The apparatus kgm for sneakerboy fixation of bone fragments in pathological processes in the lower jaw

 

(57) Abstract:

Usage: in medicine, namely in oral and maxillofacial surgery at the osteosynthesis of the lower jaw. Effect: increase the reliability of fixation of bone fragments, reducing the trauma of soft tissues when installing the apparatus, the possibility of focal intraosseous administration of drugs. The inventive apparatus for sneakerboy fixation of bone fragments in pathological processes in the lower jaw contains two transosseous rod connecting the last of the threaded rod with opposite threads, and the connecting sleeve. The apparatus is provided with a detachable lever, mandarinami and nozzles, the latter is in the form of a hollow cylinder with internal thread on one side and a through hole transosseous pin on the other side, on the sides of the nozzle made two holes with internal threads and screws, and in the center of the connecting sleeve is made a through hole for accommodating a removable lever having at one end thickening, and the other mounted on the threaded nut, and external terminals are made with a cavity at one end of the cross-cuts, and the other conical with Wintrich rods. 2 Il.

The invention relates to medicine, namely, oral and maxillofacial surgery and may find use in osteosynthesis of the lower jaw about the various pathological processes.

Known apparatus EC-1, consisting of spokes entered in percutaneous bone fragments by means of a drill, a skeleton in a straight or arc frame and fasteners /trims, nuts/. Apparatus with direct frame used in the fixation of bone fragments on the straight parts of the mandible [1]

The disadvantages of this device are:

1. Significant metal structure due to the presence of the frame, strips, etc.

2. Insufficient compression-distraction effect due to design features /in particular, the overlapping part of each other and adapt to their convergence or separation/,

3. The impossibility of introducing drugs into the bone fragments in the introduction of the spokes, which does not allow specifically to carry out drug exposure in the pathological focus,

4. The impossibility of correcting the position of the spokes in the bone, which reduces the locking effect.

The closest analogue is the machine M. M. Solov'ev, and E. M. Magarill for compr is sustained fashion rods with a set of sleeves/ with dressed nozzle, consisting of two screws from the manifold and the connecting sleeve, the rotation of which fragments are converging. When this bone clamps of the apparatus are superimposed on the lower edge of the body of the mandible.

It should be noted that for the imposition of the device the ends of the bone fragments naked, slowly covering them with a soft cloth. Then the wound is sutured closed. For removal of plate clamps the soft tissue re-cut [2]

The disadvantages of this device are:

1. Need to skeletonema the body of the mandible along the bottom edge, which is an additional injury, and can lead to serious complications /violation extrasales blood supply/,

2. Significant metal structure due to the presence of plate clamps, lattices, etc.

3. The impossibility of administering drugs to the area of the lesion /nutricote/, which reduces the effectiveness of the treatment and causes a significant number of complications infectionamoxicillin nature,

4. The inability of the correction plate clamps after setting of the device.

It should be noted that these devices are used in fractures of the lower jaw and not the tah lower jaw /jaw, traumatic, radiation and other pathological processes after removal of tumors of the mandible/, i.e., in the presence or immediate threat of development of inflammatory phenomena. With these important positions intraosseous administration of drugs directly into the lesion through the fixing bone fragments rod.

The technical result consists in increasing the reliability of fixing of a bone tomcom, reducing the trauma of soft tissues when installing the apparatus, the possibility of focal intraosseous administration of drugs.

For stable fixation of bone fragments and opportunities intraosseous injection drug use the apparatus of Cake Gennady Mikhailovich /KGM/ /on the device/.

The device is made in the form of two hollow transosseous pins with cuts on the top end. External terminals have two communicating holes in the upper and lower parts. In the lower part of the external terminals on the end of the tapered external screw thread. On the external terminals put the nozzle in the form of a cylinder with internal thread on one side and a through hole for external rod with the other.nya. Nozzles fix the connecting sleeve in the form of a cylinder with opposite threads on the ends and a through hole in the center. In the hole insert the lever in the form of a rod with a thickened end on one side and threaded with a nut on the other.

Execution of external terminals in the form of a hollow cylinder at the end of the tapered external screw thread allows use of percutaneous drill to enter the external terminals and the bone, the hole located on the side /some distance of 4 mm from the edge/ in the field of slicing allows you to enter nutricote medicinal substance. This is achieved by reducing the metal design /hollow cylinders/. The location of the holes on the side allows the latter to penetrate the bone tissue with the introduction of external rods into the bone. The presence of holes on the side allows the latter to be placed in the cancellous bone /compact between the plates of the lower jaw/. The medicinal substance is pumped through the hole in the Central part of the external terminal on the other end /if necessary, you can use a metal rod, guide him through the Central part of the transosseous core/. The presence of multi-directional threading on the ends to be fixed in the nozzle external terminals respectively bone fragments/, bringing together or spreading the latest /achieving the necessary compression or distraction effect. Two screws on the sides of the nozzles serve for additional fixing of external terminals /you can use one screw/. Existing thread and nut on one end of the lever and thickening at the other allows you to remove the lever after manipulations that serves the ease of use and reduction of metal construction.

