Graduated distraction device
SUBSTANCE: device comprises two distraction assemblies - the first one - for the first and second phalanges, and the second one - for the second and third phalanges. Each assembly is presented in the form of a pair of threaded rods, at the ends of which there are mounted two axially gradually movable arched supports. Each of the supports is provided with bone fixative holes at the ends. The holes of the adjacent arched supports of the first and second distraction assemblies are combined thereby creating an axis of rotation. In this pair, the arched support of the second assembly has a radius smaller than the radius of the arched support of the first assembly by a value to ensure combining them on the single axis and at different levels. At the top of the arched support with the smaller radius, there is an eye having an elongated hole, either fixed directly, or turning around. An eye body is curved at an angle of up to 175 degrees, and is coupled with one end of the flexing-extending threaded rod; the other end is provided with an end eye for the joint connection with a U-bracket fixed on the top of the adjacent arched support of the greater diameter of the first distraction assembly.
EFFECT: invention provides the distraction of tendons, cicatrices, digital joints of the fingers if observing their full contracture, with eliminating a risk of the distraction injury, simplifying the structure and adjustment, and ensuring the follow-up of the postoperative field in service.
4 cl, 5 dwg
The invention relates to medicine, in particular to a device for external fixation, reduction, fixation of the phalanges fingers, distraction tendons, scar formation and interphalangeal joints in the event of them full or partial contracture.
A device for reposition and fixation of bone fragments containing semiring with bone clamps made with the possibility of their connection threaded couplers, and removable repairbuy node in a corresponding screw distractor grounds with a guide that is installed with the possibility dosed move in two mutually perpendicular planes threaded rods connected to one another and by means of connecting nodes with semicircles, each connecting node is made in the form carriage mounted for movement along the guide by means attached to the threaded rods, and plates, one of which is pivotally connected to the carriage and on the other plate and at last fixed threaded and smooth rods placed on them slide with the worm, when the axes of the hinge joints of the plates perpendicular to each other, the screw terminals are connected T-shape, each have a worm connection with the sliders, and the bone fixator is made in the form of rods, supports repair the subsequent node connected to guide rods, and screw distractor made from portions having a multi-directional threaded EN 2012279 C1, A61B 17/60.
The locking part of the known device is cumbersome because of the bone fixator in the form of threaded rods, a movable carriage, plates, smooth pins, connected by a T-shape, half-rings with screw connection, sliders, numerous joints and screw distractor with areas of mixed thread. The complexity of the device makes it difficult to care for the affected area after the operation.
Known apparatus for the treatment of bone and makadamovyh anomalies brush containing nodes fixation of bone fragments with spokes, United threaded distraction and distributing weights, nodes fixation is made in the form of brackets and plates, some plates are paired arcs arranged in mutually perpendicular planes with brackets, rods are made at one end with lugs mounted on the brackets and plates on the axles, rods pivotally mounted, and distraction - at the ends of the plates and brackets, and another - at the free ends of the plates and on the tops of the brackets - EN 2029521 Cl, AW 17/60.
In addition to the structural complexity and inconvenience in the treatment of bone and makadamovyh post-traumatic deformities and abnormalities of the hands disadvantage of this apparatuses limited its application: when a complete contracture this unit does not perform the distraction of tendons and joint capsules fingers.
The prototype of the invention is a device for developing movements in the interphalangeal joints containing interconnected arcuate supports, clamps phalanges, ChibiUsa-extensor mechanism and the fastening elements, the ends of the arcuate supports spirally curved and pivotally interconnected with the possibility of reversal, the tabs of the phalanges made in the form of rigidly mounted on poles threaded rods mounted with a possibility of longitudinal movement of specification and ChibiUsa-extensor mechanism installed outside of the contour of the supports and is connected with the holders of the phalanges through slats installed on their free ends - EN 3087 Ul, AV 17/60.
The prototype disadvantages are the complexity of the design and complexity of the adjustment dosed distraction post-traumatic conditions contractures of the interphalangeal joints, tendon-ligament apparatus, neurovascular structures, and also increased the likelihood of trauma to commit, which could result in the occurrence of fractures of the phalanges of the hand when holding the distraction extension installed vertically spokes in the nail and the main phalanx of the thumb.
In addition, the device does not distraction tendons, scar formation, interphalangeal joints of the fingers in the event of them total control is actory.
In this regard, the technical problem to be solved by the device, is to provide a distraction tendons, scar formation, interphalangeal joints of the fingers in the event of them full contraction, eliminating the risk of trauma to the distraction, simplify the design and adjustment, and care of post-operative field during operation.
This problem is solved by the device dosed distraction, containing two tensile node - first - for the first and second phalanges of the fingers and the second for the second and third phalanges, each node is made in the form of a pair of threaded rods on the ends of them with the possibility of axial dosed move fixed two arcuate supports, each of which is made with holes at the ends of the bone clamp, the orifices adjacent the arcuate supports the first and second tensile sites combined, creating an axis of rotation, in this pair of arcuate bearing of the second node with radius smaller than that of the arcuate support the first node by the value of ensure alignment on a common axis and at different levels, on the upper part of the arcuate bearing with a smaller radius is fixed directly or rotated by 180 degrees. the eye with an elongated hole, the body of which is made at an angle to 175 deg. and is connected with one end of the fold is the using Piller ventilators properly-extensor threaded rod, the other end of which is made with end clevis for articulated connection of a U-shaped bracket mounted on the upper part of the adjacent arcuate bearing with a larger diameter of the first tensile node.
