Device for fixing external terminal when vneochagovogo osteosynthesis

 

(57) Abstract:

The invention relates to medicine, namely to traumatology and orthopedics and can be used, for example in the treatment of fractures and segmental defects of long bones, including complicated by purulent infection. Under General anesthesia with a scalpel make a puncture soft tissue, bone drill, respectively, the diameter of the rod 2. After this rod is screwed into the whole thickness of the bone, capturing the cortical layer. At terminal 2 ball screw clamp 1 and securing the rod in the ball clamp nuts 3 on both sides, is placed between the bar 4 and the plate 5 on the aligned holes 6. The pad 5 is set obliquely with respect to the arc 4 and secure the clamping screws 7 on the nuts 8. Due to the fact that the cover 4 is installed obliquely with respect to the arc 4, the ball clamp 1 there are two non-parallel zone elastic-plastic deformation, resulting in the absolute rigidity of the ball clamp, and therefore of the rod. Next will install the pin-rod apparatus. The technical result consists in ensuring the stability of the fixation of bone fragments and prevention of secondary complications. 1 C.p. f-crystals, 1 Il.

Among the solutions known in medicine, the closest to the present invention is a device for reposition of fragments of the femur on author. St. N 611612 S. P. Vvedensky. It contains a ring, spokes and arcs connected by a holder with threaded ends and bearing swivel finger, in which the selected hole rod having a working portion with a screw thread and a pointed end and a shank with snap ring grooves under the retaining screw and square under a removable handle.

However, this device because of the unreliability of the locking screw, which often breaks the thread when excessive, but unintentional effort, spontaneously come unscrewed, and also because of the large distance between the arcs, which reduces the rigidity of the holder carrying the rotary finger with a pin, does not provide stable fixation of the rod, which in turn leads to unreliable fixation of bone fragments and the strengthening of processes of bone resorption in the area of the rod with the simultaneous development of a purulent process of soft tissue around the terminal, which increases the risk of developing a core phenomenon of secondary complications due to the secure attachment of external terminal in the external fixation devices.

The essence of the proposed technical solution is illustrated in the drawing, which shows a General view of the holder of transosseous core ring system.

Device for fixing of external rod includes rod holder in the form of a spherical clamp 1 with hole for rod 2, which has a pointed end with longitudinal grooves and threaded and a square under a removable handle at the other end. Ball clamp 1 is mounted between the arc 4 spoke rod apparatus and the cover plate 5 and is based on their axial hole 6. Plate 5 is a segment with three holes cut from the standard arc 4 and inclined with respect to the arc 4 at an angle of 3 to 5oand connected with it by clamping screws 7 with nuts 8. An angle less 3othat does not eliminate possible bias ball clamped between the arc plate and respectively provided loads, and the angle, the greater the 5oleads to deformation of the clamping screws.

When calculating the geometric dimensions of the mount ball clip obtained the optimal ratio of the radius of the hole 6, on which rests a ball clamp, and the radius of the clamp, which is expressed by the following formula: a = 0,6 R, where a is the radius of the hole of the arc and equal to 11.8 - 12,2 mm

The application device can be seen on the example of the treatment of femur fractures. Under General anesthesia with a scalpel make a puncture soft tissue, bone drill, respectively, the diameter of the rod 2. After this rod is screwed into the whole thickness of the bone, capturing the cortical layer. At terminal 2 ball screw clamp 1 and securing the rod in the ball clamp nuts 3 on both sides, is placed between the bar 4 and the plate 5 on the aligned holes 6. The plate 5 is mounted obliquely with respect to the arc 4 and secures the clamping screws 7 on the nuts 8. Due to the fact that the cover 4 is installed obliquely with respect to the arc 4, the ball clamp 1 there are two non-parallel belts of elastic-plastic deformation, resulting in the absolute rigidity of the ball clamp, and therefore of the rod. Next will install the pin-rod apparatus. The proposed device has been tested in the Department of purulent osteology NIETO on 18 patients with femoral fractures, complications of purulent infection, received a stable fixation of bone fragments.

Clinical example: B-P. Oh (N ist. 172400) hospitalized in NIETO with a diagnosis of post-traumatic videoprovider surgery: surgical treatment of purulent-necrotic lesion, segmental resection of the femur over 8 cm, neocolony osteosynthesis of the femur speciem apparatus using ball clamps. Purulent inflammation cropped. Restoration of anatomic continuity of the femur after distraction-compression osteosynthesis was achieved through the year. During the treatment of acute suppuration of the soft tissues of the segment is not noted.

The proposed design differs from known and in particular from the prototype, almost absolute reliability of fixing of the rod, since it is based on elastic-plastic deformation of the ball of the clip.

Transosseous pin passing through the ball clamp has a fairly large amount of free angular movement and can be locked at the required angle to the arc of the external fixation device and respectively to the longitudinal axis of the tubular bones. This is essential in cases when the rod is drawn through the bone is not strictly perpendicular and at an angle less than or greater than 90othat happens quite often, especially when the rod is introduced into fragments with segmental defects of long tubular bones. Device for fixation of the intramedullary stem the proliferation spoke rod apparatus.

Thus, the proposed device allows the treatment of fractures and segmental defects of long bones, the reposition of bone fragments, prevention of osteoporosis and bone resorption in the area of the rod, purulent inflammation of soft tissues and bone by creating a stable fixation of bone fragments a simple technical solution that allows you to secure the rod entered into a long tubular bone.

1. Device for fixing an external terminal in the external fixation device containing other and the holder of the rod, wherein the rod holder is made in the form of a spherical clamp located between the arc apparatus and an overlay based on their aligned holes, and the overlay is installed obliquely in relation to the arc and connected with it by clamping screws.

2. The device according to p. 1, wherein the ball clamp is made of radius R in accordance with the formula a = 0,6 R, where a is the radius of the arc or the cover plate, on which rests a ball clamp.

 

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