BG109727A - Modular external fixation system - Google Patents

Abstract

The system finds application in human and veterinary medicine, as well as in orthopaedia and traumatology for treating traumas and distortions of different parts of the locomotory system, for the construction of external fixation appliances used in reposition, fixation and traction. The system is highly reliable and easy to use. It comprises bearers (1, 59), bone implants holders (56) that can bemounted on the bearers, transfer modules (2, 12) with cross slots (5, 8) for orienting the bearers in different planes, and supports (60) with apertures for positioning of transfer modules and/or bone implants holders.

Description

The invention relates to human and veterinary medicine and can be used in orthopedics and traumatology in the treatment of injuries and distortions of various parts of the musculoskeletal system for the construction of external fixation apparatus used in reposition, fixation and traction.

BACKGROUND OF THE INVENTION

Very often when treating with external retainers, it is necessary to quickly reposition the built-in apparatus or replace one with another. Often this necessitates dismantling the entire external retainer and retrofitting the retainer to a new position.

Known by WO9716128, a modular external fixation system comprising supports, bone implant holders capable of mounting on supports, transferable carrier orientation modules in different planes, and at least one support with holes for positioning transfer modules and / or bone implant holders at least in one plane. Here, at least one carrier has at least one end for connecting to another carrier. The bone implant holders and the carrier carrier transfer modules have a threaded body and at least one carrier opening perpendicular to the axis of the body, as well as at least one pressed to support the carrier and nuts for the threaded ends of the body. The support is one-piece and flat with cylindrical openings for the ends of the body of the holders and / or transfer modules.

The known solution has the disadvantage that the work with the built-in osteosynthesis apparatus is difficult because the bone implant holders and transfer modules do not allow the osteosynthesis apparatus to be mounted independently and independently of the built-in osteosynthesis apparatus. This is because the openings are intended for mounting or dismantling of a holder or transfer module internally located on the carrier or a transfer module, it is necessary to disassemble the entire apparatus. In addition, the support is not adapted for the quick and easy installation and release of holders and / or transfer modules.

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SUMMARY OF THE INVENTION

A problem that is solved by the present invention is the creation of a modular external fixation system that allows for independent and independent of the osteosynthesis apparatus installed and 5 dismantling of bone-implanted implants and transfer modules.

This and other problems are solved with a modular external fixation system including supports, bone implant holders with mounting capability, transferable carrier orientation modules in different planes, and at least one support with openings for positioning 10 transfer modules and / or bone implant holders. The bone implants and carrier orientation transfer modules have a body with at least one threaded end smaller than the outer body size and at least one carrier opening perpendicular to the body axis at a distance from the body threaded end, and at least one pressed to secure the carrier with 15 axial movement on the body and a nut for locking the pressed to the threaded end of the body. The carrier opening, located perpendicular to the axis of the bone implant holder body and / or transfer module, is a single-sided slit with a width that allows the carrier to be freely inserted and removed. The presser also has at least one single-sided 20 notch perpendicular to its axis with a width providing free insertion and

lowering the carrier and located at a distance from the forehead to a pressed greater than the distance of the slit of the body to its threaded end. The body of the bone implant holder and / or the transfer module has at least one anti-roll restraint projecting perpendicular to the axis of the body, and the clip has at least one closed longitudinal passage passage for the restriction protecting the anti-roll restraint. When inserting the body into the clamp so that the two through-grooves coincide and when the nut is twisted after inserting the bracket into the two-grooves, it is provided axially independent and independent of the built-in apparatus for osteosynthetic installation and the displacement of the clamp enough to ensure a firm grip the support from opposite walls of the channels of the body and the presser. When unscrewing the nut, the carrier is easily removed from the grooves. This way it is secured

dismantling each bone implant holder and / or transfer module without having to disassemble the entire apparatus. The modular system further includes at least one transfer module and / or bone implant holder having an axial nozzle less than the outer size 5 of the nozzle pressed, with retaining sockets on the surface of the nozzle and side of the nozzle face there is a peripheral peripheral canal perpendicular to the neck forming a movement in the opening of the support. At least one support from the system comprises a disk and a bracelet with the ability to rotate and lock relative to each other relatively quickly. The bracelet has concentric openings on its axis for 10 free movement of the nozzle pressed, and in the wall of the bracelet perpendicular to the nozzle openings there are locks for fixing in the locking sockets of the nozzle. The disc has profile openings corresponding to the number and angular location of the openings of the bracelet, the profile of each opening is formed by the intersection of two openings with different diameters, whereby the 15 larger diameter of the profile allows a free passage of the tip to be pressed and the small one diameter allows the neck to rotate freely. In this way, when the bracelet openings coincide with the large disc openings, the implants and / or transfer module holders can be easily mounted or dismantled, and when rotating the disc with respect to 20 bracelets so that the small disc openings fit into the necks of the the tips,

ensure their secure fixation.

