Background Art Reposition of fractures of upper extremities-forearm, wrist and arm is performed in present time at most surgical working sites, including clinics, under assistance of two persons who ensure traction in longitudinal axis of extremity while surgeon performs correction of angle shift manually, whether in sense of deviation in horizontal or vertical planes. This is reason why surgeon has limited access to the place of operation itself and to operation itself and he or she is forced to use only one hand to operation itself because he or she tries to correct fragments of bones to right position with other hand. Coordination of all three involved persons in reaching of ideal position is very arguable, while all three persons are exposed to risk of exposition by X-rays.

Orthopaedic tables, or extension devices are used on clinics but only to reposition of lower extremities on the bed, e. g. from CS AO (author's certificate) No. 251 540, or 265 124. Orthopaedic tables are demanding and complicated devices which are not available in outpatients'departments in micro-surgery of upper extremities. It is possible to act only by vertical pulling in longitudinal axis of broken extremity in known special devices. There are known also fixation and convertible devices from patent literature. It is known, for example from CS P No.

276 503 extension device in the form of frame construction fixed on metal table where horizontal movable arms in the shape of the"L"letters with possibility of vertical moving. The device is further equipped with screw turnbuckles with variability of movement. The above mentioned device is suitable for reposition of extremities, chest and lumbar vertebras. Another known device for positioning and fixation of position of hand during operation according to CS 233723 consists of horizontal support of forearm that is connected with support for hand and from elements for fixation of fingers. Elements for fixation of fingers are designed like flexible arms with arresting device for each finger separately. These supporting and fixation elements are placed on main beam. Flexible arms consist from segments connected with wire, one end of which is fixed to base board and the second one is fixed to the thimble made from elastic material. The main beam is inserted during operation under the table of common operation table.

A disadvantage of used complicated constructions to fixation of extremity fractures is that they enable to reach only the pull in longitudinal axis of extremity.

The surgeon has complicated and limited access to the palm especially in fractures of wrist or fingers. Setting up direction and magnitude of the pull in reposition of broken extremity is either impossible or very rough only.

It is known device from the leaflet of company East Cost Laser & Medical, Int. Sewell, NJ 08080, USA, that enables hanging of upper extremity on the ceiling ; it helps to reach the pull in longitudinal axis by grasping of fingers of imposed extremity with special flexible pipes changing their diameters according to pull while countermove is reached by putting the weight on such hanging arm or device and where the extremity is vertically pulled by the counterweight hanging on the wire leading via the beam that is adjustably fixed on the base board-table where the extremity freely leans bent in the elbow. Modification of this construction is also known where it is possible to reach the pull in horizontal plane which ensures only traction in longitudinal axis by the pull lead through pulley.

All devices for extension and reposition of broken extremities known up to now serve only to correction and shortening of fragments in longitudinal axis of extremity but they not enable precise angle correction of broken bone neither the temporary retention of fracture fragments as the base for whole range of possible therapeutic procedures. All constructions known up to now have forced the surgeon to set up bones to right angle position manually and they have limited him to use both of hands in operation of fracture itself due to it.

Technical problem The goal of submitted invention is creating such device that enables fixation of broken upper extremity in simultaneous spatial angle reposition of bones into anatomically correct position.

Technical solution Device for reposition and fixation of fractures according to invention removes mentioned imperfections of known devices and reaches set goal.

The device according to preamble part of the 1st patent claim consists of static part to fixation of broken extremity position and traction part for bringing about the reposition pull with the strength and direction in fixed extremity defined in advance. The static part is created like the bearing frame where two transverse adjustable beams for fixing of front or rear transverse holder of supports of upper extremity are placed on its upper part in direction of its longitudinal axis which is parallel with longitudinal axis of broken extremity forearm. There are arranged freely adjustable supports for forearm and arm to fixation of extremity on mentioned transverse holders while traction part including heavy elements possible to connect them to broken extremity and mechanism bringing about reposition pull in traction elements is connected on the front part of bearing frame.

The substance of invention leans on, that traction part of device is placed on bearing rod embedded in the traveller of bearing rod that is adjustable on vertical adjustable transverse beam that is located on the front side of the bearing frame.

There are at least two directional arms fixed on the bearing rod optionally adjustable ; each arm has on its end conduction for the wire to transferring of reposition pull. One end of particular tensile wire is connectable to designated finger of broken extremity, separately to the thumb and separately to the second and/or third finger in static part of fixed broken extremity while other end of wire is connected to the weight mean.

Such construction enables to perform the reposition pull to particular broken bones of fixed extremity in ideally set direction of pulling wire between the fracture and conduction on optionally adjustable directional arm and correct angle arrangement of bones in horizontal and vertical planes without help of third persons due to it.

