RU2774093C1 - Arthroscopic hook for bone-cartilage fragments reposition - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, in particular to surgical instruments used in traumatology and orthopedics during the operation of reposition and osteosynthesis of intra-articular fractures under arthroscopic control. The arthroscopic hook for the reposition of bone and cartilage fragments is made of steel and includes a cylindrical handle having a grooved surface for holding and manipulating, a cylindrical rod having an arcuate bend with a conical sharpening and a pressure circular platform in the form of a rigidly fixed washer, with a diameter 3 mm larger than the rod, and located at a distance of 4 mm from the top of the conical sharpening.

EFFECT: use of the invention provides instrumental, arthroscopic reposition of a bone-cartilage fragment and its stable retention until the final fixation of osteosynthesis, excluding its damage.

1 cl, 1 dwg

Description

The invention relates to medicine, in particular, to surgical instruments used in traumatology and orthopedics, in the operation of reposition and osteosynthesis of intraarticular fractures under arthroscopic control. Modern principles of surgical treatment of intra-articular fractures include anatomical reposition and stable fixation of fragments with minimal surgical aggression towards the tissues of the joint. These conditions, in particular for fractures in the area of the elbow and ankle joint, can be met with the use of arthroscopic techniques. After performing the diagnostic stage of arthroscopy, with an assessment of the features and topography of the fracture, they proceed to the therapeutic stage - mobilization and reposition of the displaced bone and cartilage fragment, first with temporary fixation (with some kind of instrument), and final fixation with a screw or bone suture. In practice, these reposition and temporary retention of the fragment is carried out using mechanical action using an obturator from an arthroscopic cannula, a needle, more often an arthroscopic hook-shaped probe. The arthroscopic hook-shaped probe has a 90 J curved end, rounded at the end, the length of the hook is 2 or 4 mm. The tool is intended for manipulations in the joint for diagnostic purposes (Orlyansky V., Golovakha M.L. Guide to arthroscopy of the knee joint. - Moscow: Fintreks, 2016, 264 s). The disadvantage of these adaptive tools is:

the impossibility of stable fixation of the instrument on the bone and cartilage fragment for the application of repositioning forces, to hold it until the moment of final fixation,

slippage of the instrument causing additional injury to the articular cartilage,

an attempt to increase pressure with an instrument creates a risk of splitting the bone and cartilage fragment.

The objective of the invention is to create a tool for arthroscopic reposition of bone and cartilage fragments devoid of these disadvantages.

EFFECT: provision of instrumental, arthroscopic reposition of the bone and cartilage fragment and its stable retention until the moment of final fixation (osteosynthesis), excluding its damage.

The solution of the problem and the achievement of the technical result provides the proposed tool - arthroscopic hook for the reposition of bone and cartilage fragments.

The tool (Fig. 1) is made of medical steel and includes a cylindrical handle 1 with a corrugated surface for holding and manipulating the tool, a cylindrical rod 2 with an arcuate bend 3, which in turn has an end part with a conical sharpening 4 and clamping circular (in the form of a rigidly fixed washer) platform 5, 3 mm in diameter larger than the rod (this size of the platform is optimal in terms of the minimum restriction of the field of view and the zone of fixation for osteosynthesis, and does not lead to additional damage to the cartilage cover), located at a distance 4 mm from the end of the tool.

The proposed tool is used as follows: after the diagnostic stage of arthroscopy. Under the control of the endoscope through a standard or additional arthroscopic access, an instrument is inserted into the joint cavity. The surgeon places the instrument on the articular surface of the fragment by introducing the end part until it rests on the platform. By manipulating the instrument, the surgeon moves the bone and cartilage fragment to the anatomically correct position (anatomical reposition is achieved). While maintaining the reposition achieved with the instrument, the surgeon, with the help of an assistant, performs the final osteosynthesis with one of the fixators (pin, screw, bone suture).

The advantages of the tool are:

convenient and stable positioning of the instrument on the bone and cartilage fragment due to the arcuate bend with a conical sharpening,

reducing the risk of damage and splitting of the fragment due to excessive penetration and pressure of the tool due to the presence of a clamping, circular platform,

the accuracy of instrumentally mediated manipulation of the fragment and reposition due to the stable position of the instrument.

Claims (1)

Arthroscopic hook for repositioning osteochondral fragments, characterized in that it is made of steel and includes a cylindrical handle with a corrugated surface for holding and manipulation, a cylindrical rod with an arcuate bend with a conical sharpening and a circular clamping platform in the form of a rigidly fixed washer , with a diameter of 3 mm more than the rod, and located at a distance of 4 mm from the top of the conical sharpening.

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