FR2707864A1 - Surgical clamp for tensioning an osteosynthesis ligament - Google Patents

Surgical clamp for tensioning an osteosynthesis ligament Download PDF

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Publication number
FR2707864A1
FR2707864A1 FR9309317A FR9309317A FR2707864A1 FR 2707864 A1 FR2707864 A1 FR 2707864A1 FR 9309317 A FR9309317 A FR 9309317A FR 9309317 A FR9309317 A FR 9309317A FR 2707864 A1 FR2707864 A1 FR 2707864A1
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end
ligament
clamp
retention
engagement
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FR9309317A
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FR2707864B1 (en )
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Taylor Jean
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Taylor Jean
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/88Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8861Apparatus for manipulating flexible wires or straps

Abstract

The clamp (10) is of the type comprising two pivoting branches (11, 12) and the ligament is of the type of which one end comprises means for engagement and retention of its other end. According to the invention, one of the branches (11) is substantially straight and is designed to be immobilised with respect to the end of the ligament fitted with the said engagement and retention means. The other branch (12) is bent and equipped with a clamping jaw (20) which can grip, without possibility of sliding, the other end (2a) of the ligament after this end has passed around the bone parts to be held by the ligament. <IMAGE>

Description

PINCE CHIRURGICALE POUR LA MISE EN TENSION CLAMP FOR SURGICAL TENSIONING
D'UN LIGAMENT D'OSTEOSYNTHESE A LIGAMENT OSTEOSYNTHESIS
La présente invention concerne une pince chirurgicale pour la mise en tension d'un ligament d'ostéosynthèse, notamment d'ostéosynthèse vertébrale. The present invention relates to a surgical clip for tensioning a ligament bone, including vertebral osteosynthesis.

II est connu d'entrelacer un ligament autour des apophyses épineuses, des vertèbres situées de part et d'autre de l'articulation à traiter, et de coudre les extrémités du ligament l'une à l'autre ou au ligament luimême, après mise en tension de celui-ci. It is known to interleave a ligament around the spinous processes of the vertebrae located on either side of the joint to be treated, and sewing the ends of the ligament to one another or to itself ligament after setting voltage thereof. Cette technique permet de stabiliser l'articulation tout en lui conservant un certain jeu fonctionnel. This technique allows to stabilize the joint while retaining some functional play.

Dans certains cas, une cale intervertébrale peut être insérée entre les apophyses épineuses d'au moins deux vertèbres successives, pour interdire tout contact mutuel des vertèbres au niveau de ces apophyses, pouvant causer l'écrasement des nerfs rachidiens. In some cases, an intervertebral spacer may be inserted between the spinous processes of two successive vertebrae, to prevent any mutual contact of vertebrae in these processes, which may cause crushing the spinal nerves.

Pour faciliter la mise en tension et le maintien en tension du ligament le temps que ces coutures soient réalisées, la demande de brevet français nO 93 05742 propose un dispositif solidaire de l'une des extrémités du ligament, comprenant des moyens d'engagement et de rétention au travers dequels l'autre extrémité du ligament peut être engagée après avoir contourné les apophyses épineuses des deux vertèbres, et au travers desquelles cette extrémité du ligament peut coulisser dans son sens d'engagement, mais pas en sens inverse. To facilitate tensioning and holding under tension the ligament time that these seams are made, the French Patent Application No. 93 05742 provides a fixed device of the one end of the ligament, comprising engagement means and retention dequels through the other end of the ligament may be engaged after passing the spinous processes of two vertebrae, and through which this end of the ligament is slidable in its direction of engagement, but not in opposite direction.

La présente invention vise à fournir une pince de mise en tension du ligament équipé d'un tel dispositif, apte à permettre de parfaitement contrôler cette tension et de la maintenir le temps que les coutures des extrémités du ligament soient réalisées, et ce, dans le faible espace disponible. The present invention aims to provide a tensioning clamp ligament equipped with such a device capable of allowing to perfectly control the tension and to maintain the time that the seams of the ends of the ligament are made, and in the small space.

A cette fin, la pince qu'elle concerne, du type comprenant deux branches pivotantes l'une par rapport à l'autre autour d'un axe, est caractérisée en ce qu'elle comprend une branche sensiblement rectiligne, conformée pour être immobilisée par rapport à l'extrémité du ligament équipé desdits moyens d'engagement et de rétention, et une branche coudée équipée d'une mâchoire de serrage apte à saisir, sans possibilité de glissement, L'autre extrémité du ligament, après que cette extrémité ait contourné les apophyses épineuses des vertèbres et ait été engagée au travers desdits moyens, les extrémités proximales des deux branches pouvant être amenées dans une position rapprochée l'une de l'autre, dans laquelle elles sont sensiblement parallèles, et être écartées l'une de l'autre par pivotement d'une branche par rapport à l'autre. To this end, the clamp it relates, of the type comprising two pivoting arms relative to each other about an axis, is characterized in that it comprises a substantially straight part, shaped to be immobilized by relative to the end of the ligament with said engagement means and retention, and a bent part provided with a clamping jaw adapted to grip without the possibility of sliding, the other end of the ligament after this end has bypassed the spinous processes of the vertebrae and has been engaged through said means, the proximal ends of the two arms can be brought into a position close to each other, in which they are substantially parallel, and be spaced apart from the another by pivoting of a leg relative to the other.