It is advantageous when the device according to invent has particular directional arms movable and rotationally adjustable in its own traveller that is movable and rotationally adjustable on bearing rod.

Such solution enables simple and fast optimal arrangement of required directions of wires'pulls between connecting places on fingers of the extremity and conducting on directional arms.

It is also advantageous when free ends of directional arms of traction part are shaped so, that they are bent in acute angle against longitudinal axis in the part of particular directional arm fixed in the traveller, advantageously under 45'angle.

Such construction enables, as far it is possible, the widest spatial adjustability of conductions for wires placed at the end of guiding arm.

It is an advantage, when the pulley creates conduction for pulling wire.

This measure decreases the friction between the wire and conduction to minimum; it makes setting up of traction pull easier.

The further advantage is that the wire is conducted through shortening mechanism of the length of pulling wire between conduction for pulling wire and loading means.

This measure removes problems with the length of pulling wire in reposition of extremities of patient with different height as well as in positioning of directional arms in adjustment of mutual angles of upper extremity bones.

Traction part of the device according to invention is characterised in that loading mean to making the pull consists of the weight.

The permanent, constant value of the pull in the wire is reached due to it and also in patient's corrected upper extremity unlike bringing about the reposition pull for example by moving screw or winch.

It is also advantageous when shortening mechanism of the length of the wire is created like the winch with the ratchet that is fixed to the weight.

This construction enables to set up very simply and quickly needed length of pulling wire according the height of patient and spatial arrangement of directional arms by manual winding up or winding off the part of wire to or from the reel of the winch.

It is also characteristic that the body of the weight of tracking part is created in the form of vessel while the hanging mechanism for putting on partial additional weights with discrete unit value is placed from the bottom side, on the bottom while regulated supply of loading liquid flows into inner space of the vessel.

Such construction of the weight enables fine and continuous weight adjustment of particular weight and also the reposition pull through the wire bringing about to broken extremity due to it. Fixation and positioning of the extremity in ideal position without possibility of moving fragments to practically unlimited time is reached by this arrangement thanks to anatomically suitable attachment of broken extremity in surgical treatment and surgeon is not under time stress during operation due to it.

It is an advantage when loading mean is alternatively placed near the rear end of bearing frame and pulling wire is led to it through conducting means while at least part of the length of the wire is under cover or led under cover.

Such construction design ensures larger and safer manipulation area for the surgeon during operation. It enables also to check operation under the X-rays imagination while possibility of exposition with X-rays of assisting persons is excluded because they are not necessary in fixation with the help of the invention.

Fixed broken extremity is ready to maximum degree to conservative treatment-putting on a plaster cast or resin bandage, operational-percutaneous fixation of fragments with wires led through the skin, putting on the outer fixation device, osteo-synthesis with the help of plate, or arthroscopic examination of wrist joint in case of internal fracture of the joint thanks to mentioned construction according to invention.

It is possible to use designed device according to invention due to its simplicity and undemanding character in ambulant treatment as well as in treatment on operating room in specialised medical facility. Mechanical construction of device excludes its failure and possibility of fine adjustment of reposition position, direction and the strength of the pull practically excludes possibility to damage patient's health condition during surgical treatment.

Description of Drawings The invention is more closely explained with the help of attached drawings where particular figures schematically show: Fig. 1-the side view on the device, Fig. 2-the front view on the device, Fig. 3-the side view on the device with illustration of angle correction, in vertical plane Fig. 4-the view from above on the device with illustration of angle correction, in horizontal plane Fig. 5-the view on the alternative with the weight near rear end of bearing frame The list of positions in the Drawings 1-bearing frame 2-front transversal holder 3-rear transversal holder 4-support of the arm 5-adjustable traveller of forearm support 6 6-forearm support 7-transversal beam 8-bearing rod 9, 10-directional arm 91,101-conduction for the wire 11-weight 111-inner hollow space of the weight 112-hanging mechanism 12-additional weight 13-suppty conduction 14, 14'-wire 15-shortening mechanism 151-winch with the ratchet 18, 18'-parallel conductions 21, 21'-traveller of the front transversal holder 2 31, 31'-traveller of the rear transversal holder 3 71-traveller of transversal beam 7 81-traveller of bearing rod 8 92, 102-travellers of directional arms 9,10 0-forearm axis 01-thumb axis 02-forefinger axis ai-corrective angle in horizontal plane between axis 0 and axis 01 a 2-corrective angle in horizontal plane between axis 0 and axis 02 Pi-corrective angle in vertical plane between axis 0 and axis 01 ß2-corrective angle in vertical plane between axis 0 and axis 02 - the angle of bending of directional end 9,10 Modes of the Invention The reposition and fixation of fractures device according to invention consists of static and traction parts. It results from attached figures that static part of device consists of bearing frame 1 that is made from metal pipe in our case that creates bearing structure of the whole device. Two holders-front transversal holder 2 and transversal holder 3 are placed directly on bearing frame 1 in transversal axis, but freely movable in horizontal plane in front-rear direction. The bearing frame 1 consist in upper part of two horizontally arranged mutually parallel conductions 18, 18', where the pair of front travellers 21, 21'and the pair of rear travellers 31, 31'are arranged that is possible to shift and adjust. Both pairs of front travellers 21, 21'and rear travellers 31, 31'are equipped with vertical conduction where particular bended ends of front transversal holder 2 and rear transversal holder 3 are vertically embedded that is possible to shift and adjust.

