structures under X-ray control, moving the bone fragments to the desired position until the x-ray image of a single line of the joint surface of the damaged and undamaged parts of the tibial condyles. Osteosynthesis is performed.EFFECT: method allows to improve the quality of repositioning, to accelerate the restoration of joint function.14 dwg
ethod for spinal osteomyelitis treatment // 2625596
FIELD: medicine.SUBSTANCE: puncture needle is introduced under ultrasound supervision in the abscess cavity, the contents is taken for the study, a drainage system is installed, which is used for abscess cavity sanitation and drainage. Laboratory research of the abscess cavity content is performed dynamically. At that, the necessary amount of antiseptic solution is determined for introduction into the abscess cavity in liters/min based on: abscess cavity volume ratio Vcavity/l multiplied by a factor of 0.7. Sanitation is carried out to achieve abscess cavity abacillation by supplying of an antiseptic solution combined with active aspiration of an antiseptic solution and dispersive suspended necrotic masses from the abscess cavity. A sodium chloride solution saturated with ozone-oxygen mixture with a level of oxidation-reduction potential of not lower than 600 mVA is used as the antiseptic solution, which is maintained during the entire sanitation by providing continuous readjustment of sodium chloride solution saturation with ozone-oxygen mixture until the end of the procedure.EFFECT: method allows to increase the efficiency of pathological focus antiseptic treatmen, provide a reliable bactericidal effect.1 ex
ethod for tethered spinal cord syndrome correction during repeated surgical intervention // 2624675
FIELD: medicine.SUBSTANCE: cut of skin and soft tissues in the Th10 vertebra projection is made, arches and Th10 spinous process are skeletonized. Laminotomy is performed unilaterally. The dura mater is opened, the lower paired dentate ligaments are dissected. After that, the dura mater is sutured, the arches and spinous process are fixed, the wound is sutured layer-by-layer.EFFECT: method allows to reduce intraoperative complications and postoperative neurological deficit, which is achieved due to additional skeletonization of the arch and process of the Th10 vertebra.1 cl
ethod for intramedular knee joint arthrodesization using extending pin // 2624674
FIELD: medicine.SUBSTANCE: extending pin with an oval hole is used which is connected to the femoral pin forming a single metal structure. The metal structure is inserted into the pre-grooved bone marrow canal of the femur to the distal metaepiphysis of the femur, using an impactor-extractor under the electron-optical transducer control, it is punched through the distal metaepiphysis of the femur, through the knee joint, through the proximal metaepiphysis of the tibia, and passing through the upper third of the medullary tibial canal before entering the tibia istus, the proximal dynamic blocking is performed by a screw through the oval hole of the proximal part of the metal structure.EFFECT: method allows to reduce trauma, prevent limb shortening.8 dwg
ethod for access to lower structures of acetabulum rear column // 2624387
FIELD: medicine.SUBSTANCE: skin is cut. The large gluteus muscle is separated along its fibers and the middle and small gluteus muscles are brought upwards. The oblique osteotomy of the large trochanter is performed, the upper sections of the square muscle of the thigh are cut. At that, a guideline is drawn, connecting the tip of the large trochanter of the femur and the distal section of the sacroiliac joint, corresponding to the upper edge of the piriform muscle. The medial part of skin incision begins stepping 2-2.5 cm caudally from the guideline. It is continued in the direction of the large trochanter of the femur until they intersect, which corresponds to the lower edge of the piriform muscle, and continued along the outer surface of the thigh. A transversal incision of the wide fascia of the femur is made at the level of the large trochanter base sufficient to place a bit or blade of the bone oscillating saw, the large gluteus muscle fibers are separated blantly. The middle, small buttocgluteous and piriform muscles are removed upwards. A revision of the posterior column, the limb bent at the knee joint is performed. External rotation is induced, oblique osteotomy of the large trochanter is performed. It is displaced back and upwards. The upper sections of the square muscle of the thigh are cut, the piriform, twin and inner inhibitory muscles are freely withdrawn upwards.EFFECT: method allows to reduce the traumatic nature of surgical intervention, to increase the view and to provide freedom of manipulation in the wound, up to the ischial hillock base, to improve the results of treatment.9 dwg
ethod for longitudinal flatfoot treatment // 2624371
