RU2151576C1 - Device for implanting plugs into the medullary canal of the femur in setting hip joint endoprosthesis - Google Patents

Abstract

FIELD: medical engineering. SUBSTANCE: device has threaded carrier rod for fixing removable nozzles, handle and scale in mm having divisors every 5 mm and digital marks every 10 mm. The first mark shows 4 denoting distance to plug base when the plug is mounted on the device. The device has three removable nozzles one of which has needles for fixing the plug and is used when introducing the plug into the medullary canal of the femur. Another one is used for removing the plug. The third one has conic thread for fixing the plug and is used for introducing the plug into the medullary canal of the femur and for its removing. Each nozzle has internal thread for being fixed on the carrier rod. EFFECT: enhanced effectiveness in introducing the plug into the medullary canal and removing it. 6 dwg

Description

 The device relates to medicine, namely to operative orthopedics.

 A device is known by which a plug is inserted into the bone marrow of the femur to obstruct the latter (Kerboull M. Arthroplastie total de hanche sur ankylose. Encyclopedie Medico-Chirurgicale (Elsevier, Paris), Technique chirurgicales - Orthopedie-Traumatologie, 44-665- B, 1996, 18p).

 However, the known device does not have the technical capabilities to remove the cork from the bone marrow canal.

 The objective of the invention is to ensure the rapid introduction of the cork into the bone marrow canal of the femur and, if necessary, remove it.

 This object is achieved by the fact that the proposed device to ensure the rapid insertion of the plug into the bone marrow canal of the femur and, if necessary, removed is equipped with a carrier rod having a handle at the ends for holding the device and a thread for fixing the nozzles, three nozzles, one of which has two needles for fixing the cork and serves to insert it into the bone marrow canal, the second nozzle has a thread for fixing the cork and serves to insert it into the bone marrow canal and remove from the latter, and the third nozzle EET two needles with hooks for fixing the stopper and serves to remove it from the latter, with all three nozzles have an internal thread for fixing the rod carrier.

 In FIG. 1 shows the insertion of a plug into the bone marrow canal using a special device (Kerboull M. Arthroplastie total de hanche sur ankylose. Encyclopedie Medico Chirurgicale (Elsevier, Paris), Technique chirurgicales - Orthopedie-Traumatologie, 44-665-B, 1996, 18p) .

 In FIG. 2 - a device for implantation and plugs in the bone marrow canal of the thigh and its removal during hip joint replacement.

 In FIG. 3 - shows the device on the operating table.

 In FIG. 4 - fixing the plug device.

 In FIG. 5 - device with a fixed plug.

 In FIG. 6: A — device with a plug before insertion of the plug into the bone marrow canal of the femur; B - insertion of a plug into the bone marrow canal of the femur.

 The device consists of a carrier rod (1); the threaded part of the device (2); device handles (3); scale (4) of the carrier rod (1) in mm with division every 5 mm and a digital mark every 10 mm, and the first digital mark starts with the number 4, which, when the plug (13) is fixed on the device, indicates the distance to the base of the plug ( 13); from the nozzle (5) for fixing and inserting the plug (13); two fixing needles (6) of the nozzle (5) for fixing and inserting the plug (13); nozzles (7) for fixing and removing the plug (13); two fixing needles (8) of the nozzle (7) for fixing and removing the plug (13); two hooks (12) of the fixing needles (8) of the nozzle (7) for fixing and removing the plug (13); nozzles (9) for fixing, inserting and removing the plug (13); fixing conical thread (10) of the nozzle (9) for fixing, insertion and removal of the plug (13); internal thread (11) of three nozzles (5, 7, 9).

 The device operates as follows.

 After preparing the proximal femur with reamers and rasps, measure the diameter of the femoral canal (14) and the required depth of landing of the plug (13) with an instrument, select the required size of the plug (13) from the set of plugs (Fig. 3) and fix the plug (13) by introducing in it fixing needles (6) of the nozzle (5) of the device (Fig. 4).

 After fixing the plug (13) on the device, it is inserted (Fig. 4, 5, 6) using the device to the required depth, which is determined by the scale of division (4) of the carrier rod (1).

 If necessary, using the nozzle (9) to insert and remove the plug (13), or the nozzle (7) only to remove the plug (13), the plug can be removed from the bone marrow canal.

