DE102009033270A1 - Marking pin, particularly for tibia, comprises proximal end part, shank portion and distal end part for insertion into marrow space with lead-through units for locking pin - Google Patents

Abstract

The marking pin comprises a proximal end part (1), shank portion (2) and a distal end part (3) for insertion into the marrow space with lead-through units for a locking pin (8). The lead-through units are arranged for rotating around the longitudinal axis in different angles to the horizontal plane (7) and longitudinal axis or frontal plane of the marking pin.

Description

The The invention relates to an intramedullary nail, in particular for the Tibia according to the preamble of the claim 1.

With the previously available tibial locking nails is a supply of metaphyseal body close Fractures on the lower leg not sufficiently possible. reason this is a residual instability in the fracture area, due to the insufficient locking options the nails. These instabilities can lead to the formation of a pseudarthrosis (not healing Bone fracture), which then has to be surgically treated.

Is known from the US 6,020,506 an intramedullary nail having pressable proximal and distal end portions which are angled relative to each other by a plurality of arcuate segments disposed axially between the end portions.

moreover the pressable proximal end portion is cranked so that between the applied at the axial ends to the central axes Tangents a relatively large angle is formed. adversely on this known intramedullary nail is he for applications in relatively straight tubular bones, in particular the Tibia is not suitable.

Also from the WO 2006/069453 A1 For example, an intramedullary nail is known, in particular for the tibia, with a proximal end portion and a distal intramedullary end portion having a curved axis, the tangents enclosing an angle of 9 ° to 12 ° in the two curved portions. Another disadvantage is that the intramedullary nail after insertion into the tibia does not have the desired positional stability.

Described in the WO 2006/040612 A1 an intramedullary nail for insertion into the medullary cavity with a proximal nail portion and an adjoining distal nail portion and with holes for bone screws in both nail sections. In the proximal nail section, there is at least one bore running obliquely to the longitudinal axis, so that the bone screws can be introduced into the tibial plateau. The disadvantage is that the blockage in the bone is not sufficient.

Of the Invention has for its object to create an intramedullary nail, which are well inserted into the medullary canal in its shape can and at the same time arrange bushings so that by the introduction of locking bolts a good positional stability can be achieved.

These The object is achieved by the characterizing features of claim 1. Further advantageous Embodiments emerge from the subclaims.

It has shown that the task by the invention Intramedullary nail is solved.

The Advantages achieved by the invention are essentially therein to see that thanks to the intramedullary nail according to the invention the new nail penetrations in the proximal area for Locking pin has opposite angles the horizontal plane and at the same time opposite the frontal plane exhibit. The axis of the locking bolt has an angle to Horizontal plane (transversal plane) from 1 ° to 20 °, Particularly preferred is an angular range of 5 ° to 15 °. The screwing direction is in the direction of the cranial of the proximal End. The angle of the locking pins in the intramedullary nail to the frontal plane is 40 ° to 50 °, preferably 45 ° alternately in ventral or dorsal direction, leaving the locking bolts each other at an angle of 90 ° on the longitudinal axis in the proximal area at intervals intersect. additionally there is a slot in the proximal area, for the Inserting a bone screw to compress the fracture. The slot in the intramedullary nail is arranged so that the axis of the compression screw lies on the frontal level. It has been shown that the distance the proximal locking bolt to each other preferably is not the same distance, but this is not according to the invention required.

According to the invention the distance of the locking pin to each other from proximal to distal increasingly, preferably in the ratio 1 to 1.2 to 1 to 1.6, while the distance of the compression screw to close to locking bolt is preferably the same size, like the distance between the two outer proximal arranged locking bolt.

At the proximal end is laterally an oblique surface arranged the transition and the contour closure between a goal strap and nail interrupts. This is at anterior-posterior images, e.g. B. by X-ray or Image intensifier (BV) the end of the nail easily and clearly recognizable. The nail entry point lies on the lateral surface of the Trochter majors. The advantage of the inclined position is also in that the bevel ensures that the proximal Nail end a contoured conclusion with the lateral Cortex wall forms. An additional groove in the sagittal plane at the proximal end of the nail is located on the medial side above which the position of the nail is fixed on the aiming bar for inserting the intramedullary nail by means of a target device.

According to the invention in the shaft area further bushings for locking bolts arranged both in the middle and in the distal end. The bushings in the middle part of the shaft area in the intramedullary nail are preferred still in the proximal region, not over the middle of the intramedullary nail out, arranged. The here arranged bushings have an angle of 0 ° to 20 ° to the horizontal plane. Favor is but an angle of 0 °.

At the distal end part is next to the bushings for the locking bolts a threaded hole arranged to an optimal mechanical distal locking. This distal threaded hole is after the arrangement of the bushings for the locking bolt arranged in the proximal direction. The implementation of the distal Threaded hole is opposite the proximal threaded hole in The axis of the intramedullary nail twisted by 90 °. Thus, one is optimal locking guaranteed.

Of the particular advantage of the shaft bushings for Locking bolt in the shaft area is in that long distal bone fragment in metaphyseal fractures additionally can be locked in this area, in addition to a lock in the distal area. But it is also possible, only one Lock, according to the requirements of the Fracture. Due to the different angles of the locking bolts in the proximal bone fragment and the additional latches in the shaft area is a previously non-existent stability in the tibia with a fracture possible.

The essential shape of the intramedullary nail according to the invention refers to the shape of the medullary canal and the arrangements for the bushings for the locking bolts and bone screws.

Of the Shaft of the intramedullary nail according to the invention has while at the proximal end portion a bend up to 8.5 ° from the axis of the proximal region. Usually is due to the bone shape, the distal end part following the Shank area again angled in the same direction as the Shank area opposite to the proximal area. This bend may additionally be up to 5 °, preferably but is an angle of 2 ° to 3 °.

