Clamp for intramedullary osteosynthesis in dogs and cats

FIELD: veterinary surgery.

SUBSTANCE: the present innovation deals with carrying out operations upon affected bones in canine and feline limbs. The suggested clamp for intramedullary osteosynthesis has a screw and a rod. The latter is designed to be hollow with inner thread for screw's passage from one side, and from another side it has two leaves with protrusions. Leaves are conical with possibility for wedging. Protrusions are designed at the ends of leaves being 1.0-2.0 mm against the surface of leaves. As a result of applying the suggested clamp one should exclude clamp's migration out of the bone at postoperational period, the procedure of operation is simplified, the time to conduct operation is shortened and the chance for osteomyelitis development is decreased along with other complications.

EFFECT: decreased traumatism of operated bone.

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The invention relates to veterinary surgery, and in particular to connectors for operations on the damaged bones of the limbs of dogs and cats. The most efficient use of the clamp at the osteosynthesis of long bones with the diameter of the bone-marrow channel higher than 5.0 mm

Famous pin-opener consisting of a rod with hard carving, three direct and three reverse grooves, which is equipped with a spring that ensures the stability of the osteosynthesis for the whole period of treatment. To conduct osteosynthesis pre rassverlivajut bone-marrow channel of the operated bone to the diameter of the pin-spin, which is installed with the help of the sender. Then pin the corkscrew is screwed with the Allen key into the medullar cavity of the Central and peripheral fragments to full compression of the spring. Pin-the corkscrew is screwed, with some effort, so that it turns the threaded part plunged into the cortical layer of bone. If the pin corkscrew is screwed with great difficulty, taking it for a size smaller or correction of bone marrow cavity drill. Pin-corkscrew larger size can split the bone, but less does not need fixing. The threaded portion of the latch must be fully contained in the distal fragment, and the lesion is at the level of the smooth part [Tkachenko S. Oleosin the ez. - Leningrad “MEDICINE” /Leningrad branch - 1987, P.29].

Also known latch Gear N.A. for osteosynthesis, containing a threaded rod mounted therein a bushing with petals having threaded on the petals, made in the form of buttress threads, the profile of which has the shape of a rectangular triangle with the hypotenuse facing the end face of the sleeve and cutting edge at the vertex [Gear N.A. Latch Gear N.A. for osteosynthesis. USSR author's certificate No. 584855 And 22.12.1997 - prototype].

When installing the above-described clamps the main disadvantage is the necessity of boring medullar channel, the application substantial and trudnoozhidaemyh efforts, as a result of this there is the threat of secession bones. In addition, these clamps twist in medullar channel, hurting the fabric over its entire length in the forward-rotational direction. And during the period of repair of the bone area of the pressure on the bone tissue clamp Gear N.A. significant at all the threaded part of the sleeve. Moreover, at the time of extraction (twisting) of the latches from the lumen of the bone-marrow channel is applied to additional trauma to the tissue and newly formed blood vessels throughout. The use of such clamps increases the injury of operiruemyh, the time for the operation, the area of contact of the tabs with bone and soft tissue (thread), and possible postoperative complications, in particular osteomyelitis.

The objective of the proposed solution is to eliminate these drawbacks, reducing the time for the operation, simplifying the design of the rod and the technology of its installation.

This object is achieved due to the fact that in the known clamp for intramedullary osteosynthesis in dogs and cats containing the screw and the rod is made hollow with internal thread for the passage of the screw with one hand and with the other hand he has two lobes with the tabs, and the petals are made with the possibility of wedging, according to the invention, the petals are made conical, and the protrusions are made at the ends of the petals of 1.0 - 2.0 mm relative to the surface of the petals.

The present invention is illustrated in the drawings, in which:

figure 1 - the proposed release in the section before installation in the medullar canal of the bone,

figure 2 - the proposed release in the incision after installation in the medullar canal of the bone,

figure 3 is a view As in figure 1,

4 is a view In figure 2.

The proposed latch is hollow rod 1 made with tapered petals 2 having projections 3. Inside the cavity of the rod 1 has a thread 4 for prohozhdenie the screw 5, which has a hole 6 for the Allen key.

Operation using the proposed release is described on the example of osteosynthesis of the femur of a dog and is performed as follows.

The rod 1 is introduced into the bone marrow canal of the bone side, made in the form of two lobes 2, bearing one protrusion 3. The introduction of the rod 1 is produced from the top of one of the epiphysis of the bone through an artificial hole made by the drill. The hole diameter is the minimum diameter of the bone marrow canal of the bone and accordingly the diameter of the rod. Easy blows of a hammer pin 1 output over the edge of a break of 10-15 mm and combine fragments of bone, previously giving them the correct axial position. Then continue the promotion of the rod to the end of the bone-marrow channel. Next, thanks to the thread 4 on the inside of the rod 1 promote the screw 5 in the lumen of the rod 1 by screwing using a hexagon socket wrench, which is inserted into the hole 6 of the screw 5. The screw 5 is screwed into the rod 1 flush. As a result, the surface of a cone-shaped petals 2 takes a position in line with the surface of the rod 1. And in this position the rod 1 still fixed in the bone-marrow channel of the two projections 3 rise of 1.0-2.0 mm above the surface of the rod 1 and petals 2. Thanks to rasklinivanie l is Peshkov 2 eliminate inadvertent advancement of the rod 1 in the postoperative period in animals. Experimentally matched the size of the tabs depending on the diameter of the bone-marrow channel (1.0 mm for rods with osteosynthesis of bones cats and small dogs, and 2.0-mm - dogs of large breeds), minimum vozmoznosyami diameter (5.0 mm), and are consistent with the diameter of the proposed release the minimum diameter of the bone-marrow channel allow for a complete screwing of the screw 5 in the lumen of the terminal 1 to eliminate split bones.

