FI104616B - External clamp - Google Patents

Abstract

The external apparatus for fixing bone fragments consists of a tube-shaped portion, of which the internal space is filled with glass fibre. The fixing tube is secured by means of nails or screws (12) to the bone fragments to be fixed, whereby a rapid hardening material is introduced into the closed tube system after completion of assembly. After setting, a plastic-glass fibre composite is obtained which has excellent strength properties and is ideally suited for use as an external fixation apparatus.

Description

! 104616

External clamp

The present invention relates to an external fastener comprising at least one resilient tubular member 5 which can be placed outside the patient against fractured bone pieces to be joined and connected to threads, nails or screws attached to various fractured bone pieces, whereby this tubular member filled with curing material provides, after curing said material, a solid frame with these yarns, nails, or screws to hold the broken bone pieces in the desired position for growth.

The function of such an external fastener is to orthopedically fix and hold together the broken bone pieces. The bones that are placed together are attached to one another via an external clamp, whereby healing can occur in the correct position. In addition, bone nails, for example screws or bridge brackets, preferably threaded, are inserted into or through the bones, and the bones are joined to the ends projecting from the body of these nails via at least one rod-like element, e.g. ',,, · This connection is made by means of clamping elements which. 25 comprising fasteners, articulations, and optionally a ball joint, coupling member, or gripping members, or the like. In this way, a framework structure can be formed which. *. ·. allows the bone parts to be firmly attached and held together.

. . 30 Known clamping elements are made of non-oxidizing • · · * ”. * Steel. In connection with the setting of the rod clamps and clamps i. · · · '· [*, The whole frame structure is thus relatively loose *!' toned, unsteady and displaceable because the opposing rods must be loose in the tensioning elements. 35 to position them correctly. Thus closed 104616.

The 2 tines cannot be installed by a single person, but require auxiliary personnel who must hold the joints, twin joints, and frame in place until the clamping and fastening can finally be completed after being installed. Special clamping devices may be used to facilitate this task. Because the steel has a very high modulus of elasticity and a smooth surface, it is not possible to achieve only a slight clamping effect by tightening the steel clamping screw, but even a slight rotation of the clamping screw causes a very large change in the clamping pressure. When installing the clamp, the rods, bone nails or screws may only be loose in the clamping elements. In addition, due to their material, the fastener parts and elements impede the transmission of X-rays. The cost of manufacturing such fasteners is also quite high.

It has been a common practice to use metal components which the surgeon forms by interconnecting the fastener in a manner that is customized.

Non-metallic components are also used to maintain the X-rays of the fasteners. Thus, DE-A-27 45 504 discloses a device for holding and / or supporting human and animal joints, this device comprising paired opposites and at least one • · .'Γ. fittings with bone screw or nail, which, V. are connected by means of fastening means to the connecting or

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threaded rods respectively. Fittings, fasteners. . 30 joints and connecting rods and fixed clamps are ♦ f «· *!. * Made of fiber-reinforced thermoplastic.

Also known from DE-A-31 41 909 · is an orthopedic bone fracture attachment device with at least one elongated member extending beyond the patient's tongue. <RTI ID = 0.0> 104616 </RTI> is inserted into bone sticks attached to various fractured portions of the bone, wherein said elongate portion and said barbs form a solid frame that holds the fractured bone portions in a desired position for fusion. the elongate portion attached to the various pieces of fractured bone by means of bone sticks comprises an elongated and flexible support portion filled with a curable material which is in this support portion in an inactive fluid state.

FR-A-2 405 063 discloses an external fastener which utilizes preformed solid components. These individual components are made of fiberglass reinforced plastic. Such external fasteners employing prefabricated fixed components are very expensive due to the manufacture of the required kits. A given set of assemblies has only a limited usability for certain fractured bone pieces, necessitating the storage of a large selection of 20 individual assemblies. Threaded components exhibit wear during repeated use. Depending on the conditions, the X-ray examination of the fracture healing is considerably more difficult with the use of metal materials. Each patient undergoing treatment will receive a portion of the 25 sets of stock for weeks: v. •, which makes it necessary to store individual components. Untrustworthy ". The patient does not return to the original hospital after leaving. In this case, the structural parts of the fastener will no longer be returned to the hospital, whereby the structural parts will be substantially lost. Rigid structural -« · · V · the systems also force the use of varying degrees of m. i.

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to a dynamized setting. Under these sanctions, a great deal of experience and wide-ranging imagination is often required to achieve a good outcome.

• · · • »i 104616 4

An external fastener according to the preamble of claims 1-2 is known from GB-A-2 086 231. This external fastener comprises at least one resilient tubular member disposed on the outside of the patient against the fractured bone pieces to be joined and connected to threads, nails or screws attached to the various bone pieces, whereby this cured tubular member forms with nails or screws, a fixed frame that holds the bone pieces in the desired position for growth, said tubular member being made of plastic and the interior of the closed tubular subsystem being filled with plastic prior to completion of installation. In connection with this external fastener 15, the interior of the sealed tubular subsystem is filled with curing material prior to installing the tubular subsystem and securing the bone pieces. The curing effect of the curable materials used can be slowed down to the time required. In particular, curing materials which cure by visible or other light are used, wherein the tubular portion filled with the curing material is coated with a light-impermeable outer coating which is removed for the curing process. However, other curing materials which cure by chemical action may also be used. The fiberglass-reinforced plastic and the glass-clear or transparent plastic are not used as the material of the tubular part in connection with this external fastener. Plastic. . The corrugated tube is used as 30 tubes. The use of such a pipe may result in cross-sectional changes when the pipe is in different planes and must be bent.

_ ·; In addition, it should be noted that the nails and threads attached to the bone pieces must not penetrate through the plastic tube 35 otherwise the curing material inside the plastic tube would leak out. For this reason, the plastic tube is provided with closed tubular connection sleeves which receive said threads, nails, etc.

