RU2482809C1 - Method of stabilisation and reposition in extrafocal osteosynthesis of fractures of pelvic bones - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to field of medicine, namely to traumatology and orthopedics and can be used for surgical treatment of fractures of pelvic bones. During operation first pin is passed in the body of iliac wing in anterior-posterior direction from anterior-posterior spine to posterior-upper spine of pelvis as reinforcing pin. Two other pins are passed under it perpendicular to it and to iliac bone plane and are bent perpendicular to first pin and iliac bone plane with creation of crossing in spongy iliac bone in the area of pin passage. Pins are fixed in Ilizarov's apparatus.

EFFECT: method ensures stable fixation of bone fragments in correct position for a long time to the moment of their fusion, excluding migration of pins and infection of pelvic bones in postoperative period, possibility of early functional loading.

1 ex, 5 dwg

Description

The invention relates to medicine, namely to traumatology and orthopedics, and can be used for the surgical treatment of pelvic fractures.

The use of extra-focal osteosynthesis for pelvic fractures presents significant difficulties due to the spongy structure of the pelvic bones. The spokes held in the cancellous bone cut through it in a short time and the structure holding on to them becomes unstable. This leads to the displacement of spokes, bone fragments, infection of soft tissues, their inflammation.

Known methods of fixation of fractures through the holding of short cross knitting needles are not widely used because of the impossibility of stable fixation of fragments and the outer parts of the needles [1].

Closest to the claimed is a method of osteosynthesis of the pubic and sacroiliac joints using the fixation unit of the bundle of short intersecting needles [2].

The disadvantages of the prototype are: firstly, the lack of production and sale of the original retainer of the spoke bundle and, therefore, the only possibility of using it only in the author's version. Secondly, even a bunch of knitting needles in a small area of the spongy bone is not able to provide long-term fixation of the spokes as a result of crushing of the spongy bone at the fixation site, which inevitably leads to migration of the spokes and loss of stability of the entire apparatus.

The technical task and the social effect of this method is the high efficiency of stabilization of the external fixation apparatus, reposition and retention of fragments in the correct position, functionality in the treatment of this pathology; use of accessible tools; the possibility of early functional load.

The proposed method of stabilization and reposition for extra focal osteosynthesis of the pelvic bones using the Ilizarov apparatus consists in the fact that during the operation the first knitting needle is carried out in the body of the iliac wing in the anteroposterior direction from the anteroposterior spine to the posterior-upper spine of the pelvis, beneath it, perpendicular to it and to the plane of the ilium and bend perpendicular to the plane of the ilium and the first spoke, and create a cross in the cancellous ilium in the area of the spokes.

Significant differences of the proposed method are: holding the first knitting needle in the body of the ilium wing as a reinforcing support in the cancellous bone for the remaining spokes held perpendicular to it and bent perpendicular to its axis; intersecting stresses in the area of the needles are distributed along the entire length of the first reinforcing support spokes held along the entire length of the ilium wing, providing stable fixation along the entire length of the ilium wing, ensuring high efficiency of stabilization of the external fixation apparatus, reposition and holding fragments in the correct position in for a long time until the bone fragments are fused, functionality in the treatment of this pathology; the possibility of early functional load.

The method is illustrated by a clinical example with reference to the drawings and radiographs, where:

Figure 1. Type of pelvic bones with knitting needles.

Figure 2. The initial x-ray in direct projection.

Figure 3. Operation: fixation of the Ilizarov apparatus on the ilium wing and thigh, removal of the prosthesis.

Figure 4. Postoperative x-ray in direct projection.

Figure 5. General view of the patient.

Clinical example: Patient A., 43 years old. Diagnosis: Instability of the endoprosthesis of the hip joint, central dislocation of the head of the prosthesis (figure 2). The operation is performed (figure 3, 4), after applying the apparatus to the pelvis

the endoprosthesis was removed and the central femoral dislocation was eliminated.

Literature

1. V.I. Stetsula. A.A. Ninth Transosseous osteosynthesis in traumatology. - Kiev "Health", 1987. - P.87 (prototype).

2. Besaev G.M. Treatment tactics and methods for fixing severe pelvic injuries in the acute period of injury. Guidelines. - St. Petersburg., 1997 .-- 14 p. (prototype).

3. Besaev G.M. Methods for treating pelvic injuries. RF patent №2111716 from 05/27/98. Priority from 11/15/95.

Claims (1)

A method of stabilization and reposition for extra focal osteosynthesis of the pelvic bones using the Ilizarov apparatus, including extra focal osteosynthesis with a beam of short knitting needles, characterized in that during the operation the first knitting needle is carried out in the body of the iliac wing in the anteroposterior direction from the anteroposterior spine to the anteroposterior the pelvic spine as a reinforcing needle, the other two are held beneath it perpendicular to it and to the plane of the ilium, bend perpendicularly to the first spoke and the plane of the ilium and create a cross in spongy ilium in the area of the knitting needles.

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