Removing the terminal 1 after the formation of callus is produced after removal of the screw 5, which allows you to bring in a starting position the petals 2 of the rod 1 and, respectively, to fix the fixing point of the projections 3 petals 2. Growing animals during the immersion of the rod 1 in a bone conducting drilling holes through which was introduced rod 1 in the medullar channel. When this screw 5 serves for removal of the rod 1 from the bone-marrow channel, as the number of turns of the internal thread 4 of the rod 1 is sufficient to lock the screw 5 in it after fixing the position of the wedging petals 2 of the rod 1.

Example 1. Male, Rottweiler at the age of 4 years, with a live weight of 46 kg Diagnosed neoscholastic fracture of the humerus with displacement of fragments. Conducted osteosynthesis under General anesthesia.

Preparation of the surgical field was carried out according to the standard technique. For wadenstein in the medullar canal of the proximal fragment was performed on-line access from the lateral side of the shoulder - the shoulder joint. To perform artificial holes in the proximal epiphysis of the humerus used a drill bit equal to the diameter of the rod and, accordingly, the minimum diameter of the bone marrow canal of the bone in (18.0 mm), which was determined radiographically. For comparison of bone fragments was performed on-line access in the middle third of the humerus (the localization of the fracture) from the lateral side. After the withdrawal of the rod over the edge of the fracture proximal bone fragment 15.0 mm combined fragments of the humerus, previously giving them the correct axial position. Promotion of the rod 1 in the bone marrow canal of the distal fragment produced until it stops. After that, he screwed the screw 5 and, accordingly, recorded the rod 1 in the bone motionless due to the projections 3, towering above the surface of the rod 1 and petals 2 in a fixed position by 2.0 mm Operating wound was saniroval and closed according to the standard technique. At this time the operation was 22 minutes less compared to the control animals, operated with the use of conventional clamps. The rod was removed at 35 days after surgery. Postoperative complications were observed, the animal recovered.

Example 2. The cat at the age of 2 years, body weight of 3.5 kg Diagnosed with an oblique fracture bolser rzooi bone with displacement of fragments. Conducted osteosynthesis under General anesthesia.

Preparation of the surgical field was carried out according to the standard technique. For insertion of the rod into the bone marrow canal of the proximal fragment was performed on-line access to the cranial side of the knee joint. To perform artificial holes in the proximal epiphysis of the tibia used a drill bit equal to the diameter of the rod and, accordingly, the minimum diameter of the bone marrow canal of the bone (5.0 mm), which was determined according to the method of selection of clamps for intramedullary osteosynthesis in cats in the age aspect. For comparison of bone fragments was performed on-line access in the lower third of the tibia (the localization of the fracture) with the medial side. After the withdrawal of the rod over the edge of the fracture proximal bone fragment to 10.0 mm combined fragments of the tibia, previously giving them the correct axial position. Promotion of the rod in the bone marrow canal of the distal fragment produced until it stops. After that, he screwed the screw 5 and, accordingly, recorded the rod 1 in the bone motionless due to the projections 3, towering above the surface of the rod 1 and petals 2 in a fixed position by 1.0 mm Operating wound was saniroval and closed according to the standard technique. While the cost of lying is neither on the operation of 29 minutes compared with control animals, operated with the use of conventional clamps.

The rod was removed on the 31st day after the operation. Postoperative complications were observed, the animal recovered.

As a result of application of the proposed release are as follows:

exception migration release from bone in the postoperative period;

- reduction of injury to the operated bone;

- simplifying the operation process;

- reduce the time on the transaction;

- reduce the likelihood of osteomyelitis and other complications.

This significantly increases the efficiency of the operation (see table).

Table.
ClipsThe number of operated animalsThe time spent on carrying out the operation (minutes)Complications after surgery
1234
Offer556-
Known5781

As the table shows, the application of the proposed release is more effective in comparison with the known and can reduce the time spent on carrying out the operation in an average of 35 minutes compared to the time, setrac is authorized when using the known clamps. In addition, postoperative complications were observed.

The proposed release was successfully applied for the osteosynthesis of long bones in dogs and cats on the basis of the research of medical-veterinary diagnostic center eagle RAY.

Clamp for intramedullary osteosynthesis in dogs and cats containing the screw and the rod is made hollow with internal thread for the passage of the screw with one hand and with the other hand he has two lobes with the tabs, and the petals are made with the possibility of wedging, characterized in that the petals are made conical, and the protrusions are made at the ends of the petals of 1.0-2.0 mm relative to the surface of the petals.



 

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