In connection with the external fastener, which is provided with resilient structural members which, when cured, becomes a rigid system, a tube filled with liquid plastic is used, which, however, can only be inserted into the free ends of the bone after being fixed to the bone. In the 10 operations in the reverse order, the tips of the nails would cause inflammation in the body, since such a tube cannot be sterilized, as would the monomeric plastic. As a result, the nails must be placed parallel to the surgeon-operated pliers in a rigid system. Fastening to more than one plane, which is always desirable for mechanical reasons, cannot be accomplished by a single tube. All homogeneous plastics have varying degrees of low tensile strength and at the same time low elasticity. This 20 necessarily leads to a large diameter of the supporting fastener tube, in order to avoid the risk of the fastener breaking under peak load. In addition, the mixing of the plastic components in an already filled tube causes further disadvantages. The weight caused by incomplete mixing, which requires that soft and light flexible bone parts have to be recovered at the end of the attachment procedure, is relatively large. Insufficient mixing also adds to the remaining conditions

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the amount of toxic monomers in the fastener. Only a soft * · (L! Ί and easy-to-compress tube) will allow the best possible mixing. This prevents the maximum possible plastic diameter from being guaranteed, especially when the fastener tube is « rope .. wrapped around numerous revolutions.

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35 hardening material, even in a filled tube, almost always results in plastic leaking out of the nail holes and thus difficult to estimate material and stability losses. When curing occurs by conduction of heat or radiation, the following problems also arise: In the case of radiation, only the surface layers can be polymerized. A fully filled tube is hardly polymerizable by radiation. Infrared radiation must penetrate through a tubular system close to the skin surface - 2 to 5 cm away, but this radiation does not heat the skin itself. The patient can be protected in a simpler way against ultraviolet radiation compared to infrared radiation, but with both types of radiation, however, extensive and complete illumination of the tubing system is required. This must be done concurrently with X-ray scanning and a bone placement procedure by the surgeon, which makes this overall arrangement technically difficult to perform, depending on the circumstances. In the case of a photosensitive plastic which is protected by a light-impermeable film, penetration of the tube 20 by means of fastening nails may already initiate the curing process. It takes about five minutes for the surgeon to completely reset the bones. The fastener must harden during this time. Longer cure times increase the X-ray load and pose a risk of deterioration of the result of the adjustment procedure due to fatigue of the surgeon.

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It is an object of the present invention to provide an external fastener such as that described

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handled in a simple way without worktops forced,. 30, whereby the position of the fastening tube can be corrected • *! · * · Before the filling mass hardens without causing the directional broken bone pieces to be displaced 4 ·; from the sea buckthorn, so that the complex, ie. fractures with large fractured bone fragments can be held in place 35 until the filling mass cures, resulting in

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104616 7 and only a small selection of components of such an external fastener must be stored in limited quantities. In addition, X-ray permeability and remarkable stability and flexibility are achieved even for small diameters. It is a further object of the invention to provide for such an external fastener a tubular member which can be used at the same time as a mold for a curing plastic mass, the end of this tube being internally connected to the cured plastic mass.

This object is achieved by the characteristic features set forth in claims 1-2.

By using the tubular part of the outer fastener as a tubular part with a fiberglass tube 15 or a fiberglass reinforced or embedded fiberglass tube, all the disadvantages of known external fasteners can be eliminated. The tubular member thus formed is filled, after installation, with a rapidly curing plastic to form a resilient and easy-to-handle material to form a rigid outer fastener which, in addition, is X-ray permeable, is very inexpensive and generally available for various tube strengths or fiberglass fillings. 25 Using such an external fastener as a disposable product will eliminate the wear problem. The application of a combination of plastic and fiberglass • 4 allows this external fastener to provide, for the first time, a material that will allow the fastener user to access the system, orthopedic 30-piece bone fixation and grip • r »: ·· 5, this system meets the requirements for an external mount V *. Especially with fiberglass «·; the use of a filled spiral tube results in: • <4 · clamping tube, which easily adjusts the clamp in positioning 35 and can be bent <i> • f M »4 I f · · 4» »« 104616 8 different levels without changing its diameter at the bending points due, on the one hand, to the particular characteristic of the fastener tube and, on the other hand, to the insertion of a fiberglass tube inside the plastic tube.

It is this shape resistance when forming and insertion of the fastener tube that ensures a smooth flow of the flowable plastic material, this material being injected into the fastener tube after mixing of the material components outside the fastener tube 10. Within the clamping tube there is then a " mixing " of the fiberglass fabric and the plastic, resulting in a combination of plastic and fiberglass. Preferably, the glass fibers attached to the material of the fastener tube, or the glass fiber tube 15 inserted into the plastic tube alone, preferably increases the tear strength of the tubular part in the form of a helical tube which is easily bent and thus easily inserted. Due to the high tensile strength it is also possible to use small diameters of put-20. Also, in the case of injection of a rapidly curing plastic mass, the plastic will also not leak out of the nail holes in the fastener tube walls, as the opening of the fastener nails or screws in the fastener tube wall will automatically open again, fiberglass, fiberglass filling or * ·,% fiberglass tube inside the plastic tube, i · ..

forming a kind of barrier lock, whereby, it is preferable to use tubular parts comprising a «i« '·· * plastic embedded in a very small mesh fiberglass I I 4 V' or a very small mesh fiberglass tubing ken1. In addition, a rather thin-walled tube can be used.

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According to a further feature of the invention, the I | ill 35, the subject external fastener comprises a single il * »f» * I <t «f VI f 104616 9 tubular member made of a fiberglass tube or fiberglass reinforced plastic or fiberglass embedded in a plastic tube, this tubular member being placed on different levels and over and attached to the bone pieces by means of threads, nails or screws. The two free ends of this tubular member are connected to one another mainly via a Y or T shaped joint, this joint having a sealable filling opening for the curing material 10. In this way, it is possible to fix broken parts of broken bones, for example finger bones, by means of a single tubular member using threads, nails or screws, without the need for any expensive frame-15 structure. Following the introduction of the rapidly curable plastic into the tubular member and the curing of the plastic, a solid and per se rigid system is obtained, whereby a good healing process can be achieved.