In Fig. 1 presents a General view of the device of Fig. 2 transosseous rod with cap and screws.

Device for fixation of bone fragments in pathological processes in the lower jaw contains a hollow external terminals 1. Perosseous rods 1 at one end with conical external thread 2 and the hole 3 on the side, at the other end of the hole 4. Holes are communicated with the groove 5. On the external terminals 1 put the nozzle 6, is made in the form of a hollow cylinder with one hand with the internal thread 7 and a through hole 8 for external rod with the other. On the sides of the hole 8 has two holes 9 with internal thread with a blind side and two screws 10. The nozzle 6 is fixed with the connecting sleeve 11 in the form of a cylinder with multidirectional outer researhing thread at the other end 16. On the thread 16 lock nut 17. In the hole 3 external terminal 1 insert a metal rod 18, the diameter equal to the inner groove 5. At the ends of the external terminals 1 are cross-shaped cuts 19.

The device operates as follows. The drill /drill/ insert and fix the external terminals 1 with the mandrel 18. After processing the surgical field and appropriate analgesia at low speed enter the external terminal 1 in percutaneous bone fragments /traditionally 1-1,5 cm from the line of fracture or diseased bone/. At the end of the tapered portion with an external thread 3 is between the inner and outer compact plates of the body of the mandible /reliability transosseous fixation rods 1 dice/. Hole 3 is located in the cancellous bone, which provides the distribution nutricote drug /for example, osteo-antibiotic/. Similarly to the other bone fragment impose external terminal 1, achieving parallelism. Then transosseous pin 1 put the nozzle 6 and rigidly fixed with screws 10. In the part of the nozzle 6 with the internal thread 7 insert the connecting sleeve 11. When the CAG 14, at the end of which wind the nut 17 on the thread 16. Rotate the lever 14 clockwise or counterclockwise, respectively, pushes or pulls together bone fragments. Desired position of the bone fragments. Then remove the nut 17 and pull the lever 14. The skin around the external terminals 1 treated with traditional methods. Take out the rod 18. In the 4 hole transosseous core 1 insert the injection needle and pump nutricote drug. Then treated with antiseptics rod 18 and insert back in transosseous pin 1 /to prevent infection/. Given that after a few days transosseous pin 1 can be rolling dice, conduct its correction due dosed screwing screwdriver /cross cuts on 19 dancechrissortega rod 1/. It also allows you to easily extract the external terminals of the bones.

It should be noted that when osteomyelitis of the jaws may experience increased intraosseous pressure, including the threat of pathological fracture/, with the introduction of hollow external terminals 1 in bone provides a normalization of the pressure due to the fluid /transudate, exudate through checkoutlist fixation of bone fragments in a predetermined position due to the possibility of moving it to external terminals, and also due to the possibility of correction of the provisions of the latter;

2. Reducing the trauma of soft tissues when installing the unit, because there is no need to elektrownie the body of the mandible.

3. Reducing the number of complications infectious inflammatory disorders due to the absence of violations extrasales blood supply /as when using prototype/ and opportunities intraosseous injection of drugs directional /for example, after determining the sensitivity of microflora to antibiotics/.

4. Low metal structure due to the hollow of external terminals, removable arm, the possibility of using one screw for fixing of external terminals 5. The possibility of decompression in the presence of intraosseous hypertension /osteomyelitis/ and intraosseous lavage, which increases the efficiency of treatment for this group of patients.

6. Reduction allergization of an organism due to focal sighting administering drugs /regional Department of bone fragments/ instead of the traditional method /oral, intramuscular and so on/ and side effects of medication therapy.

7. Convenience when izvlecheny is prohibited from stainless steel and can be sterilized by conventional methods.

Apparatus for sneakerboy fixation of bone fragments in pathological processes in the lower jaw, containing two transosseous rod connecting the last of the threaded rod with opposite threads and the connecting sleeve, characterized in that it is provided with a detachable lever, mandarinami and nozzles, the latter is in the form of a hollow cylinder with internal thread on one side and the through holes transosseous pin on the other side, on the sides of the nozzle made two holes with internal threads and screws, and in the center of the connecting sleeve is made a through hole for accommodating a removable lever having at one end thickening, and the other mounted on the threaded nut, and external terminals are made with a cavity at one end of the cross-cuts, and the other conical with screw threaded and the hole in the side, communicating with the cavity, and mandrini are located in the cavities of external terminals.

 

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