RU2452415C1 - Device for processing of butt end of bone saw - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medical equipment and can be sued in formation of amputation stump of extremity. Device for processing butt end of bone saw includes case in form of cone with stem. In case cutting knives of trapezoidal shape are installed. Apex of case cone is closed tightly and is made in form of stopping to prevent bleeding and outflow of bone marrow from tubular bone cavity.

EFFECT: obtaining instrument for formation of amputation stump of extremity.

2 dwg

Description

The invention relates to medical equipment, namely to surgical instruments for processing the end face of the tubular bone, and can be used to form an amputation stump of the limb.

A device is known for preparing mutually adjacent, adapted surfaces of the ends of bone fragments for subsequent osteosynthesis by an external fixation apparatus (see RF patent No. 2154426 "Method for processing and joining ends of long bone with a mill and a countersink," publ. 08/20/2000). In the described method, the outer surface of one of the fragments is treated with a mill with cutting edges in the form of an inner cone. The inner surface of another fragment is treated with a vertical drill with cutting edges in the form of an outer cone. The working surfaces of the milling cutter and the countersink correspond in shape to one another. The cutter and countersink are used along the guide rod. The guide rod is inserted into the channel. The channel is prepared with a drill, the diameter of which is equal to the diameter of the rod. Processing at the end of one fragment form a recess. Deepening in shape and depth corresponds to the conically shaped end of another fragment. However, when using the above-described device, a bone marrow canal is opened with a drill, where a guide rod is inserted. Such a traumatic procedure often leads to fat embolism and difficult to stop bleeding from damaged vessels of the bone marrow canal.

The closest is a device for processing bone tissue (see RF patent 2119302, publ. 09/27/1998). In this device, a hollow body having a rod is made in the form of a cone with longitudinal cutting edges on the inside and with a shank in which a keyway is made. The cutter has a key element, a spring and is mounted with the possibility of axial movement inside the cone. The cutting head of the cutter is made in the form of a cone inverse to the cone of the body. This device has the following disadvantages:

- with this device it is impossible to process the sawdust of the cancellous bone, because an internal milling cutter will injure the trabeculae, causing bleeding from the spongy layer;

- taking into account the fact that the thickness of the cortical plate of the tubular bone is 5 mm on average, processing the outer and inner edges of the bone with a 1 mm cutting edge by diverging milling cutters at an angle of 90 ° does not round off the sawdust, but forms an acute angle and necrosis of adjacent tissues;

- the cutting edge of the milling cutters with a step of 1 mm is not able to perform high-quality rounding of the edge of the sawdust of the bone due to the almost instantaneous closure of this step by bone sawdust.

The technical result of the invention is the creation of a device that is simple and reliable in operation, which will qualitatively round off the edge of the sawdust of the bone without causing injury to adjacent tissues and bones.

This technical result is achieved in that the device for processing the end face of the sawdust bone includes a body in the form of a cone with a shank. Trapezoidal cutting knives are installed in the body. The trapezoidal shape of the cutting knives allows the bone edge to be processed in only one direction, which allows the device to operate reliably without clogging with bone sawdust. The top of the body cone is closed tightly. This allows you to plug a hole in the bone marrow canal in the form of a filling, preventing bleeding and leakage of bone marrow from the cavity of the tubular bone.

Figure 1 shows a device for processing the end face of a sawdust bone, General view, figure 2 shows a device for processing bone tissue, front view.

A device for processing the end face of a sawdust bone consists of a body in the form of a conical body of revolution 1 made of medical stainless steel and polished. Four grooves 2 are made in the inner conical surface, into which trapezoidal cutting knives 3 are mounted by pressing. The housing ends with a cylindrical shank 4, designed to secure the device in the cartridge of the rotating mechanism. The top of the cone of the housing 5 is closed tightly.

The devices have different diameters and are selected according to the size of the processed end face of the bone. The trapezoidal shape of the cutting knives 3 allows you to process the edge of the bone in only one direction, for example, clockwise.

The device operates as follows. After sterilization of the device and processing of the surgical field, patchwork skin incisions are made with subcutaneous tissue and fascia. Truncate the muscles to the tubular bone. They retract soft tissues, cut bone, bandage and truncate blood vessels and nerves.

Then take the device installed by the shank in the chuck of a sterile drill (not shown). During the operation, the cutting edges of the body evenly cut off the edge of the end face of the tubular bone. In this case, the cut bone chips under the action of centrifugal force are collected in the top 5 of the cone of the body and, filling, plug the opening of the bone marrow canal in the form of a filling, preventing bleeding and outflow of bone marrow from the cavity of the tubular bone. When processing the end face of the cancellous bone, the collected bone filings clog trabeculae of the spongy surface and also cement it, preventing bleeding from trabeculae damaged during filing.

The operation is completed by suturing over the filing of the antagonist muscles and skin.

The proposed device was used in 485 cases of amputations on the femur, tibia, and tarsus bones in patients with critical lower limb ischemia against the background of atherosclerosis and diabetes mellitus. As a result of this treatment, the wounds healed faster by 3-5 days.

Processing the edge of the sawdust of a bone takes no more than one minute, the method is easy to perform, economical and prevents the undesirable consequences of the previously proposed methods (bleeding and outflow of bone marrow from the cavity of the tubular bone, the formation of the sharp edge of the sawdust of the bone, diffuse bleeding from the sawdust of the cancellous bone).

The inventive device can be manufactured by existing technical means on existing equipment.

Claims (1)

A device for processing the end face of a bone sawdust, comprising a cone-shaped body with a shank, characterized in that trapezoidal cutting knives are installed in the body, and the top of the body cone is closed tightly and made in the form of a seal to prevent bleeding and leakage of bone marrow from the cavity of the tubular bone.

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