Reposition fixator for intramedullary osteosynthesis of long bones

FIELD: medicine.

SUBSTANCE: reposition fixator for the intramedullary osteosynthesis of the long bones comprises at least two coupled identical assemblies movable in relation to each other. Each of the above assemblies represents a bearing holder consisting of two portions pivotally connected by a screw clamp in the form of extended parallelepipeds - upper and lower. The upper parallelepiped comprises two pairs of through holes placed in mutually crossing planes. The paired through holes are arranged above each other, and one of the pairs comprises transosseous elements replaceable into another pair, including a rod - a hook and a rod - a pusher with a pointed tip movable along and about their long axes. From a side wall of the upper parallelepiped, there is a handle; from a side wall of the lower parallelepiped, there is a thread shank that is used to couple the bearing holder to a sliding bar to vary a distance in between and to rotate the bearing holder about its long axis. The identical assemblies of the device are coupled by a beam, a cross-bar and two parallel canals formed therefor in the sliding bar and having respective shapes and geometrical sizes. The cross-bar has a projection in its middle portion that is provided with an alternating thread on its outer surface from both sides of the projection; a canal counteracting with the thread has a mating internal thread.

EFFECT: eliminating all the dislocations of the injured long bone fragments with higher reposition accuracy and reduced soft tissue injures within the fracture.

2 dwg

 

The invention relates to the field of medicine and medical equipment used in traumatology, and is intended to perform the bulk of reposition of bone fragments bone on the operating table for surgical intervention regarding "closed intramedullary osteosynthesis metal rod.

When intraosseous fixation of fractures of tubular bones, it is important to achieve a perfect matching its distal and proximal bone fragments that will give the opportunity to enter into the medullar cavity of the bone metal rod with minimal trauma to the soft tissues of the zone of fracture.

There are various configurations of devices to reposition and fixation of fractures of tubular bones with intramedullary osteosynthesis.

There are also known devices for reposition and fixation of fractures of tubular bones with intramedullary osteosynthesis [author's certificate SU for invention №1156677, No. 1205900, No. 1324662; RU patent for the invention №2327431], including interconnected with the possibility of change of distance with respect to each other external supports, in particular rings, and installed them in repository-clamps in the form of pointed rods or spokes, which are injected into the cortical layer of bone from different sides, not reaching the bone-marrow channel.

However, these devices are bulky, h what about the inconvenience when performing further installation intraosseous metal rod.

There are also known devices for reposition and fixation of bone fragments bone during surgical interventions for intramedullary osteosynthesis [inventor's certificate SU for the invention №545337, patents RU invention No. 2302216, No. 2350295], including needles passing through the distal and proximal metapelite bones, which are fixed in the supports external fixation device. Spokes are located relative to each other so that their introduction into the bone they were only cortical layer, not touching bone marrow channel and leaving it free for insertion of a metal rod.

However, the structural features of these devices reduce the accuracy of the reduction in their use. Execution repairbuy elements in the form of thin needles can lead to subsidence and weak fixation that will affect the result and will increase the time of treatment.

Also known device to reposition and hold the bone fragments bones [author's certificate SU for inventions№362617, №605611, №1028324, №1124954, №1526674, №1600739, №1662535, №1717126, №1734718; patents RU invention№2160064, №2281051, №2410054]. All of them are executed in the form of the branches, with one side of the sponge, on the other hand - arm, or connected by a rod to move it relative to the tion to each other, two pairs of branches.

However, the installation and operation of these devices increases the trauma surgical intervention, namely the trauma adjacent to the fracture area of the soft tissues due to the significant geometrical dimensions of the working parts of the branches that are performed for them through the incision and soft tissue spending to the bone.

The closest analogue to the claimed invention is a Device for reposition of fragments of the long bones" of the same applicant, and that the claimed application [RU patent for useful model №114601]. The apparatus includes two identical pairs of branches and repositional site. Two pairs of branches in pairs pivotally connected by a cylindrical axes and have on the one hand grips located on the internal surface of the teeth, and on the other side - arm, the ends of which are connected by a fixing their position elements. Repositional site consists of three bearing holders on the type of bars with two through holes in each and longitudinally elongated bodies in the form of three beams and three bars. Recent pairs are oriented in horizontal, vertical and sagittal planes and fixed between a can move relative to each other through the through holes of the supporting holders. In the middle part of the rod is made tabs to facilitate their lane is a mix. On the external surface of the rods on both sides of the protrusions caused multidirectional thread. Through holes of the supporting holders, through which the rod has a female thread corresponding to the thread of the plot through her rod. One pair of branches through the cylindrical axis rigidly connected to a vertically oriented beam is made as one with one of the supporting holders. The second pair of branches connected through the cylindrical axis can be rotated around her with a vertically oriented rod, and one end of the cylindrical axis fixed on the connecting threaded coupling mounted on a vertically oriented rod with providing movement along it, from the side of the second end of the cylindrical axis placed locking screw for fixing the position of the second pair of branches.

