Compression-distraction apparatus for replacement of defects of the mandible and soft tissue

 

The invention relates to medicine, namely to traumatology and orthopedics. The invention provides substitution of the defect bone and soft tissue, first of all, when the defect of the mandible and allows you to restore the anatomic shape of the lower jaw with the achievement of high aesthetic result. The apparatus includes a pair of blocks, with fins for attachment to bone fragments, compression-distraction locking retainer Assembly mounted for movement between the blocks and equipped with means for fastening the mobile bone fragment formed on one side of the defect jaw, compression-distraction fixing unit is designed in the form carriage mounted for movement on a pair of parallel guide rods rigidly connected to the blocks. The carriage is connected with a lead screw mounted at least in one unit with the possibility of rotation. Means for mounting the mobile bone fragment is formed on the body of the carriage, a pair of rotary protrusions mounted in the cavities of these projections by means of detachable connectors spokes. Each plate for attachment to bone fragments made with the discerning business

The invention relates to medicine, namely to oral and maxillofacial surgery, and can be used with the substitution of soft tissue defects and lower jaw, which remain after removal of tumors and severe injuries of the maxillofacial area.

In recent years, has increased the interest of the surgeons to the problem of replacement of defects of the lower jaw, as the number of patients with this pathology is not reduced.

Methods of treating bone defects, primarily the bones of the lower jaw, used at the present time, a variety of.

We can distinguish the following basic methods are characterized by the use of various technological tools and devices.

Restore the contours of the lower third of the face can be performed using Filatov stem [1] or with the use of dermal-fat flap, including the pectoralis major muscle [2].

Along with the advantages of these methods and used to implement the devices they have a significant drawback: the creation of perceiving the graft bed with soft tissue is only one of the stages of treatment. In the future require bone plastic surgery, the success of which depends largely on the quality transplanting bed.

The primary method of osseous defects is autologous transplantation, which under conditions of stable fixation provides a complete formation of organotypic regenerate and good anatomofunctional results [3] . Most often the replacement of defects of the mandible using autogreen of the Ilium, and autorepo.

The disadvantage of this method is suppuration of the graft, the probability of which increases with delayed bone plastic, in terms of purulent wounds. In addition, the bone graft is technically difficult and traumatic procedure. Search less traumatic methods of bone plastic surgery has led many authors to the use of allografts, preserved by freezing or lyophilization [4].

This method is used to implement devices have several disadvantages: the second plastic to use bone grafts length more than 4 cm is impractical because transplantation is necessary to produce scar-modified tissue. Perceiving the bed in these cases is devoid of periosteum and poorly vessels - the main sources of osteogenic cells. In addition, the allografts imorove titanium alloys) has led to the widespread introduction of arthroplasty in clinical practice.

This method and its underlying devices have a number of disadvantages, such as the exposure of implant failure, loosening. In addition, the use of replacement before the end of the growth of the facial skeleton can lead to stunted growth of the mandible and its deformation.

To restore the bones are widely used device for osteosynthesis of bones. A device for osteosynthesis of bones, including adaptations for attachment to the bone fragments that are installed on the tool spatial fixation [5]. This device is a compression-distraction device for external fixation of bone fragments with the help of put into them needles. It allows you to provide rotational and axial position of the bone fragments.

However, this device is difficult to use to repair the defect of the mandible considerable length.

Known compression-distraction apparatus for defect replacement jaw including a pair of blocks, with fins for attachment to bone fragments [6].

However, this device, like the previous, it is difficult to use to repair the defect bottom Celestina jaw and soft tissues, including a pair of blocks, with fins for attachment to bone fragments, compression-distraction locking retainer Assembly mounted for movement between the blocks and equipped with means for fastening the mobile bone fragment formed on one side of the defect jaw [7].

This solution is accepted as the prototype of the claimed invention, because it is the closest to him in terms of total essential features.

However, this device does not allow you to move withholding bone fragment exactly on a line that follows the contour of the recovered part of the lower jaw.

