RU2669480C1 - Fixing element for external bone fixation device and tool for its installation - Google Patents

Abstract

FIELD: medicine.SUBSTANCE: invention relates to medical equipment. Fixing element to the threaded rod of the external fixation apparatus of bones is made of a solid metal in the form of a nut with a hexagonal lateral surface, an axial threaded hole and a slot extending from the side surface to the threaded hole. Slot is made from a threaded hole extending to the side surface. Slot at the intersection with the threads of the threaded thread is congruent with the profile of the threaded thread of the mating threaded rod with a gap between them. Transverse dimension of the threaded hole at the intersection of this hole with the slot is larger than the transverse dimension of the mating threaded rod. Metal of the fastener element is capable of plastic deformation under load to ensure the contact of the turns of the threaded connection of the nut and the threaded rod. Tool for mounting the above fastening element to the threaded rod of the external fixation apparatus of the bones comprises two metal arms connected by an axial hinge. Each lever comprises a grip and a spongy working part with a clamping surface, each clamping surface being provided with a three-sided cutout. Sponges together form a symmetrical through-cutout of the hexagonal shape to encompass the hexagonal side surface of the nut and to allow the threads of the threaded connection of the nut and the threaded rod to contact.EFFECT: invention provides for expansion of the existing range of fastening elements used in external fixation devices, which ensure fast and reliable fixing of parts by threaded connection.15 cl, 21 dwg

Description

The field of technology.

The invention relates to medical equipment used in traumatology and orthopedics, is used in devices and devices for external fixation of bones and their fragments (fragments). It can be used with the Ilizarov apparatus for medical and transport immobilization of bone fragments, as well as for the planned treatment of bone fractures and deformities.

The level of technology.

There are many devices and apparatuses for the treatment of bone fractures and deformities, according to the Ilizarov method, by transosseous osteosynthesis. External transosseous fixation is also the method of choice for emergency stabilization of the musculoskeletal system in the wounded and injured in industrial accidents and natural disasters, in road or military injuries with injuries of the musculoskeletal system. The time of installation, dismantling, reassembly of the external fixation apparatus is one of the key criteria for emergency surgical care and a significant indicator in the planned treatment of fractures and deformities. Fast and stable fixation of bones and their fragments is crucial for stabilizing the patient's condition and preserving his life and health during emergency surgical care. The time of installation and dismantling during planned treatment has an impact on the final condition of the patient, the comfort of treatment, and the overall labor costs of the medical service. In order to stabilize bone fragments, external (external) fixation devices are used, for example, Ilizarov apparatus. In devices (devices)

external fixation for fastening parts often used threaded connection and such fasteners (products) as a nut.

Known apparatus G.A. Ilizarov for transosseous osteosynthesis (source [1]: patent SU 1055499). It contains supports in the form of flat rings with holes, threaded rods, reposition units, bone retainers, and fasteners in the form of washers, nuts and fixing bolts.

Known traction unit for transosseous apparatus (source [2]: patent RU 116037). Contains a sleeve with a threaded shank and a locking mechanism, a threaded rod, a moving nut, a fixing nut. The locking mechanism is made in the form of a lining provided with a hole and a groove.

Known rod compression and distraction apparatus, reposition unit and means for axial movement of transosseous rods (source [3]: patent RU 2140224). The apparatus contains a movable and fixed frame in the form of arcs with holes, rods with threads at the ends, on which are holders with transosseous rods. A reposition unit is located between the frames. The reposition unit uses a removable rotation mechanism in the form of a clamp, the bracket of which is made with the possibility of fastening on the rod, and the clamping screw - with the possibility of fastening to the arc with slots by means of a bracket made in the form of a union nut with an eye located between two nuts.

Fasteners (M6 nuts) described in the sources [1; 2; 3] made of metal in the form of a hexagonal prism with an axial threaded hole, mounted on a threaded rod by screwing from the side of any free end of the rod. Nuts [1; 2; 3] cannot be mounted on a threaded rod if its ends are not free.

Quick-release fasteners are known in the art. As a rule, these are detachable fastening nuts for quick installation, which consist of two or more parts. For example, a union nut made of plastic is known (source [4]: patent RU 2300025). A nut made of plastic has two halves of a nut equipped with internal thread, made with the possibility of assembly using a connection using hooks and a connection using spring clips.

