RU145522U1 - MILLER FOR REMOVING Cartilage FROM JOINT SURFACE OF BONES OF STOP - Google Patents

Abstract

A cutter for removing cartilage from the articular surfaces of the bones of the feet, consisting of a cylindrical cannulated body, a working part with teeth lying in a plane perpendicular to the longitudinal axis of the cylindrical cannulated body, and located radially from the center of the cylindrical body, having a cylindrical shank for fixing the cutter in the cartridge of the electric device characterized in that the cutter has an outer diameter of 5 mm, an inner hole diameter of 1 mm, a length of 70 mm, and is equipped with 8 teeth with a sharpening angle of 45 °.

Description

The utility model relates to medicine, in particular to traumatology and orthopedics, and can be used to remove cartilage from the articular surfaces of the foot bones during operations (Goman's surgery, arthrodesis of the metatarsophalangeal joint) to correct the hammer-like deformation of the second, third, fourth, fifth fingers.

In operations to correct the hammer-like deformation of the fingers, the complete removal of cartilage is very important. In case of incomplete removal, the articular surface remains uneven, which can lead to a slowdown in the recovery process (Surgery of the forefoot, edited by A.A. Kardanova, Moscow, 2012).

Various surgical instruments are known for removing cartilage from the articular surface (Operative Surgery and Topographic Surgery edited by Academician of the Russian Academy of Medical Sciences V.V. Kovanov, Moscow, 2001) - Liston's bone nippers (a surgical instrument for dissecting bone tissue, characterized by the rectilinear shape of the cutting edge of the jaws), Luer nippers (a surgical tool for biting bone tissue, the lips of which are in the form of oval spoons with a curved cutting edge). However, their use has a number of disadvantages: excessive removal of bone tissue is possible, the surface of the treated bone becomes uneven.

Known milling cutter for removing the intervertebral disc (utility model patent No. 121145 dated 03/12/2012), consisting of a hollow cylindrical shape of the working part, one end of which is represented by teeth, and the other end by a handle and a support post with a base, located in the center of the working part a piston with graduated millimeter markings, while the stepwise advancement of the cutter in the center of the base is facilitated by the presence of a thread on the working part and the base lock.

The disadvantage of the cutter is its large size, lack of cannulation.

An end mill for processing bones is also known (patent for invention No. 166449 dated 01/19/1964), the head of which is hollow, and longitudinal grooves are selected between the cutting teeth. The end mill is a cylindrical cutting tool, the end part of which has a spherical shape. Between cutting teeth running along the outer surface of the cylindrical and spherical parts of the tool, there are through longitudinal grooves, and a cylindrical hole is drilled inside the cutter along its axis. The cutting teeth end at the rear of the cutter, from which a cylindrical two-stage shank departs to fix the cutter in the chuck of the electric device.

However, this cutter has a large working part size, longitudinal grooves, which makes it difficult to position the cutter during operation.

The utility model task is a milling cutter designed for complete and uniform removal of cartilage tissue from the articular surfaces of the foot bones.

The problem is solved by a milling cutter for removing cartilage from the joint surfaces of the bones of the feet, consisting of a cylindrical cannulated body, a working part with teeth lying in a plane perpendicular to the longitudinal axis of the cylindrical cannulated body, and located radially from the center of the cylindrical body having a cylindrical single-stage shank for fixing milling cutters in the chuck of an electric apparatus, characterized in that the milling cutter has an outer diameter of 5 mm, a diameter of an internal hole of 1 mm, a length of 70 mm, equipped with 8 teeth with a sharpening angle of 45 °.

The device is shown in FIG. 1 and FIG. 2, where:

1. The working part with 8 teeth.

2. The cylindrical hole.

3. Cylindrical single-stage shank for fixing the cutter in the chuck of the electric device.

Clinical example.

Patient K. Ye. V., 59 years old, No. 49180 medical history, was admitted to 51 orthopedic department of the Clinical Hospital named after S.P. Botkin August 30, 2013 with complaints of pain and deformation of both feet.

Anamnesis: According to the patient, pain in the tarsal region and deformity of the feet have been disturbing for more than 10 years. Over the past 5 years, she noted the progression of deformation and the growth of pain. Conservative treatment without effect.

On examination: A decrease in the height of the longitudinal and transverse arches of the left foot is determined. Pain on palpation along the medial surface in the projection of the head 1 of the metatarsal bone on the left. Clinical examination revealed a valgus deformity of the axis of the first toe of the left foot and varus of the first metatarsal bone. Hammer-like deformation of 2-3 toes of the left foot. Painful areas of hyperkeratosis along the plantar surface in the projection of the heads of 2-3 metatarsal bones.

Clinical diagnosis: Combined bilateral flatfoot with hallux valgus deformity of the first toes. Hammer-like deformation of 2, 3 toes of both feet. Degenerative dislocations of 2-3 toes. Metatarsalgia.

Surgical treatment is indicated: reconstructive surgery on the left foot (arthrodesis of 1 metatarsophalangeal joint, Goman's surgery on 2 fingers)

After the preparation, on September 05, 2013, the operation was performed: reconstructive surgery on the left foot (arthrodesis of the 1 metatarsophalangeal joint, Goman's operation on the 2nd finger).

Operation progress: An incision on the back surface of the 2 toes of the left foot made access to the proximal interphalangeal joint. The head of the main phalanx has been removed. On the spoke, held in the middle phalanx, set the cutter to remove cartilage from the articular surfaces of the bones of the feet on the proximal articular surface. Using a single-stage shank, we fix the cutter in the chuck of the electric device. We make cartilage removal. Axis 2 fingers restored. Minimally invasive extensor tendon tenotomy, reduction of dislocation of 2 fingers, fixation with a knitting needle. Wounds are washed with antiseptic solutions and sutured in layers. Iodopiron. Ace. bandage.

On radiographs: Osteotomy of the head of the main phalanx. The axis of the 2nd finger is restored.

The cutter made it possible to completely and evenly remove the cartilaginous tissue and evenly match the bones of the second finger.

The cutter cannulated allows its precise positioning on the articular surface of the middle phalanx, which leads to less trauma to the soft tissues, removal of the required amount of cartilage with bone preservation. Using cutting teeth, cartilage is removed from the articular surface.

Claims (1)

A cutter for removing cartilage from the articular surfaces of the bones of the feet, consisting of a cylindrical cannulated body, a working part with teeth lying in a plane perpendicular to the longitudinal axis of the cylindrical cannulated body, and located radially from the center of the cylindrical body, having a cylindrical shank for fixing the cutter in the cartridge of the electric device characterized in that the cutter has an outer diameter of 5 mm, an inner hole diameter of 1 mm, a length of 70 mm, and is equipped with 8 teeth with a sharpening angle of 45 °.