Further, it is possible to connect a plurality of tubular portions 20 to a single frame, all of these tubular portions being interconnected via tubular couplings such that the interior spaces of all tubular portions are interconnected, i. with a pipe system formed in such a manner as to provide at least one curing material with a sealable filling opening. In addition, it is also possible to connect the plurality of tubular components contained in the tubing system in groups, whereby the tubing system formed by each group includes at least one closable filling opening for the curing material.

'In this way, • c ·. # · «· External clamp adjusts in the best way possible according to different requirements using different ...: connection pieces. As two-dimensional couplings,

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in this case, 90 ° or 180 ° bent joint junctions, as well as T, Y, and cross junctions are used. In this case, no joints should be used as pipe fittings to tighten the bone pieces, as they may, under certain circumstances, cause points which impair stability.

5 Simply inserting nails and screws through 10 tubes, folding and inserting a larger cross-section of the nail is no longer sufficient to ensure sufficient power transmission from the piping system to the fastening nails or screws with larger nail or screw cross-sections, and with greater forces when handling lower limb fractures. In this case, the nail or screw must still be anchored through the fastener to the pipe system, whereby the fastener must meet the following requirements: 15 it must be placed anywhere on the pipe, hold the nail or screw twisted rigidly, it must itself be anchored in order to divide the power seal, it must be as general as possible for various nail or screw cross-sections, ... this element must pass through X-rays.

All these requirements are met by the fastening element made of the two shell-2 surrounding the tubular part, these parts forming a tubular structural element, each with the shell-like part * 9. · Formed by at least two c ·: peel-like portions on opposite sides, which form two mounting sleeves 30 in the same plane relative to each other and receive: a screw or nail, these peel-like portions

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equipped with an external thread on its outer wall for receiving the clutch nut • · · on the clamping ring. In addition to the screws provided with their screw arm: 35: with a full-length thread, * 10 101616 screws with threaded part can be used, with the rest of the screw arm smooth. Screws with a thread passing through the screw arm are then treated as if there were no thread. The shell-like parts acting like the fastening jaws of the fastener-5 are inserted after the nails or screws have been inserted.

According to a further embodiment of the invention, the fastening element comprises an outer threaded tubing which passes through a wall passage through two opposite and mutually planar portions of the tubular member, which receives a nail or screw, the threaded tubing extending slightly outside the tubular member a threaded clamping nut which engages a clamping ring that engages a threaded portion of the threaded end, which is provided with a threaded insert on the outer portion of the threaded tube; a part having a wall-mounted pin, a dowel, etc., and a part without a rotating coupling, fitted with a tubular 25; a wall-mounted pin, a dowel, etc., whereby · · said non-threaded coupling clamp is held in place by the screws · · · '-c in the threaded pipe.

A: Both of these different fastener application applications are suitable for use with different nail or screw diameters in conjunction with the corresponding clamping rings and thus meet the requirements for the fastener.

Preferred embodiments of the invention are described in the subclaims.

• · 135 * · · · 104616 12

The invention will now be described in more detail with reference to the accompanying drawings, in which:

Figure 1 is a general view of an external fastener mounted on a plurality of interconnected tubular members over two fractured bone pieces,

Fig. 2 shows a general view of a fastener comprising one end connected to one end and attached to two fractured bone pieces by means of Kirschner yarns; Fig. 3 is a fragmentary vertical sectional view of a Kirschner thread attached to a part of the tubular part of the fastener;

Figure 4 is a general view of the fastener element,

Figure 5 is a partial cross-sectional view of the fastener element of Figure 15 4,

Figure 5 is a partial view in partial vertical section of an additional embodiment of the fastener element,

Figure 7 is a horizontal sectional view taken along line VII-VII of Figure 6,

Fig. 8 is a longitudinal sectional view for inserting the threaded pipe for inserting the fastener element of Fig. 6; Fig. 9 is a general view of the tensioning element,; 2; 5 Fig. 10 is a plan view of the tensioning element of Fig. 9; Fig. 11 is a longitudinal sectional view of one half of a tensioning member according to Fig. 9, 30 Fig. 12 is an enlarged vertical sectional view of a portion of a tubular member comprising a plastic fabric. Figure 13 illustrates an enlarged vertical section through a portion of a tubular body comprising a fiberglass fabric and a fiberglass fabric inserted therein. »· • 104616 13 dyn tubular body and several layered fiberglass tubing,

Figure 14 is an enlarged vertical sectional view of a portion of a tubular member comprising a plastic tubular body and a fiberglass tubing inserted therein, with the cured plastic inserted within this tubular member,

Figure 15 is an enlarged vertical sectional view of a portion of a tubular member comprising a helical tube 10 filled with fiberglass fabric,

Figure 16 is a vertical sectional view taken along line XVI-XVI of Figure 15,

Fig. 17 is an enlarged vertical sectional view of a portion of a tubular member comprising a plastic effective tubular body with fiberglass embedded therein; and

Figure 18 is an enlarged vertical sectional view of a portion of a tubular member comprising a plastic tubular body with fiberglass woven embedded therein.

The external fastener 10 shown in Figures 1 and 2 is denoted by 10. This external fastener 10 comprises a tubular member 11 or 211, respectively, which is in the form of a plurality of individual tubular members joined to each other (Fig. 2). This; 2; 5 tubular member 11, or 211, respectively, forms a fastening tube, the wall of which is designated 111 or

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: 211a. The tubular member 11 or 211 is secured to the two broken bone pieces marked K 1 and K 2 by means of threads, nails or screws 12.

•; "· The tubular portion 211 comprises a flexible, defined portion

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tubular body made of resilient plastic · _ 212. This tubular body 212 is filled with glass or other glass.

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...! vennäiskuiduilla. Fiberglass is filled by a tubular fiberglass tube 212 • · ·: 35 'inserted into the tubular body or the like.

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«· 104616 14 through the" sock "215 (Fig. 12). As shown in Figure 13, a plurality of individual fiberglass woven tubes 215, 216, 217 may also be inserted within the tubular body 212, whereby, in cross-sectional view, the plurality of layers 5 form fiberglass fabric. In the further embodiment of Figures 15 and 16, there are so many fiberglass tubes placed inside the tubular body 212 that the interior of the tubular body 212 is completely filled with fiberglass. It is also possible to use instead of fiberglass woven tubes 10 a fiberglass woven mat which is folded or rolled into the tubular body 212. When using multiple glass fiber woven tubes, all tubes may be of the same strength, but tubes of different thickness may be used.