The nut [4] is not intended for use with external (external) fixation devices (AVF); it is adapted for screwing on the body of the intake fittings onto the outlet pipe of the tank for transporting and storing liquids and bulk materials made of plastic or metal. The nut [4] is not suitable for use with external fixation devices. Plastic does not provide the necessary tightening force and the reliability of the fastening of parts of the external fixation apparatus. The outer surface of the nut does not provide for the use of an additional lever (key) for tightening the nut, which also does not allow providing the necessary tightening force necessary to lock the nut and securely fasten the parts. The design of the nut [4] contains 4 components and is inconvenient for use, as it requires additional manipulations during installation, and in addition there is a risk of loss (loss) of individual elements during or before installation.

Known fastener (Source [5]: AMF catalog Andreas Mayer GmbH & Co. KG, nut "DIN 6333SB - AMF-TWINNUT", article AMF 381848, AMF 381772 website http://www.amf.de/de/ home /, access mode: http://www.amf.de/application/amf_app000000?SID=2109610140&ACTIO NxSETVAL (artlist.htm, AARTxNR: 381848, APGxNR: 6333SB, USERxARTI KEL: artlistsuche.htm) = Z). The nut [5] is metal hexagonal, for quick installation consists of two connected parts and a retainer. The first part is movably connected to the second part, so that one part forms the right half, and the second left. Thread metric M6, nut height 9 mm, turnkey size 10 mm. The nut [5] is mounted on the free end of the threaded rod. When you click on the first part, it rotates on the axis and moves away from the second part, which allows you to stretch the nut along the threaded rod without screwing.

The fastener [5] cannot be mounted on a threaded rod if its ends are not loose. The design of the nut [5] is technologically complex and time-consuming to manufacture.

Zimmermann /

Kroh (Разделить гайка сократит расходы за счет облегчения сборки «от 19.07.2007 | Автор / Редактор: Дитмар Шньер и Йорг Циммерман / Радигер Кро), режим доступа: http://www.maschinermiarkt.vogel.de/geteilte-schaubemnutter-spart-kosten-durch-leichtere-montage-a-71081/; источник [7]: режим доступа: http://www.twinnut.com/information/). Крепежный элемент [6; 7], гайка шестигранная разделенная на две части, одна часть образует правую половину, а вторая левую. Две части, которые идентичны по своей внешней форме, имеют сопрягаемые выступы и углубления. Каждая часть имеет половину резьбы.Known fastener, detachable nut (Source [6]: website http://www.maschinenmarkt.vogel.de, article "Geteilte Schraubenmutter spart Kosten durch leichtere Montage" dated 07/19/2007 | Autor / Redakteur: Dietmar Schnier und

Zimmermann /

Kroh (Split the nut will reduce costs by facilitating assembly “07/19/2007 | Author / Editor: Dietmar Schnier and Jörg Zimmermann / Radiger Kro), access mode: http://www.maschinermiarkt.vogel.de/geteilte-schaubemnutter-spart -kosten-durch-leichtere-montage-a-71081 /; source [7]: access mode: http://www.twinnut.com/information/). Fastening element [6; 7], the hex nut is divided into two parts, one part forms the right half, and the second left. Two parts, which are identical in their external form, have mating protrusions and recesses. Each part has half thread.

Fastening element [6; 7] is not convenient to use, since the parts form a single whole only with a strong tightening, in a weakened state they are easily separated from one another. When loosening the nut [6; 7], its parts fall apart and it loses its place on the threaded rod. The composite design of the analogue [6; 7] is inconvenient to use, since during installation it is necessary to hold two parts, and with periodic tightening and loosening, there is a risk of losing (dropping, losing) any part.

