BG98705A - MODULAR EXTERNAL FIXATION SYSTEM - Google Patents

Abstract

External fixator, comprising bone implants, introduced into bone fractures and established in holders, indirectly connected to each other by at least one carrier with a circular cross-section and an imposed outer surface, the carriers being connected to each other by a distractor and/or a connecting element formed as a screw connector and/or an orientable and/or spherical connector, on which at least one of the interacting spherical surfaces is anti-slip, each holder and connecting element being provided with a screw locking means for independent positioning, characterised in that the holders (6, 7) and/or the orientable connector (5) have a stepped cylindrical body (38) with a step (40) and threaded ends for connection by the screw locking means (49) to a support (4), representing a flat body with connection holes (37), and each of the carriers (2) is designed as a dynamic prestressed construction.

Description

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 external fixation apparatus 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 world of external fixation systems according to the type of implants used, namely 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 drilled holes in the periphery, and of rigid straight supports - sliding and entire rods for keeping the two rings apart from each other, and for the latter solid implant elements are used, such as semi- and transfixation types and needles, which are secured and secured by special holders to the frame structure.

There are also systems that combine the two ideas and combine their benefits, for example, the Super Axial Radial Axial System / 1 /. The latter is mainly based on radial fixation with the additional use of rigid semi-transfixation needles secured by connecting elements

-2 for straight mounts mounted on spacer rings. However, the disadvantages of radial fixation devices - the heavy, bulky and inconvenient predefined construction - are not avoided here.

Another known modular system for external fixation is the ortho-radial axial-radial system (2) using substantially rigid implants. It is built on cylindrical connecting elements and compression-distraction mechanisms, directly connected pivotally, with the connecting elements being holders of implants. Flat spacer rings for radial fixation with flexible transfixing spokes are also used. This modular system is very flexible, but the support distance between the implant series is preset and depends on the length of the distractor. In addition, the use of multiple swivel joints for long transfers makes the system convenient and secure only for local breaks.

The modular elements used are relatively large in diameter, which complicates the design of the apparatus and leads to patient discomfort.

Also known is an extra-focal transaxle fixation device for traction and compression in orthopedics and traumatology (3), which includes straight and curved carriers

elements, who could at yes are coming together in between its through modular binders elements, as last with help of extra

Plates with straight toothed compression surfaces can

-3 connect the implanted elements to the supporting structure.

Regardless of its versatility, the coupling element ensures linkage stability only in a multi-wall section of the support members, without additional sliding protection, thus reducing positioning capabilities. The connecting element is bulky and with a complex and non-technological construction that does not allow flexible construction of simplified devices.

Also known is the Hoffmann External Retaining System, created in 1934 and further developed in 1968 (4), which is essentially an axial modular system for the construction of mainly frame structures of supporting elements and connecting elements.

The supporting elements are smooth cylindrical straight or curved bars - whole and sliding. Sliding support elements are compression-distraction mechanisms that can be uniaxial. It is possible to use an angled whole support element. The construction of entire parts of the supporting elements is not secured against deformation susceptibility.

The connecting elements are of two types - for fixing the supporting elements of the frame and universal hinges for connecting the implants to the frame being constructed. The connecting elements for fixing the supporting elements are made of two parts pivotally connected and having openings with a radius of at least

-4 equal to the radius of cross section of the support element

Each part is cut from one end along the aperture perpendicular to the axis of the hinge, by means of a screw connection located on the side of the cut end, the cut portions are pressed and thus securing the supporting element

This construction allows for the connection at different angles of two supporting elements lying in two parallel or perpendicular planes, the two parts being locked by pressing on the axis of the hinge of the contacting surfaces which are intruded. The item is bulky and can only be linked

W two supporting elements.

The universal hinge joints are prismatic nodes, hingedly interconnected, and at least one node consists of two portions forming an opening for the supporting members and having opposite pressurized arched sections with a radius of arc at least equal to the radius of the cross section of the supporting members. The fixing of the supporting element in the opening is carried out by means of a unilaterally arranged screw connection, consisting of a screw passing in series through threaded openings made of two flat elements, in which the parts containing the pressing opposite arcuate sections which screw are screwed together. The axes of the screw connection and of the support element are arranged in two parallel planes, the axis of the screw connection being fixed. The implanted elements are fixed by another

-5 universal joint hub, also comprising two press surfaces with arcuate portions opposite. The fixing is done here by at least two screw connections whose axes are perpendicular to the plane formed by the axes of the implants. This type of universal hinge allows for the construction of a variety of external fixation apparatus designs, but despite its great versatility, this hinge joint is very bulky and complicates the construction of the frame being constructed.

