FR2688689A1 - Device for intra-osseous fixation of an artificial ligament - Google Patents
Device for intra-osseous fixation of an artificial ligament Download PDFInfo
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- FR2688689A1 FR2688689A1 FR9203249A FR9203249A FR2688689A1 FR 2688689 A1 FR2688689 A1 FR 2688689A1 FR 9203249 A FR9203249 A FR 9203249A FR 9203249 A FR9203249 A FR 9203249A FR 2688689 A1 FR2688689 A1 FR 2688689A1
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
- A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8645—Headless screws, e.g. ligament interference screws
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0817—Structure of the anchor
- A61F2002/0841—Longitudinal channel for insertion tool running through the whole tendon anchor, e.g. for accommodating bone drill, guidewire
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0847—Mode of fixation of anchor to tendon or ligament
- A61F2002/0858—Fixation of tendon or ligament between anchor and bone, e.g. interference screws, wedges
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/08—Muscles; Tendons; Ligaments
- A61F2/0811—Fixation devices for tendons or ligaments
- A61F2002/0876—Position of anchor in respect to the bone
- A61F2002/0882—Anchor in or on top of a bone tunnel, i.e. a hole running through the entire bone
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Veterinary Medicine (AREA)
- Public Health (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- General Health & Medical Sciences (AREA)
- Molecular Biology (AREA)
- Medical Informatics (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Neurology (AREA)
- Rehabilitation Therapy (AREA)
- Rheumatology (AREA)
- Cardiology (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Transplantation (AREA)
- Vascular Medicine (AREA)
- Prostheses (AREA)
- Surgical Instruments (AREA)
Abstract
Description
DISPOSITIF POUR LA FIXATION INTRA-OSSEUSE D'UN LIGAMENT
ARTIFICIEL
La présente invention concerne un nouveau dispositif pour la fixation intra-osseuse d'un ligament artificiel.DEVICE FOR INTRA-BONE FIXATION OF A LIGAMENT
ARTIFICIAL
The present invention relates to a new device for intraosseous fixation of an artificial ligament.
On connaît les agrafes ligamentaires destinées à la fixation d'un ligament artificiel pour le remplacement d'un ligament articulaire naturel, distendu ou rompu. En particulier, lors du remplacement d'un ligament croisé antérieur du genou, une agrafe vient fixer l'extrémité du ligament prothétique sur la tubérosité antérieure du tibia, tandis qu'une autre agrafe le fixe sur la face externe du condyle fémoral externe. Dans ce dernier cas, le ligament émergeant du tunnel d'insertion tibial est replié vers le bas avant d'être agrafé, ce qui présente l'inconvénient de modifier la direction de la tension des fibres longitudinales qui constituent généralement ledit ligament. En outre, hormis le fait que l'agrafe ligamentaire implantée sur la tubérosité tibiale antérieure forme, en relief sous la peau, une bosse disgracieuse, voire gênante, cette technique de fixation du ligament nécessite de pratiquer une incision qui, une fois suturée, aggrave encore l'aspect disgracieux dû à la présence de l'agrafe sous la peau. There are known ligament staples intended for fixing an artificial ligament for the replacement of a natural, distended or broken joint ligament. In particular, when replacing an anterior cruciate ligament of the knee, a staple fixes the end of the prosthetic ligament to the anterior tuberosity of the tibia, while another staple fixes it to the external face of the external femoral condyle. In the latter case, the ligament emerging from the tibial insertion tunnel is folded down before being stapled, which has the disadvantage of modifying the direction of tension of the longitudinal fibers which generally constitute said ligament. In addition, apart from the fact that the ligament staple implanted on the anterior tibial tuberosity forms, in relief under the skin, an unsightly, even embarrassing lump, this ligament fixation technique requires making an incision which, once sutured, aggravates still the unsightly appearance due to the presence of the clip under the skin.
La présente invention vise à remédier à ces inconvénients en proposant un nouveau dispositif pour la fixation d'un ligament artificiel au niveau d'un tunnel d'insertion pratiqué dans une partie osseuse d'une articulation pour le passage dudit ligament, caractérisé en ce qu'il est constitué par une vis à tige filetée sur toute sa longueur, que l'on vient visser dans ledit tunnel osseux pour serrer ledit ligament contre la paroi interne dudit tunnel. The present invention aims to remedy these drawbacks by proposing a new device for fixing an artificial ligament at an insertion tunnel made in a bone part of a joint for the passage of said ligament, characterized in that 'It consists of a screw with a threaded rod over its entire length, which is screwed into said bone tunnel to tighten said ligament against the internal wall of said tunnel.