In addition, the claimed device has a number of features that characterize its specific forms of material embodiment, namely:
- these fastening executed nuts with washers;
- the length of the threaded rod in a pair, installed in the first tensile node is proportional to the total length of the first and second phalanges of the finger, the length of the threaded rod in a pair, installed in the second tensile node is proportional to the total length of the second and third phalanges of the thumb, and the radii of the arcuate supports, in which is mounted above a pair of bars is proportional to the diameter of the corresponding phalanges considering the distances to provide care for post-operative field during operation;
all parts are made of stainless steel, or titanium, or aluminum alloy, or brass, or other high-strength heat-resistant, including composite materials.
Figure 1 shows the position of the device in full flexion contractures, figure 2 - position of the device in partial flexion contractures; figure 3 - position of the device with the full rehabilitation of the phalanges of the finger n is 4 - front and side view of an eye; figure 5 is a front and side view of a U-shaped bracket.
The device dosed distraction contains two tensile node 1 and 2. The node 1 to the first knuckle 3 and the second knuckle 4 fingers, node 2 for the second knuckle 4 and the third phalanx of 5th finger.
Node 1 has a pair of threaded rods 6, which ends with the possibility of axial dosed movement fixed, for example nuts, two arcuate supports 7, 8, each of which is made with two holes 9 at the end of the bone clamp (not shown).
Node 2 is executed, similarly to the node 1, a pair of threaded rods 10, the ends of which are fixed two arcuate supports 11, 12 with two holes 9 at the ends.
It should be noted that the device can be used for the treatment of adults and children. To do this, it can be made different (individual) dimensions, with the length of each threaded rod 6 in a pair, installed in the first tensile node 1, is proportional to the total length of the first and second phalanges of the finger, and the length of each threaded rod 10 in a pair, installed in the second tensile node 2, is proportional to the total length of the second and third phalanges of the finger.
The radii of the arcuate bearings 7 and 8 and 11 and 12, which set forth the respective pairs of rods 6 and 10, is proportional to the diameter of the line is adequate phalanges considering the distances to provide care for post-operative field during operation.
Holes 9 for bone clamps adjacent arcuate supports 8 and 11 in the first and second nodes 1 and 2 combined, creating a single axis of rotation. In this pair of arcuate bearing 11 of the second node 2 is made with a radius smaller than that of the arcuate bearing 8 of the first node 1 to the value, ensuring their alignment at the completion of distraction on a common axis at different levels, as shown in figure 3.
On the upper part of the arcuate support 11 having an axis of rotation with a support 8, is fixed by nuts with washers lug 13, front and side view of which is shown in figure 4.
The eyelet 13 is fastened using nuts and washers on the support 11 directly or rotated by 180 degrees, depending on the mode of use of the device. The body of the lugs 13 is bending to 175 deg. to provide stretch-contraction-fixing nodes 1 and 2 using ChibiUsa-extensor threaded rod 14 with nuts.
Rod 14 one end of which is connected with the possibility of rigid fixation with eyelet 13 and the other end of the rod 14 is made with end clevis for articulated connection of a U-shaped bracket 15, secured to the upper part of the adjacent arcuate bearing 8 of the first tensile node 1.
The design of the bracket 15 shown in figure 5. The hinged connection may be a pin, rod or other, including threaded, connection through the holes shown in figure 5.
In the execution of the bracket 15 of a U-shaped due to the requirement of high reliability for fixing the position ChibiUsa-extensor threaded rod 14, which creates an additional force of distraction between the arcs 8, 11, and fixes them with nuts to the desired angle to prevent unauthorized fractures of the phalanges of the finger, tearing of scar formation of the soft tissues and tendons.
To ensure the sustainability of the device to temperature sterilization - 180-200°C requires all parts stainless steel, or titanium, or aluminum alloy, or brass, or other high-strength heat-resistant composite materials.
The device dosed distraction is used as follows. Consider three modes of operation: mode full flexion contractures of the limbs, partial contracture and full rehabilitation.
At full contraction position of the device shown in figure 1. In this mode, the first bone clamp threaded through the hole 9 of a support 7 and the first (main) phalanx 3. The second bone clamp conducted through aligned holes 9 of the supports 8 and 11 and the second (middle) phalanx 4. The third bone clamp threaded through the hole 9 of the arcuate bearing 12 and the third (nail) phalanx 5.
Bearing 7 is fixed by nuts move along a pair of rods 6 node 1 at the base of the main phalanx 3. Bearing 8, together with the support 11, is fixed by nuts move along a pair of rods 6 node 1 to the second phalanx 4, having a single axis of rotation - hole 9 op is R 8 and 11. Bearing 12 is fixed by nuts move along a pair of rods 10 node 2 on the third phalanx 5.