Known fastener, quick nut (Source [8]: AMF catalog Andreas Mayer GmbH & Co. KG, Schnellspannmutter nut No. 6332S M6 o.Bund AMF, article No. 6332S website http://www.amf.de/ de / home / access mode: http://www.amf.de/application/amf_app000000?SID=2109610140&ACTIO NxSETVAL (artlist.htm, AARTxNR: 88146, APGxNR: 6332S, USERxARTIKEL: artlistsuche.htm) = Z). Nut [8] prefabricated hexagonal metal 9 mm high, metric thread M6, turnkey size 16. Material steel hardened and galvanized. It consists of two parts of the upper and lower, one located above the other, connected by a groove and a shoulder. Both parts have a through threaded hole and a straight cut (notch) extending from the threaded hole to the side face. The size (width) of the slot corresponds to the outer dimension of the threaded thread M6 of the rod on which the nut is mounted. One part is rotated relative to the second part, so that in one position the slots made in each part are aligned and the nut is easily installed on the threaded rod, in another position (if one part is turned relative to the other), the slots are directed in different directions and the nut mounted on the threaded rod, cannot be removed from it. To install, push the nut directly onto the screw thread (threaded rod) at the mounting location, and then lock it. If the lower part of the nut is adjacent to the mounting location, the upper part is rotated 1/4 or 1/2 turn.

The fastener [8] is not convenient to use, since during operation, the components in a weakened state easily rotate one relative to another. Each part has its own outer hexagonal surface and when loosening, there is a risk of accidentally turning one part relative to the other, so that the slots are aligned and the nut is removed from the threaded rod. The design of the nut [8] is technologically complex and time-consuming to manufacture. The design of the nut [8] provides a movable one-piece connection of two parts, requires a flange on one part and a groove on the other, for which a certain amount of material is required, therefore, with a metric thread M6 in the nut hole, its turnkey size is 16, whereas in In practice (as for example in sources [1; 2; 3]) it is customary to use a standard 10 wrench for the M6 nut. The slot in the nut [8] is made straight, equal in width to the largest diameter of the threaded rod, therefore, when installing the nut, you must see the threaded erzhen and accurately correlate the slot with the threaded rod.

Nowhere in the sources [5; 6; 7; 8] there is no information on the use of the described fasteners with external (external) fixation devices, and in general in medical equipment. Materials of analogues 4; 5; 6; 7; 8 are not intended for use in medicine, do not have the necessary strength, corrosion resistance, biological inertness, necessary resistance to known sterilization methods.

The prior art knot transverse movement to the apparatus of external fixation (source [9]: patent RU 132717). The assembly consists of a housing, a lead screw, a slider located on the lead screw, and a thrust nut. The slider is made in the form of a rod with a threaded part. The thrust nut is screwed onto the threaded portion of the slide. The solid metal thrust nut is made in the form of a hexagon with a through threaded hole, contains a straight slot (notch) passing from the threaded hole to the side face. The thrust nut is made of metal with a slot (notch) corresponding to the diameter of the slide rod, the faces of the slot are parallel to each other. The diameter of the slide rod is smaller than the diameter of its threaded portion. The thrust nut is inserted into the slider shaft with a slot and then screwed onto its threaded part. The slot (notch) in the thrust nut has a width less than the diameter of the thread.

The thrust nut described in this analogue [9] is the closest analogue. The solid metal thrust nut is made in the form of a hexagon with a through threaded hole, contains a straight slot (notch) passing from the threaded hole to the side face. The size of the slot (width) corresponds to the diameter of the slider shaft. The diameter of the threaded part of the slider is larger than the diameter of the shaft of the slider, the slot in the thrust nut has a width less than the diameter of the threaded part. Therefore, the thrust nut can be screwed onto the threaded part of the slider only if it has been previously cut through the smaller diameter of the slider shaft. It is impossible to install the thrust nut [9] directly on the threaded part so that it fulfills its function (tightening, fastening). You cannot install the thrust nut described in the source [9] on a threaded rod that does not contain grooves that reduce its diameter, if its ends are not free. The slot in the nut [9] is made straight, equal in width to the smallest diameter of the threaded rod, therefore, when installing the nut, you must see the shaft and precisely correlate the slot with the shaft.

For assembly or disassembly of various parts, including fasteners in the technique, hand-held fitter's and assembler's tools, for example pliers and pliers, are used for clamping and gripping parts of various shapes.

Known pliers (source [10]: patent RU 2009033) containing two pivotally connected to each other handles (levers) with clamping jaws at one end. The sponge on the working surface has teeth, a cutting half-cylindrical groove and notches with teeth.

The geometrical shape of the working surface of the jaws does not correspond to the geometrical shape of the outer surface of a hex nut with a turnkey size of 10. The source [10] does not contain information about the use of pliers in medicine, in particular for the installation of fasteners. The analogue material [10] is not intended for use in medicine; it does not have the necessary strength, corrosion resistance, biological inertness, and resistance to known sterilization methods.