The modular external fixation system according to the invention preferably includes at least one transfer module and / or at least one bone implant holder, and / or at least one carrier having at least one end shaped like a spherical head and at least one transfer module and / or at least one transfer holder. bone implants, and / or at least one support having at least one end shaped like a spherical bed by a ball coupling. The spherical head is enclosed by a locking nut, and the spherical bed has an external thread for winding the locking nut and pressing the spherical head against the spherical bed, in addition the spherical bed has a locking screw for fixing the angular location of the axis of the spherical head the spherical

bed. This ensures the stability of the desired spatial orientation of an apparatus constructed with elements of the system.

The modular external fixation system according to the invention further comprises at least one transfer module 5 and at least one bone implant holder comprising a body and at least one end of the body a bore for a support arranged longitudinally on the body and with a threaded end arranged transversely to the body, as well as a presser for fixing the carrier with a longitudinal hole for the carrier and a transverse opening for the body with the possibility of sliding the body, as well as a nut for locking the body when wound on the thread

end of the body, with the outer dimensions of the nut larger than the opening in the pressed. The body has at least one anti-roll stop representing a projection perpendicular to the axis of the body, and the clip has at least one closed transverse passage for the movement of the stop. This enhances the system's capabilities by securing transfer modules and bone implants to one end of the carrier.

DESCRIPTION OF THE FIGURES Attached

FIG. 1 shows an axonometric view of a link with a one-sided cross section for a carrier;

FIG. 2 shows an axonometric view of a connection to a longitudinal carrier opening; FIG. 3 shows an axonometric view of a spherical connector;

FIG. 4 shows a transfer module for orienting parallel carriers; FIG. 5 shows a transfer module with parallel supports in axonometry;

FIG. 6 shows a crossover orientation transfer module;

FIG. 7 shows an axonometry cross-carrier transfer module;

FIG. 8 shows a transverse module with a transverse slot and a longitudinal opening; FIG. 9 shows a transverse module with a transverse slot and a spherical head;

FIG. 10 shows a transfer module with a transverse slot and a ball bed; FIG. 11 shows a longitudinal aperture and ball head transfer module;

FIG. 12 shows a transfer module with a longitudinal opening and a spherical bed;

FIG. 13 shows a transfer module with two spherical beds;

FIG. 14 shows a transfer module with two spherical heads;

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FIG. 15 shows a cross-sectional bone implant holder;

FIG. 16 shows a bone implant holder with a longitudinal opening;

FIG. 17 shows a bone implant holder with a spherical head;

FIG. 18 shows a cross-sectional bone implant holder;

FIG. 19 shows a transfer module for a cross-sectional support;

FIG. 20 shows a disk support and a bracelet and a transfer module for a cross-sectional axonometer support;

FIG. 21 shows the support of FIG. 20 with mounts in axonometry;

FIG. 22 shows a section of a support with a disk and a bracelet and a transfer module for

cross-sectional support;

FIG. 23a shows different types of carriers of the system according to the invention;

FIG. 24 shows an exemplary apparatus for breaking the tibia and the thigh, made up of two fasteners A and B connected by a dynamic link B.

EXAMPLES FOR IMPLEMENTATION

Figures 1 to 3 show the basic connections used in the modular external locking system according to the present invention.

FIG. 1 depicts a carrier 1 mounted in a transfer module 2 with a transverse slot to orient the carrier 1. The transfer module 2 has, in 20 cases, a cylindrical body 3 with a threaded end 4 having a smaller diameter than the outer diameter of the body 3 and perpendicular to the axis of the body unilateral a slit 5 for a carrier located at a distance from the threaded end 4 of the body 3. The width of the slit 5 allows the carrier to be freely inserted and removed 1. Contrary to the slit 5, there is a perpendicular to the axis of the body 3 of a stop 6 against 25 turning and limiting the axial travel . In this case, the restraint 6 is configured as a screw screwed into the body 3. On the body 3, a clamp 7 is mounted to secure the carrier 1 with the possibility of axial movement on the body 1. The clamp 7 has a perpendicular to the axis one-sided slot in a width allowing free insertion and removal. of the carrier 1. The slit 8 is at a distance from the forehead 30 9 of the pressed 7 greater than the distance of the slit 5 of the body 3 to its threaded end 4. The presser 7 is provided opposite to the slit 8 with a closed longitudinal passage 10 for movement of body limiter 6 it three.

