SU1109146A1 - Apparatus for closed osteosynthesis of the hip - Google Patents

Abstract

DEVICE FOR CLOSED OSTEOSYNTHESIS HIPS, comprising a rack with the guide and compresses the rod, characterized in that in order to ensure accurate matching fragments mschelkov, stoyfS i iiMOiii / VA ka is provided with a ball joint, a koto rum mounted guide, vsholnenny threaded and having a hexagonal opening compresses the rod is threaded with an anvil pad, a pointed end and an axial bore with threaded ends, the needle is installed in the axial bore of the compression rod, which is equipped with tin, made with a support platform, and an axial hole for the needle, and the head is placed in one of the threaded holes of the compression rod.

Description

5 SCHSHSHSHSH Sh. I Sch 12 13 16 Phage. The invention relates to medicine, namely to orthopedics and traumatology. A device for closed osteosynthesis of hip fragments, containing a stand with a guide and a compression rod G13, is known. A disadvantage of the known device is that it does not ensure complete restoration of mobility in the knee joint, since it cannot be used to make an exact comparison of the fragments of the femoral and tibial condyles. The aim of the invention is to accurately map the fragments of the joint lobes. The goal is achieved by the fact that, in a device for closed osteo synthesis of the femur, a rack with a guide and a compressing rod, a stand is equipped with a ball joint, in which the guide is threaded and has a hexagonal hole, the compression rod is threaded with an axial platform, pointed end and axial hole with threaded ends, the needle is installed in the axial hole of the compression rod, which is provided with a head, made with a bearing pad, and an axial hole I eat under aids, and the head is placed in one of the threaded holes of the compression rod. I FIG. 1 shows a device for closed osteosynthesis of the hip, incision; in fig. 2 - compressing rod fixed in the broken tibial condyle, i.e. initial stage of reduction; 3, the device mounted on the tibial condyles after the right laziness; in fig. 4 - stand with a device guide mounted on the compression-distraction ring; in fig. 5 - compressing rod of the device; Fig.6 head of the device. The device for the closed osteosinosis of the femur and tibia contains a threaded compressing rod 1 with a pointed end 2, a hex head 3 and an anvil pad 4. The compression core is made with an axial hole 5, the diameter of which is 2-2.5 mm Both ends of the axial hole 5 have threads 6 and 7 at a distance of 12-15 mm. The compression rod 1 is provided with a compression head 8 with an axial bore 9, an anvil pad 10 and a cut end 11. The diameter of the axial bore 9 of the head 8 is also 2-2.5 mm. The compression rod also contains a needle 12 with a cut end 13 and a tip 14, the cut end 13 corresponds to the threaded end 7, and the cut end 11 of the compensating head 8 to the threaded end 6 of the axial bore 5 The device also includes a stand 15 on which a ball joint 16 is mounted with a support 17. In the ball joint 16, a guide 18 is placed. On the one hand, the guide 18 ends with a handle 19, and on the other, with a hex hole 20, which corresponds to a hex head 3. A stand 15 is attached to a compression ring 21 with the aid of nuts 22 and 23. As the guide 18 is located in the ball joint 16, it can occupy any spatial position. The device is mounted on the tibia 24 and the condyle 25. The operation of the device is as follows. A compression-distraction apparatus is applied to both segments (thigh and shin), for example, G.A. Ilizarov or another, with the shutdown of movements in the knee joint with immobilization of the lower limb at an angle of 180 ° in the knee. This is achieved by holding four spokes perpendicular to one another — two through the femur and two through the tibial bone 24, the spokes being held away from the fracture zone. They are tightened and fastened in the rings of the apparatus 21. The rings 21, in turn, are fastened with longitudinal rods, and thus an immobilization of the damaged knee joint is achieved. This phase of the operation is well known. On one of the rings of the compression-diffraction apparatus, on the side of the fracture, the post 15 is secured by means of nuts 22 and 23. Next, radiographs are produced in two standard projections. Since the apparatus has two metal rulers — one horizontal, the other vertical — with slotted divisions and numbers, the surgeon gets a clear outline on radiographs. In addition to the rulers, tick marks and numbers, the radiograph allows to determine the contours of the knee joint, the bones that form it, as well as the location of the displaced fragment and the distance by which it is necessary to move it. The radiogram is used to calculate the direction and location of the compression rod 1 with a guide-18 into the displaced fragments of the condyle 25. Then the compression rod 1 for osteosynthesis is inserted into the hexagon hole 20 on the guide 18, adjusting the spatial position of the rack 15 to determine the exact direction and location insertion of the compressing rod 1. By rotating the guide 18 with the help of the handle 19, the compressing rod 1 is inserted into the fragment of the integer 25 to a depth of 20-30 mm (Fig. 7). A repeated X-ray diffraction is carried out in two standard projections and the calculation of the necessary movement of the fragment of the latch 25 vertically and horizontally. Changing the position of the guide 18 with the compressing rod 1, on which the bone fragment 25 is strung, with the help of the rack 15 and the guide 18 will eliminate the displacement. To ensure persuasiveness, the standing of fragments with radiographs can be checked once again, but this manipulation is not necessary. After the displacement is eliminated by rotating the knob 19 of the guide 18, the compressing rod 1 is inserted into the healthy zone of the bone 24 until it stops (Fig. 3). The length of the compressing rod 1 is matched to the bone thickness 24. Then the axial hole 5, which is in the compressing rod 1, is inserted into the needle 12 so that its pointed end 14 extends beyond the soft tissues on the opposite side (Fig. 12 is fixed in the axial hole 5 by screwing into the thread 7 in the axial hole 5. The length of the spokes 12 is 20-25 cm and, when inserted, it goes out to the opposite side of the limb beyond the soft tissues. A compression head is worn on the tip-14 of the needles 8, which is screwed with a threaded end 6. A cut is made up to 1 cm in length on the skin. A compression is created by screwing in the head 8. Then the stand 15 and the needle 12 are removed, and one stitch is put on each side on the wounds. The proposed method allows precise reposition of the intra-articular fractures of the femoral condyles and tibial bone, which plays an extremely important role in accelerating the healing period of the damaged bone with minimal traumatization of all tissues and without opening the joint cavity, as well as stable osteo Inteza and create compression between the fragments, which in turn allows the development of an early start of movements, without the danger of secondary biasing fragments. The method eliminates the use of plaster casts and allows from the very beginning to carry out a full-fledged physiotherapeutic and drug treatment, active therapeutic exercises, massage, as well as to carry out a partial load on the sore leg. Closed osteosynthesis and minimal operative trauma significantly reduce the percentage of suppurations in the postoperative period and reduces the percentage of degenerative-dystrophic lesions in the knee joint. All this accelerates the fracture fusion and increases the percentage of beneficial functions: outcomes.

FIG. 2

Y13

sixteen

/

Fig.Z

20 "

/ 21

23

Fy

eleven

Claims (1)

DEVICE FOR CLOSED HIPS OSTEOSYNTHESIS, comprising a rack with a guide and a compression rod, characterized in that, in order to ensure accurate matching of condyle fragments, the rack is equipped with a ball joint in which a guide is made, threaded and having a hexagonal hole, the compression rod is made threaded with a thrust pad, a pointed end and an axial hole with threaded ends, the spoke is installed in the axial hole of the compression rod, which is equipped with a head, made connected with the support platform, and an axial hole for the spoke, the head being placed in one of the threaded holes of the compression rod. § (L 1,1109