CH706273A1 - Surgical implant for treatment of e.g. petrochanteric femoral fractures, has inclined screw traversing intramedullary section and extramedullary section, and curved loop that is able to be deformed to adapt to anatomy of patient - Google Patents

Abstract

The implant has an intramedullary section (52) of lengthened form, where the intramedullary section is adapted for insertion in a medullary canal (37) of a fractured long bone. An extramedullary section (56) is arranged approximately parallel with the intramedullary section. A curved loop (57) is utilized for connecting the intramedullary section to the extramedullary section. An inclined screw (61) traverses the intramedullary section and the extramedullary section. The curved loop is able to be deformed to adapt to the anatomy of the patient.

Description

Technical area

The present invention relates to an implantable device for the treatment of long bone fractures. In particular, but not exclusively, it relates to an implant that can be used for the treatment of fractures of the trochanteric femoral mass. The present invention is also directed to fractures of the proximal humerus or other long bones with similar problems and therapies.

State of the art

The femoral trochanteric fractures are fractures concerning the proximal part of the femur near the hip joint. These traumas are part of the fractures called in the common language of femoral neck fractures and most often affect the elderly. Their therapy is based in most cases on rapid surgical treatment with anatomically correct reduction followed by the placement of an implant that stabilizes the fracture. These procedures have been shown to provide walking rehabilitation in fairly fast times and significantly improve the healing rate.

The currently employed techniques include the stabilization of the fracture either by endomedullary implants inserted into the diaphyseal canal, or by plates or blades screwed to the bone. Screws or other devices oriented along the axis of the femoral neck are also used to stabilize the femoral head.

The device disclosed by EP 0 546 460 B1, for example, comprises a trochanter stabilization plate connectable by a screw to a centromedullary nail and comprising two inclined screws, on either side of the medullary canal for the stabilization of the head and neck of the femur.

US 7,632,272, on the other hand, discloses an intramedullary fixation with an inclined screw for sinking into the head of the femur and a wafer for the stabilization of the greater trochanter.

The angulation of the femoral neck relative to the femoral diaphysis has a high variability with respect to the individual morphology, sex and age, it is therefore necessary to have implants reconstructing the anatomically correct angulation for each patient. This inevitably leads to a multiplication of the number of implants to be provided to each hospital to allow the emergency treatment of this type of fracture.

Moreover, so-called intertrochanteric or pertrocantérien fractures often cause a rupture of the upper part of the femur called "greater trochanter" in which attach several muscles responsible for stability and walking and exerting significant forces therein. Generally used implants do not always allow adequate stabilization of these fractures.

Brief summary of the invention

An object of the present invention is to provide an implant free of limitations of known devices, including an implant for complete stabilization of the greater trochanter in intertrochanteric fractures or pertrocantériennes.

Another object of the invention is to provide an implant easily adaptable to a plurality of anatomical configurations.

According to the invention, these objects are achieved by means of the object of the appended claims, and in particular by a surgical implant with an intramedullary section of elongate shape, adapted for insertion into the medullary canal of a long bone. fractured, an extramedullary section substantially parallel to the intramedullary section, a deformable curved loop connecting the intramedullary section to the extramedullary section, an inclined screw passing through said intramedullary section and said extramedullary section.

Brief description of the figures

Examples of implementation of the invention are indicated in the description illustrated by the appended figures in which: <tb> Figs. 1a-1c <sep> schematically illustrates an element of the implant according to the invention. <tb> Fig. 1d <sep> illustrates a variant of the implant of the invention <tb> Fig. 2 <sep> shows, in a simplified manner, an implant according to an aspect of the invention in position in the proximal portion of a femur, in frontal section.

Example (s) of embodiment of the invention

Figs. 1a-1c illustrate an element of the implant according to one aspect of the invention and which has an intramedullary section 52, essentially straight and adapted for insertion into the medullary canal 37 (visible in FIG. concerned, for example the femur. The implant also has an extramedullary section 56, substantially parallel to the intramedullary section 52, with holes 58, 59 allowing its attachment to an outer face of said bone, as will be seen later.