Known pliers designed for gripping and clamping pipes and parts of various shapes (Source [11]: Interstate standard. GOST 17438-72 Pliers. Specifications. IPK publishing house of standards. Moscow. 07/01/73. Available on the Internet, access mode: http : //files.stroyinf.ru/Data1/21/21386/#i446530). The pliers contain two levers connected by an axial joint, each lever contains a handle and a working part in the form of a sponge with a clamping surface. The clamping surface contains a flat corrugated (notch) part and is equipped with a corrugated cutout in the form of a circumference (round cutout with corrugation, serrated recess). The jaws are located opposite (oppositely symmetrical about the longitudinal axis of the tool). With squeezed grips of pliers, the clamping surfaces of the jaws in the flat part converge closely, and the grooved notches of the jaws made in the form of a part of a circle form a symmetrical through cut of an elliptical shape. Pliers have protective and decorative metallic and non-metallic coatings. The surface roughness Ra of the pliers is in the range of 1.6 to 6.3 μm. Pliers with a length of 160, 180, 200, 250, 300 mm. Pliers are made of steel grade 50 according to GOST 1050-88. Mass fraction of elements: carbon 0.47-0.55%, silicon 0.17-0.37%, manganese 0.50-0.80%), chromium not more than 0.25%.

In the source [11] there is no information on the use of pliers to install fasteners for external bone fixation devices. The analogue material [10] is not intended for use in medicine; it does not have the necessary biological inertness, resistance to known sterilization methods, and corrosion. The geometric shape of the working surface of the jaws does not match the geometric shape of the outer surface of the hex nut in size 10 turn-key.

A device for implanting interspinous fixator (source [12]: patent RU 125457). Pliers-pliers contain two pivotally connected levers containing a working part in the form of jaws and a handle. On the working surfaces of pliers, pliers, a sensitive element is removed - a pressure sensor.

Known tool pliers (source [13]: patent US 4893530, Plier-type tool), suitable for use in medicine for capturing bone. Tool [13] contains two levers connected by a hinge. The levers contain a handle and a working part in the form of sponges. The levers have the ability to slide in the hinge, which ensures the adjustment of the distance between the working surfaces of the jaws. The working (clamping) surface contains a flat corrugated part and is equipped with a corrugated cut-out in the form of a part of a circle. With squeezed grips of pliers, the clamping surfaces of the jaws in the flat part converge closely, and the grooved notches of the jaws made in the form of a part of a circle form a curly symmetrical through cut-out of an elliptical shape.

In analogues [12; 13] the geometrical shape of the working surface of the jaws does not correspond to the geometrical shape of the outer surface of a hex nut with a turnkey size of 10. There is no information in the source [12] about the use of pliers to install fasteners for external bone fixation devices and material.

Known pliers for twisting wire (source [14]: electronic catalog of medical instruments of the company Maxima Med LLC, section "Medical Instruments for Traumatology | Instruments for Traumatology | Pliers, side cutters, nippers, pliers", website http: // medinstrument.su, access mode: http://medinstrument.su/catalog/?product=1220). The pliers are an articulated medical clamping tool. The pliers contain two levers pivotally connected. The levers have handles and a working part in the form of sponges with a flat clamping surface. The working parts are brought together by the oncoming movement of two articulated halves (levers). Tool length 170 mm.

In analogue [14], the working surface of the jaws is flat, does not contain cutouts, and is not suitable for installing a fastener made in the form of a hex nut. In the source [14] there is no information about the material.

SUMMARY OF THE INVENTION

The objective of the invention is the need to expand the existing arsenal of fasteners used in external fixation devices, providing quick and reliable fixation of parts by threaded connections.

The technical solution allows you to expand the arsenal of existing fasteners used in the design of apparatus for external fixation of bones providing sufficient reliability of the tightening and fastening of parts. The technical result consists in reducing the complexity of mounting and dismantling the apparatus for external fixation of the bone, faster fixation of bone fragments and reducing the time for medical and transport immobilization.

The technical result is achieved in that the fastening element to the threaded rod of the apparatus for external fixation of bones is made of solid metal in the form of a nut with a hexagonal side surface, an axial threaded hole, and a slot extending from the side surface to the threaded one. The slot is made expanding from the threaded hole to the side surface, the slot at the intersection with the turns of the threaded thread is congruent to the thread profile of the mating threaded rod with a gap between them, the transverse dimension of the threaded hole at the intersection of this hole with the slot is larger than the transverse dimension of the mated threaded rod, metal fastener element is capable of plastic deformation under load to ensure contact between the turns of the threaded connection of the nut and the threaded rod.

