Device for intrafocal jaw compression osteosynthesis

FIELD: medical engineering.

SUBSTANCE: device has rod having bendable end and threaded end with nut and sliding union thrusting against cortical plate of fractured bone segment. The rod has sharp tip round part to be introduced into the bone fragments by rotating and four-sided part to be introduced by hammering. Bendable end is produced on the sharp tip round part of the rod. The threaded end is available on the four-sided rod part.

EFFECT: reliable compression of bone fragments; avoided relative rotation and soft tissue decubitus ulcers.

2 dwg

 

The invention relates to medicine, namely to maxillo-facial surgery and traumatology and can be used to provide conditions favorable healing of fractures of the jaw.

There are known various devices for carrying out compression osteosynthesis of the jaws.

Thus, the known device for fixation of bone fragments, in the form of metal pins and screws (Movshovich IA Operative Orthopaedics. - M, Medicine, 1984. - P.32 -40). The pins on the shape of the section are three-lobed, round, shtykovidnoe, flattened, threaded. The working part of the screw has a cylindrical or conical shape with a different pitch. The use of these structures requires open access to bone fragments and instrumental in the formation of intraosseous channel, which can cause infectious-inflammatory complications.

For closed or "blind" method of fixing bone fragments using intramedullary rod, made in the form of spokes, which are tools for the formation of intraosseous channel (Manual edited Wenbin and Nimalakunta. SPb., 1998. - S-511).

Also known construction neocolony devices containing intramedullary or extramedullary smooth or threaded mounting rods, which are fixed beams, brackets,frames and other compressicauda elements (Guide edited Wenbin and Nimalakunta. SPb., 1998. - S-511).

The disadvantage neocolony devices is the difficulty and complexity of designs, creating difficulties in their application and care. In addition, compressicauda elements placed at a certain distance from the axis of the jaw, when activated, provide islamicise effort on fragments of the jaw.

Closest to the claimed solution is the latch for the osteosynthesis of bone fractures (Ed. mon. The USSR 1641312 A1, IPC5And 61 In 17/58, 1991). The known device is made in the form of a screw, which represents a round rod consisting of two parts - threaded and smooth reduced diameter. The latch is made of a material having shape memory. When cooled screw part with a reduced diameter coincides with the axis of the screw, when heated, this part is bent perpendicular to the axis. This design allows for the convergence of nut fragments.

The disadvantage of this device should include the fact that the smooth part of the screw with the introduction of fragments of the jaw does not exclude their mutual rotational displacement and, therefore, does not provide reliable compression between the fragments. In addition, the convergence of fragments using nuts creates the conditions for the occurrence of bedsores soft tissues beneath it.

The technical result of the proposed what about the device is the provision of a reliable compression between the fragments, by eliminating their mutual rotational displacement, and the prevention of bedsores soft tissues.

The technical result is achieved in that the device for intranidus compression osteosynthesis jaws made in the form of in the form of a rod having an end with a bend and a threaded end with placed on it by the nut.

The differences between the claimed device are as follows: it is provided with a sliding clutch for emphasis in the cortical plate of the fragment, the rod is made with pointed round part for insertion into fragments by rotation and tetrahedral part for insertion into fragments by vkolachivaya, the end having the possibility of bending performed on the pointed round part of the shank and threaded end is performed on the square part of the shaft.

Comparative analysis of the claimed device and the prototype shows that the proposed device is different from the known and, hence, allows to make a conclusion on the conformity of the proposed technical solution the criteria of the invention of "novelty."

The analysis of the known devices in the patent and the literature revealed no information about the influence of the distinctive features of the proposed device for intranidus compression osteosynthesis of the jaws to achieve a technical result - ensuring the Oia reliable compression between the fragments and the exclusion of their mutual rotational displacement, that allows us to consider the claimed invention meets the criterion of "inventive step".

The device constituting the invention, intended for use in health care. This device can be used in maxillofacial surgery and traumatology. The possibility of its application is confirmed as described in the application techniques and equipment, therefore, the proposed solution meets the criteria of the invention "industrial applicability".

The essence of the claimed device for intranidus compression osteosynthesis is illustrated by figure 1 and 2.