FIELD: medicine.SUBSTANCE: for the first version, the scaphoid bone and the medial malleolus, where channels are pre-formed, are fixed to each other, while the blind channel on the scaphoid bone is formed at the posterior end of the bone inwards, parallel to its articular surface. On the medial ankle, a blind channel is formed at its anterolateral margin from the bottom to the top at an angle of 40-45 degrees from the horizontal plane in the sagittal direction. A subcutaneous tunnel is formed between the channels. Then, one end of the flexible member is fixed by a fastening member in the channel on the medial ankle, a flexible latching member is guided through the formed subcutaneous tunnel. Foot supination is performed, while bringing together the medial malleolus and scaphoid bone to the distance of 20-25 mm between them, and the second end of the flexible latching member is fixed with the fastening member in the blind channel on the scaphoid bone. For the second version, a blind channel is formed in the scaphoid bone at the posterior margin parallel to its articular surface with an increased load on the medial ankle. A through channel is formed on the medial ankle up to the posterior surface of the tibia. A subcutaneous tunnel is formed between the channels. One end of the flexible member is fixed with a fastening member in the blind channel of the scaphoid bone. The flexible latching member is guided through the formed subcutaneous canal. Foot supination is performed, while bringing together the medial malleolus and scaphoid bone to the distance of 20-25 mm between them. The second end of the latching member is fixed with the fastening member in the through channel of the medial malleolus and additionally fixed on the posterior surface of the tibia by a trigger lock. Fastening members made from biodegradable, metallic, ceramic material are used. Anchor locks with thread fastening at the basis are used as fasteners. A flexible latching member made from a synthetic non-absorbable material in the form of a lavsan thread or tape is used.EFFECT: methods eliminate foot pronation, reduce postoperative complications.16 cl, 1 ex, 4 dwg
ethod for hallux valgus operative treatment // 2624359
FIELD: medicine.SUBSTANCE: skin in the projection of the first metatarsophalangeal joint is incised along the lateral surface of the foot. The mucous bags of the first metatarsophalangeal joint capsule are excised. The exostosis of the first metatarsal bone head is removed, osteotomy is performed. Immediately prior to the operation, plasmagel is obtained from the patient's blood by centrifugation of 10 ml of blood for 5 minutes at a speed of 3200 rpm, or 3000 rpm, or 2500 rpm. The resulting plasma is incubated at 38C 15 minutes and 10% calcium chloride is added at the ratio of 1:1. At that, Z-shaped SCARF type osteotomy is performed. Then plasmagel is introduced into the osteotomy zone, metatarsal bone is prepared, the joint and skin capsule is sutured, 5 ml of activated plasma is injected paraossally into the first metatarsal bone, this procedure being repeated 5 times every 2 days.EFFECT: method allows to form a full bone callus, which allows earlier stabilization of the osteotomy zone, provides early postoperative load on the foot, reduces the risk of osteomyelitis, osteoporosis, low invasive operation provides minimal manifestations of pain syndrome in the postoperative period, reduces the risk of Hallux Varus development, does not require hospitalization of patients and anesthesia.1 ex, 1 dwg
ethod for open reposition and osteosynthesis of lower leg distal segment fractures // 2623298
FIELD: medicine.SUBSTANCE: during open reposition and osteosynthesis of lower leg distal bones fractures, combined osteosynthesis is applied using an external fixation device and plate-like metal detectors. Osteosynthesis is carried out in two stages. At the first stage, needles are directed through the middle of the heel bone from inside outwards at an angle of 15 degrees to the frontal plane of the ankle, then the needles not more than 2 mm in diameter are directed at the level of tibia tuberosity perpendicularly to the tibia sagittal axis, the external fixation device is assembled. At the second stage, open reposition and extramedullary osteosynthesis are performed under the conditions of distraction osteosynthesis. To do this, access is made along the back surface of the ankle and the lower third of the tibia, incision of skin and soft tissues is performed in parallel to the fibula, between the mid distance from the lattter and the Achilles tendon. The fibula length is restored, its temporary fixation is performed by needles. The final stabilisation of the fibula fracture is carried out with a bone metal fixator. The tibia fracture is exposed, repositioned and temporaryly fixed by needles. After an adequate level of fracture repositioning and congruence restoration in the ankle joint are obtained, the tibia fracture is stabilised by a extramedullary metal fixator, which is located on the posterior surface of the tibia. The needles are removed, the wound is sutured, using visual and EOC control.EFFECT: method allows to achieve complete anatomical repositioning and stable fixation of bone fragments, to perform osteosynthesis of both shin bones from one access and to hide the metal fixators with a sufficient volume of soft tissues, so that prevention of necrosis and infectious and inflammatory complications, restoration of painless movements in the ankle joint are provided in the near postoperative period .2 cl, 3 dwg, 1 ex

ethod for long bones treatment in children // 2622612
