Surgery – Instruments – Orthopedic instrumentation
Patent
1990-03-20
1990-12-18
Hafer, Robert A.
Surgery
Instruments
Orthopedic instrumentation
606 57, 606 59, 606105, A61F 504
Patent
active
049783475
DESCRIPTION:
BRIEF SUMMARY
FIELD OF THE ART
The invention relates generally to medical engineering used in orthopedics and traumatology and more specifically, to distraction apparatus for osteosynthesis of short tubular bones.
PRIOR ART
Human hand plays an immense part in man's activities due to its ability to perform complicated and diversified functions. Being the organ engaged in man's labour activities the hand is most frequently liable to sustain traumatic lesions both occupational and domestic, as well as various diseases.
There has been observed a considerable increase in the number of congenital malformations of the hand and foot resulting from administration of sedatives within the initial gestation period. This in turn has promoted considerable progress in the development of surgery of the hand. However, despite the advantages attained in development of external fixation apparatus for short tubular bones, light pathology of the hand still remains one of the most sophisticated problems of present-day traumatology and orthopedics. The aforesaid difficulties stem from the fact that the majority of fixation appliances are aimed at solving the problem of treatment alone, whereas success of treatment is most frequently dependent on a possibility of attaining multiple aims with the aid of a fixation apparatus.
One prior-art orthopedic device for bone fixation (FR, A 2,559,380) is known to comprise a rigid plate carrying two clamps holding fixation pins, each of the clamps comprising two grips which can be interconnected through screws, while at least one of the clamps is movable lengthwise the plate axis. Such a construction arrangement of the clamps enables fixation of each bone fraction separately and makes it possible to stretch out the bone by moving one of the clamps along the plate. However, it should be noted that such a displacement of the bone fragments is insufficiently graduated and cannot therefore assure a required displacement length and rate. In addition, some difficulties arise whenever it becomes necessary to simultaneously stretch out two or more metacarpal bones or digital phalanges.
One state-of-the-art framework for bone fixation (U.S., A, 4,554,915) is known to comprise control members for adjustment of arms in length. An open slot is provided in the other end of the arms adapted to receive a pin connectable to a corresponding bone section. Appropriate members are provided for rigid interconnection of the pins and arms. The fixing unit incorporates also connecting members to join said unit with a second row of pins which are connected to the other bone section on the other side of the fracture.
The aforesaid bone fixation framework is applicable for immobilization in cases of simple diaphyseal fractures of short tubular bones, since it ensures immobilization of bone fragments only on the opposite sides of the fractured bone but cannot be used for stretching-out the metacarpal bones, digital phalanges, or correct their deformaties.
Widely differing from the aforediscussed appliances is the construction of a distraction apparatus for children's hand (cf. Orthopedics, traumatology and prosthesis application, No. 7, 1985, Moscow, `Surgical treatment of congenital developmental defects and acquired deformities of the hand in children using distraction techniques`, by A. P. Tiazhelkov, pp. 30-32 (in Russian). The distraction apparatus comprises a support unit shaped as a cramp-like plate provided with through holes, two fixing pins secured between the arms of said plate, distraction units provided with distraction pins, made similarly to the support unit and positioned in parallel thereto, and distraction threaded rods passing through the open-end holes in the cramp-like plates to interconnect the latter. Pairs of the pins are coplanar with the respective cramp-like plates so as to pass through the bones in the dorsopalmar direction when the apparatus is positioned on the hand.
However, clinical trials have shown that passing of the pins in the dorsopalmar direction and their bringing out on the palmar aspect
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Orthopedics, Traumatology and Prosthesis Application, No. 7, 1985, Moscow, "Surgical Treatment of Congenital Development Defects and Acquired Deformities of the Hand in Children Using Distraction Techniques," by A. P. Tiazhelkov, pp. 30-32.
Brown Michael
Hafer Robert A.
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