In addition, the unilateral pinching of the support member results in the creation of uneven contact forces, which impairs the fixing properties.

The reliability of the connections made is based solely on the compressive force obtained by tightening the screw connection.

These elements of the Hoffman system build frame structures and monofixers using only rigid implant elements. On the other hand, the connecting elements provide a connection only between two supporting elements of non-planar suckers, which in turn reduces the system's capabilities. The lack of a direct connection between the supporting elements, which securely fixes their mutual position of the angle so that the axes of two adjacent directly connected elements define one plane, also reduces the flexibility of the system and increases the space volume of the built-in devices. Moreover, there is no additional insurance

-6 anti-slip.

SUMMARY OF THE INVENTION

It is an object of the invention to provide a modular external fixation system to allow connection between two or more supporting elements of the system so that the axes of all connected support elements in one connection can define one plane.

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

A problem to be solved is 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 supporting elements.

According to the invention, the problems are solved by the creation of a modular external fixation system comprising circular cross-sections of diameter 2d - whole and

sliding and modular couplings having at least one opening at the end of a supporting element and at least one opening at the end of another supporting element or implanted bone fixing member, which system has at least another connecting element constituting a flat body of thickness h and arranged on concentric circles of diameter Di with respect to the center of the connecting element is opened with

-7diameter D.

The supporting elements are integral and sliding. Sliding support elements are uniaxial compression-distraction mechanisms ending in edges with a diameter equal to the diameter of the entire support elements. Continuous portions of the supporting elements may be straight or bent, and in one particular case they may be bent in an arc from a circle. The outer surface of the load-bearing members is formed by grooves or grooves, or is made of material with better friction properties.

The supporting elements may be pre-stressed constituent bodies consisting of a tube whose outer surface is grooved and in which a core of elastic material, softer than the tube material, is housed, at least one end of the tube being rolled to the core. The prestressing of the supporting elements for increasing their stiffness is achieved by cramming the core of a softer elastic material into the tube, then by radially inflating the outer surface of the pipe for its corrugation, and by rolling it apart. the ends of the pipe to the core of the structure also strain linearly. In this way, increasing the stiffness of the support element reduces its diameter.

The modular external locking system may comprise at least two supporting elements, the ends of which are connected directly by a ball joint, the spherical surfaces being radius Isf and the surface of one spherical part being

-8 sharp edges or tips are formed and the other part is a smooth spherical surface and is made of a material softer than the material of the first spherical part. The spherical hinge is fixed with a clamping nut mounted on a ball bearing element with a spherical head, which is wound on a thread M made on the outer cylindrical surface of the spherical bed.

Opposite to the clamping nut is the thread M end of the inner hole of an Isf shaped ball with radius

W 'central opening which enters the end of a support member and has a diameter greater than 2 g and less than the diameter

211sf of the ball head

As the clamping nut is wound, the two spherical parts are clamped together, whereby sharp edges or peaks from the surface of one spherical part penetrate into the softer material of the other spherical part, thus further preventing the relative movement between the parts of the spherical hinge. in case of unwanted external influence.

The modular external locking system may comprise at least two supporting elements whose ends form a threaded connection, with one supporting element having one end terminating with a thread and the other supporting element having one end terminating with a threaded socket.

Modular couplings are composite uniaxial bodies, each containing a single step body whose axis defines the axis of the modular coupling element, which

-9 a step body has one step with the largest diameter dl and a length greater than the radius d of the supporting member, at least on one side of which there is a step with a diameter d at most equal to the diameter D of the openings of the flat connecting element larger than the diameter of 2d in cross section of the supporting elements. The length 1 of the step with diameter d is less than the thickness h of the flat connecting element and is at least equal to the radius d of the cross section of the supporting elements. This step ends with a threaded end Ml whose outer diameter is at most equal to the diameter d.

Perpendicular to the axis of the stepped body is a drilled hole whose axis and axis of the stepped body form a plane such that the diameter of this opening is at least equal to the diameter 2d of the supporting elements so that the surface is perpendicular to the axis of the body and forms the forehead with the largest diameter dl to pass through the drilled hole.