However, the implementation of transosseous elements in the form of a branch with sponges, as mentioned above, increases the invasiveness of the treatment.

The task of the invention is to develop a reposition-holding devices used in the implementation intramedullary osteosynthesis and to ensure the elimination of all kinds of displacements of bone fragments damaged bones for improving the accuracy of reduction and reduction of traumatic soft tissue in the PE eloma.

The essence of the invention is characterized by the fact that reposition-locking device for holding an intramedullary osteosynthesis of long bones includes at least two interconnected with the possibility of moving relative to each other is identical to the node, each of which represents a reference holder, consisting of two pivotally-connected by means of a screw clamp parts in the form of long, oblong parallelepiped - top and bottom, and in the upper parallelepiped made two pairs placed in vzaimoperekreshchivajushchihsja planes through holes, a pair of through holes located underneath one another, and in one of the pairs with changes in another pair installed transosseous elements - rod-hook and rod-plunger with the pointed end with the possibility of movement and rotation along and around their longitudinal axes, the side face of the side wall of the upper box is the handle-side end of the side wall of the lower box has a threaded shank through which the bearing holder is connected with the slide-type bar with the change of the distance between them and the rotation support holder around its longitudinal axis, when this connection is their between identical components carried by the beam, rod and executed in the RAM of the two parallel oriented relative to each other under them channel their corresponding forms and geometric dimensions.

Applying the device with the above-described characteristics, in which the rod has a ledge in the middle part and on its outer surface on both sides of the protrusion caused multidirectional thread and reply to it through channel in the slide has a corresponding internal thread.

The technical result of the claimed invention.

The combination of structural features of the claimed device provides the surgeon during the operation, the ability to accurately and quickly (without technical difficulties) eliminate all types of displacements of bone fragments with minimal trauma to the soft tissue region of the fracture, which lowers the risk of postoperative complications and, thus, allows for full rehabilitation as invalid when the injured muscle tissue and support ability of the limb. The possibility of use in the form of transosseous elements of rod-hook and shaft-pusher, as well as the development of their fixation with software manipulation allows to achieve sustainable engagement and retention in repositional position as one and all other bone fragments with different views of what's fracture: a longitudinal, spiral, oblique, and transverse, which eliminates the need to hold raionirovannykh bone fragments when performing intramedullary osteosynthesis, thereby enabling release of the hands of the assistant.

The execution of the designs of the identical components and parts allows you to extend the proposed device depending on specific conditions: localization of the fracture and its characteristics (simple or comminuted, oblique or transverse, and the like), and also contributes to simplification of the manufacturing process of this device and provides the ability to quickly (even during surgery) replacement parts when the failure of one or more of them.

Development of components with a precise definition, which eliminates some kind of displacement of bone fragments, allowed to provide fast acting mechanism, substantially improving its handling properties and minimizing intraoperative time.

Thus, the development of the claimed device and its use will significantly improve the quality of performance of closed intramedullary osteosynthesis and create optimal conditions for increase of efficiency of treatment of patients in which it is used.

The claimed invention is illustrated using Figure 1-2, on the which depicted: figure 1 - General view of the inventive device; figure 2 is a view of the supporting holder with visualization of a screw clamp. Figure 1-2 positions 1-15 mark:

1 - reference holder;

2 - slide;

3 - screw clamp;

4 - top box reference holder;

5 - lower parallelepiped supporting holder;

6 - paired through holes of the upper parallelepiped supporting holder;

7 - rod-hook;

8 - rod-plunger;

9 - arm support holder;

10 is threaded shank of the supporting holder;

11 - beam;

12 - bar;

13 is oriented parallel relative to each other channels under the beam and the rod in the slide;

14 is the projection of the rod;

15 - nuts.