In the further embodiment of Figures 17 and 18, the tubular member 11 is made of fiberglass-reinforced plastic or fiberglass embedded in a plastic. The tubular member 11 then comprises a tubular body 115 made of resilient, resilient plastic reinforced with glass fibers 116, whereby it is preferable that the glass fibers protrude from the inner wall surface 115a or at least positioned on the surface of the inner wall 115a to provide a kind of adhesive attachment. connection with a '25 hardened plastic inside the tubular body 115.

> # ·· It is also possible to use the fiberglass fabric 118 embedded in the plastic instead of the fiberglass fabric 118 embedded in the tubular body 115, whereby in this embodiment also the fiberglass fabric or mat 30 must be on the inner wall surface of the tubular body 115 (Figure 18). In addition to glass fibers, mineral fibers or yarns may also be embedded in the plastics material of the tubular part 11, which must, however, be made from inorganic raw materials. However, it is particularly advantageous to use for this purpose 35 'glass fibers and yarns which can also be inserted into the plastic of the tubular member 11 in the form of woven fabrics or mats or may be in the form of a fiberglass tube retracted into the plastic tubular body. It is particularly advantageous to use glass fiber reinforced thermoplastics equipped with short glass fibers of at least 1 mm in length or glass fibers of up to 3 mm in length, but such longer glass fibers are more suitable for use. Fiberglass-reinforced thermoplastic can be BS, polyamide, PC, PE.POM, PP, PS, PVC, 10 SAN, PETP or PBTP, practically any type of external fastener 10 for the manufacture of the tubular part 11, a suitable plastic or thermoplastic, respectively, which also fits well with the skin in the vicinity thereof, may be used. As fiberglass fabric, surface structures made of glass silk volatiles, glass yarns, glass braids or fiberglass webs can be used. Thus, for example, double-arm, backbone and atlas bindings are useful. However, any other suitable dressings may also be used to make fiberglass fibrous fabric.

For the manufacture of the external fastener 10, the tubular part 11 or 211, respectively, which is already filled with glass fibers, is filled in with a set of fractured bone pieces! and curing material thereafter.

, 25 This is particularly the case for fast-curing plastics, because only cure-hard plastics · · '· "ensure that the fractured bone pieces • # c' retain their position after curing. Li- • <V. ' In addition, the fastener allows the fastener 30 to hold the fractured bone pieces in the correct position without fatigue, which can cause the fractured bone pieces to t deviate from the correct position. In the case of 1 ··· material, light can also be used to reduce the cure time of ¾5 '. Quick-setting plastic • ii 104616 16 is pre-fabricated outside the fastener tube by mixing both components (hardener and plastic compound), then injected into the fastener tube.

It is preferable that the tubular body 212 is made of transparent or glass clear plastic, respectively, and that the plastic mass to be inserted therein is colored. During such an insertion of a colored plastic mass, the distribution of the plastic mass can then be monitored within the plastic body and it is controlled that all parts of the plastic body 212 are filled with plastic mass.

Instead of the tubular members 11 used in the embodiments shown in Figures 17 and 18, the tubular member 211 shown in Figures 12, 13, 15 and 16 and having the structure described above can also be used.

Figure 2 shown an embodiment comprising a tubular portion 11 of external clamp 10, 11 on both ends portion 11a, 11b being joined together by a connecting piece 16 by means of which is provided with a sul-20 undertaken whilst a filling opening 14. The mold or the fluid plastic material is fed into the tubular part 11 in the arrow X direction . The tubular member 11 is connected via iV Kirschner yarns 30 to each of the broken <1 l bone pieces K1, K2, i.e.. the tubular part 11 is secured by these Kirschner threads to both fractured bone pieces K1, K2 so that the tubular part 11 * i »ί .1 comes a short distance above each of the broken bone pieces e V '. If the purpose is to join a number of fractured bone pieces, this tubular member 11 will be placed on different levels and in different directions on these fractured bone pieces, whereby the tubular member will be secured to the individual fractured bone pieces also by Kirschner yarns. 30 or other suitable yarns ··· or sticks, whereby these Kirschner yarns are attached together to the individual fractured bone pieces, * * · · * «1 • · 104616 17 being connected at one end to the tubular member 11 Because the tubular member 11 is only positioned above and to one side of the fractured bone 5 in the embodiment shown in Figure 2, the Kirschner yarns 30 are only unilaterally attached to the individual fractured bone pieces. the er-wire portions are not attached at their free ends 10 to the corresponding tubular portion 11, but still provide the possibility of using two tubular portions 11, the first tubular portion 11 being positioned above the secured fractured bone pieces, the second tubular portion 11 being positioned below the bone pieces, wherein both tubular members 11 are connected to one another through a simultaneous adjustment of Kirschner yarns 30 through the fractured bone members. The positioning of the tubular member 11 on the fractured bone parts K, K2 to be secured may be such that all Kirschner threads 30 are positioned in the same direction within the fractured bone pieces. As shown in Figure 2, the tubular member 11 may, however, be arranged so that, for example, two Kirschner yarns 30 are guided perpendicularly through the tubular member 11c, the second member 11ld of the tubular member 11 being again bent. with respect to section 11c such that the Kirschner yarns l * * 30 passing through this tubular section lld extend transversely to the Kirschner yarns extending longitudinally through the tubular section 11c 11c.

30 For such an assembly or arrangement of each part 11c, 11d of the tubular member 11, a similar shape may be given to the existing connector 16. The tubular *, earth member 11 is in this embodiment also made of glass.

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;;; fiberglass-embedded plastic or glass-embedded glass' '35' fibrous fabric, whereby the tubular member 11 can also be made as a helical tube. The tubular member 11 may be attached to the fractured bone pieces ΚΙ, K2 by Kirschner yarns 30, or otherwise formed by yarns, nails or screws.

