Device for extending nerve pipes

FIELD: medicine; traumatology; neurological surgery; recovery surgery.

SUBSTANCE: device has drive mechanism and traction units disposed onto base. Base is mounted in case with lugs. Lugs have openings for osseous screws. Screws are provided with protruding button for finding them under skin. Edge is mounted with its protrusions onto side surfaces in guides of case walls' grooves. Drive mechanism has two similar ratchet-and-pawl gears. The latter are disposed onto parallel axes at the same level counting from base. Teeth of wheels have inclination to meet each other. Button is disposed between ratchet-and-pawl gear and it is put onto cylindrical spring. Open one-sided groove is made onto side surface of button at the side where ratchet-and-pawl gears are mounted. Groove is oriented in parallel to axes of ratchet-and-pawl gears. Base of flat symmetrical flat with z-shaped free ends is disposed inside in groove. Any end of spring is engaged with its ratchet-and-pawl and it is made in form of catch. Jaws, disposed at axes being shared with ratchet-and pawl gears, form coils with ratchet-and-pawl gears for flexible couplings of traction units. One end of links is attached to jaws. Other ends are withdrawn outside through openings at opposite side of case. Additional catch in form of symmetrical spring is mounted onto base. Bent out ends of spring are engaged with their ratchet-and-pawl gears.

EFFECT: reduced traumatism; improved results of cure.

2 cl, 1 dwg

 

The invention relates to medicine and is used in traumatology, orthopedics, neurosurgery, reconstructive surgery for the treatment of defects of the nerve trunks.

There are a number of analogues of the proposed device. Among them we can mention the Device for lengthening nerve trunks [1], in which the reciprocating motion of the flat spring cause the rotation of the ratchet wheel, the transmitting movement of the threaded shaft that converts rotational movement into translational movement of the threaded rod, beckoning require lengthening the nerve.

Closest to the claimed its technical solution is a Device for lengthening nerve trunks [2], the drive mechanism which is made in the form of a ratchet wheel with dogs. One of the dogs, leading, is a button that is installed on the cylindrical spring. When performing reciprocating movements (when pressing the button) this dog its beveled end rotates ratchet with a flexible shaft, pulling requiring lengthening the nerve. The second dog, in the form of flat springs, prevents reverse rotation of the wheel upon termination of the pressure on the spring.

The disadvantage of analog is not protruding above the surface of the button. When using analogue and prototype must premanath device, each of which will lengthen your end of the nerve, which will require a larger piece of skeletization of bones.

The essence of the invention is expressed in a set of key characteristics, sufficient to achieve the desired technical result, namely: reducing the morbidity of surgical intervention, improved treatment outcomes.

The invention consists in that the device for lengthening nerve trunks contains the drive mechanism and traction units, on the basis prescribed in the case with lugs having holes for bone screws. The device has a protruding button to detect under the skin, set the tabs on the side surfaces of the guide grooves of the wall. The drive mechanism consists of two identical star wheels placed on parallel axes at the same level from the base, the teeth of the wheels have a counter slope. Between the star wheels is a button mounted on the coil spring on the side of the button on the side of installation of star wheels, parallel to their axes, made a unilateral open groove. In the groove is the basis of flat symmetrical spring having a Z-shaped free ends, each of which is in engagement with its ratchet and performs the function of dogs. While located on the common with x is apotekama axes cheeks forming a coil for flexible traction rods nodes, on one end of which is fixed on the cheeks and the other ends are removed through openings on opposite sides of the housing to the outside. On the basis of extra dog in the form of a flat symmetrical springs, bent the ends of which are in engagement each with its ratchet.

The device differs in that the groove on the lateral surface of the button height equal to the thickness of the flat spring and width - the width of this spring.

The design of the same two star wheels placed on parallel axes, the teeth of which have a counter-slope and flat Z-shaped spring mounted between the star wheels, the role of dogs, driven total button, provide simultaneous pulling the two ends of the damaged nerve that allows you to use one device instead of two commonly used.

