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INVENTION
Patent of the Russian Federation RU2284783
METHOD OF OPERATIONAL TREATMENT OF MEDICAL FRACTURES OF THE CORD OF THE FEMALE BONE
The name of the inventor: Dubrovin Grigory Mendelevich (RU); Kovalev Petr Vladimirovich (RU); Kovaleva Elena Aleksandrovna (RU); Mechenkov Sergey Anatolievich (RU); Doroshev Mikhail Evgenievich (RU)
The name of the patent owner: Kovalev Petr Vladimirovich (RU)
Address for correspondence: 305041, Kursk, ul. K. Marx, 3, KSMU, Patent Department, Z.N. Kupriyanovoy
Date of commencement of the patent: 2005.03.09
The invention relates to medicine, namely traumatology and orthopedics, and may be applicable to the treatment of medial fractures of the femoral neck. Establish in a subjective area on a directing spokes the washer having in the center an aperture with a carving under the screw. Introduce through the holes on the periphery of the washer along the course of the neck of the hip, four V-shaped bent spokes. Install the washer without threads on the washer with spokes. Fix the two washers together with a screw, releasing the "rays" of the V-shaped spokes. The method prevents the migration of the spokes and the displacement of the fragments.
DESCRIPTION OF THE INVENTION
The invention relates to medicine, namely traumatology and orthopedics, and can be used in the treatment of medial fractures of the femoral neck.
There is a method of fixation at the fracture of the proximal femur by V-shaped spokes (AF Lazarev, EI Solod "NNPriorova Herald of Traumatology and Orthopedics N12004, M .: Medicine) .This method is not very traumatic and technically Is simple, at the same time the quality of fixation of fragments is not inferior to traditional methods of osteosynthesis, and even exceeds their quality of treatment.
However, this method, like all traditional (three-lobed nail, screws), does not have sufficient fixation strength and, in addition, the tension of the spokes obtained immediately after synthesis decreases with time due to developed osteoporosis, and as a result, needle migration and displacement of fragments are often observed .
The object of the invention is to increase the efficiency of the synthesis of medial fractures of the femoral neck by strengthening the stiffness of fixing the implant by fixing the V-shaped spokes in a double washer, both halves of which are connected with a screw.
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The task is achieved due to the fact that a circular washer with a diameter of 19 mm is installed along the guide spokes in the subject area. In the center of the washer, there is a round hole with a screw thread with a diameter of 5.0 mm. To strengthen the threaded part of the washer in the center, there is a round shape of an influx of 7 × 3 mm. Along the circumference there are 8 holes 2.0 mm in diameter in the periphery of the washer, which are located 7 mm from the center of the washer. Through the holes in the periphery of the washer, four V-shaped spokes with a diameter of 2.0 mm of the required length are inserted along the neck of the hip. After installing the spokes in the bone tissue of the femoral neck and their impaction, a washer with a diameter of 19 mm and a thickness of 2.0 mm with a center hole without threads for a screw with a diameter of 5.0 mm is installed over the washer with spokes. With a screw diameter of 5.0 mm and a length of 10.0 mm, both washers are fixed to each other, thereby releasing the V-shaped spokes in the area of their bending. After such compression an additional tension of the spokes is created, which strengthens the fixation strength of the fragments.
The description of the invention is illustrated by the figures:
1 shows fixing washers with a screw;
"A" - washer with spokes;
"A" - washer with spokes (rear view);
"B" - clamping washer;
"B" - the screw;
FIG. 2 shows a general view of the fixing implant. FIG.
The method is carried out as follows.
Under general anesthesia under aseptic conditions, a closed reposition of fragments of the neck of the femur with a preliminary fixation of their spokes under fluoroscopic control is performed. A cut of the skin and subcutaneous tissue along the external surface of the femur is made in a 5 cm-long susceptible region (Fig. 2). The exposed area of the femur is exposed layer by layer. Under the fluoroscopic control with the aid of the guide needle, the depth of insertion of the implant in the neck and head of the proximal femur is determined. After that, a washer "a" with holes for V-shaped bent spokes is installed along the guide spokes. A drill with a diameter of 2.0 mm alternately through the holes of the washer is perforated 8 channels in the cortical part of the subjective region of the thigh in the places of supposed introduction of the implant. Further along the vein of the femoral neck, V-shaped spokes are installed, their impaction is performed. Then, with the help of the screw "c", the clamping washer "b" is fixed to the washer "a" with spokes (Fig. 1). When the screw is screwed, a mutual tension occurs in the "implant-bone" system due to the extension of the "beams" of the V-shaped spokes, Which significantly increases the rigidity of fixation. The total destructive effect of the implant on the bone tissue of the cervix and the femoral head is minimal.
Then the wound is sewn layer by layer. In the postoperative period in the hip joint, active movements are carried out without load on the leg for 6-7 months. Additional immobilization of the damaged joint is not performed.
A clinical example.
Patient M. 1959 year of birth, entered the traumatology department of the railway hospital in Kursk 01.02.05. The case history №94-2. Diagnosis: Closed subcapital fracture of the neck of the left femur with displacement.
After a general clinical and radiological examination, 02.02.05, a closed reposition of the fragments with fixation by a spin-screw system was performed according to the described method. In the postoperative period, immobilization was not applied.
Thus, the task has been achieved by carrying through the fracture region of the femoral neck four V-shaped curved 2.0 mm spokes from the outer surface of the subject area, followed by fixing the spokes with two washers fixed with a screw.
CLAIM
A method for the surgical treatment of medial fractures of the femoral neck, including the installation of V-shaped bent spokes, characterized in that a washer is installed in the susceptible region along the guide spokes, having a screw-threaded hole in the center; through the holes along the periphery of the washer, four V-shaped bent spokes, a washer without threads is installed over the washer with spokes, the two washers are fixed with a screw, detaching the "beams" of the V-shaped spokes.
print version
Date of publication 06.01.2007gg
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