FIELD: medicine.SUBSTANCE: puncture needles are installed in the frontal plane perpendicular to the sagittal plane with the introduction depth of 2/3 of the cyst transversal diameter. A pre-arcuate curved rod is introduced from the bone end opposite to the pathological focus, to the cyst level with arch apex location in the intraosseous needles projection and bend arch anterior positioning. The rod is rotated, moving the rod arch top to the back and pressing the puncture needles distal ends to the back wall of the cyst. Cyst cavity is washed.EFFECT: method allows to provide treatment for thin cortical layer, to reduce the risk of vessels and nerve trunks damage.1 dwg
ethod for bone defects plastic during endoprosthetic replacement of hip and knee joints // 2622608
FIELD: medicine.SUBSTANCE: augments made of carbon composite material are used. When choosing the augments shape and size, augment size and volume are chosen with a small margin, considering the existing bone mass defect. The maximum congruence of the bone receiving surface and the landing surface for endoprosthesis components is ensured in the course of surgical intervention by adjusting the shape and size of the inserted augment according to the similar characteristics of residual bone defects.EFFECT: endoprosthesis stability.2 cl, 5 dwg
ethod for endoprosthesis femoral component intraoperative sizing based on acoustic characteristics // 2622349
FIELD: medicine.SUBSTANCE: during femur medullary canal processing, sound is recorded using rasps, and acoustic analysis is performed. Further, an amplitude-frequency analysis of the sound spectrum oscillations is performed around a rasp, followed by spectral analysis using the visual graphical method and visual colour chart construction. Medullary canal treatment is considered sufficient at oscillation frequency in the range 800-900 Hz at an amplitude of 30-40 dB. After that, the endoprosthesis femoral component of the appropriate size is implanted.EFFECT: decreased error probability.2 dwg
ethod for determination of endoprosthesis acetabular component optimal impaction // 2622346
FIELD: medicine.SUBSTANCE: after acetabulum treatment during cementless prosthesis acetabular component installation, sound is recorded and acoustic analysis is performed. Further an amplitude-frequency analysis of the sound spectrum oscillations is performed, followed by spectral analysis using the visual graphical method and visual colour chart construction. At that, optimal impaction of the hip joint endoprosthesis acetabular component is considered sufficient when dominance of the oscillation frequency in the range 600-800 Hz is reached.EFFECT: method allows accurate determination of implant optimal impaction, position of the hip prosthesis acetabular component, reduction of the number of errors, and surgeon action programming due to a amplitude-frequency analysis of the audio spectrum variations.2 dwg

Combined implant and instruments for its installation // 2621949
FIELD: medicine.SUBSTANCE: combined implant includes a wedge-shaped porous metal implant and an extramedullary metal plate. The wedge-shaped implant has side-sloping side walls connected by an upper wall in the center of which an aperture with an internal thread is located, front and rear walls. The extramedullary plate has holes with a conical recess for fixing screws with a submerged head. The extramedullary plate is made of titanium nickelide with a thermomechanical shape memory, with a conical central recess, terminating with a hole for the attachment screw with a submerged head, has paired legs on both sides, bent down at an angle of 45 and directed towards each other, has a protrusion located on the underside in the plate center in the transverse direction, made in conjunction with the longitudinal groove of the wedge implant. The wedge implant is made of porous titanium nickelide with a porosity of 70-80%, the lateral walls converge to form a wedge, the surface of the side walls is corrugated in the form of longitudinal grooves forming L shaped teeth, the front and rear walls are triangular. The upper wall is in the form of a quadrilateral, in the middle of which a longitudinal groove is located to install the extramedullary plate protrusion. In the center of the longitudinal groove, a bushing made of titanium with an axial hole with an internal thread is inserted to install the connecting screw. The wedge-like analogue of a wedge implant in the form of a wedge with smooth walls has oblique laterally converging lateral walls forming a pointed end, front and rear walls in the form of a triangle, an upper wall in the form of a quadrangle. An element for connection with an implantator is located on the top wall. The form of the wedge-analogue of the wedge implant corresponds to the shape of the wedge implant. The element for connection with the implantator is made in the form of a longitudinal groove passing in the middle of the upper wall for installation of plates located at the lower end of the implantator outer tube. In the center of the longitudinal groove, a bushing of titanium with an axial hole with an internal thread is inserted for connection to the inner core of the implantator. An implantator for installation and removal of a wedge implant and its wedge-shaped analogue includes a handle with a shock pad, a rod with a working end having a threaded portion. The implantator consists of a T-shaped body where the inner core is inserted. The implant body includes an outer tube having oppositely disposed plates at the working end for insertion into a longitudinal groove of a wedge-shaped analogue and a transverse handle having an opening in the center to insert an inner rod with a working end. The handle has shock pads on the top and bottom sides of the outer tube. The inner core has a head with a through cross hole for reception of the rotary shaft from the top and a threaded portion on the working end corresponding to the thread of the female threaded hole in the bushing of the combined implant and the wedge implant analogue.EFFECT: increased stability of fixation with accuracy and reliability of surgical manipulations.5 cl, 2 ex, 15 dwg
