RU89815U1 - LOCK FOR TREATMENT OF SYNDACTILIES - Google Patents

Abstract

A fixator for treating syndactyly, comprising an arched element, finger holders made in the form of a bracket, and a base, characterized in that each of the holders covers a finger in its transverse direction by 30-50% of its perimeter, the center line of the arched element covering the interphalangeal joints, passes in the proximal direction above the phalanges of the fingers towards the metacarpophalangeal joints, the finger holders are connected to the base of the retainer, made in the form of stops, the length of each of which is 100-150% of the length us proximal phalanx of the injured finger.

Description

This device relates to medicine and is intended for use in the treatment of syndactyly obtained, in particular, with mechanical or thermal injury to the hand.

A device for fixing the brush. (1), consisting of a frame, in the upper part of which there are finger holders, the lower part of the frame is connected with the forearm cradle. The frame is equipped with a replaceable set of curved knitting needles of various sizes. The lodgement is made in the form of an elastic cuff, and the finger holders in the form of clamps pivotally connected to each other using lanyards. Each spoke is connected to a corresponding collar through a sleeve with a fixing hole. However, this device requires the use of knitting needles, and therefore its use in the treatment of certain types of syndactyly leads to excessive intraoperative trauma.

Closest to the claimed device is a device for fixing the brush (2), containing an arched plate with through grooves in which the finger holders are movably fixed, each of which is made in the form of a bracket with a gasket and a screw clamp, as well as a base connected to two arched plates rods with the ability to move and fix, one rod is equipped with an elastic element, and the other with a ball joint with a lock, while holes in the brackets are made for ligature or Kirchner knitting needles.

However, this device, eliminating the possibility of pinching the fingers in the plane of the palm of the hand (which is necessary when treating syndactyly), fixes the fingers in a straightened state, in which the tension forces of the skin at the base of the fingers increase. These forces can cause detachment of the skin autograft during the treatment of syndactyly. To prevent delamination, a rod with an elastic element is provided in the device (2), which presses the skin autograft during the treatment of syndactyly. However, this design of the device with an elastic element on the strand creates additional mechanical pressure on the autograft, which reduces the effectiveness of the treatment. In addition, the device (2) eliminates the mobility of the distal phalanges of the fingers, regardless of whether such fixation is required during treatment. Excessive elimination of mobility reduces the effectiveness of treatment, limits the patient's self-care capabilities, and leads to a slowdown in recovery.

The technical problem solved by the proposed device is to ensure the exclusion of the approach of injured fingers, that is, only those of their movements that can lead to a relapse of syndactyly. At the same time, the possibility of other finger movements remains, which helps to accelerate the patient’s rehabilitation, reduce treatment costs, improve the patient’s self-care capabilities and, as a result, lead to a more complete functional restoration of the injured hand in physiologically optimal terms.

The fixator for the treatment of syndactyly contains an arcuate element, holders of fingers made in the form of a bracket, and a base, each of the holders covering a finger in its transverse direction by 30-50% of its perimeter, the center line of the arcuate element covering the interphalangeal joints extends in the proximal direction above the phalanges of the fingers towards the metacarpophalangeal joints, the finger holders are connected to the base of the retainer, made in the form of stops, the length of each of which is 100-150% of the proximal length phalanges of an injured finger.

A positive result from the use of the proposed device is achieved through the use of the biomechanical effect identified during the development of this device. This effect is due to the anatomical and physiological conditions that accompany the functioning of the hand. This effect manifests itself in the fact that if you straighten your fingers, that is, open your palm, then the tension forces of the skin at the base of the fingers increase. These forces can cause detachment of the skin autograft during the treatment of syndactyly. Therefore, from the standpoint of biomechanics, it is inappropriate to force the fingers to be held in the straightened state of the palm (Figs. 1 and 2).

In addition, from the point of view of anatomy and biomechanics, it is important to ensure a rational shape of the bend line of the retainer part external to the palm. This line should bend around the joints of the fingers from the outside and pass over the phalanges, bending around the back of the hand, which is provided in the proposed device (figure 1).

It is equally important, from the standpoint of anatomy and biomechanics, to ensure a rational shape and aspect ratio of the internal part of the device, that is, that part of it that is in contact with the palm of the hand. This part of the device performs the function of the stop, limiting the clenching of the brush into a fist (figure 2). Therefore, having a set of devices differing in standard sizes, it is possible according to clinical indications to control the mobility of the fingers within the acceptable limits in the treatment of syndactyly. It is necessary to take into account that, as noted above, forced fixation of the palm in the open state is biomechanically impractical, since it leads to the appearance of an unfavorable system of forces that cause the autograft to detach in the area of the canopy of the interdigital fold.

The shape and size ratio of the device are determined in order to achieve a positive effect, taking into account the anatomical, physiological and biomechanical conditions that accompany the treatment of syndactyly. If the dimensions of the holder will allow you to cover the finger in its transverse direction by less than 30% of its perimeter, the injured finger will not be held in the anatomically correct position necessary for its fixation. If the dimensions of the holder allow you to cover the finger in its transverse direction by more than 50% of its perimeter, then there will be excessive fixation of the device, which prevents it from being installed on an injured brush and removed. If the length of each of the stops is less than 100% of the length of the proximal phalanx of the injured finger, this will lead to the convergence of the injured fingers and the possibility of acquiring repeated syndactyly. If the length of each of the stops is more than 150% of the length of the proximal phalanx of the injured finger, this will lead to straightening of the fingers, and peeling of the skin autograft.

The proposed fixator for the treatment of syndactyly (Fig. 3) consists of finger holders 1 connected to each other by means of an elastic arcuate element 2 and provided with stops 3. The holders 1 in combination with other parts of the device painlessly eliminate the possibility of approaching injured fingers, thereby eliminating the tendency to relapse of syndactyly. Element 2 rests on the back of the palm in the area of the metacarpophalangeal joints of injured fingers. The stops 3 are rigidly connected to the holders 1. Between the stops 3 and the arcuate element 2 are placed the proximal phalanges of the injured fingers.

In order to take into account the anatomical features of the brush, seven device sizes are provided.

The fixative for the treatment of syndactyly is used as follows. After carrying out standard preparatory procedures, including determining the size of the device, the fixing device is attached with a bactericidal adhesive plaster to the non-injured part of the brush. In the course of treatment for medical reasons, the patient is monitored.

According to clinical indications, the device can be equipped with additional elements, in particular, silicone inserts to reduce the stiffness of the contact interaction of the elements of the device with the fingers of the injured brush.

Alternatively, the inserts may be made of porous material. In this case, the pores of the material can be filled with medicinal substances.

The use of a fixative allows the prevention and improvement of the treatment of congenital and acquired syndactyly. Other advantages of the proposed device are its non-invasiveness, ease of manufacture, relatively low material consumption and cost.

Information sources:

1. Patent of the Russian Federation 2007147, patent class A61F 5/10, application number 4935199/14, application filing date 02/20/1991, publication date 02/15/1994.

2. Auth. certificate No. 11434417, MKI A61F 5/10, application number 3659349 / 28-13, application filing date 04.11.1983, publication date 03.03.1985.

Claims (1)

A fixator for treating syndactyly containing an arched element, finger holders made in the form of a bracket, and a base, characterized in that each of the holders covers a finger in its transverse direction by 30-50% of its perimeter, the center line of the arched element covering the interphalangeal joints, passes in the proximal direction above the phalanges of the fingers towards the metacarpophalangeal joints, the finger holders are connected to the base of the retainer, made in the form of stops, the length of each of which is 100-150% of the length us proximal phalanx of the injured finger.