EP3151769A2 - Dispositif pour fixer une broche de kirschner - Google Patents

Dispositif pour fixer une broche de kirschner

Info

Publication number
EP3151769A2
EP3151769A2 EP15731843.7A EP15731843A EP3151769A2 EP 3151769 A2 EP3151769 A2 EP 3151769A2 EP 15731843 A EP15731843 A EP 15731843A EP 3151769 A2 EP3151769 A2 EP 3151769A2
Authority
EP
European Patent Office
Prior art keywords
fixing device
opening
longitudinal hole
designed
kirschner wire
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
EP15731843.7A
Other languages
German (de)
English (en)
Inventor
Heiko Baumgartner
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Individual filed Critical Individual
Publication of EP3151769A2 publication Critical patent/EP3151769A2/fr
Ceased legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/842—Flexible wires, bands or straps
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • A61B17/848—Kirschner wires, i.e. thin, long nails
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/04—Surgical instruments, devices or methods, e.g. tourniquets for suturing wounds; Holders or packages for needles or suture materials
    • A61B17/0401—Suture anchors, buttons or pledgets, i.e. means for attaching sutures to bone, cartilage or soft tissue; Instruments for applying or removing suture anchors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0642—Surgical staples, i.e. penetrating the tissue for bones, e.g. for osteosynthesis or connecting tendon to bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B17/0643—Surgical staples, i.e. penetrating the tissue with separate closing member, e.g. for interlocking with staple
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8695—Washers
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/064—Surgical staples, i.e. penetrating the tissue
    • A61B2017/0641—Surgical staples, i.e. penetrating the tissue having at least three legs as part of one single body