The arched support 8 is firmly fixed U-shaped bracket 15 (figure 5), which is made adjustable connection by inserting the rod through the holes in her body and the end eyelet on the rod 14. While the eyelet 13 (figure 4) is fixed directly on a support 11, and the adjustment and fixation of the measured displacement of nodes 1 and 2 relative to each other is along the axis of rotation of the supports 8 and 11 nuts with a washer on the rod 14 by the lugs 13.
In partial flexion contracture position of the device shown in figure 2. This mode of distraction - stretch scar tissue, joint and tendon contractures. For straightening the fingers should be dosed moving support 8 by a pair of rods 6 in the direction of the nail phalanx 5 and the fixing position on the rods 6 nuts. Supports 8 and 11 are located on the same axis of the hole 9, the bone clamp. Bearing 12 is moved in the direction of the nail phalanx 5. Due to changes in the provisions of the bearings 8, 11 and 12 by means of rod 14 relative to the opening 9 is made of rotational dosing movement of node 2 in the direction of the bracket 15, thereby resulting in the creation of additional effort (if necessary) for a wound third phalanx 5 and the second knuckle 4. The rod 14 also fixes the position of the nodes 1 and 2 of the unauthorized mechanical impact. While the eyelet 13 depending on the current conditions of distraction is reset (if necessary) on a support 11, i.e. is it a turn angle of 180 deg., while adjustment of the length of the rod 14 is nuts with washer with subsequent fixation of the side lugs 13.
The third mode is the position of the device distraction from 50-60% to full rehabilitation.
Metered movement of the supports 8 and 11 around the axis of rotation 9 holes is carried out by means of nuts on the rod 14, one of which is moved from the inner to the outer side with rigid fixation at the end of step a distraction.
To full disclosure of the joints of the phalanges and stretching of scar formation of the soft tissues and tendons of the finger, the device is on hand not less than two months, fixed in a linear (straight) position is performed using rigid fixation of all nuts.
The ability to work simultaneously on all the fingers is effected by the application of the proposed separate apparatus for each finger, using its various functions, until the introduction of additional arcs for fixation of fractures (if necessary), what is required in the treatment of patients suffering from numerous post-traumatic deformities of the bones, joints, tendons and soft tissues of the hand. This ensures who is very useful for the care of post-operative field during operation.
In the proposed device dosed distraction reduced risk of fractures of the phalanges of the finger, realized the possibility of non-traumatic dosed distraction of the joints, tendons and soft tissue, scar formation fingers.
In comparison with the known analogues, reduced the number and range of items, which achieved the simple design of the apparatus, which reduces its production, increases availability during the operation.
The proposed device has successfully passed clinical trials in the Department of traumatology of the hand in 4 clinical hospital of Moscow in 2012-2013
1. The device dosed distraction, containing two tensile node - first - for the first and second phalanges of the fingers and the second for the second and third phalanges, each node is made in the form of a pair of threaded rods on the ends of them with the possibility of axial dosed move fixed two arcuate supports, each of which is made with holes at the ends of the bone clamp, the orifices adjacent the arcuate supports the first and second tensile sites combined, creating an axis of rotation, in this pair of arcuate bearing of the second node with radius smaller than that of the arcuate support the first node by the value of providing their alignment on a common axis and at different levels, on the top part of the arcuate bearing with a smaller radius is fixed directly or rotated by 180 degrees. the eye with an elongated hole, the body of which is bent at an angle to 175 deg. and is connected with one end ChibiUsa-extensor threaded rod, the other end of which is made with end clevis for articulated connection of a U-shaped bracket mounted on the upper part of the adjacent arcuate support the larger diameter of the first tensile node.
2. The device according to claim 1, in which the said attachment is made nuts with washers.
3. The device according to claim 1, in which the length of the threaded rod in a pair, installed in the first tensile node is proportional to the total length of the first and second phalanges of the finger, the length of the threaded rod in a pair, installed in the second tensile node is proportional to the total length of the second and third phalanges of the thumb, and the radii of the arcuate supports, in which is mounted above a pair of bars is proportional to the diameter of the corresponding phalanges considering the distances to provide care for post-operative field during operation.
4. The device according to claim 1, made of stainless steel, or titanium, or aluminum alloy, or brass, or other high-strength heat-resistant, including composite materials.