Figure 1 shows a General view of the device, figure 2 - way applications, where 1 is the round part of the device, 2 - tetrahedral part of the device, 3 - threaded end of the device, 4 - nut 5 - sliding sleeve, 6 - anterior fragments of the lower jaw, 7 - line fracture, 8 - following fragments of the lower jaw.

The inventive device operates as follows. After checking the correctness of the mapping of fragments with the edge of the round part 1 of the proposed device pierce the skin and soft tissue in the area of the outer edge of the front fragment 6 of the lower jaw, some distance from the line of fracture 7 2.5-3.5 cm, to stop a pointed end 1 compact disc. Then using a hand or electric drill at low speed device is injected in to the TB, moving parallel to the bottom edge of the jaw to the next fragment 8, penetrating into it. And then, continuing the rotation, advance the device to the opposite edge of the second fragment and display its pointed end out. After this stop the rotation of the device and its promotion continue using vkolachivaya so that the tetrahedral part 2 of the device is entered in both a fragment of the jaw. Protruding from the second fragment pointed part of the device move and bend, and on the threaded end 3 of the first fragment wear a sliding clutch 5 and wind the nut 4. The nut 4 until it stops sliding clutch 5 of the cortical plate front jaw fragment makes 6 to converge fragments of the jaw to the state of compression. The tetrahedral part of the rod 2 in the fragments of the jaw eliminates the possibility of their mutual rotation.

The essence of the proposed device for intranidus compression osteosynthesis of the jaws is illustrated by the following example.

The victim L., 19 years old, delivered to the Department 18.02.2003, a day after suffering a criminal injury. Clinical and radiographic diagnosis: fracture of the body of the mandible on the right between 6 and 5 teeth with displacement of fragments. Under the mandibular anesthesia of lidocaine 2% - 3,0 held reposition of fragments of the jaw. The pointed end of the round the Asti device pierced the skin and soft tissue in the area of the outer edge of the front fragment of the lower jaw, away from the line of fracture of 2.5-3.5 cm, to lock the edge of the spokes in a compact disc. By using the electric drill at low speed all of the device introduced into the bone, moving parallel to the bottom edge of the jaw to the next fragment, entered it, and, moving to the outer edge, brought the pointed end of the rod outward. Vkolachivaya promoted formed in the wound channel of fragments of the body of the jaw tetrahedral portion of the device. The protruding tapered portion of the rod of the second fragment bit, and bent, and on the threaded end of the rod in the first fragment wore a sliding clutch and clocked nut. Tightening the nut until it stops sliding coupling of the cortical plate front fragment has achieved convergence of fragments of the jaw to the state of compression. The next day was observed moderate swelling of the tissues put in place in front of the fragments of the base of the rod. The ratio of the teeth of the upper and lower jaw normal, the condition of stable fragments.

On the 4th day after surgery the swelling of tissues in the area of the fracture is held. The state of stable fragments, normal occlusion. Conducted activate compression by rotating the nut. On the control radiographs ratio of fragments by type "skolochennoj".

On the 8th day after surgery the swelling of tissues in the damage zone is stopped. The state is the stable fragments.

The 12th day after surgery. The state of stable fragments. Is the irritation of the regenerate dosed compression of bone fragments.

16 days after surgery. The state of stable fragments.

20 th day after the operation. The bite is normal. Oculoselective tissue quiet. After removal of the device state of the fragments of the jaw stable.

21st day after the operation. The patient has no complaints. The bite is normal. The body of the mandible in the damage zone is stable. On the control radiographs ratio of fragments of the jaw in a state of "skolochennoj".

For 2002-2003, the authors were treated 17 patients with mandibular fractures Botrychium compression osteosynthesis using the proposed device. When comparing the results of treatment with traditional methods of osteosynthesis found that in the group of patients treated with the proposed device, the timing of clinical healing of fractures of the jaw were 24% shorter.

Device for intranidus compression osteosynthesis of the jaws, made in the form of a rod having an end with a bend and a threaded end with posted nut, characterized in that it is provided with a sliding clutch for emphasis in the cortical plate of the fragment, the rod is made with pointed round part for introduction is in fragments by rotation and tetrahedral part for insertion into fragments by vkolachivaya, the end, with the possibility of bending performed on the pointed round part of the shank and threaded end is performed on the square part of the shaft.



 

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