BG61553B1 - External fixture - Google Patents

Abstract

The modular system is used in orthopaedics and traumatologyfor the treatment of injuries and curvatures of different parts ofthe locomotor system and for building apparatus for externalfixation and traction. The system contains supporting elements(1), including internal (2) and moving parts (3) of circularsection and corrugated surfaces, modular connection elements (7)for connection between the supporting elements (1) and betweensupporting element and implanted elements. Another flat connectingelement (4) has holes in which modular connecting elements (5, 6 &7) are fitted for establishing connections of mutual planarlocation of the supporting elements. The modular elements (5, 6 &7) have step-like bodies with holes and ring-like bodies withcut-outs made of materials having different hardnesses.

Description

(54) External retainer

Technical field

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 apparatus for external fixation, used in reposition, fixation and traction.

BACKGROUND OF THE INVENTION

Since the end of the 19th century, there have been two major trends in the international practice in the use of external fixations according to the type of implants used, in particular the use of radial and axial external fixators.

The former consist essentially of pairs of intersecting flexible transfixing spokes, attached to flat spacer rings, which enclose the bone and have punctured openings on the periphery, and on solid straight beams, sliding and entire rods for keeping the two rings at a distance, such as the second uses rigid implant elements, such as semi-and transfixing screws and needles, which are secured and secured by special holders to the frame structure.

[0003] An extra-focal fixation apparatus for transcutaneous traction and compression bonding in orthopedics and traumatology (US 5021 054) is known, which includes straight and curved polygonal cross-section support members that connect to each other through connecting elements. The latter, with the help of additional plates with straight serrated press surfaces, can serve as implant holders and attach them to the apparatus. Each coupling element is provided with a screw-locking means.

The disadvantage of the known apparatus is that, despite its versatility, the coupling element provides stability of the connection only in multi-wall section of the supporting elements without additional protection against slipping, thereby reducing positioning capabilities. In addition, the element is bulky and with a complex and non-technological construction that does not allow the flexible construction of simplified devices.

Also known is another external osteosynthesis retainer (EP0490812) comprising bone implants for insertion into bone fragments, which implants are mounted in holders indirectly connected to one another by supports with a circular cross section and a tapered outer surface. The supports are connected to each other by a distractor and / or coupling element shaped like a screw and / or orientable and / or spherical coupling. At least one of its interacting spherical surfaces on the latter is non-slip. In addition, each holder or coupling element is provided with a screw locking means for independent positioning. The orientable coupling comprises a cylindrical body and support washers fixed to it by means of a threaded connection, whereby at least one carrier opening is formed. The holders are holders for solid bone implants and are a composite body with a carrier opening for the carrier, an implant retainer and a locking means for independently positioning the implants with respect to the carrier.

The disadvantage of this external retainer is that devices can only be built with frame structures and mono-fixers using only rigid implants. On the other hand, the coupling elements provide connection only between two carriers with axes not lying in one plane, which in turn reduces the capabilities of the system. In addition, the holders are bulky and complex and non-technological.

SUMMARY OF THE INVENTION

It is an object of the invention to provide an external osteosynthesis retainer allowing two or more retainer brackets to be connected so that the axes of all brackets connected in one connection can define one plane.

Another problem that is solved is to reduce the volume and weight of the supports by increasing their rigidity.

A problem to be solved is also to increase the reliability of the connection, preventing the relative movement between the connected elements during locking, while at the same time ensuring a more even pressure and increasing the stiffness of the supports.

Another problem that is being solved is to reduce the volume of the retainer elements and to simplify both their construction and technological implementation.

Last but not least, the proposed retainer solves the problem of flexible construction of different osteosynthesis devices according to the needs of each case, using both solid bone implants and transdermal spokes.

All these and other problems are resolved with an external osteosynthesis clamp, including bone implants for insertion into bone fractures and retained in holders. The holders are indirectly connected to each other by at least one carrier. All supports have a circular cross-section and a pleated outer surface, representing a dynamic, pre-stressed structure. The carriers can be connected to each other by means of a distractor and / or by a coupling element. The latter may be shaped as a screw and / or orientable and / or spherical connector. At least one of the interacting spherical surfaces of the spherical coupling is non-slip. Each holder and coupling element is provided with a screw locking means for independent positioning. In addition, the retaining and / or orientable couplings include a stepped cylindrical body with threaded ends. The stepped cylindrical body, in turn, has at least one step for mounting to a support, which is a flat body with connecting holes, to which it is secured by a screw-locking means.