Definitions

  • the present invention relates to a fixation device for medical care in surgery for Kirschner wires to their wandering or loosening, such.
  • bone fracture The basic medical goal of any bone fracture (bone fracture) is for the bone to grow together quickly in a functional position. Not always, this can be achieved by a prolonged immobilization by means of plaster cast, but it is a surgical intervention required to reassemble the bone or fracture ends. For this purpose, the break ends are joined together in the correct position, to then fix them by nails, screws, plates or special wires in the respective position.
  • Kirschner wires Such a Kirschner wire is a sharpened wire, with or without threads, made of steel, a nickel-containing metal alloy or titanium.
  • the Kirschner wire is drilled into the bone by rotation. While originally used only for attaching an extension, osteosynthesis (bone union) was later also used as part of fracture treatment. .hing and has proven itself, so that the Kirschner wire is still used today for the closed reduction and fixation of bone fractures. Kirschner wires can be bent over the bone and sunk or inserted percutaneously.
  • the Kirschner wires may also be wrapped around the bones, which is referred to as a tension band.
  • the principle of Buchgurtung based on the fact that a hinged as possible fixed, tensile structure in the form of a wire loop is applied to the fragments of fracture and attached to the tendon or bone attachments. By the active movement, in particular the diffraction, the applied tensile stress against the wire loop is converted into a compressive stress in the fracture gap, so that the fragments can approach and compress each other. Thus, they are held by the Wergurtung in a correct position and the fracture gap healed.
  • the advantages of osteosynthesis using Kirschner wires are basically a low surgical effort and a low invasiveness.
  • the straight drill wires find a poor grip, they were not introduced bicortically or dissolve by too little train the wire loop. In these cases, the wire may re-migrate. As a result, the stability is significantly reduced at the level of the fracture gap. It comes to a tilting of the fragments, enlargement of the fracture gap and ultimately to pseudarthroses or even by a complete failure of the construction to a dehiscence of the fragments with loss of function of the stretching apparatus.
  • the protruding from the bone, bent portion of the drill wires can rotate more than 90 °, thereby sliding the wire loop on the straight wires and thus cause a failure of the construction. Eventually, it eventually results in an increased rate of premature joint wear.
  • the present invention is based on the problem of providing a fixation device for medical care, which allows a fixation of fasteners used in surgery, in particular Kirschner wires by preventing both loosening and a wandering of the wire, and at the same time represents soft tissue protective covering of the wire.
  • a fixing device for medical care which cooperates with at least one fastening means and which has at least one opening for receiving the fastening means which engages through the at least one opening, is held in place and stable by a mounting material.
  • the fixing device according to the invention is planar as a plate, curved on all sides or cap-shaped formed as a ball gate.
  • the diameter of the opening may be formed smaller than the maximum extent of the opening passing through the fastening means transverse to the penetration direction.
  • fastening means projects only partially through the longitudinal hole. It is not completely passed through the longitudinal hole and does not slip through this, but is held by this and in this.
  • the opening is formed as a longitudinal hole, as a round hole, ellipsoidal, oval or rectangular in cross-section, wherein the formation of the opening includes a combination of said forms.
  • the fixing device according to the invention has, in addition to the one opening, at least two further openings for receiving the fastening material.
  • the fixing device can have an enlarged head area, followed by a taper.
  • the opening may be formed as a longitudinal hole, wherein the longitudinal hole has on both sides along its longitudinal direction in each case at least one bulge, and these bulges are formed regularly or irregularly compared to the longitudinal hole in comparison.
  • the fixing device according to the present invention can be designed as a ball gate, wherein circumferentially distributed depressions are formed on its outer boundary.
  • the fixing device according to the invention is formed as an annular oval, which forms an opening in the form of an oval longitudinal hole in its interior, wherein on the annular oval opposite each other and corresponding tunnel-like elevations are arranged.
  • the opening passing through the fastening means may be formed as a Kirschner wire.
  • the opening is formed as a longitudinal hole and the opening by cross-fastening means as a Kirschner wire, wherein the longitudinal and the transverse diameter of the longitudinal hole are adapted to the strength of the Kirschner wire.
  • the transverse diameter of the longitudinal hole may be formed so that it corresponds to the diameter of the Kirschner wire used plus at least 0.05mm, preferably plus 0.1mm and a maximum of plus 1, 0mm.
