RU2284795C1 - Rod usable in intramedullary osteosynthesis - Google Patents

Abstract

FIELD: medical engineering; veterinary medicine.

SUBSTANCE: device has two sharp ends and through opening in their vicinity. Extractor head piece is additionally available which one end is T-shaped and the other one has ring-shaped handle. Rectangular notches for receiving the T-shaped extractor head piece end.

EFFECT: reduced risk of traumatic complications; stable bone fragment fixation.

2 dwg

Description

The invention relates to veterinary surgery, namely to fixatives for operations on damaged bones of animal limbs. The most effective use of the rod for intramedullary osteosynthesis of tubular bones.

Known extractor and hooks to it to extract the rod from the bone [S. Tkachenko Osteosynthesis Leningrad: Medicine, Leningrad Branch 1987, - P.22-23. fig. 1-b].

Known nozzle, which is a round rod with a length of 20 cm. At one end of the nozzle there is a recess corresponding to the head of the rod. A nozzle is necessary in order to transmit hammer blows to the rod through it when it is immersed with its free end in soft tissues [Ya. G. Dubrov Intraosseous fixation of a hip fracture with a metal rod. - M.: Medicine. 1972. - S. 152. fig. 59].

The Bogdanov core for intramedullary osteosynthesis with a through hole at one end and a pointed other end is also known [Dubrov Ya. G. Intraosseous fixation of a hip fracture with a metal rod. - M.: Medicine. 1972. - S. 152. fig. 59 - prototype]. At present, the federal state-owned enterprise Zito produces double-pointed rods of the Bogdanov type with through holes near the pointed ends.

The main disadvantage of the above-described rods, as well as devices for their insertion into the bone marrow canal and removal from the bone, is that additional injury to the soft tissues and bone by the nozzle is possible, since it covers the rod in the working position and stands out for its dimensions in all directions. In addition, the desire to conceal the pointed end of the rod in the bone leads to the extension of the channel nozzle in the pineal gland. This reduces the fixing ability and provokes postoperative rod migration, which leads to an extension of the period of osteoreparation with the formation of hypertrophic callus. Moreover, striking the rod leads to the crushing of its pointed end.

The objective of the proposed solution is to reduce the trauma of the tissues of the operated animal, achieving stable fixation of fragments, as well as increasing the life of the rod.

The task is achieved due to the fact that the known rod for intramedullary osteosynthesis with two pointed ends and with through holes near them according to the invention is equipped with an extractor nozzle, one end of which is made T-shaped, and the second end is made with a handle in the form of a ring, while rectangular grooves are made at the ends of the shaft for the T-shaped end of the nozzle-extractor to enter them.

The technical essence of the proposed rod for intramedullary osteosynthesis is presented in the drawing, where:

figure 1. - the proposed rod in the context;

figure 2. - proposed rod (general view at the time of installation).

Rod 1 for intramedullary osteosynthesis with through holes 2 near its pointed ends and rectangular grooves 3 at the ends of the rod. The grooves 3 are provided for the nozzle-extractor 4, containing the handle 5 in the form of a ring on one side and a T-shaped end 6 on the other.

The use of rod 1 is described by the example of intramedullary osteosynthesis of a dog's tibia with a diaphyseal fracture and is carried out as follows. Anesthesia of the animal and preparation of the operation field is carried out according to the generally accepted method and they provide operative access to bone fragments from the medial side of the lower leg - at the location of the fracture and operative access to the proximal epiphysis of the bone. After reposition of fragments displaced in length and width, they are fixed by rod 1 through an artificial channel in the proximal pineal gland. But since for the stability of osteosynthesis, the diameter of the channel in the pineal gland is 1.0-2.0 mm smaller than the diameter of the rod 1, its introduction is provided for by light hammer blows (not shown in the drawing). For this, the rod 1 is directed by one of the pointed ends into the hole of the artificial channel made in the proximal pineal gland. Then, in the groove 3 of the opposite end of the rod 1, the nozzle-extractor 4 is inserted with the T-shaped end 6. The position of the T-shaped end 6 can be controlled by the position of the handle 5 of the nozzle-extractor 4, since it is parallel to the long side of the T-shaped end 6. Moving the nozzle - the extractor 4 deep into the shaft 1, with light strokes of the hammer on the handle 5, translate the shaft 1 into the lumen of the bone marrow canal of the combined bone fragments (the direction of striking the handle 5 with a hammer and the progress of the shaft is shown in FIG. 1-2 shaded by an arrow). At this stage of osteosynthesis, the nozzle-extractor 4 performs the function of a well-known nozzle. After completion of the insertion of the rod 1 into the bone marrow canal, the nozzle-extractor 4 is removed from the groove 3 of the rod 1 and the surgical wound by the handle 5, without changing its position. The surgical wound is sanitized and closed in a conventional manner.

After the formation of bone marrow, rod 1 is to be removed from the bone. Anesthetization of the animal and preparation of the operation field is carried out according to the generally accepted method and immediate access to the proximal epiphysis of the tibia is performed. Then, placing the nozzle-extractor 4 parallel to the long axis of the bone, enter its T-shaped end 6 into the groove 3 of the rod 1 by the above method. Then, to enter into the engagement state of the T-shaped end 6 of the nozzle-extractor 4 with the rod 1, thanks to the through hole 2, the handle 5 is rotated 180 ° in any direction. After that, a force is applied by pulling the handle 5 parallel to the long axis of the bone in the direction opposite to the introduction of the rod 1 (the direction of application of the traction force and the advancement of the nozzle-extractor 4 together with the rod 1 is shown in Fig.1-2 with an unshaded arrow). At this stage, the nozzle-extractor 4 performs the function of a well-known extractor with hooks. If it is necessary to apply greater force to remove the rod 1, it is possible to use a special hammer with a slot, used in combination with various hooks to remove the intramedullary fixators. In this case, it is possible to strike on the ring of the handle 5, but on the opposite side, used when installing the rod 1. The surgical wound is sanitized and closed in a conventional manner.

As a result of the application of the proposed rod is established:

- combining the functions of the nozzle and extractor in one tool;

- exception slipping nozzles from the rod;

- prevention of injury to soft and bone tissues with an openly transported load (a hammer for osteosynthesis) and a nozzle;

- holding the rod into the bone marrow canal to the required depth;

- elimination by the surgeon of the complex expectations of tissue injury;

- elimination of crushing of the pointed ends of the rod;

- prevention of forced sharpening of the rod, violating the factory processing and reducing its inertness to tissues;

- extension of the life of the rod;

- reducing the cost of acquiring new rods.

This significantly reduces tissue trauma during intramedullary fixation of bone fragments and increases the effectiveness of the operation (see table).

Table Kernel The number of animals operated Soft tissue and bone injury Complications after surgery Proposed 8 - - Famous 8 5 3

As can be seen from the table, the use of the proposed rod, as well as a device for its introduction into the bone marrow canal and removal from the bone, is less traumatic in comparison with the known rod and devices and allows to exclude postoperative complications. The proposed rod was successfully used in the osteosynthesis of the tubular bones of 16 dogs and cats on the basis of the medical and diagnostic veterinary center of the Federal State Educational Institution of Higher Professional Education “Oryol GAU”.

Claims (1)

A rod for intramedullary osteosynthesis with two pointed ends and with through holes near them, characterized in that it is equipped with an extractor nozzle, one end of which is made in a T-shape, and the other end is made with a handle in the form of a ring, while the ends of the rod are rectangular grooves for entering the T-shaped end of the nozzle-extractor into them.

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