Method and ruler for determining pin length in performing intramedullary osteosynthesis

FIELD: medicine; medical engineering.

SUBSTANCE: method involves measuring anatomical bone length on intact extremity from the place the pin is to be introduced to the place its distal level is supposed to be positioned. Anatomical bone curvature height is measured next to it in the middle point of length and the received values are summed. Device has linear scale for measuring anatomical bone length and another linear scale for measuring anatomical bone curvature height that is movable and arranged in perpendicular to the first one.

EFFECT: maximum medullary canal fill allover anatomical bone length; high osteosynthesis stability.

3 cl, 3 dwg

 

The invention relates to medicine, namely to traumatology and orthopedics, and can be used during the operation intramedullary osteosynthesis.

For stable intramedullary osteosynthesis necessary selection dowel of appropriate diameter, the length of which corresponds to the length of the bone medullary canal. Because of the anatomical length of the bone-marrow channel of each patient are different, when the operation determining the length of the pin is made individually using the methods developed in practice. The basis of the known methods of determining the length of the pin intramedullary osteosynthesis based on measurements made on radiographs. Known way to determine the length of the pin by measuring the length of the bone medullary canal, according to x-rays of the injured extremity by means of a special line, projected near the bone [1] or by using a stencil-mesh metal [2] also Known way to determine the length of the pin for intramedullary osteosynthesis by measurements made on the intact limb [3]. So, to determine the length of the pin in intramedullary osteosynthesis of the tibia is proposed to measure the intact tibia distance from the proposed introduction of the pin to the top of VN the inner ankle (tibia) and the obtained values subtract 2 see When osteosynthesis of the femur to determine the length of the pin serves to measure the distance from the apex of the greater trochanter to the outer condyle on the intact limb and the obtained value is taken as the length of the pin for the affected limb. However, as a rule, when carrying out the fixation pin is shorter than the required length and does not provide a stable osteosynthesis.

The objective of the invention is to develop a method for determining the required length of the pin in intramedullary osteosynthesis with regard to individual natural anatomical curvature of the bone medullary canal and devices for this purpose. The technical result is maximum filling anatomical length of the bone medullary canal and stable osteosynthesis.

The problem is solved in that to determine the length of the pin when the intraosseous fixation on the intact limb measure anatomical length of the bone from the site of introduction of the pin to the proposed location of its distal level and height of the anatomical curvature of the bone at the midpoint of this length and the obtained values are added up. The above measurement is carried out using a special line, which contains a linear scale for measuring the anatomical length of the bone and a linear scale for measuring the height anatomy is eskay curvature of the bone, installed perpendicular to and can move along the first. The scale for measuring the anatomical length of the bone is supplied by landmarks, one of which is installed with the possibility of longitudinal movement. For convenience when using the ruler moved the reference point can be set with the possibility of a fixed displacement.

The proposed method and the range illustrated by the description.

To determine the required length of the pins for internal fixation of the femur (figa, b) is measured on the back surface of the length of healthy hips from the top of the greater trochanter (In) to the posterior condyles of the femur (C), we obtain the distance And anatomic length of the femur (figa), then from point M, the midpoint And erected perpendicular to the upper edge of the hip (point N), we get the distance S is the height of the curvature of the femur in the middle point M of the anatomical length. The required length of the pin is determined by summing the values of a and S.

To determine the required length of the pins for internal fixation of tibia (figa, b) measurement of the distance from the proposed introduction of the pin (b) In the upper third of the leg, before the Foundation of the inner ankle (S), we get the value of the anatomical length of the Shin, then from point M (mid-distance) measure the height S to comb b/ber the new bone. The required length of the pin is determined by summing the values of a and S.

Figure 3 shows the proposed line containing a scale of 1 to measure the anatomical length of the bone and scale 2 for measuring the anatomical height of the bone, which can be moved along the scale 1 and the reference points 3 and 4, the guide 3 is fixed at the beginning of the scale, and benchmark 4 - can move along the scale 1. To determine the length of the required pin guide 3 is set at the level of insertion of the pin intramedullary osteosynthesis of bone as the reference point 4 is installed in the projection, which is the end of the pin after it was put inside the bone medullary canal to obtain a stable osteosynthesis, the resulting measurement determines the conditional anatomical long bone medullary canal. Scale 2 set strictly in the middle between landmarks 3 and 4 and measure the height of the curvature of the bone. The required length of the pin is determined by the sum of the values obtained.

Experimentally proved, that the determination of the length of the pin in intramedullary osteosynthesis using the described method allows to reach the maximum fill anatomical length of the bone medullary canal.

Example 1

Patient D.,aged 45. Diagnosis: closed transverse fracture of the right thigh on the border With/3 and N/3 with displacement of fragments. The treatment plan is - closed intramedullary osteosynthesis right thigh. Before the operation was carried out determination of the required length of the pin on the proposed method. As a result of the measurement value And amounted to 39 cm, the value of S was 2.5, see the Required length of the pin is defined as 41,5 see operations achieved a stable osteosynthesis due to the maximum fill pin bone medullary canal of the femur.

Example 2.

Patient M 36 years. Diagnosis: Closed fracture W/bone in/3 with displacement of fragments. The treatment plan is closed intramedullary osteosynthesis pin cyto. Before the operation was carried out determination of the required length of the pin on the proposed method. As a result of the measurement value And amounted to 35 cm, the value of S was 2 see the Required length of the pin is defined as 37 see operations achieved a stable osteosynthesis due to the maximum fill pin anatomical length of the bone medullary canal of the bone of the injured extremity. The proposed method of determining the length of the pin in intramedullary osteosynthesis and ruler of the implementation of this method allow you to simply and without x-ray images to determine the required length of the pin and thereby to provide a stable osteosynthesis for successful treatment of fractures.

The sources of information.

1 Boyko VP "Caliber is Naya plate" - the ruler. Orthopaedics and traumatology, M.: Medicine, 1983, No. 1, p.58.

2. Carlin A.N., Chernavsky, VA Basic issues of theory and practice of treatment of fractures of tubular bones. Orthopedics, traumatology and prosthetics. Medicine, 1967, 11, p.20-27.

3. Multi-volume manual of surgery, vol X11, Chapter X, Medgiz, 1960, str.

1. The way to determine the length of the pin in intramedullary osteosynthesis, including the measurement on the intact limb anatomical length of the bone from the site of introduction of the pin to the proposed location of its distal level, wherein measuring the height of the anatomical curvature of the bone at the midpoint of the length and the obtained values are added up.

2. Ruler to determine the length of the pin in intramedullary osteosynthesis containing a linear scale for measuring the anatomical length of the bone, characterized in that it is equipped with a linear scale for measuring the height of the anatomical curvature of the bone, installed perpendicular to and can move along the first.



 

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