The aim of the invention set by the authors, is to eliminate these disadvantages in the design of the device, the functioning of which is a method of distraction osteogenesis occurring when moving mobile bone fragment in the direction of the defect before contact with other tomcom and allows you to restore the anatomic shape of the lower jaw.

This objective is achieved in that the compression-distraction apparatus, including a pair of blocks, equipped with plates for fastening to the fragments of KMI and equipped with means for fastening the mobile bone fragment, formed on one side of the defect jaw, according to the invention the compression-distraction fixing unit is designed in the form carriage mounted for movement on a pair of parallel guide rods rigidly connected with the blocks, while the carriage is connected with a lead screw mounted at least in one unit with the possibility of rotation, and means for securing mobile bone fragment is formed on the body of the carriage, a pair of rotary protrusions mounted in the cavities of these projections by means of detachable connectors spokes, and each plate for attachment to bone fragments made with the possibility of bending and with through holes for the insertion of bone screws.

This set of essential features characterizing the invention. It is necessary and sufficient for any realization of the invention. Characterized by this set of features of the device allows you to implement a fundamentally new way of eliminating the defect of the bone of the body of the mandible, based on the method of G. A. Ilizarov, transformed taking into account the anatomical features of the maxillofacial area. The basis of the method consists in Acta and subsequent long-term maintenance of this process at a high level using measured strain (distraction) arising bone spur on the curved contour of the recoverable part of the lower jaw with the possibility of adjusting the position in space to education regenerate the required size and shape, fully mimic the anatomical shape of the lower jaw.

The claimed invention allows to implement this method for the restoration of the defect of the mandible. To do this, first compression-distraction apparatus for defect replacement jaw by means of plates for attachment to bone fragments attached to the fragments on the sides of the defect jaw. Then, using osteotomy create mobile bone fragment, which would be associated with soft tissue and well supplied with blood. After that, with the help of the device on the site of the osteotomy create compression of fresh bone wounds that dramatically stimulates osteogenesis, and after a certain time, then again using the claimed device produce of callus distraction by moving the bone fragment along the curved contour of the recovered part of the lower jaw to the side of the defect before contact with other tomcom with possibility of adjustment in the process of moving the position of the bone fragments in space. Together with the bone fragment in the direction of the defect is moved mucosa, muscles, nerves, vessels, and skin. Thus, there is a simultaneous substitution of a large combined defectuoso essential features, related to personal performance or use.

Preferably, guide rods and placed between them lead screw would have been threaded end parts of the through holes in the blocks, with one side end part of the guide rod would be made of smaller diameter with a shoulder, which is drawn in one unit by means of nuts screwed on the speakers from this unit, the ends of the guide rods, and on the other side end part of the guide rods were made with a semicircular grooves, fixed in the through holes of another block using pins placed simultaneously in an annular groove of the lead screw, the head of which is located at the outer surface of the block. A significant advantage of this design is that it allows removal of the blocks separately. Due to this, less injured soft tissue, as a plate for fastening to the fragments of the bones of one unit can be separated from the bone independently of the plate for fastening to the fragments of the bones of another block.

While it is desirable that the head of the screw would be made in the plan in the form of a polygon under the socket wrench, which increases adoptionin with a head and a screw threaded on the end under the nut, that ensures strength and reliability at a relatively small block sizes, which is set by this pin.

Preferably formed on the housing of the rotary carriage projections would be made C-shaped. It is desirable that the surfaces of the cavities of the projections C-shaped means for securing mobile bone fragments belonged would bushing tubular shape with a longitudinal through slit. These bushings is possible in this connection to capture inside the cavity of a C-shaped protrusion of the needles of different diameters, as well as other parts of cylindrical shape, which greatly increases the usability of the device and its capabilities during the operation.

It is advisable that each plug connection includes a screw screwed into executed in the terminal parts of the projections C-shaped through holes with the screw cutting.