ethod for formation of bone defect model // 2621947
FIELD: medicine, surgery.SUBSTANCE: invention relates to experimental surgery and can be applied for formation of bone defect model. Transverse osteotomy is performed on forearm of small laboratory animal at two levels to cortical plate, bordering with interosseous membrane. Osteotomy lines are connected in longitudinal direction. Bone fragment is removed. Bone substance is bitten out to cortical plate.EFFECT: method makes it possible to reduce trauma, reduce impact of secondary factors.
ethod of forming an individual endoprosthesis of a pelvis joint // 2621874
FIELD: medicine.SUBSTANCE: computerized tomography of pelvic bones is performed. Form on its basis 3D models of pelvic bones and prosthesis. Produce their models with the subsequent formation of an endoprosthesis. When forming a 3D model of a prosthesis, a mathematical simulation of the effect of differently directed destabilizing effects on it is carried out. Based on the simulation results, the model is corrected, after which the improved model is produced on a 3D printer and modelling of the planned operation is performed with correction of the required length of the fixing elements.EFFECT: method provides high strength of the proposed design in conditions of deficiency of the bone base and acquired deformities of the pelvic bones, operational optimization of the geometric and physico-mathematical parameters of the implant, shortens the duration of surgical intervention and, accordingly, intraoperative blood loss and the risk of postoperative complications.

ethod for front floating sternocostal valve fixation in case of bilateral rib fractures // 2621871
FIELD: medicine.SUBSTANCE: chest strap is placed bilaterally across the chest on the anterior and lateral surfaces from the back axillary line on one side to the back axillary line of the other side, for front sternocostal valve reposition and fixation to the chest strap, two double ligatures are used behind the sternum in the 3rd and the 5th intercostal spaces or in the 4th and the 6th intercostal spaces, with a clamp with arcuate sponges with a chord length of 5 cm, the lateral sections of the strap are fixed along the middle axillary lines to the adjacent ribs, which retain the connection with the spine, using pericostal ligatures.EFFECT: method allows to improve physiological properties.9 dwg
ethod for biarticular arthrodesis of talocrural and talocalcanean joints // 2621844
FIELD: medicine.SUBSTANCE: fibula diaphysis is resected to a length sufficient to fix the talocalcanean and talocrural joints. The resected portion is released from the soft tissues and decorticated. The cortical autograft is formed from the distal metaepiphyseal part of the fibula with a preserved ligament apparatus, for which the inner cortical plate of the fibula distal part is removed. A fragment of fibula diaphysis resected for the required length and prepared, is used as an intramedullary fixator. After intramedullary fixator introduction, the cavity of the talocrural and talocalcanean joints is filled with autosseous crumb from the remaining parts of the resected fibula. The cortical autograft from the non-resected distal epimetaphyseal part of the fibula is fixed to the talus and tibia using autosteal cortical wedges or biodegradable pins.EFFECT: method reduces postoperative complications.1 ex
ethod two-bundle reconstructive plasty of knee joint anterior cruciate ligament for patients with frontal knife joint instability // 2621594
FIELD: medicine.SUBSTANCE: semitendinous muscle tendon autotransplant is formed as a letter Y, the ends of which form the anterior-inner, posterior-outer and tibial bundles, respectively. anterior-inner, posterior-outer canals are made in the femur, and a tibial canal is made in the shin bone. The anterior-inner canal is made in the knee joint flexion position from 80 to 90. To form the anteior-innerl canal, a guide spoke is used to set the direction of the anterior-inner canal from the tibia through the tibial canal to the femur, a guide tube is inserted into the femur along the guide spoke, the guide spoke is removed, an anterior-inner canal is formed in the femur along the guide tube using medical equipment, corresponding to the semitendinous muscle tendon autotransplant end diameter. The semitendinous muscle tendon autotransplant is installed into the formed channels.EFFECT: method allows to avoid pathological mobility of the autotransplant.1 cl
ethod for blood loss volume reduction and circulating blood volume compensation in case of amputation interileoabdominalis or exarticulation // 2621561