Reposition-locking device for holding an intramedullary osteosynthesis of long bones includes at least two interconnected with the possibility of moving relative to each other is identical to the node. Each of the nodes represents the base holder 1, which is connected with the slide 2 type bar with the change of the distance between them and the rotation support holder 1 around its longitudinal axis. Supporting the holder 1 consists of two pivotally-connected by means of a screw clamp 3 parts in the form of long, oblong parallelepiped - top 4 and bottom 5. The propeller is the second retainer 3 can be made in the form of a screw, nut, the end surface of which has teeth and sleeve with mating teeth (see Figure 2). In the upper box 4 bearing holder 1 has two pairs placed in vzaimoperekreshchivajushchihsja planes through holes 6. Pair of through holes 6 are arranged one below the other, and in one of the pairs with changes in another pair installed transosseous elements - rod-hook 7 and the rod-plunger 8 with the pointed end with the possibility of movement and rotation along and around their longitudinal axes. By the end of the side wall of the top box 4 is the handle 9. By the end of the side wall of the lower box 5 has a threaded shank 10, through which the connection between the support holder 1 and the slider 2. The connection between identical components made by beams 11, rod 12 and is made in the slider of two parallel oriented relative to each other under these channel 13 with their corresponding forms and geometric dimensions. Thus, the rod 12 has a ledge 14 in its Central part, and on its outer surface on both sides of the rib 14 applied multidirectional thread and reply to it through channel 13 in the slide 2 has a corresponding internal thread.

Additional fixation of p the provisions of transosseous elements 7, 8 and the threaded shank 10 in the slide 2 is implemented using lock nuts 15.

Reposition-locking device for holding an intramedullary osteosynthesis of long bones is as follows.

Lay the patient on the operating table, depending on the localization of fractures of long bones. Handle of the surgical field with observance of the rules of asepsis and antisepsis. Perform installation of components and parts reposition-holding devices, including the collection of supporting holders, joining the latter to the slide by means of the threaded shank of the supporting brackets and the connection rods and beams of identical nodes together with the possibility of moving them relative to each other. The number of installed identical nodes depends on the localization of the fracture site and its nature: transverse or oblique, simple or comminuted, etc. but not less than two, one of which fixes the position of the distal bone fragment, the other proximal bone fragment. Through punctures in the skin and soft tissues lead to bone rods-hooks, providing girth bone fragment them working part - hook. All terminals-hooks mounted in respective through holes of the upper parallelepiped supporting holder, fix them with nuts. Established the up rods-pushers with pointed ends to a second pair of through holes of the upper parallelepipeds reference holders. Moving and rotating the rods-pushers along and around their longitudinal axes through a separate puncture skin and soft tissue fix the position of the bone fragments by providing compression rods-pushers bone fragments to the terminals of the hooks. Fix the position of the rods-pushers in the bearing holders by means of lock nuts. Optionally, in the case of rotational displacement eliminate them by transferring arms supporting holders perpendicular to the longitudinal axis of the bone, with transosseous elements are removed from the supporting holders, in the future, install them again, as described above, only the second pair of through holes in vzaimoperekrehivayutsya plane, then they are fixed in the bearing holders with lock nuts. The elimination of the offset of the bone fragments by length, while their compression and distraction, carried out by moving the slide along the rods and beams and change the distance so between identical nodes. Elimination of displacement of bone fragments bone width in the sagittal plane is carried out by changing the distance between the support bracket and slide due to the movement of the latter along the threaded shank of the supporting holder. Elimination of displacement of bone fragments bone width in the frontal plane produced by PE is Emesene rod-hook and rod-plunger along its longitudinal axis. The elimination of the angular displacement of the bone fragments in the sagittal plane by rotation of the handle around a screw clamp, hinge-connecting the upper and lower parallelepipeds reference holder. Elimination of angular displacement in the frontal plane is accomplished by the rotation of the arm around the longitudinal axis of the support holder. Then make a recording of the positions of all the components and parts of the device by tightening all nuts. Perform x-ray control. In the presence of residual displacements of bone fragments adjust their position using the proposed device by performing one or another of the above-described technical manipulation depending on the type of displacement (length, width, rotation, angular), and given their characteristics, namely in what plane displacement in the sagittal or frontal. Upon reaching the absence of displacement of bone fragments perform intramedullary osteosynthesis by intraosseous injection lock, in particular a metal rod. After the proposed device is removed. To do this, loosen the locknuts securing the position of transosseous elements that are further removed from the wound. Carry out layer-by-layer closure of wounds.

Example.

The invention is implemented in the experimental sample and preparing for practical the testing of medical conditions in the fgbi "Sarnico".

Reposition-locking device for holding an intramedullary osteosynthesis of long bones, characterized in that it includes at least two interconnected with the possibility of moving relative to each other is identical to the node, each of which represents a reference holder, consisting of two pivotally-connected by means of a screw clamp parts in the form of long, oblong parallelepiped - top and bottom, and in the upper parallelepiped made two pairs placed in vzaimoperekreshchivajushchihsja planes through holes, a pair of through holes located underneath one another, and in one of the pairs with changes in another pair installed transosseous elements - rod-hook and rod-plunger with the pointed end with the possibility of movement and rotation along and around their longitudinal axes, the side face of the side wall of the upper box is the handle-side end of the side wall of the lower box has a threaded shank through which the bearing holder is connected with the slide-type bar with the change of the distance between them and the rotation support holder around its longitudinal axis, and the connection between identical nodes the device carried by the beam, rod and executed in the RAM of the two parallel oriented relative to each other under them channel their corresponding forms and geometric dimensions, and the rod has a ledge in the middle part and on its outer surface on both sides of the protrusion caused multidirectional thread and reply to it through channel in the slide has a corresponding internal thread.