Preferably, the blocks would be connected to the plates for fastening to the bone fragments by means of brackets. In this case provides the most simple constructive means elevated position of the carriage above the defect of the mandible.

Chelation would be made with slits around the through holes.

It is advisable to increase the longevity of the device to the Central part of the guide rod would have a coating to reduce friction between the guide rod and the carriage, for example, of zirconium nitride.

The applicant considers it necessary also to note that although the claimed device is intended primarily for replacement of defects of the lower jaw, but it can be used for replacement of defects, as well as the treatment of fractures of other types, and in this sense is universal.

In conclusion of this section of the description, it should be noted that in addition to the above advantages, the present invention also lies in the fact that the device can be manufactured by the manufacturing equipment already used in the medical industry.

The invention is illustrated by drawings.

In Fig. 1 shows a compression-distraction apparatus for defect replacement jaw, a General view axonometric view; Fig.2 depicts the lead screw, side view; Fig.3 shows the guide rod, side view; Fig.4 depicts a lead screw, a view along arrow a in Fig.2; Fig. 5 shows a block equipped with a plate for fastening to a bone fragment, side view; Fig.6 - that the natives unit, equipped with a plate for fastening to a bone fragment, side view; Fig.10 is a top view;
in Fig.11 is a view along arrow In Fig.9;
in Fig.12 is a view along arrow G in Fig.11;
in Fig. 13 shows a section along d-D in Fig.1 characterizing the node connection Assembly lead screw and guide rods with blocks (carriage not shown);
in Fig.14 depicts a carriage, end view;
in Fig.15 - this is the same view from the other end;
in Fig.16 is a top view;
in Fig.17 depicts a needle, side view;
in Fig.18 depicts a removable sleeve, side view;
in Fig.19 - this is the same end view.

Compression-distraction apparatus 1 for replacement of the defect 2 of the lower jaw 3 includes blocks 4 and 5, with fins 6 and 7 for attachment to bone fragments (see Fig.1). In the compression-distraction apparatus 1 is entered Ilizarov locking retainer Assembly 8 mounted for movement between blocks 4 and 5 with means 9 for fixing the mobile bone fragment 10 formed on one side of the defect 2 of the lower jaw 3. Compression-distraction fixing node 8 is made in the form of a carriage 11 mounted for movement on a pair of guide rods 12, rigidly connected with the block is For clarity of the description of this construction, the applicant considers it is necessary to consider in more detail the construction of the guide rods 12, the lead screw 13 and blocks 4 and 5.

As shown in Fig. 3, each guide rod 12 has a rod shape. The end part 14 of the guide rod 12 on the one hand has a semicircular groove 15, and the end part 16 on the other hand is made of smaller diameter and has a shoulder 17. In addition, at the end of the end portion 16 is screw thread 18. To reduce friction between the guide rod 12 and sliding her carriage 11 and reduce wear of the Central part of the guide rod 12 may have a corresponding additional coverage, representing, for example, of zirconium nitride.

Lead screw 13 is also made in the form of a rod, a large part of which has a screw thread 19 to move the carriage 11 (see Fig.2). The end part 20 of the lead screw 13 has an annular groove 21 and the cylinder 22, separated from the rest of the lead screw flange 23. The head 22 may have a polygonal plan shape, as clearly seen in Fig.4. This form is convenient for dressing Allen key (not shown) to bring the rotation of the lead screw 13 to move the carriage 11. The socket wrench dress all the way into the flange 23. The other end portion 24 of the lead screw 13 has a smooth surface 25 without thread.