FIELD: medicine.SUBSTANCE: at the iliac vessels allocation stage, the trunk of the common iliac artery and external iliac vein is clamped with vascular turnstiles. At that, the external iliac vein is cannulated with a vascular cannula. A whole blood sample is taken from the lower limb excluded from the bloodstream into a polymeric container for blood collection. After the end of surgery, the whole blood is reinfused.EFFECT: method allows to reduce the volume of forced blood loss during amputation interileoabdominalis and exarticulation, reduce the cost of circulating blood compensation, and reduce the risks associated with allogeneic blood transfusion.1 ex, 3 dwg
ethod for proximal femur defect treatment // 2621538
FIELD: medicine.SUBSTANCE: method includes application of an external fixation device to the femoral 1 and pelvic 2 bones, closed metered lowering of the apex of large trochanter 7 to the lower edge of acetabulum 8 is performed using the external fixation device, soft tissues along the outer surface of the upper third of the thigh are exfoliated by the open method, middle and small gluteus muscles 17 are separated subperiosteally from the top of the large trochanter, arthrotomy and revision of the acetabulum are performed, shape of the large trochanter apex is modeled in accordance with the acetabulum size, the femur is crossed over small trochanter 10, proximal femoral fragment 11 is unfolded in the frontal and horizontal planes, forming a cervico-diaphysial angle and anteversion angle, femoral fragments are fixed with implant 13 at the obtained position, the larger trochanter top is directed to the acetabulum, transverse osteotomy 14 over acetabulum is performed, the acetabulum is transposed, inclined outwards and to the front, pelvic bone fragment is fixed to support 4, gluteus muscles are moved to the distal end of the proximal femur fragment together with the periosteum, stabilizeed and fix theobtained position and unload the hip joint EFD, hip joint passive movements are trained, after consolidation of the osteotoming fragments and achievement of stability in the hip joint, EFD is dismantled, the hip is fixed with a splint.EFFECT: favorable geometric relationships in the joint.1 ex, 9 dwg
ethod of treatment of fibrosis-clean dyslasia of bone tissue in children // 2621424
FIELD: medicine.SUBSTANCE: method includes subperiosteal marginal resection of the affected area, carrying out reparative regeneration with the formation of bone matrix with subsequent drainage of the lesion focus. In this case, before carrying out the marginal resection around the lesion, a bone box with a wall thickness of 1-2 mm, for which, using a guide in a healthy area, the bones form a channel at an angle of 35-45 to the vertical axis of the bone. Through this channel, osteoperforation is initially performed in the medullary canal in a healthy area of the bone wall. Then, one end of the drainage tube is introduced into the lesion, through which aspiration is carried out, and at the free end of the drainage tube, a discharge force of 0.15-0.35 mm Hg within 1.2-1.5 months. During resection, the cavity of the box with the medullary canal is recanalized to communicate with each other. After resection, the lesion of the lesion is continued to drain, creating at the free end of the drainage tube initially the force of the discharge of the 60-80 mm Hg during the first 5-7 days, and then the discharge force of 0.15-0.35 mm Hg for 3-9 months.EFFECT: method allows to gradually form bone regenerate and reduce difficulties due to the lack of load on the segment and additional immobilization for rehabilitation of patients after the operation.3 dwg, 1 ex

ethod of ii-v fingers extension recovery in interosseous muscle shrinkage // 2621277
FIELD: medicine.SUBSTANCE: lateral portions of II-V fingers extensor tendons, attached to interosseous muscles, are resected for 1-1.5 cm. Capsulotomy of proximal interphalangeal joints is carried out along a palmar surface. Limb is immobilized by plaster palmar splint in the position of finger extension and radiocarpal joint flexion.EFFECT: method improves the results of patients treatment by achieving extension of the affected fingers.4 dwg, 1 ex
ethod for substitution of soft tissue defects of shoulder, forearm and elbow joint // 2621275
FIELD: medicine.SUBSTANCE: thoracica lateralis artery is tied and cut off, the back latissimus muscle is cut off from its attachment sites. The non-viable tissues of the shoulder, forearm and elbow joint areas are excised. The elbow joint is fixed by a rod apparatus. The transplant based on the back latissimus muscle is placed in the elbow joint area. The chest cavity artery is sutured with the radial artery, as well as the thoracic spine is sutured with one of the accompanying veins of the radial artery and v. thoracica lateralis vein is sutured with the central segment of the forearm head vein. The skin-fascial transplant flap is hemmed to the wound edges.EFFECT: method allows to shorten treatment time and improve the results of treatment of patients by improving tissues blood supply.1 ex, 9 dwg
Dealgesia method in gonarthrosis // 2621269
FIELD: medicine.SUBSTANCE: local anesthesia is provided, para-articular longitudinal incisions of skin, subcutaneous tissue, fascia, needle perforation of condyles in various directions.EFFECT: method allows dealgesia if radical intervention is contraindicated.

