MINIMALLY INVASIVE SURGERY FOR BONE RECONSTRUCTION THROUGH THE
METHOD OF ELASTIC OSTEOSYNTHESIS DYNAMICAL STABILISED
The aim of the project is to develop a new method for the treatment of great trochanteric
fractures. This method is based on medial (centromedular) fixation, with elastic implants,
which has the purpose to realize an elastic assembly, consisting of the bone and the implant, and a
dynamic stabilization realized with a tensile plate, which does not eliminate the elastic characteristic of
the assembly.
This system for bone reconstruction through elastic osteosinthesis dynamical stabilised
as well as the surgical method has been studied in many national research projects
carried out in partnership with very important institutions: Colentina Emergency Hospital
- The Orthopedy and Traumatology Clinique, The Centre of Exellence in Mechanical Engineering
and Tribology from POLITEHNICA University from Bucharest,
SC RODAX IMPEX SRL.
The novelty of the project consists in fixing a tensile plate with screws, only distal and
proximal, maintaining the elastic characteristic of the assembly, stabilizing the capacity of sustaining
the fragments in the case of instable fractures and eliminating the
undesirable effects of torsion.
The tensile plate has the function to stabilize dynamic the intertrochanteric fractures
of the femor. Nevertheless, the intermedular nails has the main fixing role of the two bone fragments,
because of the small dimensions of their sections (0,5mm) and because of their arc form and their
flexibility, the fracture is not stabile in the condition of comminutive fractures.
The tensile plate, being positioned on the lateral side of the femor, has this role to stabilize dynamical
the assembly.
The plate acts as a tensile band which is opossite to varization forces, ensuring also the
stability of the entire assembly.
1 – Femor
2 – Centromedulare Implants
3 – Tensile Plate
4 – Autodrilling Screws
Distal, the plate is fixed to femor with two bicortical screws, which pass the distal holes
which are visible after the cut of the plate at the optim dimensions.
After the distal fixation, the proximal screw is tightened, which because of its oblique
position realizes a pressure upon the plate.
Advantages:
- it is a minimally invasive procedure which has low cost and short surgical time
and ensures an initial fixation and the stabilization of the fractured great trochanter
and enables a fast recovery of the patient. These are essential qualities of the method,
because it is used to treat older patients, which have many problems, and also politraumatic
patients.
- the minimally invasive character of this surgical procedure, which utilizes a simple,
ergonomic and easy to handle instrumentation, together with a well established
surgical method, enables a rapid surgical intervention, mechanical corect and with
a minimal traumatism for the patient.
- The surgical intervention has a short duration and the bleeding is minimal, which
is a positive aspect considering the problems of the patient. So, the patient is rapid
mobilized after the surgery (generally after 3 days), without any complications which
appear frequantly in these cases.
OBJECTIVES:
1. To research and to analyze the specific requirements which have to be fulfilled by the elastic
assembly with dynamic stabilization.
2. To settle the biomechanic aspects regarding the realization of the assembly in
accordance with the minimally invasive characteristics established for the system for the
dynamic stabilization.
3. To settle the design and the requirements of the system in accordance with
the characteristics of the minimally invasive surgery.
4. To settle the requirements for the selection and for the establish of the biocompatible
materials of the implant plate and the afferent instrumentation.
5. To analyze the pressure plate modifications under different loads with the method of
finite element analyzis.
6. To carry out the system and to evaluate it in preclinic laboratory conditions.
7. To demonstrate the functionality of the system in clinic conditions and to realize
the clinic evaluation.
8. To analyze the Life Cycle Assessment of the system.
9. To realize an optim network among the partners in order to facilitate the communication
of the researchers from diferent domains (surgeons, engineers, chemists, phisicists etc.)
to put in practice as soon as possible the results of the project.
10. To realize a management and a financial coordination of the project in order to
fulfill its objectives.