RU187382U1 - DEVICE FOR FIXING ANGLE OF BENDING OF THE KNEE JOINT WITH ITS TOTAL ENDOPROTHETISION - Google Patents

Abstract

The utility model relates to the field of medicine, namely to traumatology and orthopedics, and can be used to impart and securely fix the required bending angle in the knee joint during the operation of total knee replacement.

The technical result of the utility model is to optimize the conditions for the operation of total knee replacement, namely:

- during surgery for a better overview and surgical treatment of bones and all parts of the knee joint, it becomes possible to set the required bending angle in the knee joint, up to the maximum possible, as well as reliably fix the lower limb in this position for a long time;

- there is the possibility of attracting fewer assistants during the operation;

- reduction of financial costs for consumables and equipment maintenance.

The result of the utility model, namely, instantaneous and reliable fixation of the required bending angle in the knee joint during the operation of total endoprosthetics, is achieved due to the fact that the body is made of two hollow pipes interconnected by transverse crossbars; at the opposite ends of the body are made on a pair of legs; each pair of legs is connected by a concave-shaped support pad to accommodate the support portion of the latch.

Description

The utility model relates to the field of medicine, namely to traumatology and orthopedics, and can be used to impart and securely fix the required bending angle in the knee joint during the operation of total knee replacement.

Changing the angle of flexion in the knee joint during the operation of total knee arthroplasty can be done in three ways: using the hands of an assistant, various mechanical tires - positioners, or using various stops under the foot, delivered to the hospital complete with an operating table.

The most common way to set and fix the required angle of flexion in the knee joint during surgery is to resort to the help of an assistant. He bends the lower limb in the knee joint to the angle necessary for a better view and instrumentation by the surgeon of the femur and tibia, then fixes the lower limb on the operating table.

The disadvantages of this method are:

- the mandatory presence in the operating team of another additional assistant, which is often impossible due to a lack of free medical personnel;

- with an overweight patient, it is not uncommon for an assistant to be physically unable to maintain a predetermined bending angle in the knee joint for a long time, which is required to treat the femur and tibia, as well as all parts of the knee joint, an "unstable" fixation of the bending angle occurs. This leads, albeit to a slight extension in the knee joint, but to a sufficiently significant loss of visualization. As a result, the surgical process is often interrupted or difficult, which is one of the reasons for the increase in the duration of the operation.

The use of mechanical positioner tires [http: //www/innomed/net/kneepositioners.htm/product2620] for flexion of the lower limb in the hip joint, and as a result in the knee joint, is one of the best methods. The device is placed on the operating table under the lower limb of the patient. Either the lower leg or thigh is laid and fixed on the tire, depending on the model of the device. During the operation, the surgeon, moving the splint (proximal or distal) along the base of the positioner, can set any angle of flexion or extension in the hip joint, due to which there is a change in the angle of flexion in the knee joint, as well as reliably fix the lower limb to the stage necessary for surgical processing time.

These devices are reusable, universal for both the right and left lower limbs. The disadvantages are:

- high cost, most often some of the elements of the device are either disposable or require sterilization;

- the need for maintenance.

There are various stops under the foot [http: //www/innomed/net/kneepositioners.htm/product2725], which are mounted on the operating table. Most often these are stops, delivered to the hospital complete with an operating table. The disadvantages of this method are:

- it is possible to set just a few possible bending angles in the knee joint;

- in the presence of severe extensor contracture in the knee joint, it is possible to set the lower limb at least to the first position only after mobilization of soft tissues and removal of pathological bone growths.

- In order to achieve the maximum possible flexion in the knee joint necessary for treating the tibial plateau and implanting the tibial component, the assistance of an assistant will be required.

The problem to which the claimed utility model is directed is to expand the arsenal of technical means used during knee replacement surgery.

The technical result of the utility model is to optimize the conditions for the operation of total knee replacement, namely:

- during surgery for a better overview and surgical treatment of bones and all parts of the knee joint, it becomes possible to set the required angle of flexion in the knee joint to the maximum possible, as well as reliably fix the lower limb in this position for a long time;

- there is the possibility of attracting fewer assistants during the operation;

- reduction of financial costs for consumables and equipment maintenance.

The result of the utility model, namely, instantaneous and reliable fixation of the required bending angle in the knee joint during the operation of total endoprosthetics, is achieved due to the fact that the body is made of two hollow pipes interconnected by transverse crossbars; at the opposite ends of the body are made on a pair of legs; each pair of legs is connected by a concave-shaped support pad to accommodate the support portion of the latch.

