The plate-implant for osteosynthesis
The invention relates to medicine, namely to traumatology. The invention provides a more effective treatment of fractures by providing long-term stable fixation plate to the bone fragments. The plate-implant has a concave bottom surface and side grips on the sides. The plate is made with the screw holes with spherical supporting part of the head, which are symmetrically located in them shaped inclined surface to create compression between the bone fragments in one direction or another when svorachivanie screw and a Central recess for fixing the head of the screw. The plate also has additional made in pairs at an angle to each other threaded screw holes that provide long-term rigidity. 3 Il.
The invention relates to medicine, namely to traumatology and can be used in the treatment of fractures by extramedullary fixation of bone fragments submerged implants.
The treatment of fractures by extramedullary fixation of bones is widespread. For example, well-known surgical compressicauda plate with holes for mounting screws and holes DD 45to the longitudinal axis of the plate (A. C. of the USSR №1502019, MCI And 61 In 17/58, publ. 23.08.1989).
A device for fixation of bone fragments at the fracture containing the plate with oval holes and screws with spherical head having two threaded parts - one for fixation in a bone, the other for fixing the plate. The oval hole is one-sided inclined surface providing sliding the spherical head of the screw when screwing into the bone to provide compression. The fixing screw is provided corresponding thread (Application Germany No. 19858889, MCI And 61 In 17/68, publ. 21.06.2000).
A disadvantage of the known device is the following:
1) the inability to vary the direction of compression of the bone fragments at different sites of damaged segment;
2) lack of long-term stable fixation plate when possible bone resorption.
The closest analogue in essential traits is a dynamic compression plate limited contact (M. E. Muller, and other Manual internal osteosynthesis. The methodology recommended by the group JSC (Switzerland). Moscow, Publishing house Ad Marginem, 1996, S. 76-77, Fig.1.42 d).
In this plate on its bottom surface vol circulation bones, what also contributes to the formation of adhesions in the area of the fracture. In addition, these grooves lead to a more uniform distribution of stiffness along the plate. Holes for screws, evenly spaced along the length of the plate are oppositely and symmetrically directed inclined cylindrical surface moving in a horizontal cylindrical surface, which allows the spherical screw head to slip in an oval hole in a horizontal cylinder, creating a tightening compression in the right direction. Supporting spherical portion of the head of the screw mates with the surface of the orifice plate.
However, the known plate does not provide sufficient reliable fixation required for fusion of fragments of bone. This is due to the fact that as a result of compression of the bone fragments at the time of surgery is collapsing them all, and their subsequent partial resorption with the inevitable reduction efforts compression (C. M. Secula. Theoretical foundations of compression osteosynthesis. // Proceedings of the 1st all-Union Congress of traumatologists and orthopedists. - M.: Medicine, 1965. - N-350-358; E. R. Dadahanov. The role of sustainable and compression osteosynthesis in saille is lishvili, C. A. Safonov. Experimental study of the effect of compression on reparative regeneration of the radial diaphysis of the bone. - KN: Transosseous compression and distraction osteosynthesis in traumatology and orthopedics. Sat.scient. works Kurgan NICOT. - L., 1977. - S. 9-15). Occurs weakening state voltage in the system of the implant - bone and, consequently, weakening the rigidity of the connection screw - plate. In the result, under the influence of alternating loads there is a loosening of the entire system and bone fragments together. In addition, the slightest movement between the screw and plate leads to the destruction of the passive protective layer that prevents corrosion.
The objective of the invention is improving the efficiency of treatment of fractures by providing long-term stable fixation plate to the bone fragments.
This object is achieved by the plate-implant for osteosynthesis with a concave bottom surface and side grips on the sides containing the number of screw holes with spherical supporting part of the head along the plate and having a symmetrically located in them slanted surface to create compression between the bone fragments in one direction or another when screw screw and valued in pairs at an angle to each other threaded screw holes.
Depending on the nature of the fracture and form additional bone screw holes can be located under a converging or diverging angle in the direction of the bone.
Performing on the plate-implant additional holes with the specified direction of the axis provides the installation screws with the formation of a triangle in the plane transverse or longitudinal section of the bone and, thus, locking the mounting plate to the bone. This plate design provides long-lasting rigidity even when resorption of the ends of the fragments in the postoperative period and reliable fixation of the implant to the bone, allowing painless earlier mobilization of the operated bone.
Known plate-implants for osteosynthesis, in which the holes are made with a Central recess in the form of a paraboloid of revolution with the ability to place screws at the required angle to ensure stable fixation plate to the bone (RF Patent No. 2190980, IPC And 61 In 17/80,publ. 20.10.2002).
