RU92782U1 - DEVICE FOR REPOSITION AND FIXATION OF BILATERAL DAMAGES OF THE PELVIC RING - Google Patents

Abstract

 Apparatus for reposition and fixing of bilateral damage to the pelvic ring, including pelvic supports made with the possibility of movement relative to each other and mounted on them by threaded rods for insertion into the pelvic bones, characterized in that the pelvic supports in the front of the pelvis are interconnected by means of a reposition unit, made in the form of a parallelogram, the sides of which are the extension strips and beams articulated between each other, a threaded rod is installed diagonally between the beam and the extension bar and with the possibility of changing the distance between its fastening points, remote beam rigidly fixed with pelvic supports.

Description

The utility model relates to medicine, namely to traumatology and can be used to reposition and fix bilateral damage to the pelvic ring.

There are apparatuses of various designs for reposition and fixing damage to the pelvis. Their common feature is limited repositional properties, the inability to effectively manipulate the pelvic halves in different planes, which is necessary when restoring the pelvic ring as the main goal of treating pelvic injuries (M.E. Muller, M. Allgover, R. Schneider, X. Willinegger, Guidelines for Internal Osteosynthesis, Methodology Recommended by AO Group, Switzerland, AdMarginem, 1996, 298-299 Fig. 4.7a; Pohlemann T, Bosch U, Gänsslen A, Tscherne H. The Hannover experience in management of pelvic fractures. Clin. Orthop 1994 ; 305: 69-80).

A device for treating damage to the pelvis (US Pat. RF 2128963, 1999) containing supports, interconnected with the possibility of movement in various planes by means of screw connections and fastening elements in the form of pointed rods placed on the supports, and introduced into the bone tissue of the pelvis.

However, in the presence of multidirectional displacements of the pelvic bones, repositional capabilities of the known device are not enough, therefore, residual multidirectional displacements of the halves of the pelvis are preserved.

A device for reposition and fixation of fractures of the pelvic bones (pa. 2204956, 2003), comprising a pelvic support in the form of two half-arches with fixed threaded rods and a reposition unit in the form of a telescopic module, is known. The device provides stiffness of reposition and fixation.

The disadvantage of this device is that reposition using a telescopic module is provided only in the horizontal plane.

A known apparatus for the closed elimination of persistent deformations of the pelvic ring (Pat. Patent Utility Model 26186, 2002), including pelvic bearings connected to move relative to each other in three planes and threaded rods mounted on the supports through straight and oblique brackets through the connection node. The connection site of the pelvic supports is made in the form of threaded rods and brackets pivotally connected to it and by means of a threaded shank with a pelvic support. The device allows you to use great effort when repositioning fragments of the pelvic ring.

However, during repositioning of the pelvic bones, in particular with multidirectional displacements, the device’s design does not fully restore the pelvic ring, and often in its front sections residual deformations are preserved.

The task is to increase the repositional capabilities of the apparatus, by creating a node that will simultaneously allow the pelvic support to move in different directions.

To solve the problem in the apparatus for reposition and fixing damage to the pelvic ring, including the pelvic support, made with the possibility of movement relative to each other and mounted on them threaded rods for insertion into the pelvic bones, according to the technical solution, the pelvic support in the front of the pelvis by means of a reposition unit made in the form of a parallelogram, the sides of which are the extension strips and the beams pivotally connected between each other, between the beam and the remote stripe according to the diagonal Nali mounted threaded rod with the possibility of changing the distance between its fastening points, remote beam rigidly fixed with pelvic supports.

The repositional unit has the form of a parallelogram, the angles of which are pivotally connected, so changing the length of the diagonal leads to a change in the configuration of the parallelogram (Figure 1 shows the principle of operation of the repositional unit). The reposition unit is created in the plane of entry into the pelvis. The execution of the reposition unit of the extension strips, rigidly fixed on the pelvic supports, pivotally connected to the beams, allows you to simultaneously move the pelvic supports in opposite directions when changing the angles of the parallelogram. A threaded rod allows you to change the angles of the parallelogram, fixed diagonally, for example, one end on the extension bar, and the other at the end of the beam, by changing the distance between the points of attachment.

Thus, the proposed design of the apparatus with a repositional node in the form of a parallelogram allows you to restore the shape of the pelvic ring with bilateral damage to the pelvic bones.

The apparatus for reposition and fixation of damage to the pelvic ring, contains pelvic supports, for example, half-arcs, made with the possibility of movement relative to each other, threaded rods mounted on them for insertion into the pelvic bones and reposition unit, the outer slats of which are rigidly attached to the front pelvic supports of the apparatus interconnected by beams. A threaded rod (M6) is installed in the diagonal direction between the beam and the extension bar, fixed by means of single-plane hinges. Thus, the reposition unit has the form of a parallelogram and has the ability to change the magnitude of the angles, (Figure 5 shows a photo of the appearance of the apparatus installed on the patient). By changing the distance between the attachment points of the threaded rod by tightening the nuts, the angles of the parallelogram change and simultaneous multidirectional rotational movement of the halves of the pelvis in the plane of entry into the small pelvis. Reproduction of the pelvic bones is possible at the same time or gradually. It is possible to use parts in the design, for example, from a set of Ilizarov external fixation apparatus or other sets. Figure 2 - presents the reposition scheme using reposition unit (a - threaded rod): A - to reposition, (black arrows indicate the direction of tightening the nuts on the threaded rod). B - the result of reposition (black arrows indicate the location of the fixed (rigid) connection, white arrows indicate the location of the articulation).

Clinical example. Patient K., born in 1980, (IB 106602).

A month after the injury, the patient was hospitalized in the traumatology department of UNIITO with a diagnosis of bilateral rotationally unstable pelvic damage: fracture of the lateral mass of the sacrum on the right, rupture of the sacroiliac joint on the left, fracture of the pubic and ischial bones on both sides. In the department, pelvic osteosynthesis was performed with an external fixation apparatus and subsequent correction of deformation within three days in the apparatus of the proposed design.

As a result, the shape of the pelvis is completely restored. Functional result is good.

Figure 3 - presents the radiographs of the patient K. before surgery in 2 - projections: A - straight line; B - oblique.

Figure 4 - radiographs of patient K. after applying the apparatus of the proposed design: A - straight line, B - oblique projection.

Figure 5 - presents a photo after applying the apparatus of the proposed design (before reposition).

Figure 6 radiographs of the patient K. after reposition: A - direct and B - oblique projection.

In Fig.7 - presents a photo of the appearance of the apparatus after reposition.

Thus, the repositioning capabilities of the apparatus are increased, which allows you to restore the shape of the pelvic ring with versatile displacements of the pelvic bones.

Claims (1)

Apparatus for reposition and fixing of bilateral damage to the pelvic ring, including pelvic supports made with the possibility of moving relative to each other and mounted on them by threaded rods for insertion into the pelvic bones, characterized in that the pelvic supports in the front of the pelvis are interconnected by means of a reposition unit, made in the form of a parallelogram, the sides of which are the extension strips and beams pivotally connected to each other, a threaded rod is installed diagonally between the beam and the extension bar and with the possibility of changing the distance between its fastening points, remote beam rigidly fixed with pelvic supports.