SU1500266A1 - Method of fixing fragments of the lower jaw - Google Patents

Abstract

This invention relates to medicine, namely to oral and maxillofacial surgery. The purpose of the invention is to provide uniform contact between fragments with the prevention of trauma to the neurovascular bundle. This is achieved by inserting the spokes of the apparatus at an angle of 5-15 ° to the plane of the body of the mandible in the direction from the base of the alveolar process through the entire thickness of the bone, followed by bending them under the external fixation device and creating equal efforts at the ends of the spokes. 2 Il.

Description

This invention relates to medicine, namely to maxillofacial surgery.

The purpose of the invention is to provide uniform contact between fragments with the prevention of trauma to the neurovascular bundle.

FIG. 1 schematically shows a device for implementing the method, front view; in fig. 2 shows section A-A in FIG. one.

The method is carried out as follows.

In order to manually reposition the fragments under local or general anesthesia, metal needles 1.5 mm in diameter are inserted into the bone fragments in a bone fragment, retreating from the fracture plane by 15 mm. The spokes of the apparatus are inserted into the outer segment of the jaw body, which is anatomically safe area, at an acute angle (5-15 °) to the plane of the jaw body from the base of the alveolar process through the entire bone from the bottom downwards in such a way so that the ends of the spokes come out under the edge of the same half of the lower jaw from the inside. With such an introduction, the metal spokes do not injure the neurovascular bundle of the jaw, the neurovascular plexus of the teeth

and can be located in the bones of the lower jaw non-parallel. After the introduction of the spokes, they are bent under the external fixation device and create equal forces at the ends of the spokes. After the introduction of the spokes 1, the device is pre-assembled, for which the ends of the compression-distraction rods 2 are passed through the threaded joints of the coupling sleeves 3, and the washers are put on the studs 4 of the sleeves 3

5, leaving a distance to the forearm

6, which is necessary for the free installation of the spokes 1. Then, through the slots on the inner surface of the washer 5, the free ends of the spokes 1 are passed, which is achieved by the coupling sleeves 3, which have all degrees of freedom with respect to the spokes 1. Using the lock nut 7, the heads of the coupling sleeves 3 are fixed motionless on the compression-distraction rods x 2. Compression is required or distraction is achieved by rotating the hex tide 8, located in the middle of the compression-distraction rod 2, with a wrench. If it is necessary to correct the position of the fragments relative to the longitudinal axis, the heads of the connecting

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Coupling 3 around the axis of the compression-distraction rod 2 of one of the spokes 1, after having loosened the locknut 7.

Example. Ill L., 25 years old, entered the clinic of surgical dentistry on February 29, 80. From the analysis it is known that she was beaten by an unknown man on February 26, 1980. Diagnosis at admission: Bilateral fracture of the lower jaw (to the right in the chin section, to the left in the articular region appendix without debris displacement). Due to the fact that the right fracture was complicated by bone wound suppuration, as well as the presence of inflammatory infiltrate, the operation was performed only 07.03.80. after the elimination of inflammatory processes. Previously, temporary immobilization of fragments was used, on March 7, 80, an apparatus was applied and the fragments were tightly fixed. In view of the fact that the patient has a second fracture in the region of the mouse muscle process on the left without displacement of the fragments, the immobilization of the mandible by the Pomerantseva-Urbanskaya bus was applied. On April 22, 80, the apparatus was removed, a full fusion of the fragments occurred clinically and radiographically, despite the resulting inflammatory complication. After seven days, no traces of the apparatus overlap can be traced.

The positive effect of this method is that the bilateral fixing of the ends of the spokes 1 ensures a firm and reliable fixation of the bone fragments. In addition, there is no need to carry out systematic monitoring to determine the stiffness of their fixations and to perform additional compression. The method allows the correction of the position of the bone fragments after application of the apparatus, both along and around the horizontal axis of the body of the mandible. The use of two thin needles with a diameter of 1.5-2.0 mm reduces trauma to the bone tissue. The spokes 1 pass through the outer segment of the jaw body, which is an anatomically secure area.

Claims (1)

Invention Formula The method of fixation of the mandible fragments by external fixation, characterized in that, in order to ensure even contact between the fragments with the prevention of trauma to the neurovascular bundle, the spokes of the apparatus are held at an angle of 5-15 ° to the plane of the body of the mandible. process through the entire thickness of the bone, followed by bending them under the external fixation device and create equal efforts at the ends of the spokes. 8 cjfjual 7W cfJuB.2