 

Same patents:

FIELD: medicine.

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5 cl, 5 ex

FIELD: medicine.

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1 ex, 4 dwg

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7 dwg

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FIELD: medicine.

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3 cl, 2 dwg

FIELD: medicine.

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6 cl, 3 dwg

FIELD: medicine.

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1 ex, 4 dwg

FIELD: medicine.

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7 cl, 3 dwg

FIELD: medicine.

SUBSTANCE: invention relates to medicine. System for fixation of bone tissue contains fixer (2), at least one bone screw (3), able to be introduced into through hole (1) of fixer (2), and sensor and/or telemetric system, installed on separate plate (5), made with possibility of attachment to fixer (2). Fixer (2) and separate plate (5) contain means for formation between fixer (2) and separate plate (5) of, at least, one connection "hollow/spring".

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27 cl, 8 dwg

FIELD: medicine.

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.

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4 cl, 5 dwg

FIELD: medicine.

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.

8 dwg

FIELD: medicine.

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

FIELD: medicine.

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.

9 dwg

FIELD: medicine.

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

FIELD: medicine.

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.

7 dwg

FIELD: medicine.

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.

3 dwg

FIELD: medicine.

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

FIELD: medicine.

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

FIELD: medicine.

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.

4 dwg

FIELD: chemistry.

SUBSTANCE: invention relates to medicine and specifically to trauma surgery and orthopaedics, and can be sued for surgical treatment of ununited fractures and false joints of cylindrical bones when there is a shortage of soft tissue. The method involves, 5-6 days before an operation, performing needle biopsy of bone and soft tissue fragments from the damage centre of the cylindrical bone and determining presence and nature of obligate intracellular viral infection (OIVI). Super-selective angiographic analysis of the microvascular channel to the capillary link is also performed. Valtrex is administered to the patient 2-4 days before the operation in a dose of 500 mg twice a day. Further, the method involves performing osteosynthesis or re-osteosynthesis with resection of the ends of bone fragments, opening marrowy canals, bone stimulation and batting the space of the bone defect with a gel-like nanostructured composite implant. In the presence of OIVI, resection of bone fragments is carried out in a larger volume until the onset of "pinpoint bleeding", i.e. to areas with satisfactory intrabone blood supply. The composite implant contains thrombocyte-rich autoplasma, mixed in ratio of 1:(1-2) with granules of a complex alloplastic preparation (CAP) based on hydroxyapatite which contains 50-60 wt % collagen. The composite implant also contains either 0.08-2.8 wt % colloidal solution of nanoparticles of zero-valent silver metal Ag0, or gold Au0, or copper Cu0, or palladium Pd0, or platinum Pt0, or 5-12 wt % nanoparticles of said metals in dry form. The nanoparticles have size of 2-40 nm. A colloidal solution of said nanoparticles or colloidal nanoparticles of said metals in dry form is added to the CAP granules. Further, the prepared granules of the gel-like complex alloplastic preparation are laid in a selected ratio on the layer of thrombocyte-rich autoplasma, without mixing, for subsequent transfer into the bone defect space. In case of performing resection of bone fragments in a larger volume until the onset of "pinpoint bleeding", corticotomy is further performed on the cylindrical bone being operated on, with subsequent distraction of the bone regenerate using any existing method. Further, the bone fragments are repositioned, followed by metallo-osteosynthesis. Before wound suturing, the surface of the area with shortage of soft tissue in the projection of the ununited fracture and false joints is covered by a semi-permeable flexible plate made of the complex alloplastic preparation based on hydroxyapatite, which contains 50-60 wt % collagen. The plate has thickness of 0.25-1.2 mm. The surface area of the plate is 10-20% greater than the area with shortage of soft tissue in the corresponding projection. The part of the erythrocyte mass remaining from preparing the thrombocyte-rich autoplasma and the plasma are returned into the bloodstream of the patient by intravenously using a drip during the surgical procedure or in the early post-operation period. After the operation, valtrex is administered to the patient in a dose of 500 gm once a day for two weeks and then in a dose of 500 mg every other day for two weeks.

EFFECT: method provides reliable prevention of OIVI at a damage centre, normalisation of local microcirculation of blood, avoiding ischemic processes, and compensation for the shortening of the length of the limb of the patient being operated on while preventing weakening of the process of reparative osteogenesis and allergic reactions of the body.

6 cl, 4 ex

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