The front transversal holder 2 creates the basis for fixed forearm support 6 that is possible to shift and adjust and which is freely adjustable with the help of traveller 5 in horizontal plane in transversal direction to device axis in whole width of bearing frame 1. The rear transversal holder 3 creates basis for fixed support 4 for arm of broken extremity that is possible to shift and adjust. It is clear from pictures of static part structure, that it is possible adjust forearm support 6 arbitrarily in space as well as arm support 4. It enables ideal supporting and fixation patient's left as well as right upper extremity of any height.

Dimensioning of bearing frame 1 is designed in such a way, so it would be possible to use quality"C"-arm of X-ray scanning device. It is possible to equip the bearing frame 1 with wheels to comfortable moving of device within the framework of surgery workplace or outpatients'department and it is possible to connect to it also other devices, for example device to fixation of patient's body on the bed when it is the case of surgical operation on the hand of lying patient.

The arm support 4 and forearm support 6 are anatomically shaped in the place of contact and they have a shape of semi-cylinder according to example of construction shown on drawings. It ensures grasping of extremity in respecting of shape of arm and forearm. The press of armrest to soft part of extremity and possible damage of skin and neural vascular bundle is minimised with anatomically shaped washable flexible rest made for example from plastic foam.

The fact that the arm support 4 as well as forearm support 6 is separately freely movable in three perpendicular planes enables to use device for different lengths of upper extremity (i. e. the arm and forearm) except using the device for left and right extremity. The ability to use the device for surgical treatment of patients with different physical constitution is appreciable.

Mentioned variance of adjustment both of supports 4, and 6 on bearing frame 1 in three dimensional space as well as in mutual relation between them enables use the device to surgical treatment of different types of fractures from the view point of angle dislocation of fragments with dorsally or volarly open angle (i. e.

Colles'or Smith's type of fractures). This is crucial advantage of device according to invention that enables synergic effect (reposition and traction) to fixed extremity in angle correction and temporary retention of fragments in angle traction secured with help of traction part of the device.

Traction part of device includes distribution mechanism to bringing about optionally adjustable pull in broken extremity with help of specially constructed weights 11,12 hanging on one of ends of two pulling wires 14, 14', while its other end is separately fixed to for example thumb and forefinger of broken extremity with the help of not illustrated holders, when this is the case of fracture on this place. Both ends of wires, the end of wire 14, that ensures position of thumb and the end of wire 14'that ensures position of forefinger are separately loaded with the weight 11. Particular pulling wires 14 and 14'are led through corresponding conductions 91 and 101 embedded at the free end of particular directional arms 9, 10. Of course that it is possible to place on the bearing rod 8 another directional arm with conduction for another tensile wire within the framework of the invention in case of necessity of mutual angle adjustment of more than two bones; this another pulling wire will be analogically connected to another, the third finger of the hand and its second end will be loaded.

Mechanism of traction part of device is created in the front part of bearing frame 1, like horizontal transversal beam 7. This horizontal transversal beam 7 is fixed to vertical legs of the frame 1 of the device on travellers 71 ; it enables its movement in vertical plane practically within whole height of bearing frame 1. The traveller 81 that is possible to move and that is adjustable is embedded on transversal beam 7; the bearing rod 8 in the plane perpendicular to transversal beam 7 is fixed in the traveller ; the rod in our case is oriented with the slope of 45 ° from the front plane of bearing frame 1. The traveller 81 enables shift of bearing rod 8 in horizontal direction practically within the whole height of bearing frame 1.

Two bearing arms 9, 10, are fixed on the bearing rod 8 in traction part on travellers 92. 102 : each of the arms is equipped with conductions 91, 101 for pulling wires 14, 14'. Conductions 91,101 are created, in our case, like simple pulleys, separately for traction of thumb and separately for traction of forefinger of broken hand. Travellers 92,102 of bearing arms 9, 10 enable their adjustment in longitudinal direction on the bearing rod 8, as well as twisting around the axis of bearing rod 8. Directional arms 9,10 are bent at free ends in acute angle w against longitudinal axis in travellers fixed in the part of directional arms advantageously under the angle 45 °, while not bended part of directional arms serves to adjustment of their position in the traveller 92, 102.

