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.

Claims

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.

 

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