At least part of said step is provided with a hole for support and a support washer mounted on it made of a material with less rigidity than the material of the material of the stepped cylindrical body. Thus, if there is a mount in the hole of the foot of the cylindrical body, the support washer presses this mount against the walls of the opening and the accumulated surface of the support penetrates into the soft material of the washer. This further prevents the relative movement of the carrier relative to the holder or the orientable clutch.

The holder may be designed as a holder for solid bone implants. It is a composite body comprising a stepped cylindrical body which has threaded ends and a step, with at least part of it having a carrier opening for a carrier. On this step is mounted a support washer made of a material with less rigidity than that of the material of the stepped cylindrical body. On the other side of the holder is an implant retainer shaped like a clamping washer that forms guide holes for solid bone implants. The washer and the clamping washers are fixed with locking means made of nuts wound on the thread at either end of the stepped cylindrical body. Such embodiment of the rigid implant holders enables adjustment of the position of the constructed structure with respect to the implants by rotating the pressure washers around the axis of the holder, in particular with respect to the carrier opening.

The holder may also be provided as a spokes holder, also constituting a composite body including a stepped cylindrical body with threaded ends and a step, at least in part of which a carrier opening for a carrier is located. Here, too, on this step is mounted a support washer made of a material with less rigidity than that of the material of the step body. On the other side of the holder there is another step with a peripheral concentric conduit for a transfixation needle, with a spokes-fixer mounted on it. The latter is a body with a stepped opening, the periphery of which is cut by a slit for the transfixation needle corresponding to the peripheral concentric channel of the stepped cylindrical body. Two holes perpendicular to the axis of the needle hole are drilled in the dense section against the slit of the locking pin. The washer and the locking pin are secured with nuts, threaded at the end of the cylindrical body. Such design of the spokes supports their compact and easy to maintain construction.

The orientable connector is designed as a stepped cylindrical body with threaded edges and symmetrically arranged steps, each of which has at least a portion of a bearing opening. On each step is mounted a support washer made of a material with less rigidity than that of the step body, and each washer is secured with a nut wound on the thread at the end of the step body.

Each carrier can be shaped like a straight or bent tube with a congested surface. An elastic core with a hardness less than the hardness of the tube material is crammed into the tube at least at one end thereof. In this way, the prestressing of the carrier is achieved, increasing its stiffness, which reduces the diameter of the carrier and further eases the retainer.

At least one of the ends of the carrier may be formed as part of a screw connector, thereby achieving a linear extension of the carrier along its axis.

At least one of the ends of the carrier may also be formed as part of a ball coupling. The latter may be formed by a spherical head fixed with a clamping nut to a spherical bed, the working surface of which is made of material of a different hardness than that of the material of the head. In this case sharp edges or tips are formed on the spherical surface with greater rigidity. In one embodiment of the invention, the spherical head is less rigid and is formed as a plastic hemisphere fixedly attached to the main hemisphere. In these embodiments, as the coiling nut is wound, the two spherical parts clamp together, with sharp edges or tips penetrating the softer material. In this way the relative movement between the parts of the spherical coupling in case of unwanted external impact is further prevented.

The carrier may also be shaped like a sliding carrier consisting of two cylindrical folded parts connected to a distractor.

The advantage of the external osteosynthesis retainer according to the invention is that it creates opportunities for the construction of different external fixation apparatus and for the re-implementation of the trauma orthopedist's tactics in all cases of local and ubiquitous musculoskeletal injuries using connections and elements providing both a spatial and a planar mutual arrangement of the building blocks of the apparatus, without any restrictions on its position being adjusted. The external retainer allows for the construction of lighter and 5 more reliable external fixation devices, utilizing all types of implant elements by increasing the friction torque during mounting the supports and by improving the attachment and fixation of their 10 mounts to the holders.

In addition, the use of unified holding and orientable connectors makes the retainer more versatile and less expensive.

Due to the smaller volume of the used elements, the latch becomes compact and the devices built with it lighter and more comfortable for the patient.

The use of materials with different rigidity in the construction of the connections repeatedly increases the reliability of the connections, and additionally provides them against slipping.