Clinical example
Patient P., born in 1931, I / B N 715-579, was admitted to the medical institution TMO-2 on September 21, 1999 for planned surgical treatment.

 Diagnosis: false joint of the neck of the left thigh. Insolvency of osteosynthesis of the left femoral neck. Pronounced cystic restructuring of the head of the left thigh. Bending-contracting contracture. Pain syndrome. NF joint 4th degree.

 Concomitant diagnosis: IHD. Angina is unstable, stabilization in the second FC. H1. Hypertensive b-n, 2 tbsp., Mild labile hypertension. Chronic bronchitis with asthmatic component. PTB of the left lower leg. Common osteochondrosis.

 September 28, 1999. Operation N 213-214- Endoprosthetics of the left hip joint with a Muller N50 cup on bone cement "Palakos R", M. Müller leg N 11 on bone cement "Palakos R". P / O diagnosis: the same.

 Khir: Kolesnik A.I. Ace. Brezhneva N.L., Ivanova G.P.

Duration: 3 hours 35 minutes. Blood loss: 1200 ml
Anesthesiologist: Chursin Yu.M.

Anesthesia: endotracheal anesthesia
Op. sister: Yakovleva T.M.

Exodus: Discharged 10/12/99
Protocol
1. A section of up to 21 cm long on the outer surface of the joint layer-by-layer exposed the trochanteric region of the femur. Hemostasis and toilet wounds with antiseptics during the operation.

 2. Removed a three-blade nail and a screw.

 3. The capsule of the joint is exposed. Hemostasis and toilet wounds with antiseptics during the operation. The capsule is dissected. The head is free from the neck. The head is dislocated from the cavity; it is deformed, flattened. Hemostasis and toilet wounds with antiseptics during the operation.

 4. After preliminary processing of the acetabulum with cutters NN 48-52, a Müller cup N 50 was implanted on bone cement “Palakos R”.

 5. The proximal femur is treated with a rasp N 7.5, -11.25.

 6. Using a tool, the diameter of the femoral canal (14) was measured at a given depth, after which the plug (13) (Fig. 3) of the required size is fixed on the nozzle (5) of the device (Fig. 4) and inserted to the required depth (Fig. 5, 6).

 7. An Müller leg N 11.25 was implanted on the Palakos R bone cement.

 8. Selected head MX32.

 9. The head is set into the cavity. The range of motion in the joint is sufficient.

 10. Toilet wounds with an antiseptic. Layer wound closure with 2 drainages for active aspiration. Rubber graduates in subcutaneous fat.

 11. Elastic bandaging of the legs.

 Thus, the proposed device compares favorably with the prototype, its technical solution allows to achieve the task set in the invention due to the fact that it consists of a handle, a carrier rod with a thread at the end for mounting removable nozzles and a scale in mm with a division every 5 mm and a digital mark every 10 mm, and the first digital mark starts with the number 4, which, when the plug is fixed on the device, indicates the distance to the base of the plug having 3 removable nozzles, one of which has needles for fixing plugs and serves to insert the plug into the bone marrow canal of the thigh, the other nozzle has two needles with hooks to fix the plug and serves to remove the plug, the third nozzle has a tapered thread to fix the plug and serves to insert the plug into the bone marrow of the thigh removal, with each nozzle having an internal thread for mounting on a carrier rod; the presence of the division scale on the carrier rod allows the plug to be inserted to a predetermined depth.

Claims (1)

 A device for implanting a plug in the bone marrow canal of the thigh and removing it during hip replacement in the form of a rod for inserting a plug in the bone marrow of the femur for hip replacement, characterized in that it consists of a handle, a carrier rod with thread at the end for fastening removable nozzles and a scale in mm with a division every 5 mm and a digital mark every 10 mm, and the first digital mark starts with the number 4, which when fixed on the device t is the distance to the base of the plug having three removable nozzles, one of which has needles for fixing the plug and serves to insert the plug into the bone marrow canal of the thigh, the other nozzle has two needles with hooks for fixing the plug and serves to remove the plug, the third nozzle has conical thread for fixing the tube and serves to insert the tube into the medulla of the thigh and remove it, each nozzle having an internal thread for mounting on a carrier rod.

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