The curved handle 57 connecting the intramedullary section 52 to the extramedullary section 56 has a shape adapted to match the anatomical profile of the greater trochanter. Advantageously, the handle 57 is deformable to adapt to the individual morphology of each patient.

The deformation of the loop 57 can be obtained in several ways. In a variant, represented by FIG. 1d, the handle 57 has a number of segments of reduced section 55a-55d forming deformable hinges. With this feature the surgeon can deform the implant and obtain the desired degree of curvature by applying a reasonable force. According to another variant, shown schematically in FIG. 1b, the handle 57 is constituted by a deformable blade and / or elastic, because of its relatively small thickness.

FIG. 2 schematically shows the implant of the invention in place. The intramedullary section 52 inserted in the diaphyseal canal 37, of a femur 39, can be seen, while the extramedullary section 56 is placed on a lateral side of the bone, and the loop 57 surrounds and supports the greater trochanter 38. The Diaphyseal canal 37 will have been previously opened and reamed to the desired diameter by known techniques.

Several attachment means may be envisaged to hold the implant in place. A through screw 56, near the distal end, for example, and one or more screws 68 in one or more openings 59 to fix the extramedullary section 56 on the lateral face of the femur, as for a plate type conventional.

The implant of the invention also comprises an inclined cephalic screw 61 passing through the intramedullary section 52 and the extramedullary section 56 by two openings 58, respectively 54. The angle α between the screw 61 and the intramedullary section 52 corresponds to the inclination of the neck of the femur, so that the screw 61 can pass through the neck 32 along its axis, penetrate into the head of the femur 31 and make it integral.

[0018] Importantly, the angle α of the screw 61 can be modified by acting on the curvature of the loop 57, and the alignment of the openings 58, 54, in order to adapt better to the anatomy of each patient. The ideal angle α can be determined by preoperative radiographs of the contralateral healthy reed, or prior to the implant, when the fracture is reduced, using a surgical X-ray machine.

Preferably the intramedullary section 52, the extramedullary section 56 and the loop 57 are constituted by a single solid element, for example a metal element of titanium or surgical steel, or another biocompatible material. The implant of the invention thus comprises a very small number of detachable parts.

The embodiments presented refer only to an implant for fractures of the human femur. The present invention, however, also includes specific variants for the treatment of fractures of other long bones, including the humerus.

Reference numbers used in the figures

[0021] <tb> 31 <sep> head of the femur <tb> 32 <sep> femoral neck <Tb> 33 <September> fracture <tb> 36 <sep> little trochanter <tb> 37 <sep> diaphyseal canal <tb> 38 <sep> great trochanter <Tb> 39 <September> shaft <tb> 52 <sep> intramedullary section <Tb> 54 <September> passageway <Tb> 55a-d <September> hinge <tb> 56 <sep> extramedullary section <Tb> 57 <September> Cove <Tb> 58 <September> passageway <tb> 61 <sep> cephalic screw <tb> 65 <sep> distal stabilization screw <tb> 68 <sep> external stabilizing screw <Tb> α <September> angle

Claims (5)

1. Surgical implant for the treatment of long bone fractures, with an intramedullary section (52) of elongated shape, adapted for insertion into the medullary canal (37) of a long fractured bone, an extramedullary section (56) substantially parallel to the intramedullary section (52), a curved snare (57) connecting the intramedullary section (52) to the extramedullary section (56), an inclined screw (61) passing through said intramedullary section (52) and said extramedullary section (56). ), characterized in that said handle (57) is deformable. 2. The implant of the preceding claim, wherein said handle has segments of reduced section (55a-55d) allowing its deformation by applying a force. 3. The implant of claim 1, wherein said handle is constituted by an elastic blade and / or deformable by applying a force. 4. The implant of one of the preceding claims, wherein said intramedullary section (52), said extramedullary section (56) and said loop (57) are constituted by a single solid element. 5. The implant of one of the preceding claims, wherein said extramedullary section (56) comprises one or more openings (59) for attachment to a face of said bone by screws (68).