5 In order to anchor the Kirschner yarns 30 into a rotationally rigid tubular member 11, the free end of each Kirschner yarn 30 is bent to a U-shape of about 180 °. This bent end of the yarn is designated 30a (Figure 3). The free end of the bent thread portion 30a may be bevelled or 10 sharpened to permit easy insertion and guiding thereof into the wall 111 of the tubular member 11.

In the embodiment of the external fastener 10 shown in Figure 1, a plurality of individual tubular members 11 connected to each other 15 form a frame 20 to which both broken bone pieces ΚΙ, K2 are tightened and secured by nails, screws, sticks or wires 12. This frame 20 is formed by three longitudinal rods 21, 22, 23, each of which, for example, comprises two interconnected portions. These three longitudinal rods 21, 22, 23 are connected via semicircular arcs 24, 25 in the region of their free ends, these semicircular arcs f 24, 24 also comprising two semicircular actuators (? 5). rods 21, 22, 23, semicircular arcs 24, 25 and also the individual parts from which the longitudinal rods and semicircular C i * second arcs are formed are connected by means of connecting pieces 26. with each other, these connecting pieces 26 30 being tubular shaped like those in paragraph 16 of the external fastener shown in Figure 2. These # ι · ο connecting pieces 26 are made as T or angular pieces.

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hand to tube. It is essential that all i · '3 · 5' tubular parts connected to the frame 20 are connected »i f * • 1 I 1 a · • · f L | 104616 19, through these connecting pieces 26, are interconnected so as to form an interior with free access. In order to introduce the curable material into the frame 20 formed by the various tubular parts 11, a non-visible sealable filling opening is used. It is also possible to use a plurality of filling apertures, which in this case must be connected by means of similar connection cables to a separate filling device to ensure uniform feeding of the curable material 10 so that this plastic material, particularly in the case of quick-curable plastic, penetrates almost simultaneously.

In the embodiment shown in Figure 1, the frame 20 is formed by a tubular member 11 such that the nails, screws or threads 12 can be set to run perpendicular to the frame, allowing these perpendicular and retaining fasteners 12 to extend only through fractured bone pieces. while the needles or nails 12 passing through the longitudinal bars 21, 22 in the lower plane also pass through the fractured bone pieces ΚΙ, K2. In this case, the frame 20 may be shaped such that the frame 20 surrounds each of the two fractured bone pieces ΚΙ, K2 .25 to be fastened, on each side, with nails, sticks or screws 12 passing through these fractured bone pieces. ends.

• "» ', It is also possible to join a frame 20, «·"' 30 ie. a plurality of tubular portions 11 formed in this manner in 11 groups, wherein the plurality of tubular systems formed by each group is provided with at least one filling opening for a hardening material. The curable material can be filled into all the individual pipe systems thus formed, simultaneously or also at short intervals of time.

The fracture gap formed between the two fractured bone pieces ΚΙ, K2 is denoted by the letters BS in Figures 1 and 2.

To fasten the nails or screws to the tubular system formed by the tubular parts 11, a fastening element 40 having the structure shown in Figures 4 and 5 is used. This fastening element 40 comprises two approximately semicircular peel-like portions 41, 42 which together form a tubular structural element 43 having a diameter approximately equal to the outer diameter of the tubular portion 11. In addition to tubular sections 11 of circular cross-section, tubular sections of oval cross-section may also be used. Both shell-like portions 41, 42 of the fastening element 15 40, which form the tubular structural element 43, are formed in a manner similar to the tubular part 11 in use.

Each shell-like portion 41 or 42, respectively, of the fastening element 40 includes shell-like portions 44, 45 or 46, 47 formed on two opposing sides 20, which form two mounting flanges 48, 49 on the same plane for receiving the screw or nail 12. Peel-like parts 44, 45 or the like. The outer wall of ti 46, 47 has an outer thread 50 with threaded clutch nut 51 (Figs. 4 and 5). The nail, stick, or screw 12 are held in place and secured by •; · /. through the clamping ring 55, around which the coupling nut t · I is screwed into the outer thread of the clamping sleeve 48 • · or 49, respectively. 51 attaches. The clamping ring 55 is then positioned within the free end of the circular section of the clamping sleeve 48 or 49, respectively, so that the clutch nut 51 • · · · engages the clamping ring 55. The clamping nut 51 is tightened. tämällä compression ring is compressed the arrow Xl, 3-5. direction, with the result that it rests simultaneously on the surface of the outer wall of nail 12 under pressure, whereby nail 12 becomes retained fixedly to the element 50. The wall 111 of the tubular part 11 inserted into the fastening element 40 is provided with passages corresponding to the extension of both fastening sleeves 48, 49, which may be formed before the nail 12 is inserted. However, since the tubular member is made of fiberglass-reinforced plastic or a fiberglass fabric embedded in the plastic and has a certain degree of resilience, the tubular member 11 acts by pressing nail 12 so that nail 12 can be easily inserted through wall 111 of tubular member 11. also easily attach larger diameter nails. The fastening sleeves 48, 49 of the fastener 40 are adapted to the diameters of the nails or screws in use. Since the existing clamping rings 55 apply sufficient clamping force to the clamping sleeves 48, 49 when tightening the clutch nut 51, it is also possible to securely hold the nails and screws in the clamping sleeves 20 48, 49 when the through nails or screws 12 are smaller in size. The mounting sleeves 48, 49 are made in the same shape and have the same cross-section and diameters; ta.

.25 For securing the tubular member 11 mounted on the mounting element 40, the tubular structural members 43, 42 formed by the tubular structural member 43, 42, are provided with anchors, dowels, etc., on the inner wall.

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; "Will be inserted into the wall 111 of the tubular member 11" (30 'upon insertion of the fastening element 40. The number of dowels of these fastening pins, etc., 52 may be • 1 ·,:: arbitrary. However, it is sufficient · Two opposing fastening pins 52 (Figs. 4 and 5) are disposed in the region of both ends of the mounting element 40.

If the fastening element 40 is used together with a • 1

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f • 1 »« • · ·

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104616 22, the inner wall surfaces of both clamping sleeves 48, 49 can be smoothed.