The figures depict:

Figure 1. Image of the device, where 1 is the body, 2 is the transverse crossbar, 3 is the legs, 4 is the supporting platform.

Figure 2. The image of the G-shaped emphasis is the device retainer, where 5 is the L-shaped emphasis, 6 is the supporting part, 7 is the fixed part.

Figure 3. The image of the device in assembled form and laying the patient on the operating table, where 1 is the device body, 5 is the L-shaped emphasis, 8 is the clamp-clamp, 9 is the lateral emphasis.

The device (Fig. 1) is made of titanium. This ensures its low weight without loss of strength. Titanium does not react with detergents and disinfectants, as well as with local antiseptics, which could lead to its corrosion. The device does not require sterilization, it is easy to handle, reusable and universal for both the right and left lower limbs.

The device (frame) has the shape of a rectangle 76 cm long, 15 cm wide on legs 7 cm high. The frame body 1 (Fig. 1) is made of two large hollow pipes 76 cm long and 2.5 cm in diameter, interconnected by transverse crossbeams 2 10 cm long, 0.4 cm in diameter, the distance between which 4.5 cm. Two pairs of legs 3 are located opposite each other at opposite ends of the device body 1. The legs 3 of the housing 1 are located at a distance of 7 cm from the extreme crossbeams 2. A pair of legs 3 are connected to each other by a concave support platform 4 of a length of 24.5 cm and a width of 2.5 cm for installing an L-shaped latch (stop) 5.

L-shaped clamp 5 (Fig. 2) with a diameter of 1 cm consists of two parts. Part 7 of the L-shaped retainer 5, for fixing in the base of the standard retainer to the table, has a length of 14.5 cm; supporting part 6 of the retainer 5 for location on the supporting platform 4 with a length of 9.5 cm

The lateral emphasis 9 and the clamp-clamp 8 (Fig. 3, 4) have the dimensions and shape specified by the manufacturer of the operating table.

The device is used in the following way. The device is installed on the operating table under the operated lower limb transverse rails 2 under the thigh. At the level of one leg 3 of the device, which is most conveniently located so as not to interfere with the operation, a clamp-clamp 8 is fixed on the base of the operating table. The housing 1 of the device is fixed by means of a L-shaped clamp 5 in the hole of the clamp 8. A part of the clamp 7 is inserted into the hole of the clamp 8 , and the supporting part 6 is installed on the supporting platform 4 of the building 1. At the level of the thigh, a vertical thigh stop 9 is fixed to the operating table in order to prevent the lower limb from being removed in the hip joint after it is bent into the pelvis joint and knee joints. After treating the lower extremity with an antiseptic, the body 1 and the vertical stop 9 are covered with sterile operating linen.

During the operation, the surgeon bends the operated leg in the hip and knee joints, rearranging the foot along the frame, inserting the toes of the foot between the bars to the stop, thereby setting any necessary bending angle in the knee joint and fixing it for the time required to process one or another part of the knee joint.

With maximum bending in the knee joint to an acute angle, open anteriorly and fixing the foot on the ladder frame, a reaction is created that is directed along the axis of the lower leg from the distal to the proximal. As a result of this, there is a subluxation of the tibia anteriorly (front drawer), which creates comfortable conditions for processing the tibial plateau. Due to the good visualization of the posterior plateau, its sawdust occurs with minimal risk of damage to the posterior cruciate ligament and hamstring muscle tendon. Also, due to good visualization, the removal of pathological bone growths from the posterior tibial condyles, the final preparation of the plateau and the implantation of the tibial component is facilitated.

Clinical example

Patient N was admitted for surgery, with a diagnosis of right-sided gonarthrosis of 3 tbsp., Flexor-extensor contracture. The angle of flexion of the knee joint was 110 degrees, extension of 130 degrees. The operation is performed using the claimed device. At the first stage, after anesthesia, a bending angle of 95 degrees was set. After mobilization of the soft tissues of the joint, it was possible to bend the joint to 75 degrees, which allowed the sawdust of bones necessary for implantation of the knee joint implant. Thanks to the device, the patient's leg was fixed at different angles without the help of an assistant; It was possible to complete this operation in a shorter time than using another assistant and using standard stops.

Thus, the proposed device allows you to optimize the conditions for the operation of total knee replacement, not to involve additional medical personnel and reduce the time of surgery.

Claims (1)

A device for fixing the angle of flexion of the knee joint during its total endoprosthetics, including a rectangle-shaped body, characterized in that the body is made of two hollow pipes interconnected by transverse beams; at the opposite ends of the body are made on a pair of legs; each pair of legs is connected by a concave-shaped support pad to accommodate the support portion of the latch.

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