There is provided a nut 11 for locking the pressed 7 against the body 3 by winding on the threaded end 4. As the nut 11 is tightened, the body 3 moves axially so that its slit goes away with the slit of the body, thereby tightening the carrier 1.

In one preferred embodiment, the slit 5 of the body 3 is made at an angle to the axis of the transfer module 2 or with a recess at the bottom. This ensures a secure tightening of the carrier 1

In FIG. 2 shows a transfer module 12 with a longitudinal carrier opening. The module 12 in this case has a cylindrical body 13 with a through hole for a carrier 1 10 arranged transversely to the axis of the body 13 and with a threaded end 14 located on the axis of the body 13. The body 13 is mounted with the possibility of moving in a transverse through hole 15 of a pressed 16 for fixing the carrier 1. The presser 16 has a longitudinally impenetrable opening for the carrier 1. A nut 17 is provided for locking the pressed 7 against the body 3 by winding on the threaded end 4. The body 13, 15 is perpendicular to the opening for the carrier, has a stop 18 against turning , in this case fulfilled as of IT body 13 screw. Similarly, the clamp 16 has a closed transverse passage passage 19 corresponding to the stop 18 for the movement of the stop 18.

In FIG. 3 is an axonometric section view of a fixed spherical coupling. The spherical head 20 is mounted in a ball bearing 21 with an external thread and is fixed to it by means of a locking nut 22. In the non-fixed state of the spherical coupling, the nut 22 is able to move freely around the spherical head 20, with one end 24 having an internal thread for winding on the threaded end of the spherical bed 21 and its other end 25 is shaped like a spherical bed preventing the nut 22 from falling through the spherical head 20. A locking screw 26 is provided to provide reliable fixation of the spacer Output of mounted in position ball clutch. The spherical head may be attached to a carrier, to a clamp on a transfer module, to a base of an implant holder, to another spherical head or to another spherical bed. Similarly, a spherical bed can form an end of a carrier, I press onto a transfer module, an implant holder base, another spherical head or another spherical bed.

FIGS. 4 to 19 show various variants of bone implant holders and transfer modules for orienting the supports in different planes; FIG. 23 a shows various variants of supports 1.

The bone implant holders of FIG. 15-17 are arranged as one end, respectively, of pressed 16 and 17 and the spherical head 20, 22 is formed as a base 27 with a stem 28, the stem 28 ending with threaded ends 10 29. To the base 27 on the stem 28 are placed in succession. one-to-one pressure washers 30, each with a corresponding half-hole, forming a bone implant socket 31. In this case, the washers 30 are made of plastic but can be made of a softer material, such as aluminum. The washers 30 are fixed with a special nut 32 wound on the thread 29.

In FIG. 18 shows an embodiment of a bone implant holder, and in particular of a Kirchner needle, in which the presser 7 has an elongated end 33 which has at least one pair drilled opposite to the axis of the holder holes 34 through which the bone implant passes freely. such as a bone screw or Kirchner needle. A body 35 with a threaded end 36 and corresponding to the openings 34 perpendicular to the axis 37 of the bone implant is mounted in the elongated end 20 33 of the pressed 7. The body 35 is fixed to the end 33 of a pressed 7 with a nut 38. In one not shown in the figures, the end 33 is filled with an inner square and the body 35 is square to provide anti-roll over. This relieves the locking screw 6 when tightening the nut 36. The ends of the opening 37 are chamfered so as not to cut the Kirchner needles.

In FIG. 19 shows a transfer module pressed 7 with an axial tip 39 having a diameter smaller than the outer size of the pressed 7, with retaining sockets 40, preferably arranged 30 concentrically, on the surface of the tip 39. On the side of the forehead 41 of the nozzle 39 there is a peripheral peripheral groove 42 forming a neck perpendicular to the forehead.