On the other hand, if screws, sticks or nails with threads are used at their ends, it is preferable that the fastening sleeves 48, 49 have internal threads on their inner wall surfaces, so that additional fastening by means of the screws 12 is possible. However, since this attachment and retention is effected via the press rings 55, it is not required, however, that the attachment sleeves 10 48, 49 be threaded on their inner wall surface. Similarly, nails, screws, or needles 12 may be held in place by the mounting element 40.

In a further embodiment of the fastening element 140 of Figure 6, this fastening element comprises a tube 141 provided with an external thread 160, into which a nail or screw 12 is inserted for fastening to the fractured bone pieces. This helical tube 141 is inserted through the wall 111 of the tubular member 11. In this case, it is further advantageous for the wall 11 of the tubular member 20 to be provided with two passageways 113, 133a in the same plane relative to one another.

The threaded tube 141 of the attachment element 140 is then inserted into the tubular member 11 such that the threaded tube 141 extends bilaterally to the member 142 or 143, respectively; 25 outside this tubular part 11. The outer thread 160 formed on the outer wall surface of the threaded tube 141 can then extend over the entire length of the pipe 141. However, it is also possible to use only 9 threads. outer threads of tubular section 142, 143 at both ends.

The ends 142a, 143a of the parts 142, 143 of the threaded tube 141; in the area or at each end, respectively, a switch ♦ · · V, which is attached to the outer thread 160 of the threaded tube 141 -.:. nut 144 or 145, respectively. Each clutch nut 144 or 145 is secured to the outer wall surface of a nail or screw 12 disposed in the threaded tube 141 on both ends of threaded tube 141, 143, 143, respectively. 147 against clutch nut 144 or 145 when tightened (Fig. 6). The clamping rings 146, 147 with clamping nuts 144, 145 attached thereto are provided at the ends of the threaded tube 141 5. When the clutch nuts 144, 145 are tightened in the direction of arrows X2, X3, the clamping rings 146, 147 are clamped so that they are against the nail or screw 12. The clamping rings 55 and 10 146, 147 are made of a suitable deformable material, such as rubber or plastic, which, where possible, does not exhibit any crushing effect.

In addition, threaded coupling clamp 148 is provided on thread portion 141 and threaded coupling clamp 150 on portion 142. Threaded coupling clamp 148 is annular and provided with an internal thread so that clamp 148 may be threaded onto outer thread 160 of threaded conduit 141. two pins, pins 20, etc. in the same plane, parallel to the tubular member 11 and secured to the wall 111 of the tubular member 11, for attaching these pins 148, dowels, etc. 149 to the wall 111 of the tubular member 11, thread the threaded tube 141 into the outer thread 160, but by rotating the threaded tube 141 about its longitudinal axis, they are moved so far into the wall * 111 of the tubular member 11 that the pins, dowels, etc. 149 of the coupling clamp 148 engage. to the wall 111 of part 11.

Therefore, in the% 1? 30 'of the threaded tube portion 142, there is no thread in the clamp clamp 150, but this clamp clamp 150, also made in the form of a ring,: | the nut 152 is then threaded to the outer thread 160 of the threaded tube 141. The coupling clamp 150 is also latched with two I-M f ·

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104616 24 with a pin, dowel, etc. 151 which come into the position shown in Fig. 6 and engage the wall 111 with the clamp clamp 150 positioned against the wall 111 of the tubular member 11. The two clamp clamps 148, 150 are then held in place by the threaded tube 141 with their pins, dowels, etc. 149, 151 facing each other.

The fastener 140 is pivoted so that the threaded tube 141 is punctured through the respective through holes in the wall 10 of the tubular member 11. Thereafter, the clamp clamps 148, 150 are inserted and the threaded clamp clamp 148 is displaced against the wall of the tubular member 11 by rotating the threaded lug 141, thereby engaging pins, dowels, etc. 149 in the wall of the tubular member 11 or engaging accordingly. is possible due to the material of the tubular member 11 without the curing material leaking or being extruded out of these injection areas when being fed.

Similarly, the threaded coupling clamp 150 is inserted into the threaded tube 141 and inserted through the threaded nut 152 into the wall 111 of the tubular member 11, whereby the pins, dowels, etc. 151 of the clamp 150 are secured to the wall 111 of the tubular member 25 ).

The coupling clamp 150 is further provided with a rotary brake ** in the form of a cam portion 154 formed on the inner wall surface of the coupling clamp 150 which engages a recess 112 in the outer wall surface of the tubular section 11 V '(Fig. 7). This? 30T rotary brake is thus disposed between the clamp clamp 150 and the threaded tube 141, thus providing rotational stability between the nail and the tubular part 11 after filling and curing the plastic · · · · · *; *;

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A punch 155 is used for attaching the threaded tube 141, the tip of which is designated by reference numeral 156. This punch is rotated in place to secure the threaded tube 141.

5 For positioning and securing fractured bone pieces, it is often required to design the external clamp so that retightening or generally clamping is possible. Here, a clamping element 60 is used, which comprises two tubular ends 61, 62 closed at their outer surfaces by external threads 10 (Fig. 9). Each outer thread of both tubular portions 61, 62 is formed by one outer thread as a right-hand thread 63 and a second outer thread as a left-hand thread 64. . This stop or coupling sleeve 65 may be made of a material of tubular member 61, 62. However, it is possible to use special locking or connecting sleeves 65 which are connected via suitable connecting means, such as screw connections, to the pipe sections 61,62. The outer diameter of these holding or connecting sleeves 65 corresponds to the inside diameter of the tubular section 11 to be connected.

