RU2423945C1 - Guide for wires for fragment fixation in treatment of fractures of surgical shoulder neck - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to medicine, namely to orthopedics and traumatology, and can be used for osteosynthesis of shoulder bone by means of wires in case of fractures of surgical neck. Guide contains case, support site and handle. Case is connected with support site via handle. Handle is connected with case with possibility of rotation around axis. Support site is made in form of arch-like plate, which has hole for passing temporary fixing wire. Case for wires has 3 canals for central and extreme, angle between canals being 24°. Extreme wires cross at angle 48°. Handle is made curved.

EFFECT: invention ensures prevention of secondary displacement of fragments by passing wires in more than one plane.

2 dwg

Description

The invention relates to medicine, namely to orthopedics and traumatology, and can be used to fix fragments of the humerus with knitting needles for fractures of the surgical neck.

Known guide for fixing with needles in the treatment of fractures of the surgical neck of the shoulder, consisting of a solid body, in which there are two channels through which the needles are carried. The spokes intersect at an angle of 25 °, the angle of inclination to the axis of the upper limb 10 °. The guide is fixed to the humerus with a screw at a distance of 8 cm from the acromial process. Under the control of the electron-optical converter, reposition is performed, two spokes are carried along the guide, which cross at an angle of 25 degrees. After holding the spokes, the injured limb is immobilized according to the Turner with a wedge-shaped pillow. Knitting needles removed after 4 weeks. Immobilization lasts up to 6 weeks (S. G. Girshin. Lectures on emergency traumatology. - M .: MEDpress-inform, 2004).

This guide has the following drawback: the spokes are held in the same plane, which does not exclude the secondary displacement of fragments.

The aim of the invention is to improve the results of treatment by preventing secondary displacement of fragments.

The goal is achieved in that the casing for the spokes has 3 channels for the central and extreme knitting needles, the angle between the channels is 24 °, the extreme knitting needles intersect at an angle of 48 °; the housing through the handle is connected with the supporting platform, and the handle is connected with the housing with the possibility of rotation around the axis.

Figure 1, 2 presents a General view of the device. Designations: 1 - supporting platform, 2 - handle, 3 - body, 4 - knitting needles.

The device comprises a support pad (1) in the form of an arcuate plate with a radius of 50 mm, having a hole for holding a temporary fixing needle, a curved handle (2), a housing (3), in which there are 3 channels through which the spokes are held. Extreme knitting needles cross at an angle of 48 °. The central spoke with the outermost needles forms an angle of 24 °.

The device operates as follows: reposition is performed under the control of an electron-optical converter. The guide is installed on the outer surface of the shoulder 12 cm distal to the acromial process of the scapula. Through the support pad (1), the Kirchner fixation needle is inserted into the humerus, which prevents the guide from moving. Through the channels of the body (3), 3 Kirschner spokes are passed from the diaphyseal part to the head of the humerus, which intersect in the area of the fracture of the surgical neck, form intersecting at an angle to the plane. This achieves a fairly strong fixation. The guide and locking pin are removed. The injured limb is immobilized with a cast of plaster cast. After 3 weeks, the needles are removed, immobilization is maintained for up to 5 weeks.

An example of the practical use of the method.

G., 62 years old, was admitted to the clinic of military traumatology and orthopedics for a closed fracture of the surgical neck of the left humerus with displacement of fragments. The operation was performed according to the proposed method. The spokes were removed after 3 weeks, immobilization continued for another 2 weeks. Examined after 6 months and 9 months after surgery. Joint movements in full.

In total, 41 patients with a fracture of a surgical neck of a shoulder were operated on by the proposed technique.

All had fusion, there was no secondary displacement of fragments. No contracture of the shoulder and elbow joints.

The authors analyzed the results of treatment of patients with the proposed method and the results of treatment of 32 patients in a known manner (S.G. Girshin, 2004). It was found that in 19 patients operated on in a known manner, a secondary displacement of fragments occurred. To eliminate them, repeated surgical treatment was performed.

Thus, the proposed guide allows you to achieve fusion of the humerus while maintaining the length of the shoulder, and also prevents the secondary displacement of fragments. The latter leads to a reduction in the treatment time for patients, as well as a reduction in the radiation load on the patient and the surgical team and the time of surgical intervention, minimizing trauma to the skin.

Claims (1)

A guide for knitting needles for fixation of fragments in the treatment of fractures of the surgical neck of the shoulder, comprising a housing, a support platform, a handle, a housing through a handle connected to a support platform, a handle connected to the housing for rotation about an axis, characterized in that the support platform is made in the form of an arcuate plate having a hole for holding a temporary locking knitting needle, the spoke housing has 3 channels for the central and extreme knitting needles, the angle between the channels is 24 °, the extreme knitting needles cross at an angle of 48 °, the handle is made of duck

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