The method of osteosynthesis of hip fractures

 

(57) Abstract:

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of hip fractures. The purpose of the invention is the shortening rehabilitation by improving the stability of bone fragments and reduce the morbidity of surgical intervention. Map fragments manipulation of the lower limb. Through extended soft tissue and large skewer drill two channels along the inner walls of the upper and lower contours of the neck. Channels rassverlivajut the tap so that the line break is not less than half of its surface was immersed in the inner part of the cortical layer of the cervix. Then in the screw channels required length screws, which are firmly with the required compression ratio is fixed fragments, especially in the plane passing through the axis of the screws and thigh. After consolidating the screws are removed.

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of femoral neck fractures.

The known method of osteosynthesis of hip fractures, including the reduction and fixation of bone fragments introduced by the Central trichophytosis causes significant destruction of the trabecular bone of the neck and head, that adversely affect the consolidation process, and sometimes leads to the development of aseptic necrosis of the head or nonunion defects and false joints. Additionally, the fixation of bone fragments with a nail passing through the loose spongy tissue, not enough stable and perhaps as a consequence of the rotational displacement of the head around the nail, and its displacement along the fracture plane.

The known method of osteosynthesis of hip fracture and resortcasino fracture bilobed nail Bakichanov or lock Gear [1]

However, the known method has the same disadvantages as the prototype. Furthermore, the presence of diaphyseal lining in the release Bakichanov requires the expansion of the wound, and the latch Gear structurally complicated and causes significant intraoperative difficulties when it is deleted.

The purpose of the invention reduce recovery time by increasing the stability of the bone fragments and reduce the morbidity of surgical intervention.

The aim is achieved in that the securing head and neck are in hard contact with the cortical layer of bone fragments.

The essence of the invention is that the arm is fixed with screws is that unlike retainers, conducted through the spongy bone, gives high fixation stability.

When the hip fracture patient is placed on the operating table on the healthy side. Under General anesthesia the front access to the damaged joint layers cut through the skin and underlying soft tissue. Stupidly pushing muscles and expose the front surface of the joint capsule. Carry out a longitudinal capsulotomy and expose the area of the fracture. Manipulating the lower limb (the abduction and internal rotation of the hip), just compare bone fragments of the femoral neck. Through a large skewer thin drill conducted two channels along the inner walls of the upper and lower contours of the neck. The guide channels rassverlivajut the tap so that the line break is not less than half of its surface was immersed in the inner part of the cortical layer of the cervix. Then screw the screw channels of the required length of the screws to firmly fix the fragments, creating the necessary compression between them and providing them with high stability, especially in the plane passing through the axis of the screws and thigh.

Surgical wound is sutured in layers tightly. Impose silk sutures on the skin. ACE begin 2-3 days after surgery.

After fusion of hip fracture screws are removed through the punctures of the skin on the outer surface of the greater trochanter.

The proposed method is intended for the treatment of femoral neck fractures, especially in elderly and senile age, as traumatic and allows early activate the patient.

P R I m m e R. Patient I. E. 53 years, urgent repair complaining of severe pain in the t/b to the hip and thigh, perverse position of the left n/limbs. The injury was on the street, on the way from work fell on the right side. An ambulance arrived at the hospital. When x-ray examination revealed a fracture of the left femur. Hospitalized in the ELEVENTH ward. Imposed skeletal traction for the roughness left b/b the dice 6 kg After 6 days post-injury surgery: under the proposed method in position on the healthy side under spinal anesthesia produced front arthrotomy left t/b joint (03.02.93). Bone fragments cervical mapped. Through a large skewer, without changing the position of the hip (abduction and internal rotation) using a fine drill alternately made two channels along the inner wall of the cortical bone, a neck at the top and bottom through line paramteric half thickness in contact with the inner cortical neck. Visual inspection of the area of the fractured bone fragments immobilized. The amount of movement in the joint is full. The wound is sutured in layers tightly. The seams on the skin. Denotational plaster boot. The postoperative period without features. On the 3rd day the patient is allowed to walk on crutches with no load on the operated limb. At 15 days the patient was discharged to outpatient treatment. The patient is examined after 8 months. Returned to the previous work. No complaints. Anchor and motor function of the operated limb full. On the control radiographs revealed consolidation of the area of the fracture. The patient is asked to remove the screws.