Description of the attached figures

Further, the description with specific examples will explain the attached figures, of which:

Figure 1 is a longitudinal section view of an entire portion of a carrier;

Figure 2 is a view of different embodiments of whole carriers;

3 is a sliding carrier formed by two carriers connected by a compression-distraction mechanism;

FIG. 4 is a plan view and lateral section of a support; FIG.

Figure 5 shows a ball bearing support with cut-outs;

Figure 6 is an enlarged partial view of a spherical head with slits;

Figure 7 is a ball carrier; 8 is a sectional view of a carrier with a smooth spherical head made of two parts;

9 is a cross-sectional view of a ball carrier with slots;

Figure 10 is a sectional view of a ball joint between two supports;

Figure 11 is a sectional view of a threaded connection between two supports;

FIG. 12 is an exploded viewable carrier connector; FIG.

13 is a sectional view of one embodiment of a washer with a stepped central opening;

Figure 14 is a sectional view of an orientable parallel carrier support connector;

Fig. 15 is a sectional view of an orientable carrier connector with perpendicular apertures;

Figure 16 is a variant of an orientable carrier connector with a diameter of two feet in diameter;

Figure 17 is a cross-sectional view of a spokes holder;

Figure 18 is a stepped body of a spokes holder;

Figure 19 is a longitudinal section of a spokespeaker;

20 is a cross-sectional view through the slot and the openings of the retainer-retainer;

21 is a longitudinal sectional view of a transponder needle holder;

22 is a cross-sectional view of one embodiment of a bone screw holder;

23 is a top plan view of a support with mounting brackets and a directional coupler;

Figure 24 is a side view of a support with mounted orientable connectors;

25 is a parallel connection of supports by means of an orientable connector;

Figure 26 is a cross-sectional view of a spokes with a transfixing needle mounted;

27 shows a needle holder with mounted needles and a carrier in axonometry;

28 is an exemplary apparatus for treating fracture in the ankle and foot area;

29 is an apparatus of FIG. 28 used as dynamic ligamentotaxis.

Examples of implementation

Figures 1 to 22 show that the external osteosynthesis retainer according to the invention comprises the following basic elements: carrier 1 with integral parts 2 and sliding supports 3, support 4, orientable connector 5, spokes 6, solid implant holder 7, spherical connector 8 and threaded clutch 9.

The sliding supports 3 of FIG. 3 are two uniaxial carriers connected by a compression-distraction mechanism. The supports can be designed as a dynamic, pre-stressed structure. The whole portions 2 of the supports 1 can be / fig. 2 / in the form of straight, curved at an angle, in particular D-shaped 10 or bent arcuate 11. They consist of (FIG. 1 / of a cylindrical tube 12 having an outer diameter of 2d and made of grooves 13 on its surface. In the tube 12 made of solid material, for example chromium-nickel steel, a core 14 made of soft elastic material, for example duralumin, is crammed. At least one end 15 of the pipe 12 is flared to the core 14.

Figures 5 to 10 show the ball joint 8 and its individual parts. The entire part 2 of the carrier 1 of FIG. 5 ends at one end with a spherical head 16 of radius Jasf, with at least 1/3 of the spherical surface having grooves 17 with sharp edges 18 / FIG. 6 /. The material of which the spherical head 16 is made is rigid and may be for example chromium-nickel steel.

According to one variant not shown in the drawings, diamond crystals can form in the material of the spherical head on its surface, forming sharp tips.

In FIG. 7 the entire part 2 of the carrier 1 ends with a spherical bed 19 of radius Yasf which is made of soft material, for example duralumin. There is a thread M on the outer cylindrical surface of the bed 19.

In one embodiment not shown in the drawings, the ball bed is collet.

Another embodiment of the parts of the ball connector 8 is shown in FIG. 8 and 9. Here the ball head is made of two parts - a main hemisphere 20 made of solid material, for example steel, representing a hemisphere with a central opening 21, in which the end of a carrier is fixedly mounted 2. The carrier 2 ends with a thread 22, which extends beyond the flat dividing surface 23 of the main hemisphere 20 and is wound into a blind hole 24 of the upper hemisphere 25 made of a soft material, such as plastic. On the flat dividing surface 23 of the main hemisphere 20, a concentric axis 26 of the spherical head channel 27 is made, which enters a projection 28 of the hemisphere 25 having the shape and dimensions of the channel 271

Spherical bed 29 made of solid material, for example steel, has grooves 17 with sharp edges 18, and a thread M is cut on its outer cylindrical surface. At the bottom of the spherical bed, an axis 5 is made of wobbly cutout 30. To prevent unwanted rotation. an additional pin 31 may be fitted around the axis 26.