  • the attachment material may be threads and wires.
  • the fixing device according to the invention is made of plastic or metal and the metal is selected from stainless steel or titanium.
  • the invention also relates to the use of the fixing device in one of its abovementioned embodiments in the context of osteosynthesis.
  • the fixing device according to the invention makes it possible that no additional anchoring in the surrounding soft tissue or bony structures is necessary. In addition, the maximum load on the overlying the bone fracture area soft tissue is reduced by increasing the area. It is important that through the use of the fixing device according to the invention an otherwise usual bending of the drill wires at the two ends, such as. B. in the case of Switzerlandgurtung a patellar fracture is superfluous.
  • the fixing device according to the invention is applied only after completion of the construction required for the osteosynthesis and no predetermined length of the drill wires must be used.
  • a three-dimensional view of a fixing device according to the invention in all-round arched shape according to a first exemplary embodiment
  • a three-dimensional view of the fixation device according to Fig. La in cooperation with an osteosynthesis by Switzerlandgurtung, without associated mounting material a three-dimensional view of Fig.
  • FIG. 6a a schematic plan view of a fixing device according to the invention with an irregularly modified longitudinal hole as a single opening, a schematic plan view of a fixing device according to the invention with an oval outline and a longitudinal hole as a single opening, modified with two molded on each side bulges, a schematic plan view of an inventive fixing device with oval outline and a longitudinal hole as the only opening of Fig.
  • a schematic side view of a fixing device according to the invention in the form of an annular oval with a lateral tunnel-like elevation a schematic side view of a fixing device according to the invention in the form of an annular oval with an approximately central tunnel-like elevation, a schematic side view of a fixing device according to the invention in the form of an annular oval, a schematic plan view of the fixing device in the form of the annular Ova 8a, a schematic plan view of a fixing device according to the invention with a circular outline and an opening in the form of an oval longitudinal hole, and a schematic plan view of a fixing device according to the invention in the form of a circular ring with an opening in the form of a round hole.
  • a first embodiment of the fixing device according to the invention is shown and indicated generally by the reference numeral 1.
  • the fixing device 1 according to this embodiment is flattened in plan and formed in approximately mushroom-shaped, so that it has an enlarged head portion 3, to which a taper 5 is connected.
  • the fixing device 1 Approximately in the center, the fixing device 1 has an opening in the form of a longitudinal hole 7, which extends in the longitudinal direction in the direction of the taper 5 of the fixing device 1 and whose narrow sides are closed by semicircles whose diameter corresponds to the width of the longitudinal hole 7.
  • This longitudinal hole 7 serves to receive the bent portion of a fastening means in the form of a drill or Kirschner wire 9, which Figs.
  • Lb and lc show, wherein the bent portion of the Kirschner wire 9 for the sake of better clarity additionally with the reference numeral 9 'is provided.
  • the bent-over part 9 'of the drill or Kirschner wire 9 reaches through the longitudinal hole 7.
  • the longitudinal and the transverse diameter of the longitudinal hole 7 are based on the strength of the Kirschner wire 9 used and are tuned to this.
  • the longitudinal and the transverse diameter of the longitudinal hole 7 can thus vary depending on the thickness of the Kirschner wire 9 to be used.
  • the transverse diameter of the longitudinal hole 7 is formed so that it corresponds to the diameter of the Kirschner wire 9 used plus at least 0.05 mm, preferably plus 0.1 mm and a maximum of plus 1.0 mm.
  • the diameter of the longitudinal hole 7 in its longitudinal direction is important that this longitudinal diameter is smaller than the maximum extent of the protruding through the longitudinal hole 7, bent portion of the Kirschner wire 9 in this longitudinal direction.
  • the fact is made use of the fact that the two legs of the bent Kirschner- or drill wire 9 are closer to each other in the region of the bend and thus are spaced less from each other, as in the further course of the bend.
  • the inclusion of the Kirschner wire 9 is not limited to the longitudinal hole 7 shown for the purpose of illustrating the invention.
  • the opening for receiving the Kirschner wire 9 may, for example, also be ellipsoidal, oval or rectangular in cross section, and may include a combination of these shapes. This list is not meant to be exhaustive.
  • two further openings each in the form of holes 11, which are of circular design, are located adjacent to the two ends in the longitudinal direction of the longitudinal hole 7. These serve for receiving fastening material.