However, under the action of alternating loads is the separation of the contact screw with a Central recess paraboloid of the form (for fixing the orifice plate), raschityvaete screws leads to uneven-tangential distribution of the zones of tension and, as a consequence, the displacement of the joined fragments and loss efforts compression during the operation.
Subsequently, as with any instability, is the destruction of the passive protective layer that prevents corrosion of metal implants, and the development of metallosis tissues.
The proposed solution provides not only reposition and fixation of bone fragments between a stable and reliable fixation of the plate to the bone and long-term rigidity even when resorption ends of fragments in polaprezinc period.
Thus, the proposed set of features is new and non-obvious causes according to the invention, the criterion of "inventive step".
In Fig.1 shows a plate-implant for osteosynthesis of Fig.2 the same in case of placement of additional screws under the converging angle; Fig.3 - same as in the case of the placement of additional screws under divergent angle,
The plate-implant 1 includes holes 2 along the plate and shaped inclined surfaces of the screw 3 with a spherical supporting part of the head. In addition, the plate contains more done in pairs at an angle to each other threaded hole the plate-implant for long-term stable fixation of the fracture is performed as follows.
After anesthesia by intermuscular space exposed the damaged bone. Then reposition and preliminary binding fragments by customersthese and modeling of plates according to the standard technique is fixing it to the fragments of the diaphysis of the bone screws 3, introduced perpendicular to the axis of the bone through the holes 2, with shaped surfaces to achieve the desired compression between the fragments. Then to secure the plate to the bone and prevent displacement relative to the last after the preliminary boring bones of the appropriate diameter drill bit through the extra hole 4 in the plate introduced several pairs of screws 5 under converging angle in the plane of the cross-section of the bone (Fig.2) or under divergent (Fig.3). Formed rigid design eliminates further possibility of separation of the plate from the bone surface, thereby increasing the reliability of fixing of and providing conditions for the primary seam fracture.
The plate-implant for osteosynthesis with a concave bottom surface and side grips on the sides containing the number of screw holes with spherical bearing Castagnoli to create compression between the bone fragments in one direction or another when svorachivanie screw and a Central recess for fixing the head of the screw, characterized in that it has additional made in pairs at an angle to each other, the threaded screw holes.
FIELD: medical engineering.
SUBSTANCE: device has part fixed on bone and intraosseous part parting from it at an angle of 90є and having protrusion and slit. The on-bone part is longitudinal and narrow and has transverse protrusions having holes for receiving fastening members, and the narrow part has longitudinal rectangular area having rounded protrusion and slit 0.5-1.0 cm far from the protrusion. The slit originates on the lower edge in perpendicular to the longitudinal device axis occupying half of height of longitudinal area of the intraosseous part.
EFFECT: improved functional properties; accelerated treatment course; stable fixation of fractured bone fragments.
3 cl, 1 dwg
FIELD: medicine; medical engineering.
SUBSTANCE: device is rectangular and has four or more slits for fixing means to pass through each of them. Two slits have exit to lateral side of plate to enable one to set the plate at required position and fix it without preliminarily removing the instrument for correcting orientation relative to vertebral column. Lateral plate surface runs from edge pointing the same direction with longitudinal plate direction. The latter exactly coincides with the vertebral column direction. The system comprises several vertebral column osteosynthesis plates to keep orientation correction relative to the vertebral column unchanged. Correction is carried out by means of the instrument for correcting orientation.
EFFECT: less number of holes to be drilled for mounting the device.
11 cl, 10 dwg
FIELD: medical engineering.
SUBSTANCE: device has plate with holes and fork-like fixing unit having two teeth. The teeth are arc-shaped along longitudinal relief of frontal surface of external clavicle one-third. The teeth divergent in planes parallel to each other for arrange external fractured bone fragment. Longitudinal part of the plate is S-shaped.
EFFECT: enhanced effectiveness of treatment; high multisplitter fracture fixation reliability.
FIELD: medical engineering.
SUBSTANCE: device has metal plate having widened middle part, at least three pedicles and at least four holes in the middle part, one of them being central and one available on each of the pedicles. At least one of the pedicles has flexible member between the middle part and the nearest hole. It is manufactured as flat helical spiral with turn angle of 180°.
EFFECT: accelerated surgical operation; reliable connection of bone fragments; reduced risk of traumatic complications.
FIELD: medical engineering.