In another embodiment not shown in the drawings, the separation surface 23 of the base 20 is part of another sphere with a radius larger than Yasf, with the corresponding surface of the upper hemisphere 25 representing a negative image of the separation surface 23 of the main hemisphere 20.

With the embodiments shown in FIG. 8 and 9, lightening and lowering of the built-in devices is achieved. In addition, the manufacture of a spherical head made of soft material greatly increases the durability of the spherical bed, which in this case is of a harder material, ie. the possibility of reusing metal parts is created.

The fixation of the ball connector 8 is shown in FIG. 10, giving an example of a spherical head with grooves and a smooth spherical bed. It is analogous to fixing on a compound smooth spherical head and a spherical socket with cuts.

The spherical head 16 is mounted in the spherical bed 19 and is secured to it by means of a clamping nut 33 that runs through the entire portion 2 of the carrier 1. The enclosing nut 33 has a cut inner thread M at one end and the other end is shaped like a spherical bed 34 of radius ISF with a central hole 35 having a radius greater than radius d of the intersection of the entire parts 2 of the supporting elements 1 and smaller than the radius Isf and the ball head 16. The length of the thread M is at most 1/2 of the height of the clamping nut 33.

As shown in FIG. 11 threaded connector 9 one end 2 of the carrier 1 ends with thread M2 and one end 2 of the other carrier 1 ends with a threaded socket 36. Alternatively, the outer diameter of the thread M2 is equal to the diameter 2d of the entire parts 2 of the carriers 1 .

The support 4 has a thickness h and is arranged on concentric circles with diameters Di relative to the center of the support 4 holes with diameter D. One embodiment is shown in FIG. 4, where the support 4 is a flat ring with openings 37 of diameter D, arranged in a circle with a diameter Di, which diameter represents the average diameter of the diameters of the inner hole of the ring and its outer diameter.

Each orientable connector 5 for supports 1 shown in Figures 12 to 16 is a cylindrical assembly and includes a stepped cylindrical body 38 having at least one step 39 with a larger diameter dl and a length greater than d, both on the sides of which there are symmetrical steps 40 of diameter d and length 1. The diameter d is selected so that free movement is provided when mounting the step 40 in the hole 37 of the support 4. The length 1 of the step 40 is less than the thickness h of the support 4 and is at least equal to the radius d of the section of the supports 1. Each step 40 ends with a cut thread M, whose outer diameter is at least equal to diameter d. Perpendicular to the axis of the stepped body 38 are drilled holes 41 of such a diameter that they can move freely the entire parts 2 with a diameter of 2d of the supports 1. Perpendicular to the axis 42 of the stepped cylindrical body 38 surfaces forming the forehead 39 having the largest diameter, pass through one of the diameters of each orifice 41. The axes of the two orifices 41 may be parallel / FIG. 14, perpendicular to FIG. 15 / or at an angle to each other. The diameter of the step 40 is larger than the diameter of the opening 41, so that the supporting walls 43 are formed on the step 40. The material of which the step body 38 is made is rigid, for example chromium-nickel steel.

In FIG. 16 shows an embodiment of an orientable clutch 5 in which the foot 39 with a diameter d is divided into two parts, fixedly connected to a cylindrical part 44 of a smaller diameter, which for example may be equal to the diameter 2d of the entire portions 2i of the supports 1. '

On the two steps 40 of the steps-;

The lower body 38 has mounting washers 45 with a ring height greater than the length 1 of the step 40 with a diameter d, their outer diameter being equal to the diameter dl of the step 39 and the inner diameter being at least equal to the diameter d at step 40. At least one of the front surfaces of each support washer 45 is made, two opposite arcuate co-notches | i

in the form of segments of the cylindrical surface of the ring with an arc radius at least equal to the radius d of the cross section of the whole portions 2 of the supports 1, and with a height of the segment smaller than the radius of the arc. The material of the support washer is soft, such as duralumin.

