RU2489104C2 - Device for removal of double-rod fixer from bone - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to traumatology and orthopedics. Device for removal of double-rod fixer from bone includes handle with hook on end. In handle made is through longitudinal canal for rod of holder, and in upper part of handle - wider canal with internal thread, in which between head of holder and bottom of canal placed are spring, head of holder and bolt rod. Working end of holder is placed at distance from internal surface of hook, exceeding width of fixer. Distance between upper concave surface of hook and lower transverse surface of handle is not less than double width of fixer, with working ends of holder and hook being made with slants, whose planes are parallel and face each other.

EFFECT: increased quality of removal of double-rod fixer from bone after puncture osteosynthesis by more reliable grip and removal of fixer by device.

2 cl, 4 dwg

Description

The invention relates to medicine, namely to traumatology and orthopedics, and is intended to remove a two-rod retainer from the body, used in surgical treatment of patients with metaphysical bone fractures.

Previously, we invented a method of surgical intervention for fractures of the neck of the humerus (RF patent No. 2272592), including puncture of soft tissues with a tube and the implementation of osteosynthesis through its lumen with a two-rod clamp. The invented two-core fixator for osteosynthesis (RF patent No. 2254089) consists of a bent in half elastic-elastic knitting needle with two pointed ends, which are inserted into the bone, leaving a curved section of the fixative - an arc over its surface. After the bone has been consolidated to remove the double-rod retainer using known surgical instruments, it is necessary to make a soft tissue incision larger than when installing the retainer in order to capture the retainer arch left over the surface of the bone. The difficulties of capturing and removing such a fixative through a minimal surgical incision with conventional surgical instruments prompted us to develop a special device for extracting a double-rod fixative from the bone.

Known bone tongs Langenbek containing two branches with handles connected by an axis, and teeth are made at the ends of the branches (Chaklin VD Fundamentals of operative orthopedics and traumatology. Publishing house "Medicine", M., 1964. S. 24).

A disadvantage of bone forceps is that the jaws with opposing teeth have enlarged dimensions of the working end of the instrument and require a sufficiently wide surgical incision of soft tissues to bring it to the arc of the two-rod retainer, which increases surgical trauma. To capture the arc of the two-rod retainer, it is necessary to dilute the branches with teeth in the depth of the operating wound, which increases the invasiveness of surgical intervention. When the retainer held by the teeth is removed from the wound, discrepancy of open jaws with loss of the retainer is possible. A disadvantage of bone forceps is the lack of signs in them of improving the quality of surgical treatment by less traumatic and more reliable capture and removal of the two-rod retainer from the bone after puncture osteosynthesis.

Known bone single-tooth hook containing a handle with a curved pointed working end (Chaklin V.D. ibid., P.23).

The disadvantage of this tool is the lack of structural elements in it to prevent the hook from escaping from the retainer loop, which does not ensure the reliability of the capture of the lock, which leads to the need for repeated capture attempts to remove the lock from the bone, increasing the duration and invasiveness of the surgical intervention. There are no signs in this tool of improving the quality of surgical treatment by less traumatic and more reliable capture and removal of the two-rod retainer from the bone after puncture osteosynthesis.

Closest to the technical nature of the proposed device is the last given bone single-tooth hook, which we take as a prototype, and its disadvantages are described above.

The technical result consists in improving the quality of surgical treatment by less traumatic and more reliable capture and removal of the two-rod retainer from the bone after puncture osteosynthesis.

The technical result is achieved by the fact that the device for removing the two-rod retainer from the bone includes a handle with a hook at the end. In the handle there is a longitudinal through channel for the holder rod, and in the upper part of the handle there is a wider channel with an internal thread, in which a spring, a holder cap and a bolt rod are placed between the head of the holder and the bottom of the channel. The working end of the holder is placed from the inner surface of the hook at a distance exceeding the thickness of the latch. The distance between the upper concave surface of the hook and the lower transverse surface of the handle is not less than double the thickness of the latch, while the working ends of the holder and hook are made with bevels, the planes of which are parallel and facing each other.