SUBSTANCE: invention relates to medical equipment, and is applied in traumatology and orthopedics. Device contains first module for bone from one side of joint, second module for bone from the other side of joint and threaded bars for connection of said modules. Said first module consists of bone support with wires and wire clamps. Said second module consists of first and second bone support, threaded rods with nuts, connecting said first and second supports, wire clamps, wire holders for wire tightening, at least, one wire holder for console wires, at least, one regulated wire holder for console wires and repositioning module. First support is intended for joint end. Repositioning module has support plate with holes, rod wire clamps for console wires and posts. Posts are intended for installation of support plate on support for joint end. All said supports are made in form of flat rings and/or half-rings with holes. Brackets are used in said wire holders and in repositioning modules. Brackets represent straps with, at least, one hole and tip with thread, installed on one of strap ends. Each rod wire clamp is made with slot for wire and nuts. Rod wire clamps are installed by means of nuts in hole of brackets, with last tip being installed in holes of support plate by means of nuts. Each post is made from connecting threaded rod and two brackets, one of which is installed with tip by means of nuts in hole of support plate, the other by means of nuts - with tip in hole of support for joint end. Connecting threaded rod is installed in holes of said two brackets by means of nuts. Wire holders for tightening wires are made in form of brackets, in holes of which wire clamps are installed and tips of which are installed on second support of second module by means of nuts. Wire holder for console wires is made in form of bracket, in holes of which wire clamps are located, and tips of which are installed in holes for joint end by means of nuts. Regulated wire holder for console wires is made in form of a pair of brackets, one of which has wire clamp in hole and is by means of nuts installed with tip in hole of another bracket, and the last one is by means of nuts fixed in support holes for joint end.
EFFECT: invention ensures fixation and reposition of epiphysis fragments which results in creation of favourable anatomical and functional conditions for recovery of injured growth zone with further normal course of physiological processes of growth and preservation of extremity biomechanics due to possibility of eliminating displacement of fragments in all planes due to possibility of eliminating displacement of fragments in all planes in the process of treatment without apparatus remounting.
SUBSTANCE: invention relates to medicine. Apparatus for destruction osteosynthesis of hand and foot bones contains two and more rod modules, connected between each other with screwed bar, which ensures possibility of mutual travel of rod modules on it. Each of rod modules includes case and fixers of transcutaneous rods. Case of each rod module is equipped with straps with longitudinal through slot, in which with possibility of linear and angular travel fixers of transcutaneous rods are fixed. At least, one of rod modules is equipped with compression-destruction screw nut with radial openings for spanner, installed in slot of case, on threaded bar, made with derotation facets along the entire length.
EFFECT: invention provides possibility of realising distraction of small bone fragments destruction, for instance, bones of hand and foot, in passing transosseous elements (rods or wires) into them at different angles, with high stability of fragment fixation, as well as simplification of manipulation of compression or destruction.
4 cl, 8 dwg
SUBSTANCE: invention relates to medicine, namely to dentistry, and can be used in increase of volume of bone and soft tissues in case of vertical atrophy of alveolar process with the aim to prepare patient to carrying out dental implantation. Distraction apparatus contains bearing screw and installed on it means of movement of mobilised bone fragment of patient's jaw from basal bone, and fastening screws for fastening said means on bone fragment and basal bone. Said means of bone fragment movement are made in form of mobile and immobile consoles, each of which has a hole, in which fastening screw is installed. Mobile console is installed on bearing screw with possibility of longitudinal reciprocating movement. Hole in immobile console is made polyhedral and in direction to axis of bearing screw. Shank of fastening screw which is in interaction with it is also made polyhedral with possibility of interaction with said polyhedral hole in immobile console. Shank of fastening screw is located transversally to thread part of said fastening screw.
EFFECT: invention provides possibility of growing alveolar process at certain angle to the vertical outwards or inwards.
SUBSTANCE: invention relates to medical equipment, namely to devices, which are applied in traumatology and orthopedics. Device for destructive osteosynthesis of wrist joint area consists of components of Ilizarov's apparatus set and contains two rings and half-ring, connected with screw bars. On palm-elbow surface of hand and forearm there is expandable external support, which consists of three thread bars, whose length is twice less than adjacent thread bars between ring and half-ring, and three plates, fixed with screw nuts. Connection of half-ring with ring of Ilizarov's apparatus is carried out on perimeter, which exceeds perimetre of half-ring.
EFFECT: invention ensures increased efficiency of treating patients with fractures, fracture-dislocations of wrist joint and their consequences.
2 ex, 5 dwg
SUBSTANCE: invention relates to medicine, namely to traumatology-orthopedics. Essence of invention lies in the following: apparatus for treatment of fractures of shin and foot bones contains supports, connected by means of threaded bars, brackets, wire-fixers and intraosteal rods. Circular supports of apparatus are made composite, and consist of similar modules, representing sectoral plates in form of ring quarter with holes located along contour. One end of plate is provided with rectangular open pocket with hole on the side, parallel to plate plane, width of the other end being made equal to width of internal size of pocket. On peripheral sides of plates, closer to their end parts, made are semi-circular projections, located in such a way that holes in them are located between holes along plate contour. Plates are connected to each other by means of bolts with nuts.
EFFECT: invention provides possibility of treating patients with combined injuries of shin and foot, accompanied with bone fractures, vast defects of skin and underlying soft tissues, with simultaneous stabilisation of bone fragments of injured segment, with reconstruction of its axis and possibility of collection of small bone fragments, due to restoration of periosteum tension, performing interventions on vascular-nervous bundles, covering skin defects and underlying soft tissues, with reduction of treatment time and improvement of its outcomes.