Preferably, the material of the fastener should be resistant to periodic exposure to biological fluids, thermal and chemical sterilization. The material should provide the possibility of plastic deformation of the fastener during installation (squeezing, clamping) and at the same time maintain sufficient strength and rigidity when tightening to provide the necessary force, sufficient to hold the parts during connection. The hardness of the material should be in the range of 18 to 36 HRC. The fastener can be made of titanium alloy brand VT6. It is envisaged that the fastener may have a protective and decorative coating. A protective and decorative coating can be obtained by anodic oxidation, nickel plating or chromating. For use with the Ilizarov apparatus, the fastener must contain a threaded hole with a metric thread of M6 × 1, have a turnkey size of 10, a height in the range of 4 to 6 mm, and surface roughness Ra in the range of 0.22 to 1.25 μm.

The fastener is mounted on the threaded rod and secured by plastic deformation (compression, crushing) with a special tool.

The tool for installing the fastener to the threaded rod of the external bone fixation device contains two metal levers connected by an axial hinge. Each lever contains a handle and a working part in the form of jaws with a clamping surface, while each clamping surface is equipped with a trihedral cut. The jaws together form a symmetrical through-hole of a hexagonal shape to cover the hexagonal lateral surface of the nut and to allow contact between the turns of the threaded joint of the nut and the threaded rod.

The tool for installing the fastener to the threaded rod of the external bone fixation device must be stronger and harder than the fastener, and also must be resistant to periodic exposure to biological fluids, thermal and chemical sterilization. It is provided that the tool can be made of 40X13 steel according to GOST 5632-72 and has a hardness of the clamping surface of the working part in the range from 52 to 60 HRC Rockwell units, while the levers are subjected to heat treatment, hardening and tempering. The tool may have a protective and decorative coating obtained by nickel plating or chromating. Preferably, the tool has a surface roughness Ra in the range of 0.32 to 1.25 μm. Convenient for creating the necessary effort and use of the tool, the total length is in the range from 130 to 200 mm. Most (at least 65%) of which falls on the length of the handles. To install a fastener adapted to the Ilizarov apparatus in the tool, the trihedral cut-out must have such dimensions that the jaws together form a symmetrical through cut-out of a hexagonal shape with an internal size of 10 mm and the width of the jaws of at least 10 mm.

The above essence ensures the achievement of the claimed technical result.

The invention is illustrated by graphic materials, which show:

FIG. 1 - fastener, general view;

FIG. 2 - fastener, top view;

FIG. 3 - fastener and mating threaded rod, view from the side of the slot, before compression of the fastener;

FIG. 4 - blank for fastener, cross section;

FIG. 5 - blank for fastener, cut a slot;

FIG. 6 is a drawing of a workpiece to increase the transverse dimension of a threaded hole;

FIG. 7 - fastener, top view, cross section;

FIG. 8 - blank for fastener with grooves;

FIG. 9 - blank for fastener with grooves;

FIG. 10 - tool, general view;

FIG. 11 - tool, top view, the levers are unclenched;

FIG. 12 - tool, top view, levers are compressed;

FIG. 13 - tool, threaded rod and mounting element, General view;

FIG. 14 - instrument, embodiment, general view;

FIG. 15 - tool, embodiment, top view, the levers are unclenched;

FIG. 16 - tool, embodiment, top view, levers are compressed;

FIG. 17 - external fixation apparatus mounted on the shoulder (fragment shown), a support block mounted using fasteners is shown;

FIG. 18 is a reference block of an external fixation apparatus installed using fasteners;

FIG. 19 is a support block of an external fixation apparatus installed using fasteners and washers with a cutout;

FIG. 20 - mounting element mounted on a threaded rod, before compression, cross section.

FIG. 21 - mounting element mounted on a threaded rod, after compression, cross section.

Implementation of a technical solution.