  • threads and wires including polyethylene special threads made of UHMWPE, as commercially available from Arthrex Inc. under the brand name FiberWire®.
  • threads 13 are introduced here and knotted by receiving a cerclage wire 15 applied to the fracture therebetween and to the bone, which is illustrated in FIG. 1c.
  • a cerclage wire 15 applied to the fracture therebetween and to the bone, which is illustrated in FIG. 1c.
  • a wire wrap to understand, as it is known, for example, in the patella (patellar) fracture or in the elbow hook as wrap.
  • the leadership of Cerclagerahtes 15 is also already apparent from Fig. Lb and shows that the bent portion of the Kirschner wire 9, the cerclage wire 15 summarizes.
  • the further holes 11 have a diameter of at least 0.6 mm in order to be able to introduce a strong fastening material.
  • the fixing device 1 is curved on all sides.
  • the (bone or body-distant) surface facing away from the imaginary bone or body to be fixed is convex, and the surface (bone or body-proximate) facing this bone or body is concave.
  • the illustrated fixing device 1 is not only metal, here preferably titanium, but also plastic suitable. All edges of the respective openings of the fixing device, i. of the longitudinal hole 7 and the other, circular holes 11 are deburred in the embodiment. The same applies to the outer edges of the fixing device.
  • Kirschner drill wire 9 When Kirschner drill wire 9 is used alone, ie without the Cerclage 15, fixation can be performed transosseously by means of bone suture. The one or more stand-alone wires 9 are then secured by means of the fixing device 1 on the bone or soft tissues with fastening material.
  • the described fixation device 1 according to the invention can be used correspondingly in a so-called spiked-wire osteosynthesis. In this fixation method known as Spickung bridge usually two to three introduced by drilling Kirschner wires 9 the break and serve to stabilize it. By means of the fixing device according to the invention, the Kirschner wires 9 are held in place.
  • the tension belt is to be mentioned, which will be explained below with reference to FIG. 2 using the example of the tension belt on the elbow.
  • the current principle and thus the known state of the art is explained:
  • two Kirschner drill wires 9 are parallel introduced longitudinally from a fragment across the fracture gap 17 to the other fragment as close to the joint surface.
  • the aim is also to pierce the counter cortex 19 and to let the Kirschner drill wire 9 survive less than 1 cm, which is made clear in Fig. 2 by the letter a) as reference numerals.
  • a wire loop from a cerclage wire 15 is placed in a figure-of-eight shape around the ends 21 of the Kirschner drill wire 9 protruding from the bone near the approach of the tendons and guided by a transverse bone bore 23.
  • the fixation device according to the invention is without additional attachment to the bone, tendons or other soft tissue structures.
  • Exemplary embodiment 1.2
  • FIG. 3 is a variant of the under 1.1 as a second embodiment. explained illustrated first embodiment of the fixing device according to the invention and therefore only briefly explained below. For this purpose, identical features to the first embodiment with the same, but provided by 100 extended reference numerals.
  • the only difference of this variant of the fixing device 101 according to the invention this is not curved on all sides, but formed in a plate-like planar shape. This has the advantage that the fixing device 101 can be adapted to the corresponding anatomical bone conditions by selecting the appropriate curvature configuration for medical care.
  • the fixing device 101 is formed in plan view approximately flattened mushroom-shaped, has an enlarged head portion 103 and an adjoining taper 105.
  • An opening in the form of a longitudinal hole 107 is again provided approximately centrally, which extends in its longitudinal direction in the direction of the taper 105 of the fixing device 101 and whose narrow sides are closed by semicircles whose diameters correspond to the width of the longitudinal hole 107.
  • This longitudinal hole 107 serves to receive the bent portion of a fastener in the form of a drill or Kirschner wire, which is not illustrated here in detail again. Reference is therefore made to the further explanations to the first embodiment. They apply analogously here.
  • the diameter of the longitudinal hole 107 in its longitudinal direction is also important here that this longitudinal diameter is smaller is, as the maximum extent of projecting through the longitudinal hole 107, bent portion of the Kirschner wire 109 in this longitudinal direction.
  • two further openings each in the form of holes 111 are located adjacent to the two ends in the longitudinal direction of the longitudinal hole 107. These serve to receive fastening material, as already explained.
  • the leadership of Cerclagedrahtes is already apparent from Fig. Lb in connection with the first embodiment and there shows, as already described and here as applicable, that the bent portion of the Kirschner wire 9 the cerclage wire 15 summarizes.
  • the further holes 111 have a diameter of at least 0.6 mm in order to be able to introduce a strong fastening material.
  • the advantages described above such as a significant improvement in the pressure conditions by reducing the pressure on the overlying soft tissue, are also true.