ethod of treatment of brushes of bones of bills segments of limbs in children // 2621172
FIELD: medicine.SUBSTANCE: applying the osteoperforation holes in the unaffected ray with passage of both cortical layers. The intraosseous needles are placed through the unaffected segment: one needle in the anterior section of the cyst, and the second in the posterior-superior section of the cyst distal to the enostosis. Continuous washing of the cyst cavity with drugs is performed.EFFECT: method allows to increase the stability of needle installation in the treatment of cysts with an extreme degree of thinning of the cortical layer, reduce the risk of damage to blood vessels and nerve trunks.2 dwg, 1 ex
ethod for limb fracture treatment // 2620897
FIELD: medicine.SUBSTANCE: local decompression is applied to the affected limb by placing this limb in a local decompression chamber equipped with a sealing device, while local decompression is performed by pulses of negative air pressure of 1.5-2.5 kPa, with a pulse duration of 1.5-2 minutes and a pause of 50-60 seconds.EFFECT: method allows to reduce the pain syndrome, shorten the fracture healing period.1 tbl
ethod for treatment of invaginated c2 vertebra odontoid process associated with type i chiari malformation // 2620888
FIELD: medicine.SUBSTANCE: invention may be applicable for the treatment of invaginated C2 vertebra odontoid process associated with type I Chiari malformation. The invaginated C2 vertebra odontoid process is removed and front stabilization of C1-C2 spinal segment is made from one transoral access.EFFECT: method ensures normalization of liquorodynamics, ensures cerebellar amygdala lifting to its normal position.4 cl, 14 dwg
ethod for knee joint osteoarthrosis treatment // 2620495
FIELD: medicine.SUBSTANCE: injection of platelet-rich of autoplasma in an amount of 2 ml at the first injection into the aseptic necrosis zone and/or the cystic cavity located in the subchondral zone, using a needle, via the medial condyle of the tibia and/or the medial condyle of the femur, 2-3 times per treatment course with an interval of 7-10 days. For each subsequent injection, the volume of platelet-rich autoplasm is 2 times greater than for the previous injection.EFFECT: method allows to ensure low invasiveness of intervention, to shorten the pain relief period, to quickly restore the structure of the affected bone area, does not require the patient to stay in hospital, significantly improves the results of treatment of patients with this pathology, shortens the rehabilitation period and improves the quality of life.4 cl, 1 ex

ethod of palliattive treatment of child hearing in people with a spastic paralicous // 2620358
FIELD: medicine.SUBSTANCE: soft tissues are cut. Cut off the round ligament of the hip joint. Resect the head of the femur. The wedge-shaped osteotomy of the femur is performed, forming the proximal and distal fragments of the femur, as well as a small fragment of the femur. After the osteotomy of the femur, acetabuloplasty is performed, the acetabulum dysplasia is corrected, giving the acetabular lid a horizontal position. In this case, a small fragment is placed in the ileal bone cleft over the acetabulum. The valgus form is attached to the proximal femur. The angle of valency is chosen from 90 to 120 degrees. The upper edge of the proximal femur fragment rests on the horizontal part of the acetabulum. Immerse the proximal fragment of the femur with a small trochanter in the acetabulum, fix the fragments of the femur with the anvil plate. The caudal plate is bent along the contour of the proximal femur.EFFECT: stable position of the proximal end of the femur relative to the pelvic bones with the remaining mobility of the femur.2 dwg
ethod for installation of screws for spine transpedicular stabilization // 2620355