In FIG. 13 shows a variant of a washer 45 in which the inner hole is stepped, the hole having a smaller diameter having a diameter smaller than the diameter d of the step 40 and the opening having a larger diameter having a diameter of at least equal to of the diameter d of the step 40, and a length greater than or equal to the length of the step 40.

The washer 45 is fixed to the step body 38 with a nut 49 threaded at the end with thread Μ1.

The one shown in FIG. 17 the spokes 6 is a composite body consisting of a step body 50, a support washer 45, a tie rod 51 and two clamping nuts 49. The step body 50 is made of solid material, for example chromium-nickel steel, and has one step 39 also with largest diameter dl. One end to the step with a diameter of dl 39 is shaped as an end for fixing a carrier 1 with a step 40 with a diameter d and an opening 41. The other end after the step with a diameter dl has a step 52 with a diameter at least equal to the diameter d whose circumference is made channel 53 having a width at least equal to the diameter of the flexible transfixing needle, which channel is perpendicular to the axis of the step body 50, spaced a and a from the forehead of the step with the largest diameter 39. The foot with the largest diameter dl 39 has a length greater than adiusa of the opening 41. The step body 50 and at both ends threaded ends Ml. The foot 39 may be divided into two parts fixedly connected to a smaller cylindrical part.

On the step 52 is mounted a spinner-retainer 51, representing a prismatic body with a stepped central opening 54, whose diameter is greater than or greater than the diameter of the step 52, and the length of the hole with a larger diameter is at least equal to the length step 52. The smaller diameter hole has a diameter equal to or larger than the outer thread diameter Ml. The periphery of the spinner 52 is cut at most to the central axis by a slot 55 having a width equal to or greater than the width of the channel 53 on the step body 50. The dividing plane of the slot 55 is perpendicular to the axis 56 of the spinner 51 and is at a distance equal to or less than the distance a. Two parallel holes 57 with a diameter corresponding to the diameter of the implanted spoke and with axes lying in the dividing plane of notch 55, the distance between the openings 57 being at least equal to the larger radius of the step opening 54. The spokes-retainer 51 is fixed by a nut 49 to the step body 50. It is made of solid material, for example chromium steel.

Solid implant holder 7 / FIG. 21 and FIG. 22) also consists of a step body 58, a support washer 45, and nuts 49, and there are also two clamping washers 59. The step body 58 is also of solid material, for example steel, and has a step 39 of the largest diameter dl. One end is formed as an end for fixing the carrier 1 by a step 40, on which a support washer 45 is mounted, another step by a thread Ml, on which a press nut 49 is wound and perpendicular to the axis of the hole with a diameter at least equal to the diameter. 2d, at the cross-section of the whole portions 2 of the supports 1. Here, too, the step with the largest diameter dl 39 has a length larger than the radius of the opening 41. The other end after step 39 is shaped like a step 60 having a diameter equal to the outer diameter of its thread having a smooth cylindrical portion of equal length or less the thickness of two clamping washers 59, and ends with a thread of outer diameter Ml. The pressure washers 59 are made of insulating material and are flat circular bodies with a central opening into which the step 60 enters. The opposite faces of each pressure washer 59 are made with arched grooves 61, located symmetrically about the axis of the central opening and at a distance b from one of another, with an arc radius equal to the radius of the implanted elements, and with a height less than the radius of the arc. The clamping washers 59 are fixed with a nut 49 threaded to the thread Ml. Here, too, there may be an option in which the step 39 is divided into 5 parts.

In FIG. 22 shows an embodiment of a solid bone implant holder 7 with an extended step 39, wherein the end for fixing the pressure washers 59 of the extended step 39 and one end of the nut 49 are formed as support steps 62 with an outer diameter equal to the outer diameter of the clamping washers 59.

The embodiments thus presented according to the invention cannot limit it with respect to the whole inventive design. For example, the constituent elements of the retainer may be made of a material other than metal, for example by transmitting X-rays or other beams, and the outer shape of the constituent components of the retainer and the orientable connector may be a multi-wall prism whose description cylinder is of diameter section dl.