De cette façon, la partie intra-osseuse du ligament est fixée parallèlement au tunnel osseux, c'est-à-dire dans la même direction que sa partie intra-articulaire, et sans qu'il soit nécessaire de l'attacher contre l'os au moyen d'une agrafe. En outre, la vis étant normalement enfouie jusqu'à ce que sa tête vienne affleurer au niveau de l'ouverture du tunnel osseux, le cas échéant élargie à son extrémité par un lamage adéquat, le ligament ainsi fixé peut être sectionné presque au ras de la corticale il n'apparaît alors pratiquement aucune saillie disgracieuse ou douloureuse sous la peau. In this way, the intraosseous part of the ligament is fixed parallel to the bone tunnel, that is to say in the same direction as its intraarticular part, and without it being necessary to attach it against the bone by means of a staple. In addition, the screw being normally buried until its head comes flush with the opening of the bone tunnel, if necessary widened at its end by an adequate counterbore, the ligament thus fixed can be cut almost flush with the cortex there appears practically no unsightly or painful protrusion under the skin.
D'autres caractéristiques et avantages de l'invention ressortiront mieux de la description qui va suivre d'un mode d'exécution d'une vis ligamentaire donnée à titre d'exemple non limitatif en référence au dessin annexé sur lequel
- la figure 1 est une vue extérieure de profil de la vis avec, agrandi à plus grande échelle, le détail du filetage,
- la figure 2 est une vue en perspective schématique de l'articulation fémoro-tibiale, montrant plus particulièrement la mise en place de la vis ligamentaire, représentée sur la figure 1, au niveau des extrémités tibiale et fémorale d'un ligament prothétique pour le remplacement du croisé antérieur du genou.Other characteristics and advantages of the invention will emerge more clearly from the description which follows of an embodiment of a ligamentous screw given by way of nonlimiting example with reference to the appended drawing in which
FIG. 1 is an external profile view of the screw with, enlarged on a larger scale, the detail of the thread,
- Figure 2 is a schematic perspective view of the femoro-tibial joint, showing more particularly the placement of the ligamentous screw, shown in Figure 1, at the tibial and femoral ends of a prosthetic ligament for the replacement of the anterior cross of the knee.
Suivant la forme d'exécution reproduite sur la figure 1, la vis de fixation d'un ligament, ou vis ligamentaire 1, comporte une tige 2 de forme cylindroconique, avec une partie cylindrique 3 s'étendant sous la tête 4 de ladite vis 1 qui est prolongée, du côté distal, par une partie conique ou au moins tronconique 5. La longueur de la partie cylindrique 3 est prise la plus grande possible et, préférentiellement, elle aura au moins une longueur égale à la moitié de la longueur totale de la tige 2. According to the embodiment reproduced in FIG. 1, the ligament fixing screw, or ligament screw 1, comprises a rod 2 of cylindroconical shape, with a cylindrical part 3 extending under the head 4 of said screw 1 which is extended, on the distal side, by a conical or at least frustoconical part 5. The length of the cylindrical part 3 is taken as large as possible and, preferably, it will have at least a length equal to half the total length of the rod 2.
Suivant une caractéristique avantageuse de l'invention, aussi bien les parties cylindrique 3 que tronconique 5 de la tige 2 sont filetées, ce qui permet d'introduire la vis ligamentaire 1 très progressivement dans l'os. A cet égard, le pas du filetage présente une longueur adéquate, par exemple 2,25 millimètres, pour que la vis 1 puisse être introduite sans effort ; le cas échéant, s'il s'avérait utile d'augmenter ce pas, on pourrait tout à fait doubler le filetage. According to an advantageous characteristic of the invention, both the cylindrical 3 and frustoconical parts 5 of the rod 2 are threaded, which allows the ligamentary screw 1 to be introduced very gradually into the bone. In this respect, the thread pitch has an adequate length, for example 2.25 millimeters, so that the screw 1 can be introduced without effort; if necessary, if it proved useful to increase this pitch, one could completely double the thread.