A tubular clamping nut 66 is threaded onto the outer threads 63, 64, 25 of both tubular sections 61, 62, the outer wall surface of which is provided with a gripping profile. In the embodiment shown in Fig. 9, the clamping nut 66

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is provided with a plurality of gripping surfaces 66a that delimit * 1 'the hexagonal cross-sectional shape of this clamping nut * 30' (Fig. 10). The clamping nut 66 comprises a plurality of through holes 67 disposed in successive rows, i. adjacent to each other and extending in the longitudinal direction of the clamping nut jT :. These through holes 67 allow | The process of monitoring and testing of the tightening process thus operates as 33 observation windows. Tensioning element 60 for both tubes - «· •«

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The outer wall surface portions of the parts 61, 62 of the parts 61, 62 are preferably colored with different colors so that the colors visible from the borehole 67 can be used to evaluate the progress of the tightening process. For a more secure attachment of the tubular member 11 to the abutment 5 or the coupling sleeves 65, these sleeves are provided with a corrugated or rib profile 68 as shown in FIG. Reference number 69 denotes an air outlet. The clamping element 60 thus formed results in a structural element which makes it easy to tighten the tubular parts, e.g. The tubular parts 61, 61 may also be made as hollow screws, the interior of which is filled with fiberglass by a rear section of the fiberglass tubular body 212 receiving fiberglass 15, whereby a portion of the pure fiberglass filler or fiberglass tube is formed. This portion of the fiberglass filler or fiberglass tube tube serves as a hollow screw filler, thereby providing a fixed connection between the clamping element 60 and the fastener tube after casting the plastic, this plastic flowing into the free fibrous portion of the fiberglass filler. At the same time, the hexagonal forming of the clamping element 60 provides the advantage that the clamping element 60 can be grasped from the outside by means of correspondingly shaped tools and rotated about its longitudinal axis. compressing.

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As fastening tubes, i.e.. As tubular parts 11, plastic tubes fitted with a fiberglass fabric on the outside or inside can also be used, whereby this fiberglass fabric can be embedded in this plastic material when making tubular material from plastic.

*. With the use of Kirschner yarns 30, it is advantageous to ensure the attachment of these yarns 30 by means of a clamping tube f · · •> t · * · * r · * / »• m 27 104616 and cable ties 80 placed around the yarns 30 (FIG. 3). These cable ties prevent the wires 30 from sliding off their anchorage attachment in the fastener tube when the fastener tube is filled with plastic.

The fastening elements 40, 140 and the tensioning element 60 are made of suitable plastics having considerable strength, in particular tensile strength, however other suitable materials may be used.

12 and 13, the tubular member 211 10 comprises a tubular body 212 made of resilient plastic. The tubular body 212 is provided with a fiberglass tube 215 which abuts against the inner wall of the tubular body 212. When using a tubular system comprising a plurality of tubular sections 211, fiberglass tissue tubes are retracted into individual plastic tubing sections 15 prior to joining and securing these tubular sections. Also, longer tubular bodies 212 with fiberglass tubing inserted therein can be used and, if necessary, cut to the required lengths.

Within the tubular body 212, a single fiberglass woven tubing 215 may be inserted (Figure 12). However, a plurality of la-fiber woven tubes 215, 216, 217 may also be placed inside the tubular body 212 to form multiple layers (Figure 13). As required, these fiberglass wedges may have different wall thicknesses. The tubular member 211 thus formed is then filled with a curable plastic. In Fig. 14, such a curable plastic is represented by

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This arrangement provides the advantage * that * such a fastener tube may be sterilized before being used '30. The fiberglass tube can also be sterilized before being retracted into the tube body. Tubular part 211? <'Ϊ thus functions as a casting mold. The curable plastic penetrates into the fiberglass tube after being introduced into the fiberglass tube * through the glass fibers, after it has been cured to form a solid internal bond after curing. and plastic. The function of the outer plastic tubular body is merely to hold this structure together, acting as an outer barrier layer, whereby it can be made thin-walled. In this way, a very stable joint material is obtained. This stability can be adjusted by applying different amounts of layers of fiberglass tubing.

The tubular body 212 is, as shown in Figures 15 and 16, made of helically shaped, preferably transparent or glass-clear plastic. The interior of the tubular body 212 is filled with glass fibers 218 comprising a wound glass fiber woven mat or a plurality of nested glass fiber woven tubes. This glass fiber filler 218 completely fills the interior of the tubular body 212.

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Claims (23)

