METHOD FOR LOCKING INTRAMEDULLARY LOCKING NAIL Russian patent published in 2024 - IPC A61B17/72 A61B17/17 

FIELD: medicine.

SUBSTANCE: method for distal blocking of an intramedullary lockable nail with a canal during osteosynthesis of long bones consists in the fact that in the position of the patient on the side in the supra-trochanteric region, a layer-by-layer incision is made to the bone, medullary canal is opened with a cannulated curved awl, image intensifier control is performed, a guide pin is inserted through a hole in the cannulated curved awl deep into the medullary canal, the curved awl is removed, closed manual reduction of the fracture is performed until the bone fragments are compared. Guide pin is delivered through both fragments and the image intensifier control is performed. Medullary canal is drilled with intramedullary drills along the guide pin. Required length of the locked nail is measured. Lockable nail is inserted into the medullary canal along the guide pin, and the image intensifier control is performed. Thereafter, a distal target is inserted, a protective guide is inserted into the lower distal opening, into which a trocar is inserted, which reaches the cortical layer of the bone, trocar is removed, a drill guide is inserted into the protective guide, through which a hole is made in the bone through both cortical layers by a drilling pin, penetrating both cortical layers and a hole in the nail. Drilling pin penetration into the lower distal locking hole is controlled by extending the guide pin in the distal direction along the nail canal, it meets the resistance of the drilling pin at the level of the lower distal blocking hole. Thereafter, a diamond-shaped plate and additional metal sleeves are fitted on the protector guide. In the center of the plate there is a hollow cylindrical elevation, inside which there is a hole for the pin and the drill, and along the perimeter of the plate of the device there are through holes, inside of which there is a thread for metal bushings, inside the bushings there is a through hole for a pin. Then, additional fixation pins are inserted percutaneously into the bone through the centering sleeves and holes in the device to prevent displacement of the distal target guide, the protector guide and the drill guide. Further, the pin inserted into the distal blocking hole is removed. Hole in the bone is drilled through a canal formed earlier with a pin by a drill guide, passing through both cortical layers and a hole in the nail. Drill is removed. Measuring device of the locking screw is inserted, a screw of the required length is selected and the locking screw is screwed into the formed hole. Fixation pins, the device for guiding the holes for the distal locking screws and the protective guide are removed. Similarly, the locking screw is delivered through the upper distal locking hole.

EFFECT: invention provides simplifying the technique of distal blocking of intramedullary blocked nails during surgical treatment by the method of intramedullary blockable osteosynthesis, preventing reduction of distal blocking strength, reducing the time of using the image intensifier, thereby reducing the X-ray load on the patient and personnel, reducing the length of the surgical intervention and the composition of the surgical team.

1 cl, 22 dwg, 1 ex