Application of the invention

In FIG. 23 and 24 show joints of members of the retainer in which the axes of two or more supports 1 lie in one or more parallel planes. Orientable connectors 5 are mounted to the support 4 by inserting the steps 40 of the orientable connectors 5 into the openings 37 of the support 4 and fixing with a nut 49. In the openings 41 from the other end of the connectors 5 are fixed by nuts 49 the whole parts 2 of the supports 1. During this fixation, the grooves 13 of the carrier 1 penetrate the material of the support washer 45 and further provide the anti-slip retainer. The position of the supports 1 is adjusted by unscrewing the nuts 49, orienting in the desired direction and then tightening the nuts 49.

The position of the axis of the supports 2 and 3 of FIG. 10 in the space is adjusted by tightening the clamping nut 33 after orientation in the desired direction. The notches or tips of the spherical part made of solid material penetrate into the soft material of the other spherical part, increasing the contact area and thus securing the connection further against slipping.

The carriers of FIG. 25 are fixed by tightening the nuts 49 and tightening the washers 45 to the supports 1. In this case, the grooves 13 of the supports 1 penetrate into the material of the washers 45 and provide anti-slip.

FIG. 26 shows a spokes holder 6 on which a spokes 63 is mounted, the end 64 of the transfixing spokes 63 being pushed through the inner end of one aperture 57 so as to pass through the slot 55 of the spokeswitch 51 and enter the other aperture 57 through its outer edge. Adjusting the tension of the transfixing spoke 63 is achieved by rotating the spokesman-retainer 51, in this case in a counterclockwise direction, and subsequent fixing by means of a nut 49,

In FIG. 27, the solid implants 65 are mounted to the holder 7 by clamping the pressure washers 59 in the arc grooves 61 by tightening the nut 49. The position of the solid implants 65 with respect to the axis of the holder 7 can be adjusted by rotating the pressure washers 59 about this axis . The carrier 1 is mounted in the opening 41 of the step body 58 and is fixed with a nut 49 so that the grooves of the carrier 1 penetrate the material of the support plate 45 and provide the elements against relative displacement relative to each other.

With the external osteosynthesis locker according to the invention, a variety of osteosynthesis apparatus can be flexibly constructed, as shown in FIG. 28 and 29 a three-prong apparatus for treating fracture in the ankle joint and the foot is exemplary and is given only to illustrate the capabilities of the retainer.

Using the fastening shown in FIG. 28, wherein the sliding supports 3 are fixedly connected to the support 4, traumatology may be treated in the case of malarial, talar or calcaneal fracture of the heel, as well as in their combination, by ligamentotaxis, which may be dynamic in the treatment stages. , as shown in FIG. 29.

The apparatus shown uses solid implants, which identify three anchor points below the fractured strips. Implants are connected via holders 7 to supports 1, which may be either part or all of the sliding attachments are compression-distraction mechanisms, and in the stages of placement, dosed traction on the shoulder for diastasis of the ankle may occur. Here, the support 4 plays the role of an artificial joint, bearing the created loads. By releasing the nuts 49 of the holders 7, the optimum position for adjustment is selected by extending the corresponding arm formed by the carrier.

Claims (17)