On a step of diameter made of a material softer than that of a step body, with a ring height greater than the length 1 of a step with a diameter d

At least one of the front surfaces of the annular body are operated by two opposite arcuate coaxial notches in the form of segments from the outer surface of the ring, with an arc radius at least equal to the radius of the hole penetrated into the annular body and with

-10W ** segment height less than arc radius. The step and annular bodies are fixed to each other with a clamping nut, threaded at the end with thread Ml of the step body, so that if there is a mounting element in the opening of the step body, the arcuate notches of the annular body are pressed against the bearing body of the stepped body. In this case, the soft material of the annular body penetrates into the grooves on the surface of the supporting element, thus further preventing the relative movement of the supporting element relative to the connecting element.

It is possible for the foot with the largest diameter dl to be divided into two parts connected to a smaller diameter part.

In the case of the modular connecting element intended for connecting the supporting elements, on the other side of the step with the largest diameter dl of the step body, a symmetrical step with diameter d and length 1 is made, ending with a thread Ml, and a hole is drilled with a diameter at least equal to 2d, the axis of which is parallel, perpendicular or at an angle to the axis of the first opening and is perpendicular to the axis of the stepped body. A ring-shaped body with arcuate notches is also mounted on the second step with diameter d, which is fixed with a clamping nut.

With the modular coupling element, a tensioner designed to attach and tighten flexible transfixing spokes on the other side of the foot with the largest diameter dl

-11 a step having a diameter of at least equal to the diameter of bis length 1 is made, on the periphery of which a canal is made with a width at least equal to the diameter of the implanted needle, which canal is perpendicular to the axis of the step body and whose the axis is at a distance from the forehead of the foot with the largest diameter dl. This step also ends with a threaded end Ml. On it is mounted a spokes-retainer, which is symmetrically with respect to the central axis a body with a central opening whose diameter is at least equal to the diameter of the foot with a peripheral canal and with a length at least equal to the length of the foot with a peripheral canal.

The hole with a smaller diameter has a diameter equal to or larger than the outer diameter of the thread Ml of the stepped body.

The periphery of the speaker-latch is cut with a slot forming a plane perpendicular to the central axis. The width of the slit is equal to or greater than the width of the peripheral canal of the step body and the plane passing through its middle is at a distance from the forehead

- at the end with a larger aperture at most equal to the distance a from the staircase. Two openings with a diameter at least equal to the diameter of the implanted needle and with axes lying in the plane passing through the middle of the slot are drilled in the dense portion of the periphery of the locking pin.

-12The locking pin is secured with a nut threaded on the thread Ml of the step body.

For the modular coupling designed to connect the apparatus to the rigid implanted elements, on the other side of the step with the largest diameter dl of the step body, a step with a diameter equal to the outer diameter of the thread Ml is made, on which the holders are mounted of implanted elements. This step is at most equal to the thickness of the implant element holders. The latter consist of two flat circular washers with a central hole with a diameter at least equal to the outer diameter of the thread Ml, with arched grooves on the side of each washer on the side of the central opening in which the grooves accommodate the implanted elements. The position of the flat washers is fixed by a threaded nut Ml, cut at the end of the step on which the washers are mounted. Such an embodiment of the solid holders w

Implants make it possible to adjust the position of the structure being constructed with respect to the implanted elements by rotating the flat washers around the axis of the element, and in particular with respect to the opening for the supporting element.

The modular external fixation system according to the invention enables the construction of various external fixation apparatus and the implementation of the tactics of

-13 Orthopedic traumatologist in all cases of local and ubiquitous injuries of the musculoskeletal system, by using connections and elements providing both spatial and planar mutual position of the building blocks of the system, without imposing restrictions on the correction of the position of the the apparatus.

The system allows for the construction of lighter and more reliable 'modular' exterior fixation devices using all types of implant elements by increasing the friction torque during the fixation of the supporting elements and by improving the attachment and fixation of the implants attached to the connecting elements.

Using a set of unified modular connectors makes the system more versatile and less expensive.

The smaller volume of the connecting elements makes the system more compact and the devices built with it lighter and more comfortable for the patient.

The use of materials with different hardness at w

The built links increase the reliability of the links several times by further securing them against slipping.

-14Description of drawings

The accompanying drawings are further explained in the description with specific examples, in which:

Figure 1 is a longitudinal section of an entire portion of a support member;

Figure 2 is a view of different embodiments of whole carrier elements;

Fig. 3 shows a sliding support member representing a compression-distraction mechanism;

FIG. 4 is a plan view and side elevation of a flat connecting member; FIG.