SUBSTANCE: invention relates to medicine, namely to traumatology and ortghopedics, and is intended for treatment of fractures of long tubular bones. Apparatus contains supports, threaded bars, connecting supports, intraosseous rods, rod-fixers and remote rod-fixers on form of beam. Supports are made in form of arch-like plates, curved on radius in their plane, and bent in said plane in form of projections from terminal parts of plate toward its salience. Projections and terminal parts of plate are provided with holes with bilateral countersink. Holes, located on radius, are made along plate. Beam of remote rod-fixer is immovably fixed on cylindrical pedestal, which has axial threaded hole and is installed on base in form of washer, on the centre of lower surface of which placed is square boss with axial through hole. Base is installed on base with boss in hole, located on radius along plate. On the upper surface of base made are radial teeth, which contact with teeth of respective shape on the lower surface of pedestal. Pedestal and base are connected with support by means of screw connection. On wide sides of rod-fixer beam made are transverse teeth, along axis of said sides made is through oval slot for installation of intraosseous threaded rods, fixation of which in remote rod-fixer is performed by means of special nuts and washers. Nut has spherical head and hexagonal shank, which are connected to each other by means of tube. Washer is made rectangular and is provided with longitudinal oval slot for intraosseous rod. In the centre of slot made is depression of respective shape for head of spherical nut. On the end of upper surface, along short side of said washer, made is step, on the opposite end of lower surface, for the half of washer height - depression in the centre, for the width of central slot. On the lower surface of washer made are transverse teeth, in shape corresponding to teeth on lateral surfaces of remote bracket.
EFFECT: invention ensures increase of fixation rigidity, reduction of operation treatment trauma with improvement of its outcome and creation of comfort for patient.
SUBSTANCE: invention refers to medicine, namely to orthopaedics and traumatology. A wire is delivered through a heel bone. It is used for skeletal traction to remove lengthwise bone fragment dislocation. Then two supplementary wires are delivered in a frontal plane: in a distal tibial epimetaphys and in a proximal tibial epimetaphys. The supplementary wires are fixed in supports of a derotation device from two rings of a standard Ilizarov's osteosynthesis kit. The rings are coupled by three telescopic rods. The fracture is reduced. Edgewise dislocation of the bone fragments is removed, and the bone fragments are rotationally dislocated. The telescopic rods are fixed in the achieved position. The skeletal traction wire is removed from the heel bone. The X-ray control follows. A plaster bandage is applied on a shin with covering knee and ankle joints. After the plaster bandage is dried, the derotation device is removed.
EFFECT: method provides tibial and fibular fragment union in an anatomically correct position and reduced length of hospital treatment.
2 cl, 1 ex, 6 dwg
SUBSTANCE: invention refers to medicine, namely traumatology and orthopaedics. A compression rod apparatus for long bone reduction comprises threaded bearing rods with a threaded portion longitudinally movable with the use of axial movement screw nuts of a tube body with distal and proximal axial deflection assemblies arranged on the body in mutually perpendicular cavities with transosseous rod holders and transosseous rods fixed therein. The apparatus additionally has a spacer ring 1 with proximal 2 and distal 3 hinged joints arranged on both end thereof. The proximal hinged joint 2 is fixed with the use of an O-ring groove 4 and a retaining screw 5 on the proximal end 1-P of the spacer ring 1 with the proximal hinged joint 2 rotating about an axis of the spacer ring 1. The distal hinged joint 3 is arranged on a distal smooth end 1-D of the spacer ring 1 with the distal hinged joint 3 rotating about the spacer ring 1 and movable along the spacer ring 1 and further rigid fixation thereon in a required position with the use of a clamping bolted assembly with a screw 6. The proximal hinged joint 2 and the distal hinged joint 3 are identical and consisting of a body 9 and a loop 10 coupled by a connecting axis 7 with a collar 8. The body 9 is rigidly fixed on a short end 7A of the connecting axis 7 with the use of a pin 11, while the pin 10 is arranged on the other end of the connecting axis 7 rotating and rigidly fixed in the required position with the use of the clamping bolted assembly with the screw 6. Each body 9 has a hole 12 for placing and further rigid fixation in the required position with the use of the clamping bolted assembly with the screw 6 of the proximal threaded bearing rod 13 or the distal threaded bearing rod 14, as well as a hole 15 perpendicular to the hole 12 for placing a short end 7A of the connecting axis 7 of the proximal hinged joint 2 or the distal hinged joint 3. Each loop 10 has a hole 16 for placing and further rigid fixation in the required position with the use of the clamping bolted assembly with the screw 6 of the proximal end 1-P or the distal end 1-D of the spacer ring 1. An axis of the hole 16 is perpendicular to an axis connecting the axis 7 of the hinged joint, as well as there is a hole 30 for placing and further rigid fixation in the required position with the use of the clamping bolted assembly with the screw 6 of the other end of the connecting axis 7. The tube body 17 of the distal threaded bearing rod 13 or the proximal threaded bearing rod 14 comprises small holders 18 of transosseous rods 19 and extensions 20 with placed grasping forceps 21 of the transosseous rod 19. The grasping forceps 21 are movable along the extension rod 20 and further fixation in the required position with the use of the clamping bolted