  • the maximum load on the soft tissue overlying the bone fracture area is reduced by increasing the area.
  • the material used for the fixing device 101 shown here is metal, preferably titanium. All edges of the respective openings of the fixing device, i. of the slot 107 and the other, circular holes 1 1 1 are deburred. The same applies to the outer edges of the fixing device.
  • Embodiment 1.3
  • Fixing device in all-round arched shape or plate-like planar shape with reduced number of holes
  • the third embodiment of the inventive fixing device to be explained here is a variant of both the first embodiment shown in FIG. 1.1 and that of the variant explained below under 1.2.
  • This third embodiment is not shown in detail in the accompanying drawings.
  • the modification of the fixing device according to this third exemplary embodiment is again flattened in plan view and formed in approximately mushroom-shaped and has an enlarged head portion, followed by a taper.
  • this fixing device Approximately in the center, this fixing device has an opening in the form of a longitudinal hole which extends in its longitudinal direction in the direction of the taper of the fixing device and whose narrow sides are closed by semicircles whose diameters correspond to the width of the longitudinal hole.
  • This longitudinal hole is also used again for receiving the bent portion of a fastener in the form of a drill or Kirschner wire, reference being made to the Fig. Lb and lc.
  • the bent part of the drill or Kirschner wire passes through the longitudinal hole.
  • the longitudinal and the transverse diameter of the longitudinal hole depend on the strength of the Kirschner wire used and are matched to this, so that he can not slip out of the longitudinal hole, but gets stuck in this.
  • the diameter of the longitudinal In the longitudinal direction this is again smaller than the maximum extent of the bent part of the Kirschner wire protruding through the longitudinal hole in this longitudinal direction.
  • Fig. 4a a fourth embodiment of the fixing device according to the invention is shown, which will be explained below.
  • the same features are provided with the same, but extended by 200 reference numerals to the first embodiment.
  • the fixing device 201 is a cap whose cross-section, as shown in FIG. 4b, corresponds to a ball gating.
  • the fixing device 201 is bent in the shape of a cap or arched on all sides in such a way that the surface (bone or body-remote) facing away from the fixed bone or body to be fixed convex and the bone or body facing (bone or body-close) surface is concave.
  • a longitudinal hole 207 is located almost centrally. However, this is to be regarded as a depression in the fixing device 201 on the underside, which is indicated in FIG. 2b by the reference numeral 225.
  • the longitudinal hole 207 is also used here for receiving the bent portion of the fastener not shown in detail in Figs. 4a and 4b in the form of a drill or Kirschner wire.
  • the illustrated fixing device 201 is next to metal, here preferably titanium, and plastic. All edges of the respective openings of the fixing device, i. of the slot 207 and the other, circular holes 211 are deburred in the exemplary embodiment. The same applies to the outer edges of the fixing device.
  • Fixing device with all-round arched shape or plate-like planar shape and modified longitudinal hole
  • FIG. 5 shows a further embodiment of the fixing device according to the invention.
  • identical features to the first exemplary embodiment are provided with the same but by 300 extended reference symbols.
  • This embodiment is shown in a two-dimensional view, as shown in FIG. 5. This makes it clear that they can be curved on all sides as well as formed in a plate-like planar shape. For the formation in a plate-like planar form has already been explained above that this is the Part has to be able to adjust the fixing device 301 by selecting the appropriate respectively for medical care curvature configuration of the corresponding anatomical bone conditions.
  • the fixing device 301 according to this embodiment is formed approximately oval in plan, but may also be formed in the plan around.
  • the fixing device 301 has an opening in the form of a modified longitudinal hole 307.
  • This longitudinal hole 307 has on both sides along its longitudinal direction in each case a bulge 329, 329 ', which are formed irregularly in this embodiment in comparison to each other.
  • the longitudinal hole 307 serves to receive the bent portion of a fastening means in the form of a drill or Kirschner wire not shown in Fig. 5 and the bent portion of the drill or Kirschner wire passes through the longitudinal hole 307th
  • the longitudinal and transverse diameters of the longitudinal hole 307 are based on the thickness or thickness of the Kirschner wire used and are matched thereto. Longitudinal and transverse diameters of the longitudinal hole 307 thus vary depending on the thickness of the Kirschner wire to be used. Essential here is the transverse diameter of the longitudinal hole 307, which is formed according to the first embodiment so that it corresponds to the diameter of the Kirschner wire used plus at least 0.05mm, preferably plus 0.1mm and a maximum of plus 1, 0mm.