Suivant une autre caractéristique de l'invention, mieux apparente sur le détail agrandi de la figure 1, la vis 1 est pourvue d'un filetage non triangulaire ; en effet, étant donné que les ligaments artificiels sont couramment réalisés à partir d'une bande textile roulée sur elle-même, cette disposition de l'invention permet de ne pas cisailler lesdits ligaments lors de la fixation de la vis 1 à l'intérieur du tunnel osseux. According to another characteristic of the invention, better apparent on the enlarged detail of Figure 1, the screw 1 is provided with a non-triangular thread; in fact, given that artificial ligaments are commonly produced from a textile strip rolled up on itself, this arrangement of the invention makes it possible not to shear said ligaments when the screw 1 is fixed inside of the bone tunnel.
A cet effet, suivant la variante d'exécution préférentielle décrite ici, les filets 6 de la vis 1 sont ronds, ou du moins arrondis, le fond 7 des filets 6 étant, quant à lui, cylindrique ; par exemple, dans le cas d'un filetage de pas égal à 2,25 millimètres, les filets 6, de section sensiblement hémi-circulaire, peuvent avoir un rayon de 0,75 millimètre, avec une hauteur égale à 0,6 millimètre. Le noyau de la partie cylindrique 3 de la tige 2 pourra, dans ce dernier cas, avoir un diamètre de 4 millimètres, la partie tronconique 5 ayant, par exemple, une petite base d'environ 2,2 millimètres de diamètre au niveau du fond du filetage. To this end, according to the preferred embodiment variant described here, the threads 6 of the screw 1 are round, or at least rounded, the bottom 7 of the threads 6 being, for its part, cylindrical; for example, in the case of a thread of pitch equal to 2.25 millimeters, the threads 6, of substantially semi-circular section, may have a radius of 0.75 millimeter, with a height equal to 0.6 millimeter. The core of the cylindrical part 3 of the rod 2 may, in the latter case, have a diameter of 4 millimeters, the frustoconical part 5 having, for example, a small base of approximately 2.2 millimeters in diameter at the bottom thread.
La forme arrondie des filets 6 n'est bien entendu pas obligatoire et, en particulier, il est tout à fait possible de choisir un filetage carré ou trapézoïdal ; ces filetages, sans être autant à bannir qu'un filetage triangulaire, présentent néanmoins le désavantage d'avoir des filets 6 aux arêtes vives qui sont donc le cas échéant coupantes. The rounded shape of the threads 6 is of course not compulsory and, in particular, it is quite possible to choose a square or trapezoidal thread; these threads, without being as much to banish as a triangular thread, nevertheless have the disadvantage of having threads 6 with sharp edges which are therefore possibly cutting.
Une fois vissée dans un tunnel osseux d'où émerge un ligament artificiel préalablement mis en place pour le remplacement d'un ligament articulaire, la partie cylindrique 3 de la tige filetée 2 sollicite très fortement ledit ligament contre la paroi interne dudit tunnel, sans toutefois l'endommager. A cet égard, une vis à tige entièrement tronconique solliciterait le ligament uniquement dans sa partie la plus large, à savoir sous la tête, et ne procurerait donc pas un serrage uniformément réparti sur une longueur aussi longue que celle de la partie cylindrique 3. La répartition de la force de serrage ici obtenue, combinée avec la forme adoucie des filets 6, procure par conséquent une fixation du ligament dans le tunnel osseux qui est incontestablement plus durable et plus sûre que celle jusqu'alors connue en employant des agrafes ligamentaires classiques. Once screwed into a bone tunnel from which emerges an artificial ligament previously put in place for the replacement of an articular ligament, the cylindrical part 3 of the threaded rod 2 very strongly urges said ligament against the internal wall of said tunnel, without however damage it. In this respect, a screw with an entirely frustoconical stem would stress the ligament only in its widest part, namely under the head, and therefore would not provide a uniformly distributed tightening over a length as long as that of the cylindrical part 3. The distribution of the clamping force obtained here, combined with the softened shape of the threads 6, consequently provides fixation of the ligament in the bone tunnel which is undoubtedly more durable and safer than that hitherto known by using conventional ligament staples.
La vis ligamentaire 1 précédemment décrite peut être utilisée de deux manières différentes
- dans une première variante, une incision suffisamment large est pratiquée dans les chairs recouvrant l'os de l'articulation à restaurer pour que l'entrée du tunnel osseux d'où émerge le ligament artificiel préalablement mis en place soit parfaitement accessible et visible. Dans ce premier cas, l'extrémité distale de la vis 1 peut être disposée en regard de l'entrée du tunnel osseux concerné pour y être vissée par tout moyen conventionnel.The ligament screw 1 described above can be used in two different ways
- In a first variant, a sufficiently wide incision is made in the flesh covering the bone of the joint to be restored so that the entrance to the bone tunnel from which emerges the artificial ligament previously placed is perfectly accessible and visible. In this first case, the distal end of the screw 1 can be placed opposite the entrance to the bone tunnel concerned to be screwed there by any conventional means.