The fastening element (Fig. 1; 2; 3) for the apparatus for external fixation of bones is made of solid, metal alloyed stainless steel 20X13. The fastening element is made in the form of a nut with a hexagonal side surface 1 (Fig. 1; 2), an axial threaded hole 2 (Fig. 1; 2), and a slot 3 (Fig. 1; 2). The initial contour 4 (Fig. 2) of the cross-section of the fastener is a hexagon, the distance between the faces is 10 mm, the key size is 10. The height of the fastener is in the range from 4 to 6 mm. The slot 3 is made from the side surface 1 in the direction of the threaded hole 2. The slot 3 is made expanding from the threaded hole 2 to the side surface 1, with an angle in the range from 120 to 130 degrees. The pitch of the turns of the threaded thread 5 (Fig. 1) in the threaded hole 2 is 1 mm ± 0.1 mm. The profile of the threaded thread 5 of the threaded hole 2 is an equilateral triangle with an apex angle of 60 ° ± 2 °, the height of the initial triangle is 0.866025 mm ± 0.04 mm, the working height of the profile is 0.541266 mm ± 0.04 mm. The slot 3 at the intersection with the turns of the threaded thread 5 is congruent to the threaded profile of the mating threaded rod 6 (Fig. 3) with a minimum clearance between them. “Congruent” here means that the geometrical parameters of the surfaces of the slit 3 at the intersection of 7 (Fig. 3) with the turns of the threaded thread 5 corresponds to the geometrical parameters of the profile of the threaded thread (M6 × 1) of the mating threaded rod 6. Transverse dimension L (Fig. 2) the threaded hole is larger than the transverse dimension of the mating threaded rod 6. The distance between the troughs of the threaded thread 5 of the fastener is larger than the diameter D (Fig. 3) of the threaded threads of the mating threaded rod 6. The distance between the protrusions 5 bovoy slicing fastener larger than the diameter d (FIG. 3) of the valleys threading mating threaded rod 6. The metal fastening member capable of plastic deformation under load. The proportionality (yield strength) of 20X13 alloyed stainless steel is in the range from 430 to 490 MPa. Steel 20X13 chrome (chromium content from 12 to 14%) is corrosion-resistant, hardness is in the range from 18 to 24 HRC. The roughness of the outer surfaces of Ra is not more than 0.32 microns.

The blank for the manufacture of the fastener is a hex nut (Fig. 4). A slot 3 is made in the nut from the lateral surface 1 to the threaded hole 2 (Fig. 5). In order to ensure the transverse dimension L (Fig. 2) of the threaded hole is larger than the transverse dimension of the mating threaded rod 6, the fastening element is unbent by driving through the threaded rod the conical section 8 (Fig. 6), on which the thread diameter is increased. The workpiece, passing through the conical section 8, is unbent, plastic deformation occurs in the material, the transverse size of the threaded hole 2 increases. The edges 9 (Fig. 7) of the slot 3 diverge. To ensure the deformation of the material in the required place in the workpiece, grooves 10 (Fig. 8; 9) can be made over the entire height of the nut. Grooves can be made on the outer side surface 1 and / or on the inner surface of the threaded hole 2.

To perform its function (tightening, fasteners) in a threaded connection, the fastener, when installed on the mating threaded rod, must be crimped (clamped, compressed) to ensure contact between the turns of the threaded thread. In the process of crimping, the material of the fastener is deformed. The fastener is mounted on the threaded rod and secured with a special tool.

The tool (Fig. 10; 11; 12; 13; 14; 15; 16) for installing the fastener to the apparatus for external fixation of bones contains two metal levers 11 (Fig. 10; 11; 12; 13; 14; 15; 16) connected axial hinge 12 (Fig. 10; 11; 12; 13; 14; 15; 16). Each lever contains a handle 13 (Fig. 10; 11; 12; 13; 14; 15; 16) and a working part 14 (Fig. 10; 11; 12; 13; 14; 15; 16) in the form of jaws with a clamping surface 15 (Fig. 10; 11; 13; 14; 15). Each clamping surface 15 is equipped with a triangular cutout 16 (Fig. 10; 11; 13; 14; 15). The sponges together form a symmetrical through-cutout of a hexagonal shape 16 (Fig. 12; 16). Levers 11 are made of steel 40X13 (according to GOST 5632). The levers 11 are subjected to heat treatment, hardening and tempering, the hardness of the clamping surface 15 of the working part is 14 58 HRC units according to Rockwell. Quenching is carried out by induction with soft start in an inert environment. The roughness Ra of the surfaces is not more than 0.32 microns. The handles 13 shown in FIG. 10; eleven; eleven; 13 are sufficient to create a high working force, the total length of the tool is 130 mm. The distance from the axis of the axial hinge 12 to the end of the working part 14 is 26 mm