Further Advantages and details will become apparent from the following description with reference to the accompanying drawings.

The Invention will hereinafter be an embodiment be explained in more detail.

It demonstrate:

1 Intramedullary nail in semi-lateral view

2 Intramedullary nail in plan view to the frontal plane

3 Intramedullary nail in plan view to the sagittal plane

The 1 shows the semi-lateral view of the intramedullary nail in the position, in addition to the bushings with locking bolts 8th also the bends are shown. The intramedullary nail is divided into a proximal end part 1 , a shaft part 2 and a distal end part 3 , In the end part 1 are proximal penetrations 4 with locking bolt 8th arranged. The axes of the locking bolts 8th form with the horizontal plane 7 an angle γ, in this case 10 °. At the same time is in the proximal end part 1 a slot 12 arranged with a bone screw 13 , In the shaft part 2 are two shaft bushings 5 arranged for locking bolts, not shown. Also in the distal end part 3 are more distal ducts 6 with locking bolt 8th and a distal threaded hole 14 shown. In the 1 can also be seen that the intramedullary nail is several times angled slightly.

In the 2 is clearly the division in proximal end part 1 , Shaft part 2 and distal end part 3 to recognize. In the proximal end part 1 are again the bushings 4 with the locking bolts 8th and the slot 12 with the inserted bone screw 13 , The shaft bushings 5 in the shaft part 2 are shown here without locking bolts. The shaft 2 In this example, it is opposite the proximal end part 1 by the angle α, angled in this example by 8.5 °. The distal end part 3 is opposite the shaft part 2 by the angle β, in this example by 2.5 ° in the same direction as the shaft part 2 opposite the proximal end part 1 angled. In the distal end part 3 are also locking screws 8th and the distal threaded hole 14 shown. At the end of the proximal end part 1 Cranial are the oblique surface 9 towards lateral and the groove 10 center.

In the illustrated 3 In the plan view in the sagittal plane, in particular the angles δ are clearly visible. Because the longitudinal axis 11 is located on the frontal level, it is easy to see that the arrangements of the locking bolts 8th from this dorsal and ventrally differ in angles δ. This angle is in this example 45 °, so that the position of the locking bolt 8th offset from each other by 90 °. Also, the shaft penetrations 5 and the locking bolts 8th in the distal end part 3 clearly visible.

LIST OF REFERENCE NUMBERS

1

proximal end

2

shank part

3

distal end

4

proximal execution

5

Shaft bushing

6

distal execution

7

WL

8th

locking bolt

9

slope area

10

groove

11

Longitudinal axis / frontal plane

12

Long hole

13

bone screw

14

distal threaded hole

α

shaft angle

β

Distalwinkel

γ

Horizontal angle

δ

Frontal plane angle

QUOTES INCLUDE IN THE DESCRIPTION

This list The documents listed by the applicant have been automated generated and is solely for better information recorded by the reader. The list is not part of the German Patent or utility model application. The DPMA takes over no liability for any errors or omissions.

Cited patent literature

• - US 6020506 [0003]
• - WO 2006/069453 A1 [0005]
• WO 2006/040612 A1 [0006]

Claims (12)

Intramedullary nail, in particular for the tibia, with a proximal end part ( 1 ), a shank part ( 2 ) and a suitable distal end part ( 3 ) for insertion into the medullary cavity with passages for locking bolts ( 8th ), characterized in that bushings ( 4 . 5 . 6 ) rotating about the longitudinal axis ( 11 ) at different angles (γ, δ) to the horizontal plane ( 7 ) and to the longitudinal axis / frontal plane ( 11 ) of the intramedullary nail are arranged. Intramedullary nail according to claim 1, characterized in that the angle (γ) of the lead-throughs ( 4 ) in the proximal end part ( 1 ) from 1 ° to 20 ° to the horizontal plane ( 7 ) amount. Intramedullary nail according to claim 1, characterized in that the angles (δ) of the lead-throughs ( 4 ) in the proximal end part ( 1 ) to the frontal level ( 11 ) 40 ° to 50 °. Intramedullary nail according to claim 1, characterized in that the spacings of the bushings ( 4 ) in the proximal end part ( 1 ) to each other from proximal to distal are increasing. Intramedullary nail according to claim 1 or 4, characterized in that the spacings of the bushings ( 4 ) in the proximal end part ( 1 ) are preferably increasing in the ratio of 1 to 1.2 to 1 to 1.6. Intramedullary nail according to claim 1, characterized in that shaft penetrations ( 5 ) for locking bolts ( 8th ) in the shaft area ( 2 ) are arranged. Intramedullary nail according to claim 1 or 6, characterized in that the shaft passages ( 5 ) in the shaft part ( 2 ) are preferably arranged in the proximal region near the middle of the intramedullary nail. Intramedullary nail according to claim 1, characterized in that the intramedullary nail at its proximal end part ( 1 ) a laterally disposed inclined surface ( 9 ) having. Intramedullary nail according to claim 1, characterized in that the intramedullary nail at its proximal end part ( 1 ) cranially a groove ( 11 ) having. Intramedullary nail according to claim 1, characterized in that the shaft part ( 2 ) opposite the proximal end part ( 1 ) is angled by up to 8.5 °. Intramedullary nail according to claim 1, characterized in that the distal end part ( 3 ) in relation to the shaft part ( 2 ) is angled up to 5 °. Intramedullary nail according to claim 1, characterized in that in the distal end part ( 3 ) next to the distal bushings ( 6 ) a distal threaded hole ( 14 ) is arranged.

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