- dans une seconde variante, qui sera maintenant décrite en référence à la figure 2, l'incision pratiquée dans l'aponévrose et les muscles est volontairement de faible largeur ; dans ce cas, on parlera d'ailleurs plus d'une moucheture cutanée que d'une incision. Afin de décrire un cas d'utilisation relativement courant, on a représenté, sur la figure 2, la dernière etape de la mise en place d'un ligament artificiel 8 pour le remplacement du ligament croisé antérieur du genou. - In a second variant, which will now be described with reference to FIG. 2, the incision made in the fascia and the muscles is deliberately of small width; in this case, we will also speak more of a skin speckle than an incision. To describe a relatively common use case, there is shown in Figure 2, the last step of the establishment of an artificial ligament 8 for the replacement of the anterior cruciate ligament of the knee.
La figure 2 montre ainsi le squelette de l'articulation fémoro-tibiale avec, du côté du fémur 9, une première extrémité du ligament 8 émergeant du tunnel d'insertion fémoral (non représenté sur la figure) et, du côté du tibia 10, la seconde extrémité dudit ligament 8 émergeant du tunnel d'insertion tibial. Du côté tibial, ou du côté fémoral, le ligament est fixé à un fil de traction 11 ayant préalablement servi à le faire passer au travers des deux tunnels d'insertion, alignés ou non en coïncidence l'un avec l'autre. FIG. 2 thus shows the skeleton of the femoro-tibial joint with, on the side of the femur 9, a first end of the ligament 8 emerging from the femoral insertion tunnel (not shown in the figure) and, on the side of the tibia 10, the second end of said ligament 8 emerging from the tibial insertion tunnel. On the tibial side, or on the femoral side, the ligament is fixed to a traction wire 11 having previously served to pass it through the two insertion tunnels, aligned or not in coincidence with each other.
Dans la technique de pose du ligament 8 ici mise en oeuvre, on a passé, par des moyens adéquats, une broche 12 au travers des deux tunnels fémoral et tibial, laquelle est donc coincée par le ligament 8 contre la paroi interne des deux tunnels d'insertion fémoral et tibial. Cette broche 12, qui émerge hors de la peau par la moucheture cutanée pratiquée dans les chairs, va servir, suivant la présente invention, à engager et à guider une vis ligamentaire 1 jusqu'à l'entrée des tunnels fémoral et tibial qui, sans cette broche de guidage 12, seraient totalement inaccessibles au praticien. In the technique for fitting the ligament 8 here implemented, a pin 12 has been passed through suitable means through the two femoral and tibial tunnels, which is therefore wedged by the ligament 8 against the internal wall of the two tunnels. femoral and tibial insertion. This pin 12, which emerges from the skin through the skin speckle practiced in the flesh, will serve, according to the present invention, to engage and guide a ligamentous screw 1 to the entrance to the femoral and tibial tunnels which, without this guide pin 12, would be completely inaccessible to the practitioner.
A cet effet, il est prévu de forer longitudinalement la vis ligamentaire 1 de part en part, de sorte qu'elle puisse être coulissée librement le long de ladite broche de guidage-12. En faisant alors progresser la vis 1 le long de cette dernière, jusqu'à ce que son extrémité distale vienne au contact de l'entrée du tunnel tibial, le praticien est assuré d'engager la tige 2 de la vis 1 aux côtés du ligament 8 sans, d'ailleurs, qu'il lui soit possible de dévier de la direction des tunnels d'insertion. To this end, provision is made to drill the ligament screw 1 right through, so that it can be slid freely along said guide pin-12. By then advancing the screw 1 along the latter, until its distal end comes into contact with the entrance to the tibial tunnel, the practitioner is sure to engage the rod 2 of the screw 1 alongside the ligament 8 without, moreover, that it is possible for it to deviate from the direction of the insertion tunnels.