In FIG. 20 to 22 shows a support containing a disk 43 and a bracelet 44. The bracelet 44 has concentric openings on its axis 45 for free movement of the nozzle 39 of the press 7, and there are locks 46 in the wall of the bracelet 44 perpendicular to the openings 45 for the nozzle 39. for fixing in the locking holes 40 5 of the nozzle 39. The disk 43 has profile openings 47 corresponding to the number and angular location of the openings 45 of the bracelet 44. The profile of each opening 47 is formed by the intersection of two circles with different diameters, whereby the larger diameter allows the profile freely the passage of the nozzle of the press 7, and the small diameter allows free rotation of the neck 42

39. The disc 43 and the bracelet 44 are secured to be rotatably relative to each other by the case of two restraining screws 48 which are wound in the body of the bracelet 44 and pass through the corresponding grooves of the kidney-shaped 49 of the disc 43, with the heads of the stop screws 48 above the grooves 49. This groove shape allows the disc to rotate toward a circle at a certain angle when the screws 48 are slightly loosened. In the case of the disc 43, a stop 51 is fixed by means of screws, in which there are elongated notches 52 for the heads of the stop screws 48. The stop 51 serves to manually rotate the disc 43 towards the bracelet 44. The stop 51 is of D-section. the step enclosing the periphery of the disc 43 and part of the periphery of the bracelet

44. In this way, the concentric guidance of the disk 43 is carried out with respect to the bracelet 44. For a more convenient rotation of the stop 51, a flap is made on its periphery.

FIG. 23 a shows different variants of carrier 1 - straight, curved, curved, with loose ends, or with a nozzle. Preferably, the supports 1 are designed as a dynamic, pre-stressed structure. They consist of a cylindrical tube 53, the outer surface of which is preferably grooved. In the tube 53 made of solid material, for example chromium-nickel steel, a core 54 is made of soft elastic material, for example duralumin. The pipe 53 from the free ends of the carrier 1 is flared to the core 54. Options g) and h) show a carrier 1 shaped like a hoop, the ends being fixed by a suitable connecting element. In this case, the connecting element is configured as opposite clamping washers 55 forming openings for opposite ends of the carrier 1, the clamping washers 55 being fixed by a screw 56.

With the modular external fixation system according to the invention, flexibly versatile osteosynthesis apparatus can be constructed. Figure 24 shows an exemplary apparatus illustrating a possible system for constructing two fasteners A and B connected by a dynamic link B. By means of the shown fastening, using sliding supports 1 connected to one another by a distractor 55 is constructed

a two-pronged complex treatment device for breaking the tibia and the thigh, which can be dynamic in the treatment stages.

Clamp A is an axial two-sided outer clamp for fracture of the femur. It consists of a compressor-distractor 55, at both ends of which are fixed by means of a spherical connection straight carriers 1. On the 15 carriers 1, the required number of bone implant holders 56 are attached, in this case two screw holders per carrier, one being placed in the area of the fracture and the other is away from it. Implant screws 57 are secured in the openings of the screw holders 56, which are screwed into the bone. By rotating the body of the compressor distractor 55, it is shortened / lengthened, thereby enlarging or extending the fragments of bone. The two spherical connections

allow further repositioning of fragments. After the position of the fragments is finally established, the spherical connections are secured with locking screws and the compressor distractor 55 is secured to the spherical nut of the spherical connection.

Lock B is a semi-circular double-sided external lock. There is an additional straightening bracket here 58. This makes it a two-sided and two-sided bi-lock. The first side of the carrier frame consists of a compressor 55, at which both ends are secured by spherical linkages 1 on each carrier 1 a screw holder 56 and one transfer module 2 with cross channels are attached. Implant screws 57 are secured in the openings of the screw holders 56, which are screwed into the bone. The transfer modules 2 are connected via semicircular supports 59 to the transfer modules 2 by

the second side of the frame. The second side of the carrier frame consists of a straight carrier 58 on which two screw holders 56 and two transfer modules 2 with cross channels are attached. As the body of the compressor 55 is rotated, it shrinks / lengthens, thereby enlarging or extending the fragments of bone. Both spherical connections allow further repositioning of the fragments. In this case, the screw holders 56 and the transfer modules 2 mounted on the mounting bracket 58 are slightly loosened to allow them to move along the axis of the mounting bracket 58. After the position of the mounting bracket is finally established.

the fragments, the spherical connections are fixed with locking screws, and the compressor 55 is secured to the spherical nut of the spherical connection.

Finally, the screw holders 56 and the transfer modules 2 attached to the carrier 58 are also tightened.

With B is indicated the support used as a circular limiter of 15 rotations in movement in the knee joint. The support 60 interconnects locks A and B in a dynamic system, limiting the rotation of the system in one plane. In the first days after the operation, the rotation of the transfer modules 39 around their own axis is fixed, which then locks the lock A towards the lock B. Subsequently, the modules 39 are loosened, which allows to control the bend angle of the knee joint.