SUBSTANCE: device has supraosseous part and intraosseous part parting at an angle of 90° and having rectangular rectilinear longitudinal segment having protrusion on both ends. The supraosseous part is longitudinal, narrow, 2 mm wide member having transverse protrusions modeled along the frontal boundary of the medial malleolus having holes for receiving fastening members. The intraosseous part protrusions are rounded and sharp along curvature arc.
EFFECT: improved functional results; improved fracture consolidation conditions.
FIELD: medical engineering.
SUBSTANCE: device has plate having canals for inserting screws and optional epimetaphyseal fixing member. The canals for inserting screws are arranged along plate boundary and made divergent at an angle of 40-60° to pass through cortical layer without affecting medullary canal.
EFFECT: reliable high-strength fixation.
FIELD: medicine, traumatology, orthopedics.
SUBSTANCE: the present innovation deals with metalloosteosynthesis of intra-articular and peri-articular fractures. According to the first variant, the suggested plate contains an osseous plate with openings and a fixing unit as a fork with teeth and foramens for a screw. Osseous part of teeth, branching fan-shapely, circles metaphysis and has a curvature at the angle of 180°. Submergible parts of teeth are parallel to each other. Teeth are designed to be round in cross-section. Teeth are being in a plane parallel to that of osseous plate. The length of submergible part of teeth knowingly exceeds the diameter of a semilunar fragment of patient's elbow bone. According to the second variant, the plate contains an osseous plate with openings and a fixing unit as a fork with teeth and foramens for a screw. Osseous part of teeth, branching fan-shapely, circles metaphysis. Submergible parts of teeth are parallel to each other. Teeth are designed to be round in cross-section. The distance between submergible parts of teeth is 1.5-2 times higher against the width of an osseous plate. According to the third variant, the plate contains an osseous plate with openings and a fixing unit as a fork with teeth and foramens for a screw. Perosseous part of teeth, branching fan-shapely, circles metaphysis, and submergible parts of teeth are being parallel to each other. Teeth are designed to be round in cross-section. The plate has a curvature according to the shape of condylar edge of patient's brachial bone. Osseous part of teeth is supplied with a crosspiece to provide the chance to be fixed up with screws.
EFFECT: higher efficiency of osteosynthesis.
3 cl, 4 dwg
FIELD: medical engineering.
SUBSTANCE: device has irregularly curved Kirschner wire having loop for wire cerclage and stepwise bends arranged on both sides of the loop with a structure having three longitudinally arranged fragments for making bone contact. The loop is placed on the middle fragment in the device center with pipes transversely joining three longitudinally arranged fragments. The pipes are displaced towards the loop for preventing engagement with bone and are bow-shaped to possess springing properties.
EFFECT: enhanced effectiveness of treatment; accelerated treatment course; low treatment costs.
FIELD: medicine; traumatology; orthopedics.
SUBSTANCE: device provides ability of moving along several axes and fixing bone screws at stable position at angle to bone plate; additional mechanical elements are not required. Device for osteosynthesis has through opening made for placement of bushing for bone screw, which bushing can be adjusted along several axes. Device also has bushing made for introduction into through opening. The bushing has central channel made for placement of bone screw. Channel has longitudinal axis. Peripheral external side of bushing is made making contact with internal surface of through opening. Bushing is made for radial compression and radial expansion. Cross-lateral section, which passes in perpendicular to central axis, has non-circular shape. Cross-section of bushing, which passes in perpendicular to longitudinal axis, has shape to correspond in essence to shape of cross-section of through opening to protect bushing, being introduced into through opening, from turn relatively longitudinal axis and to keep ability of angular orientation adjustment relatively through opening.
EFFECT: improved efficiency of procedure.
33 cl, 8 dwg
FIELD: medicine, oral surgery, ophthalmosurgery.
SUBSTANCE: one should fulfill two vertical mucosal incisions of transitional fold being below and laterally against infraorbital foramen. Then, according to these incisions, one should form foramens in anterior wall of maxillary antrum, dissect cicatricial adhesions of soft tissues in area of restored osseous fragments at isolating periorbital fiber till its free movement together with oculomotor muscle in orbital cavity. One should forma fatty interlayer between oculomotor muscle and osseous wall, moreover, a transplant should be fixed from one side towards anterior department of the lower orbital wall, and from another side - to osseous department of retrobulbar orbital part. Then it is necessary to suture osseous fragments of orbital wall with the transplant along the whole length. The innovation enables to form correct ratio between osseous fragments of periorbital fiber and oculomotor muscle, decrease traumatism of mucous-periosteal layer in area of vestibule of mouth, decrease disorders in circulation in area of operation and, also, reconstruct normal movement of patient's eyeball.
EFFECT: higher efficiency of reconstruction.
2 dwg, 1 ex