The application of the proposed method of osteosynthesis of femoral neck fractures can significantly reduce the rehabilitation period and reduce the likelihood of postoperative complications due to the increased stability of the fragments, the compression between them and the small operating room trauma.

The METHOD of OSTEOSYNTHESIS of HIP FRACTURES, which would reposition and fixation of bone fragments, characterized in that the fixation is realized with two screws, introduced coaxially with the neck from the side of the greater trochanter through the fracture so that the threaded portion at the line of fracture below.

 

Same patents:

The invention relates to medicine, namely to dentistry
Solution: bone // 2055535
The invention relates to medicine, namely to traumatology and orthopedics, dental surgery, and can be used in the treatment of patients with lesions of bone
The invention relates to medicine, namely to traumatology, orthopedics, and can be used in the treatment of ankylosis, contractures, near - and intra-articular fractures and defects of joints

The invention relates to medicine, namely to traumatology and orthopedics, and can be applied in surgical treatment of chronic isolated ruptures of the fibular collateral ligaments of the knee joint

The invention relates to medicine, namely to traumatology and orthopedics in the treatment of shortened hip

The invention relates to medicine, namely, orthopedic surgery
The invention relates to medicine, namely to prosthetics short thigh stump
The invention relates to medicine, namely to traumatology and orthopedics, and can be used to restore the function of the knee joint in deforming arthrosis of different etiology

The invention relates to medical equipment, namely to the instruments used in traumatology and orthopedics for the manufacture of emphasis on the spokes

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should isolate and dissect the tendons of anterior tibial and long fibular muscles to dissect the tendon of posterior tibial muscle against the site of fixation and direct it towards plantar rear area in front of internal ankle through the tunnel in subcutaneous fiber, then one should subcutaneously direct dissected tendons of anterior tibial and long fibular muscles onto plantar rear area to suture them so to leave free the tendinous end of posterior tibial muscle which should be intraosseously fixed to median wedge bone that keeps the process of foot repulsion during walking.

EFFECT: higher efficiency of therapy.

5 dwg, 1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should perform reposition of talus fragments followed by resection of articular surfaces of talus and calcaneus by maximally restoring anatomy of tarsal plantar department without forming any groove in talus and resecting wedge-like fragments with their wedge bottom towards the side being opposite to deformation. Then one should develop an autotransplant out of ileum's ala by taking into account the form of modulating resection at its length being from talus' posterior edge up to Chopart's joint without vascular pedicle. Autotransplant should be fixed due to applying Ilizarov's apparatus that enables to cure aseptic necrosis, pseudoarthroses, remove pathological foot's phenomena at shortened time for operative interference and narcosis, decreases traumaticity of operative interference at total decrease of therapy terms.

EFFECT: higher efficiency of therapy.

1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: one should perform incision along internal surface of talocrural joint, open internal ankle and distal tibial metaepiphysis, perform osteotomy of internal ankle, remove cartilages at articular surfaces of internal ankle and internal department of patient's talus, carry out fibular osteotomy being above incorrectly fused fracture, dissect distal fibular fragment outwards, perform osteotomy of incorrectly fused fracture of posterior tibial edge to be then repaired and osteosynthesized, remove cartilages from articular surfaces of fibula and tibia and talus, remove posterior-external subluxation of talus, conduct temporal transarticular fixation of talocrural joint with needles at correct position of talus, perform osteosynthesis of osseous fibular fragments after osteotomy fulfilled, fix external ankle with a screw to tibial and talus epiphysis, perform osteosynthesis of internal ankle, remove transarticularly introduced needles, fill talocrural fissure developed with osseous transplants developed out of anterior-external department of distal tibial metaepiphysis.