  • the diameter of the longitudinal hole 307 in its longitudinal direction is important that this longitudinal diameter is formed smaller than the maximum extent of the projecting through the longitudinal hole 307, bent portion of the Kirschner wire in this longitudinal direction.
  • a greater degree of freedom is achieved in the medical treatment of a bone fracture. Because by the bilaterally along the longitudinal direction of the longitudinal hole 307 each formed bulges 329, 329 'and especially in that they are formed and oriented irregularly compared to each other, the fixing device 301 provides a recess for the Cerc- wire in the sense that the fixation device 301 can better mold in the medical care of the corresponding bone fracture and does not protrude through the coming from below leadership of Cerclagerahtes.
  • the fixing device 301 is bent or arched on all sides.
  • it is adapted to the corresponding anatomical bone conditions by selecting the appropriate curvature configuration for medical care.
  • the (body-distant) surface facing away from the imaginary body to be fixed is convex
  • the (body-proximate) surface facing this body is concave.
  • metal here preferably titanium, and plastic are suitable in the all-round curved or arched training.
  • the initially plate-like planar shape which is adapted starting from this by selecting the appropriate for the medical care curvature configuration of the corresponding anatomical bone conditions, are suitable as material as well as metal and plastic. All edges of the respective openings of the fixing device 301, ie the longitudinal hole 307, the bulges 329, 329 'and the other, circular holes 311 are deburred in the embodiment. The same applies to the outer edges of the fixing device.
  • this embodiment can also be used with sole application of one or more Kirschner drill wires and in connection with the cerclage in the case of the tension belt.
  • the Kirschner wires are held in place.
  • Exemplary embodiments IV.1 - IV.3 fixing device in all-round arched form or plate-like planar form with modified longitudinal hole as single opening
  • FIGs. 6a-6c further embodiments of the fixing device according to the invention are summarized and provided for explanation, the same features to the first embodiment with the same, but provided by 400 extended reference numerals.
  • FIGS. 6a-6c All illustrations of FIGS. 6a-6c are shown in a two-dimensional view. You can both curved on all sides as well as be formed in a plate-like planar shape. The plate-like planar shape can again be adapted to the corresponding anatomical bone conditions by selecting the appropriate curvature configuration for medical care.
  • the fixing device 401 according to the variants of this embodiment shown in Fig. 6a and 6b is formed in plan view in each case approximately oval. Arranged approximately centrally in this oval, the respective fixing device 401 has an opening in the form of a modified longitudinal hole 407.
  • the fixing device 401 according to the variant shown in Fig. 6a corresponds insofar to the embodiment of Example III, as the longitudinal hole 407 on both sides along its longitudinal direction in each case a bulge 429, 429 ', which are formed irregularly compared to each other.
  • the longitudinal hole 407 on both sides along its longitudinal direction in each case two bulges 429, 429 ', which are regularly formed in comparison to each other.
  • a further, not separately shown variant is that the fixing device 401 according to the variant shown in Fig. 6b, but in plan view is approximately round.
  • the longitudinal hole 407 serves to receive the bent part of a fastening means in the form of a drilling or Kirschner wire, not shown in FIGS. 6a-6c, and the bent part of the drill or Kirschner wire passes through the slot 407 without slipping through it.
  • the diameter of the longitudinal hole 407 in the longitudinal direction is again smaller than the maximum extent of the protruding through the longitudinal hole 407, bent portion of the Kirschner wire in this longitudinal direction.
  • these embodiments are characterized for use in small or small bones and represent variants that also allow a simplified production. All the variants described are either bent from the outset on all sides or curved or have a plate-like planar shape, which can again be adapted to the corresponding anatomical bone conditions by selecting the respective curvature configuration suitable for medical care.
  • the (remote) body facing away from the imaginary body to be fixed is convex and the (body-proximate) surface facing this body is concave.
  • metal preferably titanium, and plastic are suitable.
  • this embodiment can also be used with sole application of one or more Kirschner drill wires and in connection with the cerclage in the case of the tension belt.
  • the Kirschner wires are kept stationary.
  • Fixing device in all-round arched shape or plate-like planar shape in the form of an annular oval
  • FIGS. 7a and 7b further embodiments of the fixing device according to the invention are shown summarized again and are explained in their explanation.
  • FIGS. 7a and 7b correspond to a two-dimensional view.
  • the embodiments can be arched on all sides or formed in a plate-like planar shape.
