Method and device for carrying out reparative bone tissue regeneration

FIELD: medicine; medical engineering.

SUBSTANCE: device has supporting rings and pins manufactured from electric conductive material, fixing threaded rods manufactured from electric conductive material for clamping and fixing the supporting rings fastened on supporting rings with plug-type connection members and dielectric members and/or telescopic rods manufactured from electric conductive material for clamping and fixing the supporting rings. At least one of supporting rings is electrically insulated from the rods by means of dielectric members connected thereto.

EFFECT: accelerated bone tissue repair.

3 cl, 2 dwg

 

The invention relates to medicine, namely to traumatology and orthopedics, and can be used in the treatment of patients with diseases of the musculoskeletal system, bone fractures by the method of transosseous osteosynthesis.

Measurement of long tubular bones show that the electric potential difference between the ends of tubular bones have amplitudes of the order of a few millivolts. The amplitude and distribution of biological potentials of bone depend on the viability of the cells. In particular, their amplitude is reduced in the vicinity of the lesion, although there is a significant electrical charge at the site of fracture or bone tumor. Any damage to the bone tissue is accompanied by the disruption of the electrical properties and the change in the amplitude and distribution of biological potentials. If osteomalacia a change in the electrical parameters, as a rule, corresponds to the dynamics of the anatomical and functional restoration of the damaged segment having a tendency to original state.

The known method of forming a bone fusion and functional recovery with compression-distraction osteosynthesis with the use of the Ilizarov frame, consisting of support rings, telescopic rods, threaded rods, spectation, spokes, which allows small what ramatically rigidly fix fragments and it does not limit the function of the joints and limbs in General [1].

The disadvantage of this method is that the apparatus together with bone fragments form a closed electrical circuit that leads to the alignment of electric potentials by bone and reduce electronegativity in the area of damages, i.e. damages natural conditions osteomalacia due to effects on the natural reparative electrogenic.

Also known is a method of treatment of patients with complicated fractures of tubular bones by application of Ilizarov apparatus, including the effects of electric current on the fracture area through the spokes of the apparatus for external fixation (Ilizarov) and/or additional electrodes packages bipolar pulses with the amplitude of the positive part of 3-8 times more than the negative, the frequency of 5-15 kHz for 30-60 seconds and pauses between packets free length of 10-15 seconds [2].

The disadvantage of this method is the short duration of the impact relative to the period of osteosynthesis, which can significantly reduce the time for external fixation of bone fragments.

The technical result of the invention is to create conditions close to natural, to speed up the process of reparative regeneration of bone tissue with compression-distraction osteosynthesis.

To achieve this, the technical result in the known method operativnoy bone regeneration with compression-distraction osteosynthesis using the apparatus for external fixation of bone fragments, which exercise influence on the magnitude of the electric potential in the field of fracture of the proposed electric potential in the field of fracture to restore to natural biological values by opening a closed electrical circuit created by the external fixation device.

The external fixation device to implement the method of reparative regeneration of bone tissue, including made of electrically conductive material of the supporting ring with spokes mounted on the support rings fit connections, locking threaded conductive telescopic rods for tightening and fixing the supporting ring with spokes proposed at least one of the support rings to isolate from the locking rods connected with him through the dielectric elements, such as sleeves. This support ring, spokes, locking rods external fixation device can be made of metal.

The invention is illustrated by drawings, which depict diagrams of Ilizarov frame with insulating elements between the support ring and threaded rods. 1 shows a longitudinal section of the apparatus (the apparatus shown in the two support rings, variants are possible with three or more rings), figure 2 - cross section.

The external fixation device includes spokes 1 is 2, mounted on the support rings 3 and 4, respectively. Support rings 3 and 4 is fixed between the rods 5.

In the joints of the rods and the support rings on the rods worn seals - dielectric sleeve 6. Needles 1 and 2 fix the bone fragments 7, surrounded by soft tissues 8. Needles 1 and 2 mounted on the support rings 3 and 4 using spiegelzaal 9.

Implementation method:

In the operating implement external fixation of bone fragments by Ilizarov, when this is passed through the fixed fragments of metal spokes 1 and 2, the ends of which are fixed on a separate support rings 3 and 4 are made of conductive material. The support ring 3, which is fixed to the spokes 1, is fixed relative to the support ring 4 with spokes 2 through the screw and/or conductive telescopic rods 5. At least one of the support rings. 3, 4 are electrically isolated from terminals 5, United with him by dielectric elements, such as sleeves 6. The dielectric sleeve 6 installed between the support ring and the locking rod.