assembly with the screw 6. The transosseous rods 19 are placed in the small holder 18 and the grasping forceps 21 by a second hole 22 a diameter of which matches with an external diameter of the transosseous rod 19, the axis of which are perpendicular to the axis of the tube body 17. The transosseous rods 19 are placed in the hole 22 movable and rigidly fixed in the small holder body 18 and the grasping forceps 21 with the use of screw nuts 23. The second hole 22 is created from one side from the basic hole 27 of the small holder 18. On the opposite side of the small holder 18 there is an opening slot of the clamping bolted assembly with the screw 6. The holder body of the grasping forceps 21 comprises a hole 28 a diameter of which matches with an external diameter of the tube body 17. The tube body 17 of the proximal threaded bearing rod 13 and the distal threaded bearing rod 14 comprises an additionally arranged stop ring 24 of rigid fixation in the pre-set position of a slide tube 17 on the threaded bearing rod 13 or 14 with the use of a lock bolt 26 through a hole 30 in the tube body 17 after pre-set movement of the tube body 17 along the proximal threaded bearing rod 13 and the distal threaded bearing rod 14 with the use of screw nuts 29 of axial movement of the tube body 17. A wall of the stop ring 24 has various walls and comprises a threaded hole 25 for placing a lock bolt 26 thereon and fixation in the pre-set position of the slide tube 17 on the proximal threaded bearing rod 13 and the distal threaded bearing rod 14. The invention provides osteosynthesis of all types of long bones, one-stage bone reduction and bone fragment reduction preceded by application of a structure in a stabilising mode.
EFFECT: invention provides osteosynthesis of all types of long bones with the use of three-dimensional alignment of the rod apparatus, one-stage bone reduction, elimination of all types of remote bone reduction, use for a short bone fragment of patient's extremity, bone fragment reduction preceded by application of the structure in the stabilising mode.
7 cl, 24 dwg
SUBSTANCE: invention relates to medicine, namely to traumatology-orthopedics, and is intended for treatment of fractures of long tubular bones. Apparatus contains supports in form of arc-shaped plates, curved on radius in their own plane, and bent in said plane in form of projections from end parts of plate towards its convexity. Projections and end parts of plate are provided with holes with bilateral countersunk. Along plate made are holes located on radius, threaded rods, connecting said supports, intraosseous rods, rod-fixers, and remote rod-fixer in form of bar. Holes, located along plate, are made square. Base of remote rod-fixer is provided with square boss, located along axis, which has threaded axial hole for screw. On wide sides of bar made are transversal teeth, along axis of these sides made is through slot, whose width corresponds to diameter of used intraosseous threaded rods, whose fixation in bar is realised with nuts and washers of square shape, which have on one of working surfaces teeth corresponding in shape to teeth on bar sides.
EFFECT: invention makes it possible to reduce operation trauma, improve treatment outcome, create relative conveniences for patients.
SUBSTANCE: invention refers to medicine, namely traumatology and orthopaedics. Oval supports are applied to a femoral bone and a shin bone. The supports are coupled by six strata. A proximal strata is arranged at 200-210 mm from a knee joint fissure, while a distal strata - at 120-130 mm from the knee joint. The proximal support shall be inclined 90° in a sagittal plane, while the distal support - 60°.
EFFECT: method enables tibial displacement with respect to the femoral bone according to the physiological amplitude of knee joint motions, eliminated risk of trophic disorders caused by the apparatus supports or strata compressing skin.
1 ex, 16 dwg, 1 tbl
SUBSTANCE: subtalar implant comprises a body in the form of a truncated cone threaded on an external surface and having a key hole along the axis. The body comprises three long slots equally spaced and dividing the body on three equal parts. The slots in the screwing off direction has platforms lowered by a height of a thread tooth, while teeth from the opposite side of the slot are rounded at a radius.
EFFECT: device provides more reliable fixation, prevents its migration from a subtalar sinus and provides the stable correction of the talocalcanean joint in the correct position.
SUBSTANCE: silicone tendon prosthesis is removed from an incised fingertip if observing a pus formation around. A broad-spectrum antibiotic is prescribed. An exposed tendon canal is used for regular rinsing with a disinfectant solution, and drainage. Once the inflammation has been completely managed, the finger canal is dilated from three approaches: from the fingertip, from the middle of the finger, and from the middle of a palm that is ensured by inserting a dilator as far as it can go into the soft tissues at the level of a proximal phalanx. An oblique incision of the skin and soft tissues of the finger are made along the palm surface of the finger to expose the tendon canal and to find a dilator tip. With the dilator inside the tendon canal of the finger, the canal is dilated actively with using the reciprocating dilator from the fingertip to the middle of the proximal phalanx; then the dilator is removed. A third incision is made of the palm, and once a tendon canal opening is found on the finger base, the dilator is inserted therein in the opposite direction from the palm to the fingertip. The dilator is brought up to the middle of the finger until the dilator tip is seen in the pre-formed oblique insicion. The canal is dilated with using the reciprocating dilator; the sutured ends of palm flexors are mobilised. The superficial ends of the flexors are brought onto the skin; a defect of a deep finger flexor is replaced with a thin autograft.