Figure 5 shows a supporting element made of cuts;

6 is an enlarged spherical head with slits;

Fig. 7 shows a ball-bearing support element with a partial view of a spherical bed;

Fig. 8 is a sectional view of a spherical head made up of two into supporting parts;

Figure 9 is a sectional view of a support element with a smooth element with a spherical bed with slits;

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

11 is a sectional view of a threaded connection between two supporting elements;

12 is a modular connecting element for disassembled supporting elements;

-15Fig.13 is a sectional view of one embodiment of a annular body with a stepped central opening;

Fig. 14 is a sectional view of a modular coupling element for supporting elements with parallel openings

Fig. 15 is a sectional view of a modular connecting member of supporting elements with perpendicular openings;

Fig. 16 shows a variant of a modular coupling element for a carrier element with a two-diameter step having the largest diameter dl;

Fig. 17 is a cross-sectional view of a modular coupling element;

Fig. 18 shows a stepper body of a spinner;

Fig. 19 is a longitudinal section of a spokespeaker;

Fig. 20 is a cross-sectional view through the slot and the openings of the spokespeaker;

Fig. 21 is a longitudinal section of a modular needle holder connection;

FIG. 22 is a cross-sectional view of one embodiment of a modular screw-holder fastener; FIG.

element

Fig. 23 is a plan view of a flat binder with mounting binders and supporting elements;

Fig. 24 is a side view of a flat connecting element with modular connecting elements mounted;

25 shows parallel coupling of supporting elements

using a modular coupling element;

26 is a cross section of a modular

transaxle-mounted tie-rod coupler;

Fig. 27 is a modular connecting element needle holder with mounted needles and supporting element in axonometry; 28 shows an exemplary apparatus for treatment when broken at the ankle area becomes the step; 29 shows the apparatus of Fig. 28 used as

dynamic ligamentotaxis.

Examples of implementation

As can be seen from Figures 1 to 22, the modular external locking system according to the invention comprises the following basic elements: supporting elements 1 with integral parts 2 and sliding supporting elements 3, flat connecting element 4, modular connecting element for supporting elements 5, modular connecting element -spinner 6, modular rigid connection element

implants 7, ball joint 8 and threaded connection 9.

The sliding carrier elements 3 of FIG. 3 are uniaxial compression-distraction mechanisms that can be implemented as a dynamic structure.

-17The whole parts 2 of the supporting elements 1 can be / fig.2/ in the form of straight, bent at an angle, in particular D-shaped 10 or bent arcuate 11. They consist / fig.1/ of a cylindrical tube 12 with outer diameter 2d and with riffles 13 on its surface, such as a core 12 in a tube 12 made of solid material, such as chromium-nickel steel

14 made of a soft elastic material, such as duralumin, and at least one end 15 of the pipe 12 is retracted to the core 14.

Figures 5 to 10 show the ball joint 8 and its individual parts. The entire part 2 of the support element 1 of FIG. 5 ends at one end with a spherical head 16 of radius ISF, with at least 1/3 of the spherical surface having slits 17 with sharp edges 18 (FIG. 6/).

The material of the ball head is solid and can be made

According to chrome-nickel steel, for example.

not shown in the drawings, the material of the spherical head on its surface can be crammed with diamond crystals that form sharp tips.

In Fig. 7, the entire part 2 of the carrier element 1 ends with a ball bearing 19 of radius Isf made of soft material, for example duralumin. A thread M is cut on the outer cylindrical surface of the spherical bed 19.

-18In one embodiment not shown in the drawings, the spherical bed is a collet.

Another embodiment of the parts of the ball joint 8 is shown in FIGS. 8 and 9. Here, the ball head is made of two parts: a base 20 made of solid material, for example steel, which the base represents a hemisphere with a central hole 21, in which is fixed to the end 2 of the supporting element 1

The end 2 ends with a thread 22 which extends beyond the flat separation surface of the base and is wound into a blind opening of the upper hemisphere 25 made of a soft material such as plastic. On the flat separation surface 23 of the base 20 a concentric axis 26 is formed on the spherical head channel into which a projection 28 of the hemisphere 25 enters, having the shape and dimensions of the channel 27.

The spherical bed 29 made of solid material, for example steel, has slits 17 with sharp edges 18 and a threaded thread M is cut on its outer cylindrical surface. A releasing cutout 30 is made at the bottom of the spherical bed.

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 greater than βοφ, and the corresponding surface of the upper hemisphere 25 is a negative image of the separation surface 23 of the base 20.

