RU2816059C1 - Osteosynthesis device for proximal femoral fragments after corrective osteotomies - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: osteosynthesis device for proximal femoral fragments after corrective osteotomies comprises an angular plate with a proximal portion and a diaphyseal pad. Proximal part is made in the form of a rectangle with a narrowing at the end of its length for introduction into the bone, with stiffness ribs in side and central parts to ensure angular and rotational stability and a hole for installation along the guide pin. Diaphyseal pad has holes for the screws.

EFFECT: invention provides higher clinical effectiveness in children in need of corrective osteotomy in the proximal femur due to stable osteosynthesis of femoral fragments in the course of metal implantation.

1 cl, 1 dwg

Description

The invention relates to medicine, in particular to orthopedics and to submersible implants for performing external osteosynthesis of bone fragments. The device can be used for osteosynthesis of the femur in its proximal part after performing corrective osteotomies.

A known plate for osteosynthesis of the proximal femur in children (RF patent for utility model No. RU 152608U1 dated June 10, 2015), which includes a proximal part, which is made in the form of a blade - an isosceles triangle with a base at the point of transition of the blade to the diaphyseal part and a distal part with holes for screws, which are made in the form of partially overlapping circles, and the inner wall of one part of the hole is made with a conical chamfer, and the other with a thread; the locking screws have a double thread for the bone and for fixing the screw to the plate.

However, the disadvantage of this design is the presence of a tip at the end of the blade, as well as the absence of stiffening ribs on it, which, in conditions of reduced bone density, can lead to malposition of the metal structure and loss of the achieved intraoperative correction of the spatial position of the femoral bone fragments. In addition, the presence of three holes partially overlapping each other can significantly weaken the strength characteristics of the metal structure, and therefore its fracture is possible with early load on the lower limb in the postoperative period.

A known bone plate for osteosynthesis of fragments of the proximal femur, which includes a blade part having stiffening ribs to ensure its stable fixation and a hole for a guide pin and a diphyseal pad (Lollipop. The locking pediatric osteotomy plate system. https://orphangroup. com/producty/hirurgicheskaya-metodika-lollipop).

The disadvantage of this design is the presence of three separate elements of the metal fixation device (the blade part of the plate, the diaphyseal pad, a screw for connecting and fixing the blade and the diaphyseal pad to each other), which can lead to instability of the system at the level of the articulating surfaces with subsequent loss of the achieved intraoperative correction.

The objective of the proposed device is to increase the effectiveness of treatment for children who require corrective osteotomy in the proximal femur by ensuring stable osteosynthesis of femoral bone fragments during installation of the metal structure.

To technically implement this task, a device has been developed for osteosynthesis of femoral bone fragments in the proximal part after corrective osteotomies, containing an angular plate with a proximal part and a diaphyseal overlay. The proximal part is made in the form of a rectangle with a narrowing at the end of its length for insertion into the bone, the presence of stiffening ribs in the lateral and central parts, as well as a hole for passing the guide pin. The diaphyseal pad begins at the proximal junction and contains holes for screw insertion.

Thus, the device for osteosynthesis of fragments of the femur in the proximal part after corrective osteotomies, due to the presence of lateral and central stiffening ribs, provides primary stable fixation of the proximal part into the femoral neck, eliminating, first of all, rotational instability, and the presence of a hole for the guide pin greatly simplifies the process of installing the structure and eliminates the possibility of its migration from the given implantation trajectory. These design features will make it possible in some cases to completely abandon external plaster immobilization and verticalize the patient as early as possible, which will increase the effectiveness of treatment for children who require corrective osteotomy in the proximal femur.

The drawing shows a device for osteosynthesis of femoral bone fragments in the proximal part after corrective osteotomies

1 - proximal part

2 - side stiffeners

3 - central stiffener

4 - hole for installation along the spoke guide

5 - diaphyseal pad

6 - holes for screws

The device for osteosynthesis of fragments of the femur in the proximal part after corrective osteotomies is made in the form of an angular plate containing a proximal part (1) and a diaphyseal pad (5), located relative to each other at an angle of 120°. The proximal part is made in the form of a rectangle with a moderate narrowing at the end of its length with the presence of stiffening ribs in the side (2) and central parts (3), as well as a hole for installation along the guide pin (4). The diaphyseal pad (5) contains holes for inserting screws (6).

A device for osteosynthesis of femoral fragments in the proximal part after corrective osteotomies is used as follows.

With the patient lying on the contralateral surgical side, access is made to the femur in its proximal part.

After a linear dissection of the fascia lata and a T-shaped dissection of the lateral head of the quadriceps femoris muscle, the upper third of the femur is exposed subperiosteally. Under the control of an electronic optical converter (EOC), a guide pin is inserted into the femoral neck, taking into account the upcoming individual correction of the deformity of the proximal femur. A cannulated punch is used to perforate the lateral cortical layer of the femur. Next, an osteotomy of the femur is performed, for example with an oscillating saw. Then, along a pin passed into the neck of the femur, through the hole (4), a proximal part (1) is installed, containing lateral (2) and central (3) stiffeners. Next, the fragments of the femur are compared with each other and with the diaphyseal lining (5) so that the latter is parallel to the diaphysis of the femur. Screws are inserted bicortically through the holes (6) in the diaphyseal pad. The wound is sutured layer by layer. An aseptic dressing is applied. A control radiography of the hip joints is performed in the anteroposterior projection.

Claims (1)

A device for osteosynthesis of fragments of the femur in the proximal part after corrective osteotomies, containing an angular plate with a proximal part and a diaphyseal plate, characterized in that the proximal part is made in the form of a rectangle with a narrowing at the end of its length for insertion into the bone, with the presence of stiffening ribs in the side and central parts to ensure angular and rotational stability and a hole for installation along the guide pin, and the diaphyseal pad contains holes for passing screws.