This widely modifiable position both of conductions 91, 101 for wires 14 enables mutually adjust axis of pulled fingers to required correction angle a1 between axis 01 of the thumb and axis O of the forearm and angle a2 between axis 02 of the forefinger and axis O of the forearm in horizontal plane (see Fig. 5), and angle J3i between axis 01 of the thumb and axis O of the forearm and angle _ between axis °2 of the forefinger and axis O of the forearm in vertical plane (see Fig. 4).

The device according to invention is designed so, that mutua) adjustment of particular elements of static and traction parts enables to reach ideal position of fragments of fractures in wide range of the space as well as their temporary retention during time needed to surgical solution of fracture without help of second and third persons. Operator is able to use both of his hands to operation of broken extremity and he has good access to broken extremity; it also enables quality fixation of fracture (for example plaster cast, resin). Device also enables to watch whole course of operation under the X-ray image.

Specially designed construction of loading means which are made like weights 11 in the example enables to reach continuous and very precise adjustment of pull in broken extremity. The body of traction weights 11 (see Fig.

No. 4) has the shape of vessel, for example of cylindrical shape with defined volume, for example 500 ml that is designed in the inner hollow space 111 of the body of weights 11. The vessel has the hanging mechanism 112 for putting on partial additional weights 12 with defined unit value for discrete adjusting of weight 11 placed from its bottom side, on its bottom. The body of the weight 11 in our case is equipped in its bottom with the thread for the screw; it is possible to fix on the bottom of the vessel with the help of screw partial weights 12 of defined unit weight for example 20 Dg discs as needed. The change of value of rough pull of traction in jumps is reached due to it. Fine continuous adjustment of value of pull is reached by continuous adding of loading liquid in such a way that loading liquid flows from not shown external reservoir of loading liquid, for example from infusion set into inner hollow space 111 of vessel designed in the body of the weight 11. It is possible to finish such additional calibration of traction weights 11 any time during visual control of fracture fragments position with X-rays.

Loading device in the form of weights 11, 12 may be located directly under conduction 91, 101 of directional arms 9,10 ; such like it is shown at the Fig. No. 4, or it may be located near the rear head of bearing frame 1 with an advantage under the bearing frame 1 so not to take the area outside it and pulling wire 14 is led to it from conduction 91, 101 through leading means in the form of pulleys. The wire 14 may be pulled for example in the pipe of bearing frame 1 or in other way, under the frame, while it is equipped with the cover. How it results from Fig. No. 6, the device in shown variant is equipped with shortening mechanism 15 of the wire length between conduction 91, 101 and the weight 11. Shortening mechanism 15, the winch 151 with the ratchet in our case, serves to adjustment of the length of pulling wire 14 between attachment to fingers and weights 11. The needed length of the wire is variable upon the height of fixed extremity and adjusting of directional arms 9, 10. The winch 151 is connected to the weight 11 and creates the mean to loading the weight 11 on other end of the wire 14.

The upper extremity is fixed in device for fixation and reposition of fractures in following way: The arm of extremity will be leaned against arm support 4 and forearm will be leaded against forearm support 6; its placing will be adjusted with particular travellers. Longitudinal forearm axis O will be fixed into required position due to it.

Then will be fixed on ends of fingers, for example on the end of thumb and forefinger one end of pulling wires 14, 14'that are separately led through conduction 91, 101 placed on the end of directional arms 9, 10 to their loading <BR> <BR> means-weights 11, 12. Each of directional arm 9, 10 will be adjusted with their travellers 92, 102 so, the wire 14 connected to the thumb would be in imaginary anatomically right axis or thumb axis °1 necessary to surgical operation and the wire 14'connected to the forearm would be in imaginary anatomically right axis or forearm axis 0g necessary to surgical operation. Required length of wires 14, 14' will be subsequently adjusted with shortening device 15 and required pull needed to reposition of bones of the hand will be brought out by adding the weight or bringing the loading liquid into the vessel in the body of loading weights 11. The broken extremity is fixed in ideal position in such a way and it is possible to perform surgical operation on it.

Industrial application The device for reposition and fixation of fractures is serviceable in medicine at clinics and surgical outpatients'departments. It is possible to manufacture it easily in the industry and it is possible to keep it easily under hygiene conditions. It is possible to use the device like holder of fingers and hand during operations of soft parts in the area of forearm, wrist and palmw (tendons, arteries, nerves) in the surgery of extremities.