In a preferred embodiment, a rigid loop is made on the screw head in the plane of its axis.

The essence of the technical solution and a specific example of the device is illustrated by drawings. Figure 1 shows the device, side view. Figure 2 is the same front view. Figure 3 is the same, bottom view. Figure 4 - the working end of the device after capturing the periosteal part - the arc of the retainer. Figure 1-4 marked: 1 - the handle of the device; 2 - a through channel under the holder rod; 3 - a wide channel with an internal thread in its upper part for a screw; 4 - the bottom of the wide channel; 5 - bottom surface of the handle; 6 - hook on the working end of the handle; 7 - the bottom surface of the hook; 8 - the upper surface of the hook; 9 - pointed bevel end of the hook; 10 - the inner surface of the hook; 11 - rod holder; 12 - bevel of the working end of the rod of the holder; 13 - hat holder; 14 - spring holder; 15 - screw with external thread; 16 - screw head; 17 - a ring of a screw head; 18 - cortical surface of the bone; 19 - an arch of a clamp; 20 - spoke retainer in the bone; 21 - the second spoke of the retainer in the bone.

They work like this. Before using the device, a screw 15 is installed by rotating the ring 17 so that the working end of the holder rod 11 does not extend from the lower opening of the through channel 2. Through the small incision of soft tissues above the cortical bone surface, the working end of the device is inserted into the wound before the fixation loop. The pointed end 9 of the hook is brought into the arc 19 of the latch. By applying force to the rigid ring 17, the spokes 20 and 21 are removed longitudinally from the handle 18 from the bone 18 and the two-rod retainer is removed from the wound.

The significance of the differences of the invented device is as follows. The implementation of a through longitudinal channel in the handle under the holder rod provides the ability to direct the holder exactly to the end of the hook, to exclude the hook exit from the arc of the two-rod clamp, which increases the width of the wide channel with an internal thread, in which a spring, a holder hat and a rod are placed between the head of the holder and the bottom of the channel bolt, ensures that the holder is held by the spring outside the hook. In the initial position, the placement of the working end of the holder from the inner surface of the hook at a distance greater than the thickness of the latch does not prevent the passage of the arc of the latch between the hook and the end of the holder. The presence of a screw allows it to be pressed onto the head of the holder when screwing it in, compressing the spring and installing the holder on the end of the hook, covering the retainer arc from all sides and excluding the locking of the retainer arc from the device. The distance between the upper concave surface of the hook and the lower transverse surface of the handle is not less than double the thickness of the latch, makes it possible to hold the hook immediately under two arcs of the two latches to simultaneously remove both latches. The execution of the working ends of the holder and the hook with bevels, the planes of which are parallel and facing each other, provides a tight contact of the surfaces of their ends and eliminates the hook and injury of body tissues by a hook when removing the device from the surgical wound. The presence of a rigid loop on the screw head in the plane of its axis makes it possible to apply additional longitudinal force with fingers or a lever to extract the retainer from the bone.

Thus, the claimed device in the aggregate of its features provides an increase in the quality of removal of the two-rod retainer from body tissues after puncture osteosynthesis by more reliable capture and extraction of it from the bone by the device. Using the invented device reduces injury to body tissues, reduces the time spent on staff work and creates an economic effect.

The application of the invention is possible in pediatric and field surgery, as well as in veterinary medicine.

Claims (2)

1. A device for removing a two-rod retainer from the bone, including a handle with a hook at the end, characterized in that the handle has a through longitudinal channel under the holder rod, in the upper part of the handle there is a wider channel with an internal thread, in which between the head of the holder and the bottom the channel contains a spring, a hat of the holder and a bolt rod, and the working end of the holder is placed from the inner surface of the hook at a distance exceeding the thickness of the latch, the distance between the upper concave surface of the hook and The transverse surface of the handle is not less than double the thickness of the latch, while the working ends of the holder and hook are made with bevels, the planes of which are parallel and facing each other. 2. The device according to claim 1, characterized in that a rigid loop is made on the screw head in the plane of its axis.

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