Conformément à une caractéristique complémentaire de la présente invention, il est prévu que la vis 1 présente une tête 4 cylindrique à six pans creux pouvant coopérer avec une clé 13 à six pans, elle-même forée pour pouvoir coulisser le long de la broche de guidage 12. De la sorte, en engageant la partie distale de la clé 13 dans la partie proximale de la tête 4 de la vis 1, le praticien peut sans difficulté enfoncer cette dernière jusqu'à la zone de fixation du ligament 8, puis la visser exactement dans le tunnel tibial. Pendant cette opération de vissage, il est à noter que la broche de maintien 11 permet de tendre le ligament 8 dans sa position d'élongation optimale, parallèle au tunnel tibial, ce qui assure d'obtenir une fixation des fibres longitudinales actives du ligament 8 dans leur direction propre. In accordance with a complementary characteristic of the present invention, it is provided that the screw 1 has a cylindrical head 4 with hexagon socket which can cooperate with a hexagon key 13, itself drilled so as to be able to slide along the guide pin 12. In this way, by engaging the distal part of the key 13 in the proximal part of the head 4 of the screw 1, the practitioner can without difficulty drive the latter up to the ligament fixation zone 8, then screw it exactly in the tibial tunnel. During this screwing operation, it should be noted that the holding pin 11 makes it possible to tension the ligament 8 in its optimal elongation position, parallel to the tibial tunnel, which ensures that the active longitudinal fibers of the ligament 8 are fixed. in their own direction.
Une fois le ligament 8 fermement bloqué par la vis ligamentaire 1, le praticien peut retirer la broche de guidage 12, puis décrocher l'extrémité du ligament 8 de la partie distale de la broche de maintien 11, avant de proceder à une résection de l'extrémité dudit ligament 8 qui déborde hors du tunnel osseux tibial. Once the ligament 8 is firmly blocked by the ligament screw 1, the practitioner can remove the guide pin 12, then unhook the end of the ligament 8 from the distal part of the holding pin 11, before resection of the end of said ligament 8 which projects beyond the tibial bone tunnel.
On rappellera enfin que cette technique de mise en place et de fixation du ligament 8 présente des avantages indéniables quant à la diminution des suites opératoires ; en effet, le vissage de la vis ligamentaire 1 le long de la broche 12 se fait "à l'aveugle", mais en toute sécurité, sans qu'il soit donc nécessaire de pratiquer, sur l'avant du tibia ou la face externe du fémur, une trop large incision de l'aponévrose et des muscles ; de cet fait, la suture et la cicatrisation des chairs sont très rapides et ne laissent pratiquement aucune marque disgracieuse sur la peau. Finally, it will be recalled that this technique of placing and fixing the ligament 8 has undeniable advantages as regards the reduction of the operating suites; indeed, the screwing of the ligamentary screw 1 along the pin 12 is done "blind", but in complete safety, without it being therefore necessary to practice, on the front of the tibia or the external face of the femur, too wide an incision of the fascia and muscles; because of this, the suturing and scarring of the flesh is very rapid and leaves practically no unsightly marks on the skin.
Claims (8)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9203249A FR2688689A1 (en) | 1992-03-18 | 1992-03-18 | Device for intra-osseous fixation of an artificial ligament |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| FR9203249A FR2688689A1 (en) | 1992-03-18 | 1992-03-18 | Device for intra-osseous fixation of an artificial ligament |
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| Publication Number | Publication Date |
|---|---|
| FR2688689A1 true FR2688689A1 (en) | 1993-09-24 |
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Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| FR9203249A Withdrawn FR2688689A1 (en) | 1992-03-18 | 1992-03-18 | Device for intra-osseous fixation of an artificial ligament |
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| Country | Link |
|---|---|
| FR (1) | FR2688689A1 (en) |
Cited By (73)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| DE4329788A1 (en) * | 1993-09-03 | 1995-03-09 | Rudolf Mauk | Bone screw for osteosynthesis |
| US5458601A (en) * | 1994-03-28 | 1995-10-17 | Medical University Of South Carolina | Adjustable ligament anchor |
| WO1999005421A1 (en) * | 1997-07-26 | 1999-02-04 | Unifix Limited | Improved fixing anchor |
| US5961521A (en) * | 1993-06-04 | 1999-10-05 | Smith & Nephew, Inc. | Surgical screw and washer |
| EP0941705A3 (en) * | 1998-03-10 | 2000-02-02 | Howmedica Inc. | Screw and method of attachment to a substrate such as bone |
| US6056752A (en) * | 1997-10-24 | 2000-05-02 | Smith & Nephew, Inc. | Fixation of cruciate ligament grafts |
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