RU2806051C1 - Fixing structure for kirschner wires for maxillofacial osteosynthesis - Google Patents

Abstract

FIELD: medicine.

SUBSTANCE: invention relates to maxillofacial surgery and is intended for the treatment of facial bone fractures. The prototype of our design is the wire fixation in the G.A. Ilizarov apparatus. The fixing structure for Kirschner wires for maxillofacial osteosynthesis consists of two sliders and an even number of wire holders placed on two parallel axial wires. The slider has a through oblong hole for the rod, two through holes for the axial wires and two holes for the fixing bolts. The spoke holder has interconnecting holes for the Kirschner spoke, for the axial spoke and for the fixing bolt. The structure is mounted on a flat distractor rod and fixed with nuts. The Kirschner wire is inserted into the bone fragment through the oblong hole of the wire holder, while the required position of the wire is ensured by angular movements of the wire in the hole of the wire holder and rotations of the wire holder on the axial wire. A Kirschner wire inserted into the bone is secured by screwing in a bolt. The proposed fixation design provides rigid fixation of two, three or four Kirschner wires in external devices and maxillofacial osteosynthesis devices. The advantages of the design are its versatility and variability for osteosynthesis tasks, depending on the nature of the facial injury, the area of damage and the required number of wires to hold the bone fragment. The peculiarity of the design and fastening of the wire holders provides freedom of angular movement of the wires for cross insertion into the bone fragment. The cross insertion of the spokes, provided by the inventive device, increases the rigidity of fixation of bone fragments using external devices.

EFFECT: fixing structure is compact, small in size, easy to use, lightweight and convenient for the patient.

1 cl, 8 dwg

Description

The invention relates to maxillofacial surgery and is intended for the treatment of fractures of the facial skull.

A device for osteosynthesis of mandibular fractures is known (A.A. Datsko, USSR author's certificate No. 1149954, class A61B 17/56, 06/29/83). The disadvantage of the device is its bulkiness and heavy weight, as well as the presence of a large number of structural units in the form of movable brackets, arcs and other elements that reduce the rigidity of the device in the event of any loosening of the connection. A conditional disadvantage in terms of functionality is the narrow specialization of the device, which limits its scope of application.

Shvyrkov's compression-distraction apparatus is also known (M.B. Shvyrkov, 2003, patent No. 2264189, A61B 17/60), the scope of which is also limited to the lower jaw. The disadvantage of the device is the presence of massive parts that fix the spokes, the use of a special type of threaded wires, as well as the parallel arrangement of the spokes, which limits the capabilities of the device in providing rigid fixation of bone fragments.

The closest in technical essence, adopted as a prototype, is the Ilizarov apparatus (G.A. Ilizarov, 06/09/1952, USSR author's certificate No. 98481), which provides rigid fixation of fragments due to the cross arrangement of the spokes in the bone. The advantage of the device is the method of fixing wires that penetrate bone fragments, in which both ends of the wire are secured in a fixing ring covering the damaged limb. The negative side of the advantages of the Ilizarov apparatus is its inapplicability where it is impossible to apply a fixation ring with full coverage of the damaged bone.

The well-known Ilizarov apparatus cannot be used for fractures of the facial bones, to which, as a rule, there is only one-sided access, and the complex geometry of the facial skull excludes the possibility of applying enclosing fixing rings.

The purpose of the claimed invention is to increase the rigidity of fixation of bone fragments during osteosynthesis of facial skeleton fractures with apparatus and devices.

The problem to which this invention is aimed is to eliminate the disadvantages of fixing the pins in external devices and maxillofacial osteosynthesis devices.

The technical result to be achieved by the claimed invention is to reduce the size and weight of the device for fixing the spokes in the device, increase the freedom of angular movements of the Kirschner spokes in the fixation device, prevent slippage of the spokes in the device, and compatibility of the removable device with various external devices.

The technical result is achieved by the fact that in the fixing structure for Kirschner spokes, including two sliders, two axial spokes and at least two spoke holders, an all-metal slider, made in the shape of a hexagon, has a through oblong hole for the rod and is located on the distractor rod fixedly away from rotation with the possibility of axial movement, two holes for axial spokes and two end holes for fixing bolts, the axial spoke is installed in the hole of the slider with the possibility of axial movement and a fixed position, and the spoke holder, made in the shape of a metal hexagon, has a hole for the fixing bolt, oblong through transversely intersecting holes for the Kirschner wire and the axial spoke, and is movably mounted on the axial spoke, with the ability to occupy fixed positions at the required angle.

The through oblong holes of the sliders allow axial movements of the structure and prevent its rotation on the distractor rod. Elongated, intersecting in transverse directions, through holes for spokes in the spoke holder provide mobility of the working spoke in the spoke holder, mobility of the spoke holder on the axial spoke and the possibility of simultaneously securing the spoke and spoke holder in the required position using a fixing bolt. The mobility of the pin in the pin holder and the pin holder on the axial pin provide a wide range of pin positions when choosing the required angle of its insertion into the bone fragment. The modular principle of installation of the fixing structure allows you to change the number of pin holders in the structure, depending on the nature of the facial injury and the required number of working pins required to hold the bone fragment. The length of the axial spokes is selected in accordance with the required number of spoke holders. Cross insertion of the wires into the bone fragment provides the necessary rigidity of fixation by preventing displacement of the fragment in all planes.