-19 With the embodiments shown in FIGS. 8 and 9, lightening and reducing the cost of the apparatus is achieved. In addition, the manufacture of a spherical head made of soft material greatly increases the durability of the spherical bed, which here is of a harder material, ie. it creates an opportunity for • repeated use of metal parts.

The fixation of the ball joint 8 is shown in Figure 10, giving an example of a spherical head with slits 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 fastened to it by means of a clamping nut 33 passing through the entire portion 2 of the supporting element 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 with a radius DSf with a central hole 35, which hole 35 has a radius greater than the radius d of the intersection of the entire parts 2 of the supporting elements and smaller than the radius DSf of the ball head 16. The length of the thread M is at most 1/2 of the height of the clamping nut 33

In the threaded connection 9 shown in FIG. 11, one end of the supporting element ends with thread M2 and one end 2 of

ANOTHER carrier element ends with a threaded socket 36. Alternatively, the outer diameter of the thread M2 is equal to diameter 2d of the entire parts 2 of the bearing members 1.

-20The flat connecting element 4 has a thickness h and is arranged on concentric circles with diameters Di relative to the center of the flat connecting element 4 with holes D.

An embodiment is shown in FIG. 4, where the flat connecting element 4 is a flat ring with openings 37 of diameter D arranged in a circle with diameter Di, which diameter represents the mean diameter of the diameters of p of the ring and its outer inner aperture

Each illustrated at a knot and includes at least one step greater than r, of symmetrical steps is so selected that the flat connecting harness. The length 1 of the flat connecting element 4 and is the cross-section of the supporting elements with a threaded end M equal to the diameter d. the stepped body 38 is that they can be freely modular connecting element for figures 12 to 16, is a stepped cylindrical body with the largest diameter dl on both sides with a diameter at mounting element 4 to d and the length of the step 40 of the step diameter.

bearing elements 5, cylindrical 38, which also has a length of made

1. The diameter d in the hole 37 freely drags a thickness h equal to the radius d

Each step 40 completes an outer diameter of at least the axis of such diameter, parts 2 with provide less than at least

Perpendicularly drilled holes 41 to move the entire diameter 2d of the supporting elements 1. Perpendicular to

-21the axis 42 of the stepped body 38 of the surfaces forming the foremost feet of the foot 39 extends through one of the diameters of each aperture 41. The axes of the two apertures 41 may be parallel / fig.14/, perpendicular / 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 carrier walls 43 are formed on the step 40.

The material of which the step body is made is rigid, for example chromium-nickel steel.

FIG. 16 shows an embodiment of a modular support element for a supporting element in which the step 39 with diameter d is divided into two parts connected immovably with a cylindrical part 44 of smaller diameter which, for example, may be equal to the diameter 2d of the entire parts 2 of the supporting elements 1.

On the two steps 40 of the step body 38 are mounted annular bodies 45 with a ring height greater than the length of the step 40 with a diameter d whose outer diameter is equal to the diameter dl of the step 39 and the inner diameter is at least equal to the diameter d of the step 40

At least one of the front surfaces of each annular body 45, two opposite arched coaxial grooves 46 are made in the form of segments of a 'cylindrical ring surface with an arc radius at least equal to the radius d of the intersection of the entire parts 2.

-22 Support elements 1 and with a segment height less than the arc radius. The material of which the annular body is made is soft, for example duralumin.

13 shows an embodiment of an annular body in which the inner opening is stepped, the opening 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 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 annular body 45 is fixed to the annular body 38 with a nut 49, wound at the end by a thread Ml.

The modular coupling element 6 shown in FIG. 17 is a composite body consisting of a step body 50, a ring body 45, a tie rod 51 and two clamping nuts 49. A step body 50 made of solid material, for example chromium-nickel steel one step 39 with the largest diameter also dl. One end to the step with a diameter of dl 39 is shaped like

W end for fixing a supporting element with step 40 with diameter d and aperture 41. The other end after the step with diameter dl, there is a step 52 with a diameter at least equal to the diameter d, on the periphery of which a channel 53 of width at least is made. equal to the diameter of the flexible transfixation needle and which groove is perpendicular to the axis of the step body 50, spaced a from the forehead of the step with