The tool shown in FIG. fourteen; fifteen; 16 has ergonomic handles 13, one of which contains recesses 17 (FIG. 14; 15; 16) for the fingers of the hand, is equipped with a spring element 18 (FIG. 14; 15; 16) providing for the separation of the levers 11. The tool shown in FIG. fourteen; fifteen; 16 has a protective and decorative coating obtained by chromating, surface roughness Ra of not more than 0.32 microns. The handles 13 in FIG. fourteen; fifteen; 16 are convenient for creating high effort. The total length of the tool is 200 mm. The distance from the axis of the axial hinge 12 to the end of the working part 14 is 45 mm. The jaws together form a symmetrical through-cut of a hexagonal shape 16 with an internal size of 10 mm. The width of the working part 14 is 10 mm. The tool is additionally equipped with wire cutters made in the form of adjacent recesses 19 (Fig. 10; 12; 13; 14; 15; 16) on the working part 14 of the levers 11 and in the form of adjacent cutting faces 20 (Fig. 14; 15). In the center of the axial hinge 12 of the tool shown in figures 10; 13, a threaded hole 21 is made for mounting an additional axis (a transverse handle, not shown in the diagrams) and threaded rods (for example, for bending or straightening them).

Using a technical solution.

The invention used in traumatology and orthopedics, together with devices for external (external) fixation of bones. In particular, it is used with the Ilizarov apparatus for the medical and transport immobilization of bone fragments, as well as for the planned treatment of bone fractures and deformities. In order to stabilize bone fragments, an external fixation apparatus (Ilizarov apparatus) is mounted on the injured limb. Mount supports of rings and / or half rings and connect them with threaded rods with M6 × 1 thread (Fig. 17; 18). For this, cross-knitting needles and / or Shants rods (screw rods) are carried out in the bones. Shantz spokes and / or rods are fixed in the supports, the supports are interconnected. The threaded rods are set so long that they, if necessary, provide the possibility of reposition and distraction. A closed reposition of fragments is carried out. To fix the repaired fragments, an additional support block 22 (Fig. 17) is made in the form of a flat arc 23 (sector, part of a flat ring, (Fig. 18) with through holes and slots. The support block 22 is fixed to the threaded rods 6 (Fig. 17) ; 18) the apparatus by the claimed fasteners 24 (indicated in Fig. 18) installed by means of the declared tool. For this, an arc of 23 slots is installed on the threaded rods 6, it is mounted on the side without mounting / dismounting the threaded rods 6. Take the fastener 24 and insert it with a slot 3 on the mating threaded rod 6 (Fig. 20.) The slot 3 is made expandable to the side face 4, and at the exit point is much larger than the diameter of the threaded rod 6, so when installing the fastener 24 there is no need to accurately correlate the slot 3 with the threaded rod 6, the lateral faces of the slot 3 perform the function of guides and the fastener 24 is easily mounted on the mating threaded rod 6 and held thereon by contact of the turns of the threaded thread. Then the tool is taken by the handles 13. The handles 13 are pulled apart, while the working parts 14 and the clamping surfaces 15 of the levers 11 diverge, turning in the axial hinge 12. The working parts 14 of the levers 11 are brought to the fastening element 24 and bring the handles 13. The fastening element 24 to the moment it is preferable to hold it compressed by the tool, so that the thread profile of thread 5 coincides with the thread profile of thread of rod 6. The working parts 14 converge. The force from the handles 13 is transmitted to the clamping surfaces 15 and presses the fastener 24 along the side surface 1. The force from the clamping surfaces 15 deforms the material of the fastener 24. The edges 9 of the slot 3 converge (Fig. 21), the distance between the edges 9 decreases, the shape of the threaded hole 2 changes (the material is plastically deformed), mating with the threaded rod 6, the contact of the turns of the threaded connection is ensured. The distance between the edges 9 of the slot 3 becomes smaller than the transverse dimension of the threaded rod 6 and the fastener 24 does not fall from it. If grooves 10 were made in the fastener 24, deformation of the material takes place in the area of the grooves 10 (Fig. 20). When installing the fastener 24, it is necessary to control the amount of force. It is necessary to create a force sufficient to compress the fastener 24, but not to create such a force that the fastener 24 is completely blocked on the threaded rod 6 without the possibility of rotation. Similarly, all fasteners 24 are mounted on threaded rods 6 and rotated all the way into the arc 23, providing the necessary tightening force. Thus, the arc 23 is fixed. Between the arc 23 and the fastener, washers with a cutout 25 can be placed (Fig. 19). The washer with a cutout 25 contains a longitudinal recess in which the locking pin 26 can be placed (Fig. 19). The Shants core is drawn into the bone fragment and its free end is attached to the arc 23. The supports of the external fixation apparatus (Ilizarov apparatus) are stabilized, and the nuts are tightened. During the period of fixation, if necessary, the dismantling of the support block 22, the fasteners 24 are weakened and the arc 23 is removed. At the same time, there is no need to mount / dismantle the supports and threaded rods of the apparatus. The fastening element 24 can be installed on the threaded rod 6, on any of its free section, in case the ends are not free (fixed in the supports). The use of the invention, which provides fast and reliable fixation of parts by means of a threaded connection, as a result, the laboriousness of mounting and dismounting an external bone fixation apparatus is reduced. The total time of installation, disassembly, and reassembly of the external fixation apparatus is reduced, which affects both the total labor costs of the medical service, the patient’s final condition, and the comfort of treatment.

