RU2061415C1 - Distractor for performing plastic restoration of iliac bone - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has curved branches 1 connected by hinge 2 and working parts 3 with external grooves 5 connected to branches 1. Working parts 3 are made in form of wedges with supporting platforms 6. External grooves 5 have locking recesses with guiding surfaces for iliac bone fragments to be placed in. Supporting platforms 6 have surfaces for cortical plates. The width of the recesses can be correspondent with to the iliac bone thickness. EFFECT: enhanced effectiveness of treatment. 3 cl, 2 dwg

Description

 The invention relates to medicine, and in particular to devices for the expansion of bone wounds and the introduction of bone grafts.

 Many different expanders are known (see, e.g., A. St. N 1718842, A. St. N 1491478, etc.), but most of them are not intended for breeding bone fragments.

 Closest to the proposed technical solution is a device according to A.S. N 76542. This device contains articulated curved branches with articulated working parts made of working grooves. However, this device does not allow one to enter the osteotomy zone and especially the difficultly oriented one without difficulty, and therefore the possibilities of manipulation in a bone wound and the introduction of a graft are very limited. And although by A.S. N 1217372 it is known that the outer grooves are guides, and according to A. St. N 1505517 the execution of the working parts with wedge-shaped and with supporting platforms, which simplifies the work with the device, there is no reliable fixation of the sawdust plane when creating diastasis between them.

 The problem to which the invention is directed, is the rapid and accurate introduction of a bone graft into the resulting diastasis during complex reconstructive surgery on the bones, as well as reducing soft tissue trauma.

 The task is achieved in that the working parts of the distractor are made in the form of wedges with supporting platforms, and the external grooves are in the form of locking recesses with guiding surfaces for fragments of the ilium, while the supporting platforms are made with surfaces for cortical plates.

 The movable joint between the jaws and the rotary working parts provides the required position of the tool in relation to the operating wound, which leads to a decrease in labor intensity and a reduction in the duration of the operation.

 The essence of the technical solution is illustrated by the drawing, where in FIG. 1 shows a General view of the device; and in FIG. 2 side view of the device.

 The device contains curved jaws 1 connected by a hinge 2, and rotary working parts 3 connected to the jaws, rotatable 180 degrees by a fixing screw 4. The rotary working parts 3 have external grooves 5. The working parts 3 of the device are made in the form of wedges with supporting sites 6 having surfaces under the cortical plates, and the external grooves 5 in the form of retaining grooves with guide surfaces for fragments of the ilium.

 The operation of the device can be illustrated by the example of a pelvic osteotomy according to Salter.

 After accessing the ilium and crossing the pelvis along the nameless line, rotary working parts 3 are inserted into the osteotomy zone and, when the curved branches 1 are brought together, a bone graft of the required shape is introduced between the working parts. In this case, the supporting pads 6 are located on the inner and outer cortical plates, and the ends of the distal and proximal fragments of the ilium are tightly embedded in the external grooves 5, the width of the recesses of which corresponds to the thickness of the ilium, which prevents the displacement of the instrument in the wound, and due to the fixing screw 4 between jaws 1 and working parts 3 there is an increased possibility of manipulation (the location of the tool at the desired angle).

 Clinical example: Patient B. 2 years 11 months. He was in the Department of Pediatric Orthopedics NNIIITO from 08.31.92 to 02.11.92 years about the residual subluxation of the left thigh. On September 8, 1992, an operation was performed - intertrochanteric corrective osteotomy of the left femur, pelvic osteotomy according to Salter on the left with the use of a distractor for iliac plasty, the time of surgery was 1 hour. The operation was successful. The postoperative course is smooth. Primary postoperative wound healing. In satisfactory condition with the nearest clinical-Rg-logical results, the patient was discharged home.

 The above device was used in the pediatric orthopedics department of the Nizhny Novgorod Research Institute of Traumatology and Orthopedics in 5 patients with good results.

 This device allows you to quickly and accurately insert a bone graft into the resulting diastasis, significantly reduces the time of surgery and reduces the efforts of the surgeon during this manipulation.

Claims (2)

 1. A distractor for iliac plasty, comprising curved jaws connected by a hinge and rotary working parts connected to the jaws with external grooves, characterized in that its working parts are made in the form of wedges with supporting platforms, and the external grooves in the form of locking recesses with guide surfaces under fragments of the ilium, while the supporting areas are made with surfaces under the cortical plates.  2. The distractor according to claim 1, characterized in that the width of the recesses corresponds to the thickness of the ilium.

Images