As pok is Kam bones by means of bracket 26. Plate 6 for attachment to bone fragments made with the possibility of bending and with a through hole 27 for installing bone screws. Under the enabling bending refers to the ability of the hands to mould the surface of the plate 6 with the purpose of adhesion to the bone of the lower jaw. This can be done in various ways, for example, by performing plate 6 made of such a titanium alloy and of such thickness that it was possible to manually bend it at the time of surgery to fit the shape of the seat bones of the lower jaw, to which you will attach this plate with bone screws. This purpose is served is made in the plate slots 28 around the through holes 27. The fixing unit 6 to the bracket 26 enables you to lift the position of the guide rods 12, and hence the carriage 11 on the place of surgery. In the block 6 is made of three through holes. Through holes 29 are designed to accommodate them in the end parts 14 with a semicircular grooves 15 of the guide rods 12. A through hole 30 is designed to be installed therein the end portion 20 with the annular groove 21 of the screw 13. To lock installed in unit 4 end parts of the guide rods 12 and screw 13 with ensuring the e of the through hole 31, each of which is intended for installation therein of a pin 32. The design of the pin 32 shown in detail in Fig.8. The pin 32 is made of cylindrical shape with a head 33 and a screw thread 34 on the end under the nut. The head 33 of the pin 32 has a shoulder 35 to rest on the surface of the block 4. In addition, at the end of the pin is made protrusion 36 to facilitate the catching-up nut.

According Fig.9, 10, 11 and 12, block 5 of the compression-distraction apparatus 1, as well as the block 4 and connected with the plate 7 for attachment to the bone fragments by means of a bracket 37. Plate 7 for attachment to bone fragments made as plate 6, with the possibility of bending and with through holes 38 for installing bone screws. Under the enabling bending refers to the ability of the hands to mould the surface of the plate 7 in order to more snug fit to the bone of the lower jaw. This can be done in various ways, for example by performing plate 7 of this titanium alloy and of such thickness that it was possible to manually bend it at the time of surgery to fit the shape of the seat bones of the lower jaw, to which will be attached to the plate 7 of the bone screws. This purpose is served is made in the plate slots 39 warslow form for example, it can be done in terms of the G-shaped form, as it is implemented in the described embodiment of the invention. The fixing unit 5 to the bracket 37 allows you to lift the position of the guide rods 12, and hence the carriage 11 on the place of surgery. In the block 5 is made of three through holes. Through holes 40 are designed for threading through them, the end parts 16 of the guide rods 12 to the stop shoulder 17 in block 5. While speaking on the other side of the block 5 ends of the guide rods 12 with screw threads 18 are screwed nuts 41 (Fig. 1). A through hole 42 is designed to be installed therein the end portion 24 of the lead screw 13 with a smooth surface 25. This is formed by the second bearing lead screw 13.

Let us now consider in more detail the connection node Assembly lead screw and guide rods with blocks, intended to move the carriage 11 (Fig. 13). In this site guide rods 12 and placed between them lead screw 13 threaded end parts of the through holes in the blocks 4 and 5, and one side end part 16 of the guide rods 12 are made of a smaller diameter with a shoulder 17, which is drawn in block 5 by means of a nut 41 screwed on in alausa rod 12 is made with a semicircular grooves 15, fixed in the through holes 31 of another block 4 by means of pins 32, are placed simultaneously in the annular groove 21 of the screw 13, the head 22 of which are located outside the outer surface of the block.

Let us now consider in detail the carriage 11 moving along the guide rods 12 by rotating the lead screw 13. As shown in detail in Fig. 14, 15 and 16, the carriage 11 includes a housing 43 in which you have two through holes 44 with a smooth surface designed for threading through them guide rods 12. Between the holes 44 in the housing 43 of the carriage 11 is formed a through hole 45 with a screw surface. It is intended for screwing into him lead screw 13. As a result of this construction the carriage Assembly is threaded on the guide rod 12 during rotation of the lead screw 13 is moved along the guide rods 12.

On the carriage posted by a means for fastening the mobile bone fragment 10 formed on one side of the defect jaw.