EFFECT: method enables relieving the infection, conducting early re-canalisation and tendoplasty.
1 ex, 9 dwg
SUBSTANCE: what is involved is a Z-osteotomy of diaphysis of a first instep bone with a middle cut plane of the Z-osteotomy lying along the axis of the first instep bone or approximately parallel with it. Two additional osteotomies are performed by making two additional cuts: additional cut is inclined to the upper cut so that an additional cut line on an upper surface of the first instep bone is at an angle of 5 to 30° to an upper cut line on the upper surface of the first instep bone; an additional cut is inclined to the lower cut so that the cut line on the lower surface of the first instep bone is at an angle of 5 to 30° to a lower cut line on the lower surface of the first instep bone; the formed bone fragments are removed; a sole fragment is displaced laterally and/or rotated in a horizontal surface; a medial or lateral angle of the sole fragment is integrated into an intramedullary canal of the instep bone; the sole and back fragments of the instep bone are fixed to each other using cannulated compression screws; a pre-dissected tendon of a great toe adductor is re-fixed to a first instep bone head using an anchor fixator for fixing the tendon to the bone.
EFFECT: prevented postoperative dislocation.
3 cl, 5 dwg
SUBSTANCE: minimally invasive transdeltoid approach, opening into a subacromial space and dissection of a rotatory cuff with a long two-centimetre incision from an edge of a greater tubercle to the centre of a humeral head; an EOP-assisted awl is introduced into the humeral head from the greater tubercle to the centre of the head downright and rotated downright to eliminate an incomplete dislocation; the greater tubercle is reduced; and the head is directed in the position optimal for introducing a nail wherein the head is fixed to an articular process of a shoulder blade using two pins introduced through a lesser tubercle from the front and through the greater tubercle at the backside of the canal from a rod canal formed in the geometrical centre of the humeral head. The head is matched with a distal fragment, and the rod is introduced into the canal, and the head, tubercles and diaphysis are fixed using altitude clamps. The temporary pins are removed thereafter.
EFFECT: method enables matching the humeral fragments, providing the optimum conditions for the intramedullary osteosynthesis ensured by the reliable temporary head fixation.
9 dwg, 1 ex
SUBSTANCE: anterior approach to a wing of ilium is involved. A triangular bone graft with a base and sides not less than 1.5 cm on a muscular pedicle is cut out of a tailor's muscle. The graft with the muscular pedicle are displaced in the medial direction. An iliolumbar muscle is separated in the distal direction and dissected away within a tendon at a lesser trochanter. The muscle is displaced inward. The approach extends through a lateral portion of an external obturator muscle. An ischial bone is exposed at the wound depth and protected with elevators inward. The ischial bone is incised in the oblique direction anteroposteriorly with 2 parallel section from the medial side spaced 3-5 mm. A posterior portion of the ischial bone is cracked at the wound depth with using fulcrum motions of the flat chisel. A periosteom is incised above a pubic bone and transected with the flat chisel at the base under the protection of the elevators. The iliac bone is transected in a supra-acetabular portion of the pelvis either crosswise, or semicircularly using a Gigli saw or a flat chisel directly above an anterior inferior spine of an iliac bone. A mobilised acetabular fragment is rotated onto a femoral head until covered completely, a trochanteric portion of the femur is pressed to medialise a hip joint. The cut-out bone graft on the muscular pedicle is placed in an anteroexterior portion of the iliac bone in a cleft between the fragments. The pelvic fragments and graft are fixed with K wires downright from an anterior superior spine.
EFFECT: recovering the anatomic relations in the hip joint, reducing the technical difficulties of the acetabular transposition, increasing the stability of the fragment fixation following the pelvis osteotomy, and improving the trophism within a contact zone of the pelvic bone fragments.
SUBSTANCE: what is involved is a posteromedian surgical approach to an upper cervical spine. That is followed by a subperiosteal dissection with exposing an occipital bone, a posterior arch of atlas, a spinous process and a C2 vertebral arch. A posterior atlantooccipital fixation is carried out from both sides from a body mid-line with using a polyaxial combined screw and rod fixation according to Harms-Melcher procedure. A posterior spinal fusion of C1-C2 spines follows. For this purpose, a C2 spinous process is dissected away at an attachment to the vertebral arch. The C2 spinous process is split in a section with plane extending though a mid-height from an apex of the spinous process to its base to form two extended halves having a width matching that of the spinous process until it splits, and representing two autografts having a cortical layer from one side, and a spongy bone layer - from the other side. The posterior arch of atlas and the C2 vertebral arches are decorticated; each autograft are laid on C1-C2 vertebral arches from each side on the right and on the left from the body mid-line and along to provide a contact mating of the spongy bone layers with the pre-decorticated relevant vertebral arches. The autografts are fixed to the C1 and C2 vertebral arches.