-23 largest diameter 39. The foot with the largest diameter dl 39 here has a length greater than the radius of the opening 41. The stepped body 50 at both ends ends with a thread 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 a little equal to the length of the step 52. The hole with a smaller diameter has a diameter equal to or larger than the outer diameter of the thread Ml. The periphery of the spokesman-taper 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 stepped body 50. The dividing plane of the spokesman is even or less than the periphery of the plane separating parts, two parallel openings 57 having a diameter corresponding to the diameter of the implanted spoke and with axes lying in the separation plane of the slot 55 are drilled, with the distance between the openings 57 at least equal to the greater radius of the step opening 54. -fix the anchor 51 is fixed with a nut 49 to the step cross section a

- retainer 51, the distance is perpendicular to the axis and spaced

In the dense part of the speaker-retainer 51, the slit and the dense part symmetrically two equal

-24 body 50. Made of solid material, such as chromium-nickel steel.

The modular coupler element for solid implants 7 (Fig.21 and Fig.22) also consists of a step body 58, a annular body 45 and a clamping nut 49, and there are also two clamping washers 59. The step body 58 is also made of rigid material, for example, steel, and has a step 39 of the largest diameter dl. One end is shaped as an end for fixing a support element by a step 40 on which a ring body 45 is mounted, another step by a thread Ml, on which a press nut 49 is wound and a perpendicular to the axis of the hole with a diameter at least equal to the diameter. 2d of section of the entire parts 2 of the supporting elements. Here, too, the step of the largest diameter dl 39 has a length greater than the radius of the opening 41. The other end after the step 39 is shaped like a step 60 with a diameter equal to the outer diameter of the thread Ml, having a smooth cylindrical part of length equal to or less than the thickness of two clamping washers 59 and ending 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, and 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

-25and less than the radius of. the rainbow

The clamping washers 59 'are fixed with a clamping nut 49 threaded Ml

Here, too, there may be an option where the step 39 is divided into two parts.

FIG. 22 shows an embodiment of a modular rigid element implant element 7 with an extended step 39, wherein the end of the clamping washers 59 of the elongated step 39 and one end of the clamping nut 49 are shaped as support steps 62 with an outer diameter equal to of the outer diameter of the pressure 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 system may be made of a material other than metals, for example, transmitting X-rays or other beams, and the outer shape of the constituent components of the modular connecting elements may be of a multi-wall prism, describing

is a cylinder with cross-sectional diameter dl.

Application of the invention

On Figures 23 and 24 show the joints of elements of the system, in which the axes of two or more members 1 lie in one or more parallel planes. To the flat binder

element 4 are mounted modular connecting elements for the carrier

elements 5 by mounting the steps 40 of the modular

-26 connecting elements 55 in the openings 37 of the flat connecting element 4 and fixing with a nut 49. In the openings 41 on the other end of the elements 5 are fixed by nuts 49 the whole parts 2 of the supporting elements 1. During this fixing the grooves 13 of the supporting element 1 penetrate in the material of the annular bodies 45 and provide the system with additional anti-slip.

The position of the supporting elements 1 is adjusted by unscrewing the nuts 49, orienting them in the desired direction and subsequently tightening the nuts 49.

The position of the axes of the supporting elements 2 and 3 of FIG. 10 in the space is adjusted by tightening the gripping 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 in addition against slipping.

The supporting elements of Fig. 25 are fixed by tightening the nuts 49 and clamping the annular bodies 45 to the supporting members 1. In this case, the grooves 13 of the supporting elements 1 penetrate into the material of the annular bodies 45 and provide anti-slip.

FIG. 26 shows a modular coupling element spiker 6 on which a spokes 63 is mounted, the end 64 of the transfixing needle 63 being pushed through the inner end of one opening 57 so that it passes through the slot 55 of

27 the locking pin 51 and entering the other opening 57 through its outer end.

Adjusting the tension of the transfixing pin 63 is achieved by rotating the transducer-retainer 51, in this case counterclockwise, and subsequent fixing by means of a nut 49.

27, the rigid implants 65 are mounted to the module 7 by clamping in the bow grooves 61 of the pressure washers 59 by tightening the nut 49.

The position of the solid implants 65 with respect to the axis of the module 7 can be adjusted by rotating the pressure washers 59 about this axis. The support element 1 is mounted in the opening 41 of the step body 58 and is fixed with a nut 49 so that the ridges of the support element penetrate into the material of the annular body 45 and provide the elements against relative displacement relative to each other.