It is made on the housing 43 of the carriage 11 a pair of protrusions 46 C-shaped with a fixed in the cavity 47 of these tabs spokes 48 by means of detachable connectors. Each split soede 50 with a screw threaded. For Assembly tools needle 48 is inserted into the through hole 47, and then begin to voracity screw 49 into the opening 50. As a result of this reduced size of the through hole 47, the walls of which are tightly compresses the needle 48.

The pin 48 shown in detail in Fig.17. It has a cylindrical body, on the front castrandom the end of which has a bone thread 51, for example according to GOST R 50582-93, and the other leg 52, which is intended for connecting the means for wrapping the end of the spokes into the bone. Instead of spokes may be used other means of fastening directly into the bone, such as needles, rods, etc.

If the pin 48 has a diameter substantially less than the diameter of the cavity 47 of the projections 46 of the carriage 11, to grip the inside of each cavity 47 may be inserted into sleeve 53 of tubular shape with a longitudinal through slit 54 (Fig.18 and 19). The sleeve 53 is placed inside the cavity 47 so that its outer surface is in contact with the inner surface of the cavity 47. If now inside the cavity of the sleeve 47 to put the needle 48 of reduced diameter, when screwing in the screw 49 for fastening spokes wall cavity 47 is securely grabs the sleeve 47 and pin 48 on the inside of it.

The invention is used as follows.

gelatinous bone fragments of the lower jaw, produce sponging the edges of the fragments. On the bone fragments on either side of the defect is fixed with a compression-distraction apparatus using bone screws. Outline introduction spokes in the distal mobile bone fragment. According to the layout of the spokes make the osteotomy bone fragment. Into it enter the spokes 48 of the compression-distraction fixing node and is fixed to the carriage 11. Give compression. After this tissue sutured in layers.

Actually the operation can be carried out using the described device in a variety of techniques. One of these techniques consists in the following.

First, outline the position of the compression-distraction apparatus 1, defining the attachment plate 6 of the block 4 and the plate 7 of block 5. Then into the holes 29 of the block 4 is passed through guide rods 12 and into the opening 30 also pass through lead screw 13. The crown 22 of the lead screw 13 bit does not reach the surface of the block 4, and the annular groove 21 of the screw 13 is located opposite the through holes 29 in the block 4. Guide rods 12, thus, pass through the holes 29, so that made them semi-circular grooves 15 are located also across from end-to-end otwoa through each hole 29 in unit 4 threaded pin 32 to lock the head 33 of the pin 32 in the surface of the block 4. To prevent loss of the pin 32 on the left on the other side of the block 4, the end of the pin 32 with a screw thread 34 of the screw nut (not shown due to its popularity) to its emphasis in the surface of the block 4. In the Assembly the ends of the guide rods 12 are secured within the block 4, and the end of the lead screw 13, while still attached to the block 4, however, due to the annular groove 21 lead screw 13 is able to rotate around its longitudinal axis. Then the free ends of the guide rods 12 pass through a smooth through hole 44 of the carriage 11. Then begin to voracity lead screw 13 having a screw thread through hole 45 of the carriage 11. As a result of this rotation, the carriage 11 is moved along the guide rods 12. On the opened ends of the lead screw and guide rods put on the block 5. While the end part 24 with a smooth surface 25 of the lead screw 13 is just with a small technology gap inside the through holes 42 of the block 5, which serves for her support. Opposite the end part 16 of each guide rod 12 is inserted through the hole in the block 5 up until this block will not rest against the shoulder 17 on the guide rod, and its Coney rod 12 is screwed a nut 41 to rest on the surface of the block 5 with subsequent skin tightening. The result is a rigid spatial structure with movable along the guide rods 12 of the carriage 11. To move it can be used socket wrench or any other suitable means to move.