FIELD: medicine.SUBSTANCE: preoperative planning is performed based on computer tomography. Based on the computer tomography performed, a markup map is created by creating a multiplanar reconstruction, on its basis an image is formed, where the trajectories of screws insertion, the distance between the points of screws insertion, the distance between the supraspinal ligament and the point on the screw trajectory at the same level are marked. On the formed markup map, the insertion points are determined intraoperatively, the deflection angle in the sagittal plane is determined from the side x-ray image and controlled by fixing the direction by installation of an additional spoke, and the deflection angle in the axial plane is determined indirectly, based on the distance from the apex of the spinous process - the supraspinal ligament determined on the markup map, the deflection angle in the axial plane is controlled by the distance to the apex of the spinous process - the supraspinal ligament, using a marking compass with a ruler, or a caliper.EFFECT: method allows to reduce the radiation load, ensure the accuracy of the screw introduction.7 dwg
ethod for bone defect plastics // 2620160
FIELD: medicine.SUBSTANCE: patient's platelet-rich autoplasma is obtained that is intraoperatively mixed with demineralized bone chips and demineralized bone powder. The resulting mixture shall fill with the entire volume of the individual stereolithographic model to the edges, the model has the form of a blank mould with the volume corresponding to the bone defect volume. The mould is turned upside down, and its contents is transfered to the bone defect, with preliminary application of demineralized bone powder to the defect bed walls.EFFECT: method provides complete regeneration of bone tissue.
ethod for elimination of bone defect with bone-replacing material // 2620018
FIELD: medicine, surgery.SUBSTANCE: invention relates to experimental surgery. Transverse osteotomy is performed on one of paired bones of small laboratory animal at two levels to cortical plate, bordering with interosseous membrane. Osteotomy lines are connected in longitudinal direction and bone fragment is ablated. Internal surface of cortical plate is exposed by biting out bone substance. Bevelled surface, corresponding in size and form to preserved cortical plate of tubular bone in formed bone defect, is formed in block of bone-replacing material. Adjoining skeletal muscle is released from common muscular fascia on site, adjoining bone-replacing material. Threads are passed through edges of common muscular fascia with embracement of bone-replacing material. Peripheral nerve, located in chute of bone-replacing material, is fixed with muscular tissue by pulling skeletal muscle to surface of bone-replacing material by threads.EFFECT: method prevents development of neuropathy in postoperative period.1 ex, 3 dwg
ethod for treating non-specific chronic fistulous implant-associated spinal spondilitis (versions) // 2620017
FIELD: medicine.SUBSTANCE: group of inventions relates to traumatology and orthopaedics and can be applied for surgical treatment of non-specific chronic fistulous implant-associated spinal spondylitis. Partial or complete dismounting of transpedicular fixing system, mechanical necrectomy of bone canals in vertebral arches and bones are realised. Afer mechanical necrectomy bone canals are processed with argon plasma torch. To fill in bone canals material of thick cream consistency is used.EFFECT: group of inventions makes it possible to sanitise the focus around the implant and prevent infection recurrence.3 cl
ethod for operative treatment of shoulder bone condyle head false joint for children and adolescents // 2619494
FIELD: medicine.SUBSTANCE: using an osteoperforator installed in the distal part of shoulder boned condyle head perpendicular to the false joint zone, a bone autograft is withdrawn, is released from the scar tissue and driven into the formed bone channel. Parallel to the bone channel, a biodegradable screw is inserted.EFFECT: method allows to reduce trauma, reduce the risk of contracture.
ethod for surgical treatment of complicated elbow joint varus deformity with supracondylar syndrome // 2618082
FIELD: medicine.SUBSTANCE: wedge supracondylar corrective osteotomy of the humerus is performed in slant horizontal and slant frontal planes. Two K-wires with thrust pads are directed X-wise. Additional K-wires are directed through the olecranon and humerus in the frontal plane. Ilizarov apparatus consisting of 2 half rings is mounted.EFFECT: method can completely eliminate the distortion, ensure the stability of fixation.5 dwg
 
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