  • the plate-like planar shape can be adapted to the corresponding anatomical bone conditions by selecting the respective curvature configuration suitable for medical care.
  • the (remote) surface facing away from the imaginary body to be fixed is convex, and the (body-proximate) surface facing this body is concave.
  • the fixing device 501 according to the variants of this embodiment shown in FIGS. 7a and 7b is formed approximately oval in plan view in each case.
  • an annular oval 531 is formed as a whole, which thus defines an opening in the form of an oval longitudinal hole 507 in its interior.
  • the longitudinal hole 507 receives the bent portion of a fastener in the form of a drilling or Kirschner wire not shown in Figs. 7a and 7b and the bent portion of the drill or Kirschner wire passes through the oval longitudinal hole 507 in the manner already described.
  • tunnel-like elevations 533 are arranged opposite one another and corresponding to each other on the aforementioned annular oval 531.
  • the variants of Fig. 7a and 7b differ in that the aforementioned tunnel-like elevations 533 are formed in Fig. 7a offset from the center of the annular oval 527, while they are in the middle of the variant, Fig. 7b shows.
  • the fastening material can now be carried out in the form of threads or wires without shearing them.
  • the corresponding tunnel-like elevations 533 make it possible for the fixation device 501 to be better able to form in the medical treatment of the corresponding bone fracture and not to protrude through the guidance of the cerclage wire coming from below.
  • metal here preferably titanium, and plastic are suitable in the mentioned different embodiments.
  • All edges of the respective openings of the fixer 501, i. of the longitudinal hole 507 and the tunnel-like elevations 533 are deburred in the embodiment. The same applies to the outer edges of the fixing device 501.
  • this embodiment can be used with sole application of one or more Kirschner-Bohr wires and in connection with the cerclage in the case of Switzerlandgurtung. By means of the fixing device according to the invention, the Kirschner wires are kept stationary.
  • Fixing device in all-round arched shape or plate-like planar shape with a single opening and in a reduced form
  • FIGS. 8a to 8d Embodiments of the fixing device according to the invention are shown in FIGS. 8a to 8d, which have the same features as the first embodiment with the same, but extended by 600 reference numerals.
  • the representations correspond to a two-dimensional view.
  • the embodiments can be arched on all sides or formed in a plate-like planar shape.
  • the (remote) surface facing away from the imaginary body to be fixed is convex and facing this body (close-fitting) surface concave. The advantages of this vaulting are already mentioned.
  • no further opening or other guide is provided for receiving further fastening material in the form of threads or wires.
  • the fixing device 601 according to the variant of this embodiment shown in FIG. 8a is formed in plan view approximately as an annular oval 631, which defines in its interior an opening in the form of an oval longitudinal hole 607.
  • Fig. 8b shows this again as a plan view.
  • the fixing device 601 according to the variant shown in Fig. 8c, in contrast, has a circular outline, with an opening in the form of an oval longitudinal hole 607th
  • the fixing device 601 according to the variant of this embodiment shown in Fig. 8d is generally formed as a circular ring 635, with an opening in the form of a round hole 607 in its interior.
  • the longitudinal hole 607 takes the bent portion of a fastener in the form of a drill or Kirschner wire not shown in FIGS. 8a to 8d and the bent portion of the drill or Kirschner wire passes through the respective longitudinal hole 607 in the already described Way, ie in particular, that the drill or Kirschner wire is held in the longitudinal hole without slipping through this.
  • the diameter of the longitudinal hole 607 in the longitudinal direction is again smaller than the maximum extent of the projecting through the longitudinal hole 607, bent portion of the Kirschner wire in this longitudinal direction.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un dispositif de fixation en matière plastique ou en métal pour les soins médicaux, qui coopère avec une broche de Kirschner (9) en tant que moyen de fixation, et qui comporte une ouverture pour recevoir le moyen de fixation et au moins deux autres ouvertures pour recevoir le matériel de fixation sous forme de fils (13) et de câbles. La broche de Kirschner (9) traverse ladite ouverture et est maintenue en place de manière stable par le matériel de fixation. Le dispositif de fixation peut être conçu sous forme de plaque (101) ou présenter une forme (1) bombée de tous côtés, ou se présenter sous la forme d'un segment de sphère (211). La présente invention concerne également l'utilisation dudit dispositif de fixation pour l'ostéosynthèse.
EP15731843.7A 2014-05-09 2015-05-11 Dispositif pour fixer une broche de kirschner Ceased EP3151769A2 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE202014003940.2U DE202014003940U1 (de) 2014-05-09 2014-05-09 Vorrichtung zur Fixierung eines Kirschnerdrahtes
PCT/EP2015/000968 WO2015169453A2 (fr) 2014-05-09 2015-05-11 Dispositif pour fixer une broche de kirschner