With the offered modular system for external fixation, a variety of osteosynthesis apparatus can be flexibly constructed, with the trioporus apparatus illustrated in FIGS. 28 and 29 for the treatment of ankle fracture and the step being exemplary and given only to illustrate the possibilities on

the modular system. P help of for acreage showing ano n a phi 2 8, whereby sliding supporting elements 3 are still

connected to the flat connecting element 4 can be realized

-28 treatment in traumatology for malarial, talar or calcaneal fracture of the heel, as well as in their combination, by ligamentotaxis, which can be dynamic in the stages of treatment, as shown in Fig. 29.

The apparatus shown uses solid implants, which are used to separate three anchor points below the fracture strips. The implants are connected via modular connecting elements 7 to the supporting elements, which may be part or all of the sliding in the form of compression-distraction mechanisms, and in the stages of treatment can be dosed traction on the shoulders for diastasis of the ankle. Here, the flat connecting element 4 plays the role of an artificial joint, bearing the created loads. By releasing the clamping nuts of the modular connecting elements 7, the optimum position for adjustment is selected by extending the corresponding arm formed by the supporting element.

Claims (8)

Patent Claims 1. A modular external fixation system comprising circular cross-members of diameter 2d-intact and sliding, the entire supporting elements being straight and curved, and modular connecting elements having at least one opening, which enters the end of the carrier element and having at least one other opening in which there is an end of another supporting element or implanted element for fixation to the bone, as open modular connecting elements, which enter the ends of the supporting elements, contain compression arcuate sections with radius of arc at least pa a vein of radius d at the cross section of the supporting members, and the openings into which the implanted elements enter have two pressing surfaces containing opposite arcuate portions with a radius of arc corresponding to a radius '' W of the section of the implanted release joint and implant elements between the modular elements erizing that contains at least two beams for direct connection by means of a part and element and comprising helical tightening of the supporting and pressing surfaces of the member, whose spherical pivots a spherical head and a spherical ends are adapted containing two bed radius SFF, one part is made of material with greater hardness -30and on whose spherical surface sharp edges or tips are formed, the other part having a smooth spherical surface and having a nut with a cut inner thread at one end, which is wound on a thread M, made on the outer cylindrical surface, and on the cylindrical surface of the spherical surface the other end of the nut is shaped like a spherical bed of radius ISF with a central hole with a diameter greater than 2d in diameter of the supporting elements and less than 2a in diameter. The ball of the spherical head and / or the edges of at least two supporting elements form a threaded joint. dyne, with one bearing member having a threaded stem and the other bearing member having a threaded socket and / or continuous portions of the bearing members having an outer diameter of 2d, the outer surface of which is made of grooves and may be pre-stressed composite cylindrical bodies, the modular coupling element is symmetrical to one longitudinal axis and the openings into which the ends of the supporting elements or implants enter are perpendicular to the axis, and this modular coupling element comprises a stepped body with an axis coinciding with the ax, a non-uniform step having a diameter d and a length 1 in which a step has a portion of a hole punched in the step body at least equal to the diameter 2d of the supporting member, and at least one pressing surface of the openings of the modular connecting element, which includes the ends of supporting elements is made of a softer material than the material of the other clamping part and the screw -31 the release and tightening connection of the supporting and implanted elements is arranged along the axis of the modular connecting element, this axis and the axis of the connected supporting element defining one plane and having at least one other connecting element representing a flat body of thickness h with disposed on concentric circles of diameters Di with respect to the center of the connecting element, openings with a diameter D at least equal to the diameter 2d of the supporting elements, and the thickness h is greater than the length 1 of the step d by the diameter of the step body of the modular th e connecting element. Modular external fixation system according to claim 1, characterized in that the connecting element is a flat ring with openings of diameter D. Modular external fixing system according to claims 1 and 2, characterized in that the ball head is made of two fixedly connected parts made of a material of different hardness, the material of which the upper hemisphere is made - soft The material of the base of the spherical head and the material of the spherical bed are made of cuts with sharp edges or sharp tips on the spherical surface of the spherical bed. 4. Modular external locking system according to claims 1, 2 and 3. , characterized in that the spherical bed represents collet. 5. . Supporting element for an external modular system fixation, representing a cylindrical body with a forming circle having a diameter of 2 g, characterized in that consists of a pipe of inner diameter dl in which it is housed the core of elastic material that fills the tube, such as at least at one end of the supporting element, the walls of the pipe are flanged to the core, the outer surface of the pipe is grooved and the material of which the pipe is made has a hardness greater than that of the core material. 