EFFECT: method enables more stable fixation of the upper cervical spine with providing the optimum conditions for the autograft osteogenic modification.
2 cl, 1 ex
SUBSTANCE: group of inventions refers to medicine. A device applicable in the surgical management of a patient suffering pectus excavatum comprises a plate placed under the patient's skin and accommodating substantially a centre that is above a chest when in use, and two side pieces that are above the ribs when in use. The centre comprises at least one hole enclosing a fastener for the plate attachment to the patient's chest. The plate curve, length and width are those that the plate rests against ribs to hold the chest when in use. A kit applicable for the surgical management of the patient suffering pectus excavatum comprising the above device, and at least one fastener applicable for the device attachment to the patient's chest. A method for the surgical management of the patient suffering pectus excavatum involves the following stages: patient's chest is incised, and the plate is inserted under the skin and on the outside of a thorax; and the above plate has the curve, length and width that the plate extends on both sides of the chest, and may be placed on the outside of the patient's thorax; the chest in lifted into the required position, and the above plate is fastened to the chest.
EFFECT: invention provides reducing a risk of complications and injuries.
25 cl, 8 dwg
SUBSTANCE: invention refers to medicine, veterinary science, orthopaedics, namely to methods of treating a hip dislocation in small laboratory animals by means of subcutaneous fixators. An open reposition of the hip dislocation is followed by a perforation of a femoral bone, femoral neck and head and an iliac bone along a medial line at an angle to a distal line of the femoral bone with using a guide drill. A triangular-pointed stylette is removed from a guide drill sleeve and replaced by a doubled primary suture to be brought out from the femoral bone, femoral neck and head, and the iliac bone from the medial line of the iliac bone. Another intermediate suture is threaded into a loop formed thereby. The guide drill sleeve is removed from the drilled canal thereby spinning the primary and intermediate sutures. A fixing suture is inserted into a loop of the intermediate suture and drawn through a bone canal; thereafter, nylon monofibre and an orthopaedic pin are inserted into the loop from the medial surface of the iliac bone. A primary loop is drawn from the bone canal, pressed to the iliac bone so that an upper portion of the pin or monofibre extends into a greater trochanter. On the side of the femoral bone, the suture is knotted three times with the orthopaedic pin pre-inserted between the knot and bone, with the loop or double suture with the ends brought out under the skin within the grater trochanter. Then 10-14 days later, the skin within the greater trochanter is incised, and the rest is pulled out on the side of the iliac bone; then the double monofibre that retracts the suture fastened on its end, is removed with demounting the structure supporting the joint.
EFFECT: method enables eliminating the defects of the proximal hip and cotyloid cavity, recovering the spatial relationships in the hip joint by improving the methods for fixation accompanying the hip dislocation.
SUBSTANCE: invention refers to orthopaedics and can be applied for treating hallux valgus. A first sphenoid bone is displaced in the medial direction, with an anterior portion of the first sphenoid bone being adapted to a base of a first instep bone due to preserving resection. Performing a medial osteochondral exostosis of a head of the first instep bone and a tenoligamentocapsulotomy along the lateral surface of a first metatarsophalangeal articulation is followed by recovering a correct relation in a first metatarsocuneiform joint, eliminating foot deformities, fixing the achieved relation to create an arthrodesis of the first metatarsocuneiform joint.
EFFECT: method enables preventing the shortening of a first foot radial, providing a simultaneous correction of the deformities.
SUBSTANCE: invention relates to traumatology and orthopedics and can be applied for surgical treatment for deforming arthritis of ankle joint. Cartilages are ablated from joint surfaces of shin tibia and talus. Cut of skin is performed on external surface in the area of injured ankle joint on posterior edge of external ankle-bone. After exposure of fibula from lower third to its top at the level of joint space of ankle joint oblique osteotomy of fibula is performed above anterior and posterior tibial-fibular and calcaneal-fibular ligaments at 40-50° angle to its longitudinal axis. Anterior and posterior tibial-fibular and calcaneal-fibular ligaments are transversely dissected to 1/3-1/2 of their width. Volume of space formed between joint arthrodised surfaces of tibia and talus is filled with gel-like nanostructured composite implant, which contains platelet-enriched autoplasma in ratio 1:(1-2) with granules of complex alloplastic preparation, based on hydroxyapatite, containing 50-60% of collagen.
EFFECT: method makes it possible to improve possibilities of bone regeneration stimulation.
4 cl, 3 ex
FIELD: medicine, orthopedics, traumatology.
SUBSTANCE: one should isolate and dissect the tendons of anterior tibial and long fibular muscles to dissect the tendon of posterior tibial muscle against the site of fixation and direct it towards plantar rear area in front of internal ankle through the tunnel in subcutaneous fiber, then one should subcutaneously direct dissected tendons of anterior tibial and long fibular muscles onto plantar rear area to suture them so to leave free the tendinous end of posterior tibial muscle which should be intraosseously fixed to median wedge bone that keeps the process of foot repulsion during walking.
EFFECT: higher efficiency of therapy.
5 dwg, 1 ex