Publications (1)

Publication Number Publication Date
EP3151769A2 true EP3151769A2 (fr) 2017-04-12

Family

ID=51206385

Family Applications (1)

Application Number Title Priority Date Filing Date
EP15731843.7A Ceased EP3151769A2 (fr) 2014-05-09 2015-05-11 Dispositif pour fixer une broche de kirschner

Country Status (4)

Country Link
US (1) US10842544B2 (fr)
EP (1) EP3151769A2 (fr)
DE (1) DE202014003940U1 (fr)
WO (1) WO2015169453A2 (fr)

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Publication number Priority date Publication date Assignee Title
CN104939904A (zh) * 2015-07-01 2015-09-30 王维山 带固定环的张力带用钢丝
US10675072B2 (en) 2018-01-02 2020-06-09 Acumed Llc Bone fixation with a plate and a coupler connected by flexible members
CN114288005A (zh) * 2021-12-29 2022-04-08 戴建辉 一种克氏针固定器及其使用方法
CN116370052B (zh) * 2023-06-07 2023-08-18 杭州锐健马斯汀医疗器材有限公司 钛板、钛板组件及钛板植入系统

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Publication number Priority date Publication date Assignee Title
DE3722538A1 (de) 1987-07-08 1989-01-19 Wasserstein Isidor Vorrichtung zur fixierung von knochensegmenten
GB8924806D0 (en) * 1989-11-03 1989-12-20 Neoligaments Ltd Prosthectic ligament system
US5306301A (en) * 1993-02-11 1994-04-26 American Cyanamid Company Graft attachment device and method of using same
FR2703239B1 (fr) 1993-03-30 1995-06-02 Brio Bio Rhone Implant Medical Agrafe pour prothèse inter-épineuse.
DE19603887C2 (de) * 1996-02-03 1998-07-02 Lerch Karl Dieter Anordnung zum Fixieren eines aus der Schädelkapsel zum Zwecke des operativen Eingriffs herausgetrennten Knochenstücks am verbliebenen Schädelbein
US6117139A (en) * 1998-12-25 2000-09-12 Nagoya Screw Mfg., Co., Ltd. Ligament graft-securing device
JP2002159500A (ja) * 2000-11-28 2002-06-04 Koseki Ika Kk 靭帯固定システム
FR2921246B1 (fr) * 2007-09-21 2009-11-06 Tornier Sas Dispositif de fixation de fils de suture
US8585743B2 (en) * 2008-09-15 2013-11-19 Biomet C.V. Low profile screw and washer system for bone plating
US20110029025A1 (en) 2009-07-31 2011-02-03 Medoff Robert J Locking pin plate assembly adapted for fracture fixation
WO2011037614A1 (fr) * 2009-09-22 2011-03-31 Jamy Gannoe Ensemble fixation orthopédique et procédé d'utilisation
DE102012004070B4 (de) * 2012-03-02 2015-05-13 Marius von Knoch Chirurgische Befestigungsvorrichtung

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Also Published As

Publication number Publication date
WO2015169453A3 (fr) 2016-03-10
DE202014003940U1 (de) 2014-06-27
US10842544B2 (en) 2020-11-24
US20170135738A1 (en) 2017-05-18
WO2015169453A2 (fr) 2015-11-12

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