The dual design of the device provides a reduction in the morbidity of surgery (section of skeletization of the bone is reduced almost by half), decreases it increases convenience for the patient, which independently carries out the distraction during the day, producing a pressing efforts on one button instead of two, as usual, in case of using two devices.

The device shown in the drawing, with the removed cap and body.

<> The device includes a housing 1 with a cover 2 and placed on the base 3. In the walls of the base 3 with the axis 4 attached to them by the star wheels 5 of the drive mechanism. On the same axes 4 fixed cheeks 6, forming a coil for laying flexible rods 7 traction mechanisms. One of the ends of the rod 7 is fixed in the holes 8 on the cheeks 6, and the other two end brought out through holes 9 in the ends of the housing 1. Between the star wheels 5 on the cylindrical spring 10 is installed, the button 11. On the side of the button 11 by the installation of star wheels 5 and parallel to their axes 4 are open groove 12 in which is placed a flat base symmetrical spring 13. The free ends 14 of the spring 13 are Z-shaped and, performing the function of the dogs in the drive mechanism, are in engagement with the teeth of the star wheels 5. For fixing rotation of the ratchet 5 on the magnitude of the tooth at the base of the 3 extra dog in the form of a flat spring 15. The base 3 with the drive mechanism and traction node is installed in the housing 1, and the grooves 16 on the inner side surfaces of the housing 1 serve as guides for the projections on the lateral surfaces of the buttons 1 and to prevent distortions of the buttons in the operation of the device. Ears 18 of the housing 1 is made holes 19 under the bone screws.

The device is used as follows. Skeletonize ucast the segment of the limb, producing prolonged nerve. This skeletonema area should be the same distance from the ends of the prolonged nerve. Device-free coils and fixed on them flexible rods of required length is fixed with bone screws to skeletonname part of the bone. The free ends of rods hem to lengthen the ends of the nerve. The wound is sutured in layers so that the seam was on the outside of the projection device, placed in the soft tissues.

In the next patient, a certain number of times per day produces clicking "all the way" on a raised below the skin above the surface of the housing 1 button 11, powering the drive mechanism of the device. One click to rotate the reel in one tooth. When driving down button 11 protruding from her body bent free ends 14 a symmetric flat spring 13 pressing on the teeth of the star wheels 5, the motion passed traction mechanisms, resulting in the rotation of their coils. Spinning reel drags flexible rod 7, one end of which is fixed on the cheeks 6 coils. Reaching its end position, the button 11 under the action of the spring 10 returns to its original position. This bent the ends 14 of the flat spring 13 which acts like a dog slides on the bevel teeth of the star wheels 5, leading to the Zats is initiated following the teeth, and more dogs in the form of a flat spring 15 and prevent the return of the star wheels 5 in their original position.

At the final stage stretching of the nerve trunks towards each other going into the ends of the coils. After removal of the device the ends of the shafts refresh excision of neurom. Nerve trunks sew.

Sources of information

1. Patent No. 2161918, And 61 In 17/00, 17/04, BI 2001, No. 2.

2. Patent No. 2207812, And 61 In 17/00, 17/04, BIPM 2003, No. 19.

1. Device for lengthening nerve trunks containing the drive mechanism and traction units, on the basis prescribed in the case with lugs having holes for bone screws with protruding button to detect under the skin, set the tabs on the side surfaces of the guide grooves of the walls of the housing, wherein the drive mechanism consists of two identical star wheels placed on parallel axes at the same level from the base, the teeth of the wheels have a counter-slope, between the star wheels is a button mounted on the coil spring on the side of the button on the side of installation of star wheels parallel to their axes made unilateral open groove, in which is placed a flat base symmetrical spring having a Z-shaped free ends, each of which is in engagement with their snoring is not far away and made in the form of dogs, while located on the common with the star wheels the axes of the cheeks form of star wheels reels for flexible traction rods nodes, one end of which is fixed on the cheeks and the other ends are removed through openings on opposite sides of the housing to the outside, on the basis of extra dog in the form of a flat symmetrical springs, bent the ends of which are engaged, each one with its ratchet.

2. The device according to claim 1, characterized in that the groove on the lateral surface of the button height equal to the thickness of the flat spring and width - the width of this spring.



 

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