The exemplary embodiments and variations described are for illustration only and do not limit the inventive idea, the scope of which is determined by the scope of the claims.

Claims (8)

Patent Claims 1. A modular external fixation system comprising supports, bone implant holders capable of mounting on supports, transferable carrier orientation modules in different planes, and at least 5 one support with holes for positioning transferable modules and / or bone implant holders , wherein the bone implant holders and the carrier carrier transfer modules have a body with at least one threaded end having a smaller diameter than the outer body size and at least one carrier opening perpendicular to the axis of the body in the distance and at least one pressed to lock the carrier with the possibility of axial movement on the body and a nut for locking against the body by winding on the threaded end of the body, characterized in that - the support opening (1) located perpendicular to the axis of the body (3) of bone implants held and / or the transfer module (2) is a unilateral slit 15 (5) having a width allowing the carrier (1) to be freely inserted and removed; - the clamp (7) has at least one one-sided slit (8) perpendicular to its axis with a width that allows the carrier (1) to be freely inserted and removed and located at a distance from the forehead (9) to the pressed (7) larger than the slit distance ( 5) the body (3) to its threaded end (4); 20 - the bone implant implanted body (3) and / or the unilateral slit transfer module (5) has at least one stop (6) counter-projecting perpendicular to the axis of the body (3); - the single-sided slit (7) has at least one closed longitudinal passage passage (10) for movement of the stop (8) of the body; 25 - at least one transfer module and / or bone implant holder is pressed with an axial tip (39) with a diameter smaller than the outer size of the presser, with retaining sockets (40) on the surface of the tip (39) and on the side there is a peripheral groove (42) perpendicular to the forehead (41) forming a neck for movement in the opening of the support at the end (41) of the nozzle; 30 - at least one support comprises a disk (43) and a bracelet (44) capable of relatively rotating and locking one another, with the bracelet (44) having concentric axial openings (45) for free movement of the nozzle (39). »· The press, with brackets (46) fixed in the wall of the bracelet (44) perpendicular to the openings (45) for the nozzle (39) and the disc (43) having profile openings (47) corresponding to the number and angular location of the openings (45) of the bracelet (44), the profile of each 5 holes (47) being formed by the intersection of two circles with different diameters, wherein the larger diameter profile allows the free passage of the nozzle (39) of the holding-down device and the small diameter allows for free rotation of the neck of the nozzle. 2. Modular system for external fixation according to Claim 1, characterized in that at least one transfer module (2) has at least one end shaped like a spherical head (20) and at least another transfer module (2 (has at least one end shaped like a spherical bed (21)) from a spherical coupler. 3. Modular system for external fixation according to Claim 1, characterized in that at least one bone implant holder is provided 15 has an end shaped like a spherical head (20) and at least one further holder has an end shaped like a spherical bed (21) by a spherical clutch. 4. Modular system for external fixation according to Claim 1, characterized in that at least one carrier has an end shaped like a spherical head (20) and at least one other carrier has an end shaped like a spherical head 20 bed (21) from ball coupling. Modular external locking system according to any one of claims 2, 3 and 4, characterized in that the ball head (20) is enclosed by a lock nut (22) and the ball bearing (21) has an outer thread (23) for winding the lock nut (22) and for clamping the ball head 25 (20) to the ball bearing (21), furthermore the ball bearing (21) has a locking screw (26) for fixing the angular location of the axes of the ball head (20) and the ball bearing (21). 6. Modular system for external fixation according to Claim 1, characterized in that it further comprises at least one transfer 30 module (12) and at least one bone implant holder having at least at one end a body (13) with a bore opening for a support arranged longitudinally on the body (13) and with a threaded end (14) disposed transversely to the body (13), as and a press (16) for fixing the carrier having a longitudinal hole for the carrier and a transverse opening (15) for the body (13) with the possibility of sliding the body (13), as well as a nut (17) for locking the body (13) when winding on the threaded end (14) of the body (13), with the outer dimensions of the nut (17) being larger than the opening (15) for the body 5 in the press (16), with the body (13) having at least one stop (18) against a roll representing a projection perpendicular to the axis of the body (13), and the press (16) having at least one closed transverse passage (19) for movement limiter (18). 7. Modular system for external fixation according to Claim 10 1, characterized in that the carrier (1) comprises a tube (53) and an elastic core (54) crimped and fixed at least at one end in the tube (53), the core (54) being made of a material with a hardness smaller than that of the pipe