The essence of the claimed invention is illustrated by drawings and diagrams presented in Fig. 1-8: in FIG. 1 shows a diagram of the fixing structure; in fig. 2 - design diagram without spoke holders; in fig. 3 - diagram of the device and general view of the slider; in fig. 4 - diagram of the device and general view of the spoke holder; in fig. 5 - general view of the fixing structure; in fig. 6 - diagram of the angular movements of the Kirschner spokes in the oblong hole of the spoke holder; in fig. 7 - diagram of the angular movements of the Kirschner spokes together with the spoke holder on the axial spoke; in fig. 8 - general view of the fixing structure with Kirschner wires fixed at arbitrary angles.

The inventive fixing structure for Kirchner spokes includes two sliders 1 and 2, two axial spokes 3 and at least two spoke holders 10. The slider 1, 2 is made in the form of an all-metal hexagon, has a through oblong hole 6 for the rod, two through holes 4 for the axial spoke 3 and two holes for the fixing bolts 5. The axial spoke 3 is installed in the hole 4 of the slider 1, 2 with the possibility of fixation, the length of the axial spoke is determined by the number of spoke holders in the structure. The spoke holder 10, made in the form of an all-metal hexagon, has communicating holes: a through oblong hole 11 for the working spoke, a through oblong hole 13 for the axial spoke and a perpendicularly located hole for the fixing bolt 12. The spoke holders 10 are installed through the axial holes 13 on the axial spokes 3, located in pairs, on both axial spokes, maintaining the symmetry of the structure. The structure, through the oblong holes 6 of sliders 1, 2, is installed on a flat distractor rod 7 and fixed with nuts 8.

The inventive fixation structure for Kirschner wires works as follows. The installation of the structure is carried out in accordance with the surgical intervention plan, the spoke holders 10 in an amount sufficient to fix the required number of Kirschner spokes 9 are installed in pairs on the axial spokes 3 of the appropriate length. The axial spokes 3 are fixed in the sliders 1, 2 by screwing in the bolts 5. The structure is installed through the through oblong holes 6 of the sliders 1, 2 on the distractor rod 7, the position of the structure on the rod 7 is fixed with nuts 8. After anesthesia and treatment of the surgical field, the structure is placed in the required place 10 mm above the skin, then loosen the bolt 12 in the pin holder 10 and pass the Kirschner wire 9 through the through oblong hole 11. The angle of inclination of the Kirchner pin 9 required for insertion into the bone fragment is ensured by the rotation of the pin holder 10 on the axial pin 3 and the freedom of the angular movements of the spoke 9 in the oblong hole 11 of the spoke holder. The needle is inserted into the bone fragment using a surgical drill. After inserting the 9 Kirschner wire into the bone, it is rigidly fixed in the wire holder 10 to the axial wire 3 by screwing in the bolt 12. In the same way, the manipulation is repeated with other Kirschner 9 wires in the wire holder 10, achieving a cross arrangement of the wires in the bone fragment.

Thus, the proposed fixation design allows for rigid fixation of the required number of Kirschner wires in external devices and maxillofacial osteosynthesis devices. The advantages of the design are its versatility and adaptability to the tasks of osteosynthesis; the modular principle of the device allows you to change the number of component elements during installation, depending on the nature of the facial injury, the area of damage and the required number of wires to hold the bone fragment. The peculiarity of the design and fastening of the wire holders provides freedom of angular movement of the wires for cross insertion into the bone fragment. The cross insertion of the spokes, provided by the inventive device, increases the rigidity of fixation of bone fragments using external devices. The fixing structure is compact, small in size (26×22×7 mm), easy to use, lightweight and comfortable for the patient.

Section "Brief description of drawings".

In FIG. Figure 1 shows a diagram of the fixing structure: 1, 2 - sliders; 3 - axial spoke; 4 - hole for the axial spoke; 5 - bolts; 6 - through oblong hole of the slider; 7 - distractor rod; 8 - nut; 9 - Kirschner wire; 10 - spoke holder; 11 - through oblong hole; 12 - mounting bolt; 13 - axial oblong hole.

In FIG. Figure 2 shows a diagram of the fixing structure without spoke holders: 1, 2 - sliders; 3 - axial spokes; 4 - holes for axial spokes; 6 - through oblong hole of the slider; 7 - distractor rod; 8 - nut.

In FIG. Figure 3 shows the slider, device diagram and general view: 4 - holes for axial spokes; 6 - through oblong hole for the distractor rod.

In FIG. 4 shows a spoke holder, a diagram of the device and a general view: 10 - a spoke holder; 11 - through oblong hole; 13 - axial oblong hole.

In FIG. Figure 5 shows a general view of the fixing structure for sleep

In FIG. Figure 6 shows a diagram of the fixing structure in a lateral view with angular movements of the Kirschner wire in the through oblong hole of the spoke holder.

In FIG. Figure 7 shows a diagram of the fixing structure in a forward view with angular movements of the spoke holder on the axial spoke.

In FIG. Figure 8 shows a general view of the fixing structure with Kirschner wires fixed at arbitrary angles.

Claims (1)

A fixing structure for Kirschner wires for maxillofacial osteosynthesis, containing two sliders, two axial spokes and at least two spoke holders, characterized in that each slider is made of solid metal in the shape of a hexagon with two holes for axial spokes and two end holes for fixing bolts, in this case, the slider is located on the distractor rod fixed from rotation with the possibility of axial movement, the axial spoke is installed in the hole of the slider with the possibility of axial movement and a fixed position, and the spoke holder is made in the form of a metal hexagon with communicating holes for the fixing bolt and transversely intersecting oblong through holes for the spokes Kirschner and for the axial spoke, while the spoke holder is mounted on the axial spoke movably with the ability to occupy fixed positions at an angle.

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