The fastener and tool can be made of known materials by machining on modern industrial equipment and used on the basis of stationary surgical clinics or mobile emergency medical centers.

Claims (15)

1. The fastening element to the threaded rod of the apparatus for external fixation of bones, made of solid metal in the form of a nut with a hexagonal side surface, an axial threaded hole and a slot extending from the side surface to the threaded hole, characterized in that the slot is made expanding from the threaded hole to the side surface , a slot at the intersection with the turns of the threaded thread congruent to the thread profile of the mating threaded rod with a gap between them, the transverse dimension of the threaded holes at the intersection of this hole with a slot larger than the transverse size of the mating threaded rod, the metal of the fastener is capable of plastic deformation under load to ensure contact between the turns of the threaded connection of the nut and the threaded rod. 2. The fastener according to claim 1, characterized in that it is made of alloyed stainless steel selected from the following grades: 20X13,30X13, 14X17H2, 12X18H10T. 3. The fastener according to claim 1, characterized in that it is made of titanium alloy grade VT6. 4. The fastener according to claim 1, characterized in that the hardness of the material is in the range from 18 to 36 HRC. 5. The fastener according to claim 1, characterized in that it has a protective and decorative coating. 6. The fastener according to claim 5, characterized in that the protective and decorative coating is obtained by anodic oxidation. 7. The fastener according to claim 5, characterized in that the protective and decorative coating is obtained by nickel plating. 8. The fastener according to claim 5, characterized in that the protective and decorative coating is obtained by chromating. 9. The fastener according to claim 1, characterized in that the threaded hole has a metric threaded thread with a diameter of 6 mm in increments of 1 mm (M6 × 1), a turnkey size of 10 mm, a height is in the range from 4 to 6 mm, surface roughness Ra is in the range of 0.22 to 1.25 μm. 10. A tool for installing a fastener to a threaded rod of an external bone fixation apparatus according to claim 1, comprising two metal levers connected by an axial hinge, each lever contains a handle and a working part in the form of jaws with a clamping surface, each clamping surface having a trihedral cut , the jaws together form a symmetrical through-hole of a hexagonal shape to cover the hexagonal lateral surface of the nut and to allow contact between the turns of the threaded joint of the nut and the threaded joint ryezh. 11. The tool according to p. 10, characterized in that it contains levers made of alloy stainless steel grade. 12. The tool according to p. 10, characterized in that the hardness of the clamping surface of the working part is in the range from 52 to 60 HRC Rockwell units. 13. The tool according to p. 10, characterized in that the levers are subject to heat treatment, hardening and tempering. 14. The tool according to p. 10, characterized in that it has a protective and decorative coating obtained by nickel plating or chromating. 15. The tool according to p. 10, characterized in that the roughness Ra of the surfaces is in the range from 0.32 to 1.25 μm, the length is in the range from 130 to 200 mm.

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