6. Modular connecting element for a modular system for external fixation, you have two openings formed by pressure surfaces with arched sections and screw connections for collecting and spacing the pressure surfaces, characterized in that it has one central stepped body with a step with a step large diameter dl, located in the middle and / or having a central, two-footed staircase with the largest diameter dl fixedly connected to a cylindrical part n smaller than the diameter dl, and on both sides made of other steps of diameter d and length 1, as holes perpendicular to the axis of the step body on a part of the steps with diameter d are holes with a diameter of at least 2d and smaller than diameter d, so that supporting walls are formed on the step of diameter d, with the axes of the openings parallel or crossed in space, a -33 The ends of the step body are made of thread Ml whose outer diameter is at most equal to the diameter d of the steps, with annular bodies mounted on the step body made of a material softer than that of the step body and with a height of ring - greater than 1 in length and at least one of the front surfaces of each annular body are made of two opposite arcuate axial cuts in prominent segments of the cylindrical surface of the ring, with an arc radius at least equal to the radius r w * of the openings with a height of segment smaller than the radius r of the arc of the segment, and the annular bodies are fixed to the stepped body auxiliary nuts coiled thread Ml of the ends of the step body. 7.Modular coupler-coupler for a modular external locking system having an opening formed by pressure surfaces with arched sections and a screw connection for collecting and spacing the pressure surfaces, characterized in that the body with a foot / foot or the largest / largest foot / body there is a centrally large diameter diameter dl joined by a smaller diameter than the diameter there is one diameter central staircase dl located in the middle bottom body p two steps with the most still with cylindrical part c , and dl, and FROM one side on the step of diameter dl is a step made of diameter d and length 1, and perpendicular to the axis of the step body 34 is a drilled hole with a diameter of at least 2d and less than the diameter d, with a threaded end Ml having an outer diameter at most equal to the diameter d being made after the step with diameter d, a ring-shaped step is mounted on the step with diameter d body made of a material softer than the material of the step body and with a ring height greater than length 1 and at least on one of the front surfaces of the annular body two opposite arched coaxial notches are made in the form of segments of the cylindrical surface ring with w radius of the arc at least equal to the radius d of the openings and with a segment height less than the radius d, and ^{4 the} annular body is fixed to the step body with a threaded nut Ml and the other end after the step diameter d1 has a step with a diameter at least equal to the diameter d having a groove having a width at least equal to the diameter of the transfixing needle periphery and having a groove perpendicular to the axis of the step body at a distance a from the forehead of the step having the largest diameter dl , which ends the step with a threaded end Ml and on this step is mounted a spokes-locking device, symmetrically with respect to the central axis, a body with a central opening whose diameter is at least equal to the diameter of the foot with a peripheral channel and a length at least equal to its length, and the periphery of the speaker-retainer is cut with a slot forming a plane perpendicular to -35central axis with a width at least equal to the width of the peripheral canal of the step body, spaced a from the forehead of the spinner-lock, with two holes with a diameter at least equal to the diameter of the implanted spoke drilled in the dense part and with the axes lying in the plane passing through the middle of the slot, the spokes-retainer being locked with a nut threaded thread Ml on the stepped body. 8. A modular rigid implant element fastener for an external fixation system having an opening formed by pressurized surfaces with arcuate sections and a screw connection for collecting and spacing the pressing surfaces, characterized in that it has a single, large, central, stepped body with a step the diameter of dl located in the middle has a central step body of two steps with the largest diameter dl, fixedly connected to a cylindrical part with a diameter dl, and on one side of the step with a diameter dl a step of diameter d is made. length 1, and a hole with a diameter of at least 2d and smaller than the diameter d is drilled perpendicular to the axis of the stepped body, with a threaded end Ml having an outer diameter most equal after the step with a diameter d. diameter d, on the step diameter d is mounted a ring body made of a material softer than the material of the step -36 body and ring height greater than length 1 and at least on one of the front surfaces of the annular body two opposite arched coaxial notches are made in the form of segments of a cylindrical ring surface with radius of arc at least equal to the radius d of the openings and the height of the segment smaller than radius d, and the annular body is fixed to the step body with a nut wound on the thread Ml, and at the other end after the step with the largest diameter dl of the step body is made a step with diameter at most slightly equal to the outer diameter of the thread Ml, on which were mounted the implanted elements, which are two flat washers with a central hole, and on one face of each washer, curved grooves on the side of the central hole are placed implanted elements in which the grooves are in position the flat washers are fixed with a nut threaded Ml, cut at the end of the step.