EFFECT: increased accuracy of reposition, improved conditions for fusion.

3 dwg

FIELD: medicine.

SUBSTANCE: method involves using wires as temporary fixing members. The wires are introduced reach the external cortical layer after setting the fracture for the period a permanent fixing member is under setting. The wires are removed from the opposite bone side with respect to the fixing member.

EFFECT: enhanced effectiveness in fixing and holding small-sized splinters; high reposition accuracy.

2 dwg

FIELD: medicine.

SUBSTANCE: method involves elongating arm biceps and brachial muscle in distal part. Brachioradial muscle is partially detached from the place of its attachment to achieve full forearm extension.

EFFECT: complete repair of mobility in articulation.

1 dwg

FIELD: medicine.

SUBSTANCE: method involves carrying out reduction and fixation of fractured bone fragments. At least two adjustable length rods are used. The rods have end heads and openings for making attachment to mandible. One of the heads is freely rotatable relative to the rod and the other one is movable along longitudinal rod axis. Reduction and fixation is made in positioned centric jaw relation. The rods are set between the mandible and maxilla to the right and left of the center at the level of failed second incisor and second bicuspid teeth.

EFFECT: reduced risk of traumatic complications; reduced periosteum detachment.

3 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: method involves producing and transplanting and implantable segment containing mature cartilage tissue cells fixed on absorbable supporting matrix for repairing animal cartilage. The implantable segment has absorbable elastic supporting matrix for culturing and fixing living cells thereon. Instrument for introducing the implantable segment, having mature cartilage tissue cells on supporting matrix, into defective animal cartilage area, has clamps and external tubular envelope. The envelope has an end holdable by user and an end for making introduction into defective cartilage area. Holder and telescopic member are available in the envelope end holdable by user. Injection canal is partially embedded into the holder and projects beyond the holdable envelope end towards the end for making introduction. The clamps are attached to the telescopic member. They are well adapted for catching and releasing the implantable segment when telescopically moving the holder in the envelope.

EFFECT: enhanced effectiveness in arranging and fixing implantable segment in the implantation place.

47 cl, 11 dwg

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should perform reposition of osseous fragments at simultaneous reinforcing their thickness with porous titanium nickelide implants. Then one should perform osseous fixation of apophysotendinous stump with titanium nickelide clips at shape memory effect. In particular case, reinforcing should be fulfilled due to implanting elastic porous titanium nickelide plate. In paticular case, reinforcing could be performed due to implanting finely granulated porous titanium nickelide at granules size being 0.1-2 mm. In particular case, reinforcing should be carried out due to implanting elastic porous titanium nickelide plate and finely granulated porous titanium nickelide at granules size being 0.1-2 mm.

EFFECT: higher efficiency of fixation, decreased traumaticity.

3 cl, 2 dwg, 1 ex

FIELD: medicine, traumatology, orthopedics.

SUBSTANCE: in case of the suggested method of treating one should isolate extensor's tendon damaged in area of nail phalanx to suture it with a certain suture, the ends of ligature should be directed through oblique canal in nail phalanx to withdraw through the skin and fix them on S-likely curved free end of a needle that fixes the nail phalanx. In case of the present method of therapy it is possible to exclude the pressure upon soft tissues of volar surface of nail phalanx to prevent the development of scar-resulting bedsore and disorder of palpable sensitivity of patient's finger.

EFFECT: higher efficiency of therapy.

1 cl, 2 dwg

FIELD: medicine, orthopedics, traumatology.

SUBSTANCE: one should form a transplant out of femoral biceps' tendon, form an oblique-cross-sectional transfemoral canal in isometric area upon external femoral condyle, right to the front against insertion fibular collateral ligament, apply proximal end of crossed femoral biceps' tendon through this canal, fix the end of crossed femoral biceps' tendon upon internal femoral condyle. The method enables to prevent tendinous rupture at the site of its new fixation and avoid the loss of articular bending function.

EFFECT: higher efficiency of therapy.

2 dwg, 1 ex

Up!