In one embodiment, execution of the dielectric sleeve mounted on the supporting ring closest to the fracture 10. There is also a variant of the dielectric elements on two or more support rings. P the following dielectric elements remain for the entire period of osteosynthesis.

The installation of insulating elements between the support rings and locking pins for the external fixation device is opened, the electrical circuit created the elements of the apparatus, resulting in the restoration of electric potential in the field of fracture and its distribution along the bone to natural biological value. The result is the creation of conditions close to the conditions of the natural reparative electrogenesis inducing osteocephalus, the possibility of the bone and the body as a whole to cope with the damage. Thus, the proposed method allows to eliminate the forced alignment of electric potentials by bone and reducing electronegativity in the damaged area, resulting in acceleration of the process of reparative regeneration of bone tissue with compression-distraction osteosynthesis.

The effectiveness of the method is confirmed by the following examples.

Example 1.

Patient G., aged 30, and a/b No. 1323, received 17.05.2001, for operative treatment with a diagnosis of viral deformity of the lower extremities. 22.05.2001 were corrective osteotomy of both tibial bone at the level of the proximal metafit, installation of Ilizarov on both shins. In the operating installed insulating sleeve on the machine left the deer, produced insulation proximal support ring from the telescopic rods. Correction in the apparatus was made with 22.05.01, 04.06.01, Beginning to walk without additional support with 18.06.01, the Dismantling of the apparatus: with his left foot made 03.06.01, with the right leg 05.06.01, In the postoperative period, the patient noted a less pronounced pain syndrome in the surgical wound of the left tibia, objectively swelling of the left tibia was smaller than the right. Less pain on the left has allowed the patient earlier to activate the left leg.

By the time of the removal apparatus x-ray picture looked like this. The resulting wedge-shaped defect in the area of correction of the tibia is filled with clearly defined regenerate, evenly thick-walled in a lateral direction and ending in a bone fracture on the outer surface of the tibia, which is defined as moving from one fragment to another unbroken bone beams. On the inner side at the base of the wedge regenerate determined by a clear boundary of the transition from tissue to regenerate soft tissues, and the left boundary is more pronounced than the right.

Example 2.

Patient Z., 21, and/b No. 1291, received 14.05.01, for operative treatment with a diagnosis of "Viral deformity of the lower extremities". 17.05.01 were corrigir the possibility osteotomy of both tibial bone at the level of the proximal metafit, installation of Ilizarov on both shins. In the operating installed insulators on the device left leg, made the isolation of the proximal support ring from the telescopic rods. Correction in the apparatus was carried out 22.05.01, 01.06.01, the Patient began to walk without additional support with 14.06.01, the Dismantling of the apparatus: with his left foot made 01.06.01, with the right leg 04.06.01, In the postoperative period, the patient noted a less pronounced pain syndrome in the surgical wound of the left tibia, objectively swelling of the left tibia was smaller than the right. Less pain on the left has allowed the patient earlier to activate the left leg.

By the time of the removal apparatus, x-ray analysis formed wedge-shaped defect in the area of correction of the tibia filled with clearly defined regenerate, evenly thick-walled in a lateral direction and ending in a bone fracture on the outer surface of the tibia, which is defined as moving from one fragment to another unbroken bone beams. On the inner side at the base of the wedge to regenerate soft tissues, and the left boundary is more pronounced than the right.

Clinically after dismantling the apparatus of patients reported no pain in the neck osteotomy of the left tibia. In the right tibia in the field octet the MIA continued pain, the load on the limb was gentle within 10-14 days.

Thus, the use of this method facilitates the creation of optimal conditions for reparative regeneration of bone tissue with compression-distraction osteosynthesis.

Used sources of information:

1. Ilizarov GA "Orthopaedics. Traumatology and prosthetics". M., 1971, No. 11, p.7-15.

2. USSR author's certificate No. 1438047, MCI: a 61 N 1/36, 1986 prototype.

1. The external fixation device, including made of electrically conductive material of the supporting ring with spokes mounted on the support rings fit connections, are made of electrically conductive material fixing threaded rods for tightening and fixing the supporting rings and dielectric elements, wherein at least one of the support rings are electrically isolated from the terminals via United with him dielectric elements.

2. The apparatus according to claim 1, characterized in that the supporting ring, spokes and locking rods made of metal.

3. The apparatus according to claim 1, characterized in that the dielectric elements are in the form of sleeves.



 

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