An outer fixing device comprising at least one flexible tubular portion (11; 211) of plastic, which may be provided externally to the patient in relation to broken bone fragments (K1, K2) to be fixed and which may be joined to the various bone fragments attached trees, nails or screws, wherein the tubular portion filled with a curable material, after curing of the material, together with the trees, nails or screws forms a solid frame which interconnects the bone fragments so that they can coexist in the desired position, characterized in that the hose-shaped part (11; 211) of the outer fixing device (10) consists of a hose body (212) filled with glass fibers of a transparent or glass-clear plastic material and that it is formed as a spiral hose, fast-curing plastic material is introduced into the interior of the closed hose system. An external fixing device comprising at least one flexible, tubular portion (11; 211) of plastic, which can be arranged outside the patient in relation to broken bone fragments to be fixed and which can be connected to the trees, nails or screws attached to the various bone fragments, wherein the filled with a curable material: hose-shaped part after curing of the material together. man with the trees, nails or screws forms a solid frame, which holds together the bone fragments so that they can co-9 JV. male growth in the desired position, characterized by I *. "That the hose-shaped part (11; 211) of the outer fixing device (10) consists of a glass fiber reinforced," r "transparent or glass-clear plastic material and that it is designed as a spiral hose, whereby after completion of mounting * * · A fast-curing plastic material inserted into the interior of the * t · V 'hose system. 35. • »f · · i · · • ·« 9 «·» 9 • t » Outer fixing device according to claim 1 or 2, characterized in that the tubular part (11; 211) of the outer fixing device (10) consists of a glass fiber tissue embedded in a transparent or glass-clear plastic material. 4. I · · · «· 40 104616 External fixing device according to claim 1 or 3, characterized in that the fiberglass filling in the hose body (212) consists of at least one hose (215) retracted in the hose body (215) or a glass fiber mat wound into a hose body. External fixing device according to any of claims 1-4, characterized in that the two free ends (11a, lib) of a hose-shaped part (11; 211) are joined to each other via a preferably Y- or External fixing device according to any of claims 1-5, characterized in that the hose-shaped part (11; 211) is passed over the bone fragments in different pianos and directions and that it can be connected by means of trees, nails or screws to the bone fragments. . External fixing device according to any one of claims 1-6, characterized in that several hose-shaped parts (11; 211) are joined to a frame * (20), all hose-shaped parts (11; 211; 21, 22, 23, 24, 25) are joined together by a hose-shaped an--· iV. closure piece, such that the inner space of all tubes! 'shaped parts (11; 211; 21, 22, 23, 24, 25) is connected to each other, the tubing system thus designed | At least one has a closable insertion opening for the curable material. • * f «· ί · :. External fixing device according to claim 7, characterized in that several hose-shaped parts 35 (11; 211; 21, 22, 23, 24, 25) of the hose system are joined together IKI t · »» * «· 4 · · tf • ·« f% * * · »· I:« * 37 1 0 4 6 1 6 in groups, the hose system formed by each group having at least one closable insertion opening for the curable material. 9 I i i » Exterior fixing device according to claims 1-58, characterized in that in the use of fixing trees, such as e.g. Kirschner trees (30), each tree has its free end (30a), after bending the tree end approx. 180 °, recessed in the tubular member (11; 211) and connected to this rotationally stable. 9 T • · · 9 r · • · 104616 36 External fixing device according to any of claims 1-8, characterized in that, when using fixing screws or nails, these have been fixed by means of a fixing element (40; 140) to the tubular part (11; 211). Exterior fixing device according to claim 10, characterized in that the fixing element (10) consists of two shell-shaped and the hose-shaped part (11; 211) surrounding parts (41, 42) which complement each other to form a tubular building element (43), 20 wherein each shell-shaped part (41, 42) on at least two opposite sides has shell-shaped shaped sections (44, 4; 46, 47) which complement each other to form two in-line mounting studs (48, 49) and serves to receive a screw or a nail (12), the shell-shaped sections (44, 45; 46, 47. carrying on its outer wall an outer thread (50) for receiving a clutch nut (51) , which includes a clamping ring (55), which is attached to the end of the fastener (48, 49). External fixing device according to claim <pp 10 or 11, characterized in that each of the shell-shaped part (41; 42) of the fixing element (40) is on its own. , inner wall has at least two fixing pins, mandrels ··· * or the like (52). Exterior fixing device according to claim 3, characterized in that the fixing element «9 · i n · ·» t * i i; (140) consists of a through opposite and in line with each other openings (112, 113) in the wall (111) of the tubular part (140). (11) threaded tube (141), which is provided with an outer thread (160) and which receives in its inner space 5 a nail or screw, the threaded tube (141) on each side being removed from the tubular member (11). ) having a section (142, 143) and each section (142, 143) in the region of its ends (142a, 143a) carries a clutch nut (144) engaged in the outer thread (160) on the threaded tube 10 (141) , 145), which includes a clamping ring (146, 147) arranged at each end of the threaded tube (141), which is brought into abutment on the outside of the coupling nut (144, 147) when pulling the coupling nut (144, 145). arranged in the threaded tube 15 (141) the nail or screw (12), and the threaded tube (141) The fragments (K1, K2) facing portion (143) carry a threaded and clamping clamp (148) seated on the outer thread with a pin (20) engaging in the wall (111) of the tubular member (11). (149), and in the second section (142) a threadless coupling clamp (150) having a pin, mandrel, etc. engaging in the wall (111) of the tubular member (11; 211). (151), wherein the threadless coupling clamp (150) of the threaded tube (141) is retained by a nut (152) and connected to the threaded tube (141). stationary by means of a cam (154). · '· .. *! External fixing device according to any of claims 1-13, characterized in that each fracture bridging hose section (11; 211) has a tensioning element (60). External fixing device according to claim 14, characterized in that the clamping element (60) consists of two tubular sections (61, 62), which are externally provided with outer threads, wherein an outer thread of the < both outer threads on both sections (61, 62) are designed as the right-hand thread (63) and the second outer thread as the left-hand thread (64), each tube-shaped section (61, 62) at its protruding end (61a, 62a) is provided with a hose-shaped or connecting rod (65) for hose-shaped parts (11; 211), and on the outer threads (63, 64) of the two tubular sections ( 61, 62) screwed a tubular clamp nut (66) provided with a grip profiling, e.g. gripping surfaces (66a) and with a number of consecutive holes in the longitudinal direction of the clamping nut (67). A T-shaped connector (16), which is provided with a closable insertion opening (14) for the curable material. Exterior fixing device according to claim 15, characterized in that sections of the outer wall surface of both tubular sections (61, 62) of the clamping element (60) have different colors. Exterior fixing device according to claim 15 or 16, characterized in that the wall of the tubular section of the clamping element (60) is provided with ventilation openings (69). External fixing device according to claim 9, characterized in that the Kirschner threads (30) are poured at the hose-shaped part (11; 211) by cable ties (90) on the hose-shaped part (11; 211). Exterior fixing device according to any one of claims 1-17, characterized in that, when fixed by means of trees, nails or pins, the recesses of the hose-shaped part (11; 211) are secured in the wall (111) by means of cable ties on the hose-shaped portion (11; 211). * "1 External fixing device according to any one of the preceding claims 1-19, characterized in that one or more hoses (215) are retracted by a glass fiber web in the hose body (212) of the hose-shaped part (211). It is said that the hose body (212) together with the fiberglass tissue hose or fiberglass tissue hoses (215, 216, 217) and the interior of the tubular member (211) cured; the plastic material forms a composite element. • · · External fixing device according to claim 20, characterized in that the glass fiber tissue tubes (215, 216, 217) arranged in the interior of the hose body (212) have identical or different thicknesses. Exterior fixing device according to claim 20 or 21, characterized in that the inner space of the hose body (212) has a filling (218) of several glass fiber tissue tubes which are pulled into one another or of a glass fiber tissue tissue wound into a hose. External fixing device according to any of claims 1-22, characterized in that the tubular part (11; 211) consists of transparent or glass-clear plastic material and that the curable plastic material is colored. tl »• • 9 ·· I * · * • f • V • r * • · I · · • * · 9. r I · • 9 9. i 9 9 · I · · · •« · • · · < 1 · <«· I • If« • «« «4 4 4 • * 4 4 4 IM 4 14 · • • 4 4