Claims 1. An external retainer comprising bone implants inserted into the bone fragments and mounted in holders indirectly connected to one another by at least one circular cross-section carrier and a grooved outer surface, the supports being connected to each other by a distractor and / or connecting element shaped as a screw connector and / or orientable, and / or spherical connector on which at least one of its interacting spherical surfaces is non-slip, each holder and coupling element being provided with a screw locking means isimo positioning, characterized in that the holders (6, 7) and / or the orientable coupling (5) have a cylindrical body (38) with a step (40) and threaded ends for connection by means of a screw locking means (49) to the support (49). 4) is a flat body with connecting holes (37), and each of the supports (2) is designed as a dynamic, pre-stressed structure. The clamp according to claim 1, characterized in that the holder is designed as a holder (7) for solid bone implants. A latch according to claim 1, characterized in that the holder is configured as a holder (6). Clamp according to Claim 1, characterized in that each carrier (2) is shaped like a straight or bent tube (12) with a rigid core (14) crammed into it and at least at one end with a hardness of less than that of the pipe (12). Clamp according to claims 1 to 4, characterized in that at least one end (15) of the carrier (2) is formed as part of a screw (9) or spherical (8) clutch or distractor (3). A clamp according to claim 5, characterized in that the spherical connector (8) is formed by a spherical head (16) fixed by a clamping nut (33) to a spherical bed (19), the working surface of which is made of a material with a hardness other than that of the material on the working surface of the head (16), with sharp edges or tips (18) being formed on the spherical surface with greater rigidity. A retainer according to claim 6, characterized in that the working surface of the spherical head (16) is less rigid and is formed as a plastic hemisphere (25) fixedly attached to the main hemisphere (20). 8. Osteosynthesis outer retainer support, characterized in that it is a flat ring (4) with attachment openings (37) arranged on concentric circles. 9. Outer osteosynthesis retainer with circular cross-section and grooved surface, characterized in that it is made as a dynamic, pre-stressed structure with a straight or curved (10, 11) shape, containing a tube (12) in which a resilient core (14) having at least one end (15) having a hardness less than that of the tube (12). 10. Outer osteosynthesis retainer with circular cross-section and grooved surface, characterized in that it is a dynamic, pre-stressed straight or curved structure (10, 11) having a tube (12) in which it is a resilient core (14) crimped and fixed at least at one end (15) having a hardness less than that of the pipe (12), wherein at least one of its ends is formed as part of a screw connector (9). 11. Outer osteosynthesis retainer with circular cross-section and grooved surface, characterized in that it is a dynamic, pre-stressed structure with a straight or curved (10, 11) shape, comprising a tube (12) in which an elastic core (14) having at least one end (15), having a hardness less than that of the tube (12), at the bones of one of its ends, is formed as part of a spherical connector (8). A carrier according to claim 11, characterized in that the spherical connector (8) is formed by a spherical head (16), 5 fixed by a clamping nut (33) to a spherical bed (19), the working surface of which is made of material with a hardness other than that of the material on the working surface of the head (16), sharp edges or tips (18) being formed on the spherical surface 10 with greater rigidity. A carrier according to claim 12, characterized in that the working surface of the spherical head (16) is less rigid and is formed as a plastic hemisphere (25) fixedly attached to the main hemisphere (20). 14. External retainer carrier, shaped like a sliding carrier of two cylindrical hinged parts (2) connected to a distractor (3), characterized in that each of the parts of the carrier (2) is designed as a dynamic a straight or bent tensile structure (10, 11) comprising a tube 25 bar (12) in which an elastic core (14) having a hardness of less than this is crimped and fixed at least at one end (15) of the pipe (12). Orientable connector of outer 30 osteosynthesis retainer, comprising a cylindrical body and a threaded locking washer thereon, forming at least one carrier opening for the carrier, characterized in that the cylindrical body (38) is stepped, 35 in symmetry steps (40) and ends with threaded ends, the bearing openings (41) being two and each located at least on part of each step (40) and the support washer (45) mounted on the step (40) 40 and secured by nut (49) threaded at end of body (38), wherein material is o which is made of less rigidity than that of the material of the stepped cylindrical body (38). 45 16. Holder for external osteosynthesis retainer, constituting a composite body with a carrier opening for the carrier, an implant retainer and with a locking means for independently positioning the implants with respect to the carrier, characterized in that it is made as a holder for solid bone implants, the composite body (7) comprising a stepped cylindrical body (58) terminating with threaded ends and having a step (40), at least in part of which the support opening (41) for the carrier (2) is located, on which the step (40) is mounting washer (45) made of material with less rigid than that of the material of the stepped cylindrical body (58), and the implant retainer is designed as clamping washers (59) forming guide holes (61) for rigid implants, the locking means being the nuts (49) securing the support the washer (45), and the pressure washers (59) at the ends of the body (58). 17. Outer osteosynthesis retainer, characterized in that it is made as a spokes holder, constituting a composite body (6) comprising a stepped cylindrical body (50) terminating with threaded ends and having a step (40), at least in part which is provided with a support opening (41) for a carrier (2) and on which a support washer (45) is made of a step (40) made of a material with less rigidity than that of the material of the stepped cylindrical body (58) having another step (52) with a peripheral concentric groove (53) for a trans-spokes, on which a step hello (52) is fitted with a spokes-retainer (51), representing a body with a stepped opening (54), its periphery is cut with a slot (55) for the transfixing needle, in which the dense part, opposite the slot (55), are drilled two perpendiculars to the axis (42) of the holes (57) for the transfixing spoke, and the support washer (45) and the spoke-retainer (51) are fixed with nuts (49) wound on the thread at the end of the body (50).