After that, the assembled structure is fixed on the lower jaw over the defect by means of plates 6 and 7 in the screw through holes 27 and 38 of the bone screws into the bone of the lower jaw at the sides of the defect. To ensure a solid attachment to the bone due to a more snug fit of the lower surfaces of these plates can be deformed by the surgeon's hands during operation. It is provided as a result of execution of the slots 28 in the plate 6 and the slots 39 in the plate 7, weakened their cross-section. In addition, the ability to manually change the shape of the surfaces of the plates 6 and 7 is provided by a number of other techniques, in particular the selection of plate thickness and choice of material from which they are made. The applicant also notes that the surface of the plate 7 is in terms of G-shaped. The presence of additional lateral process can further increase the stability of the block 5.

After that make mounting pins 48 on the carriage 11. DL is Artie 50, covering with tightness of the needle inside the hole 47. If necessary spokes 48 can be released in the unscrewing of the screw 49, moved inside the hole 47, and then re-recorded by rotation of the screw 49 to skin tightening.

It should be noted that instead of the original full Assembly of blocks and the guide rods with the carriage, followed by fastening the gathered Assembly entirely on the lower jaw, you can do it consistently, that is, first on one side of the defect fasten with plate 6 block 4, to pass through it with fixation of the guide rods 12 and lead screw 13 with subsequent dressing of the carriage 11, is attached to the block 5 and the fixing by the plate 7 on the bone of the lower jaw on the other side of the defect.

The applicant considers it necessary to clarify the purpose of the sleeve 53. This fixture is made due to the fact that quite possibly will need to be installed in the hole 47 of the spokes or other cylindrical parts of different diameters. This creates a problem, since the through holes 47 can be changed internal dimensions at a relatively small value. For example, before installing spokes 48 through the through holes 47 of the carriage 11 in these holes is required is, moreover, the sender may have a significantly larger diameter than the needle. In this case, the sleeve 53 allows to use a single hole 47 for mounting therein the sender and of different diameter.

Further, the applicant describes one way of conducting operations using the claimed apparatus.

First, one or another technique to determine the direction of movement of the carriage and growing regenerate. Then according to the result obtained fix the device on the remaining part of the jaw so as to provide the growing regenerate the exact contour of the lower jaw, as shown in Fig.1. Knowing the distance between the spokes, plan pre-installation site of the spokes on the lower jaw, that is, put two points in places where you want to install these spokes. Then adjust the carriage with spokes to the place where you will be drilling holes in the bone. Spokes 48 when it is installed in the through holes 47 by means of bushings 53. Take out the pins 48 with the sleeve 53 of the carriage 11. In their place is inserted into the carriage napraviti through which drill holes for the threaded portion of the spokes. Then napraviti removed and in each through hole 47 again, first insert the sleeve 53, and then inside it enter pin 48 with posledney the pin 48 within the holes 47 by svorachivaniya screw 49 into the opening 50 of the carriage 11. Thereafter, the milled surface of the future joint bones and carry out the cutting of the piece of bone with screwed-in spokes from the rest of the jaw. Then make the compression for the formation of callus. To do this, first the rotation of the lead screw 13 is cut off mobile bone fragment 10 hanging on the spokes 48 by means of the carriage 11, pull up tight compression only that the cut surfaces of the mobile bone fragment 10 and the rest of the jaw, i.e. create compression in the area of the incision. Exercise their keeping in the compressed state the time necessary for the formation of callus at the site of compression. Then begin the process of distraction (increase of callus in the stretch) for the formation of the regenerate. When using the lead screw 13 moves the carriage 11 mounted on it mobile bone segment 10 in the opposite direction to the edge, which was not cut mobile bone fragment, to building regenerate (bone spur). In General, during the day the transfer occurs at a value of 0.7-1 mm, It is carried out by two to four turns of the lead screw on the value from the1/2to1/4full ku formed bone spur, for example, to carry out the lifting and lowering of the mobile bone fragment 10 to form the correct contour of the lower jaw and ensure precise mating with the edge, which was not cut mobile bone fragment 10. The design of the device allows you to adjust the height position of the roaming mobile bone fragment by raising the spokes in the carriage with subsequent fixation. After docking the mobile bone bone with another tomcom the mandible their impact and withstand a certain time to complete the splice. In this condition the apparatus to leave the solidification of the regenerate. Then the device is removed.

The phone allows you to hold the bone fragment (bone fragments) specified in the correct anatomical position, and also allows you to set the direction (vector) of distraction. In the carriage, and spoke, moving the forming jaw osteotomies bone fragment is on a trajectory that follows the contour of the recovered part of the lower jaw that allows you to restore the lower jaw on the defect similar form, which is a significant advantage of the invention.

A significant advantage of C is due to the less injured soft tissue, as the plate 6 can be separated from the bone independently of the plate 7.

Another advantage of the invention is that the carriage design allows you to screw the spokes 48 perpendicular to the bone. This provides reliable fastening the spokes to the bone. Obviously, this will additionally be facilitated by the implementation of the protrusions 46 C-shaped carriage is rotatable relative to the housing 43 with capability subsequent fixing them relative to each other.

In case of failure of the fixing pins in the bones can increase the strength of the connection. This can be done by different methods, for example, if the attachment was carried out by the spokes with a diameter of 2.7 mm using a sleeve 53, to change them on the spokes of larger diameter, for example, 3 mm In this case, the sleeve must be removed from the through holes 47.

The invention is illustrated by a clinical example.

Patient Y., 1962 R., history 16501 (2000). He admitted with a diagnosis of gunshot fracture of the mandible, post-traumatic defect of the mandible (size 5.5 cm). In the preoperative period was conducted antibacterial, restorative therapy; additional stimulation and cleansing tissues wassim manufacturer of stereolithography model. In the firm "Comet" made individual compression-distraction apparatus. Under General anesthesia performed by the method described above.

On the 11th day started distraction (distraction was 1.06 mm / day) under radiological control. The magnitude of the regenerate was 60 mm, the Postoperative period was uneventful. Conducted a comprehensive anti-inflammatory therapy and treatment aimed at the stimulation of regeneration of bone tissue and increase body resistance.

This observation illustrates the most typical injuries of bones, for which treatment can be applied to the claimed invention.

Thus, when the application of the proposed method is the substitution of the defect of the bone and soft tissues, is a higher aesthetic result.

Apart from the variants of the invention are possible and numerous other modifications.

They are all covered by the following claims.

Sources of information
1. Khitrov F. M. Recovery of the missing half of the lower jaw, the soft tissues of the cheeks, half of the chin, lower lip and floor of mouth. M.: Medicine, 1984, S. 204.

2. Nerobeev A. I. Restored the EMA Cervical Locking Plates CSLP. M, a Subsidiary of CJSC "MATHIS medical Russia, 1999, S. 1.

4. USSR author's certificate 938956, authors: N. Plotnikov.A. and Nikitin, A. A., class a 61 F 5/04, published. 1982.

5. USSR author's certificate 1286188, class. And 61 In 17/58, published. 1987.

6. U.S. patent 5364396, CL 606-53, published. 1994.

7. USSR author's certificate 1503780, class. And 61 In 17/58, published. 1989 (prototype).


Claims

1. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue, including a pair of blocks, with fins for attachment to bone fragments, compression-distraction locking retainer Assembly mounted for movement between the blocks and equipped with means for fastening the mobile bone fragment formed on one side of the defect jaw, characterized in that the compression-distraction fixing unit is designed in the form carriage mounted for movement on a pair of parallel guide rods rigidly connected with the blocks, while the carriage is connected with a lead screw mounted at least in one unit, with the possibility of rotation, and means for securing mobile bone fragment is a proprietary plug connections spokes, and each plate for attachment to bone fragments made with the possibility of bending and with through holes for the insertion of bone screws.

2. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 1, characterized in that the guide rods and placed between them lead screw threaded end parts of the through holes in the blocks, with one side end part of the guide rod is made of smaller diameter with a shoulder, which is drawn in one unit by means of nuts screwed on the speakers from this unit, the ends of the guide rods, and on the other side end part of the guide rod is made with a semicircular grooves, fixed in the through holes of another block with the help of pins, placed simultaneously in an annular groove of the lead screw, the head of which is located at the outer surface of the block.

3. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 2, characterized in that the cylinder and screw are made in the plan in the form of a polygon under the socket wrench.

4. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue

5. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 4, characterized in that the surfaces of the cavities of the projections C-shaped means for securing mobile bone fragments adjacent sleeve tubular shape with a longitudinal through slit.

6. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 5, characterized in that each plug connection includes a screw screwed into executed in the terminal parts of the projections C-shaped through holes with the screw cutting.

7. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 1, characterized in that the blocks are connected with the plates for fastening to the bone fragments by means of brackets.

8. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 1, characterized in that the plate for fastening to the bone fragments are made with slits around the through holes.

9. Compression-distraction apparatus for replacement of defects of the mandible and soft tissue under item 2, characterized in that the Central part of the guide rod has a coating for snizeni the effects of the lower jaw and soft tissues under item 9, characterized in that as a coating to reduce friction between the guide rod and the carriage used, for example, of zirconium nitride.

 

Same patents:

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of comminuted, intra - and periarticular fractures

The invention relates to medicine, namely to traumatology and orthopedics, and is intended for the surgical treatment mainly fractures of the femur

The invention relates to medicine, namely to orthopedics and traumatology, and may be applicable for the surgical treatment of fractures of the neck of the humerus

The invention relates to medicine, namely to orthopedics

The invention relates to medicine, namely to orthopedics and traumatology, and may be applicable to the treatment of fractures of the jaw with the use of temporary implants

The invention relates to medicine, namely to devices used in orthopedics for fixing the sternocostal complex when stereocontrolled

The invention relates to medicine, namely to traumatology

The invention relates to medical equipment, namely, devices for performing compression osteosynthesis of femoral neck fractures

The invention relates to medicine, namely to traumatology and orthopedics, and can be used for the treatment of injuries and diseases of bones and joints with the use of external fixation devices

The invention relates to the field of medical equipment, namely, devices for osteosynthesis with the use of external fixation devices, and is intended for mejregionalnoi compression diaphyseal fractures in the external fixation device

The invention relates to medicine, namely to orthopedics and traumatology, and may be applicable for the replacement of defects of the mandible

The invention relates to medical technology and is used to reposition and fixation of bone fragments in fractures of the pelvic ring man

The invention relates to medicine, in particular Orthopaedics and traumatology, namely, spinal surgery, and is used in the treatment of diseases and injuries of the spine in the specialized field of vertebrology and neurosurgery

The invention relates to medicine, namely to traumatology and orthopedics

The invention relates to medicine, in particular for orthopedics, namely medical devices used for fixation and correction of the spine and designed to determine the technical condition of the structural elements of the device for external transpedicular fixation

The invention relates to medicine, namely to orthopedics in the treatment of the spine

The invention relates to medicine, in particular for orthopedics, namely the treatment of gonarthrosis

The invention relates to medicine, namely to orthopedics and traumatology, and may be applicable for femur lengthening

The invention relates to traumatology and orthopedics

The invention relates to medicine, namely to surgery, and may be applicable for fixation of the middle division of the foot in the treatment of fractures and deformities of the bones of the foot

FIELD: medical engineering.

SUBSTANCE: device has reposition sliding bars having members for fixing bones and connecting unit. The connecting unit has at least one member for fixing bones, lead screws and rods. The connecting unit is combined from base and clamp member connected with hold-down screw allowing rotation. Radial corrugated elements are available on base and clamp sides facing each other. Holes are available in base and clamp casings for receiving the attached rods and rotatably anchored hold-down screws. Through holes are produced in reposition sliding bars having smooth internal surface for the rods and internal screw thread for holding lead screws.

EFFECT: enhanced effectiveness of treatment; accelerated treatment course.

9 cl, 25 dwg

Up!