Cette pince permet ainsi d'assurer une parfaite mise en tension du ligament, avec contrôle de la tension exercée et possibilité de maintien de cette tension, par immobilisation des branches l'une par rapport à l'autre, le temps que s'opèrent les coutures des extrémités l'une à l'autre ou les coutures de ces extrémités au ligament lui-même. This clip thus ensures perfect tensioning of the ligament, with control of the tension exerted and possibility for maintaining this tension, by immobilization of the legs relative to each other, the time to operate the stitching the ends to one another or the seams of these ends to the ligament itself.

Avantageusement, la pince est équipée de moyens permettant de maintenir ces deux branches dans une pluralité de positions relatives déterminées, pour permettre de régler, en atteignant telle ou telle position déterminée, la tension conférée au ligament, et de maintenir le ligament sous tension le temps que lesdites coutures soient réalisées. Advantageously, the clamp is equipped with means for maintaining the two arms in a plurality of relative positions determined to enable to adjust, upon reaching a particular predetermined position, the tension imparted to the ligament, and to maintain the power ligament time that said seams are realized.

Selon une forme de réalisation préférée de cette pince According to a preferred embodiment of this clamp
- I'extrémité de la branche rectiligne comprend une cavité lui permettant, par engagement selon une direction perpendiculaire au ligament, de venir coiffer sans possibilité de jeu, la cage tubulaire que comprend avantageusement l'une des extrémités du ligament pour délimiter le conduit d'engagement de l'autre extrémité de ce ligament, et - I'extrémité of the straight leg comprises a recess enabling it, by engagement in a direction perpendicular to the ligament to fit over without the possibility of play, the tubular cage advantageously comprises one end of the ligament to delimit the duct of engagement of the other end of the ligament, and
- la mâchoire de serrage est constituée, d'une part, par la partie proximale de la branche coudée de la pince et, d'autre part, par un doigt monté pivotant autour d'un axe perpendiculaire à cette partie proximale, ce doigt étant actionné, d'un côté de cet axe, par un ressort qui tend à l'éloigner de l'extrémité proximale de la branche coudée et, de l'autre côté de cet axe, par une tige filetée traversant un alésage taraudé aménagée dans la partie proximale de la branche coudée, qui permet, lorsqu'elle est serrée, de rapprocher l'extrémité proximale du doigt de l'extrémité proximale de la branche coudée, la tige ayant une longueur telle que son extrémité libre soit aisément accessible au praticien et étant conformée à cette extrémité libre pour recevoir un outil, tel qu'une clé ou un tournevis, permettant sa manoeuvre en rotation. - the clamping jaw is formed, firstly, by the proximal portion of the angled leg of the clip and, secondly, by a finger pivotable about an axis perpendicular to said proximal portion, said finger being actuated, one side of this axis, by a spring which tends to move it away from the proximal end of the angled leg and the other side of this axis, by a threaded rod passing through a threaded bore arranged in the proximal portion of the angled leg, which, when tightened, to bring the proximal end of the proximal end finger of the angled leg, the shaft having a length such that its free end is easily accessible to the practitioner and being shaped to the free end for receiving a tool such as a wrench or screwdriver, allowing its rotation operating.

La cavité de l'extrémité proximale de la branche rectiligne permet de parfaitement immobiliser cette branche par rapport au ligament, et de présenter la mâchoire de serrage de l'autre branche à proximité de l'extrémité du ligament que cette mâchoire est destinée à saisir. The cavity of the proximal end of the rectilinear branch enables perfect immobilize the leg relative to the ligament, and to submit the clamping jaw of the other leg near the end of the ligament that this jaw is intended to enter.

Avantageusement, des moyens sont prévus pour assurer le maintien de l'extrémité proximale de la branche rectiligne en position engagée sur cette cage. Advantageously, means are provided to maintain the proximal end of the straight arm in the engaged position on the cage. Par exemple, les parois de la branche rectiligne délimitant la cavité peuvent comporter des nervures parallèles à l'axe d'engagement et les parois latérales de la cage peuvent comporter des encoches dans lesquelles ces nervures s'engagent lors de la mise en place de l'extrémité proximale de la branche rectiligne sur la cage. For example, the walls of the rectilinear branch defining the cavity may contain ribs parallel to the engagement pin and the side walls of the cage may have notches in which these ribs engage in the establishment of proximal end of the straight branch of the cage.

La tige filetée permet, par sa longueur, une manoeuvre aisée de la fermeture de la mâchoire et un serrage du ligament qui élimine tout risque de glissement. The threaded rod permits, by its length, an easy actuation of the closure of the jaw and a clamping the ligament which eliminates any risk of slipping.

Pour sa bonne compréhension, I'invention va être à nouveau décrite ci-dessous, en référence au dessin schématique annexé représentant, à titre d'exemple non limitatif, une forme de réalisation préférée de la pince chirurgicale qu'elle concerne. For a good understanding, the invention will be further described below with reference to the accompanying drawings showing by way of example, a preferred embodiment of the surgical forceps which it relates.

Dans ce dessin, In this drawing,
La figure 1 est une vue à plat de cette pince; Figure 1 is a plan view of the clamp;
La figure 2 en est une vue de profil Figure 2 is a side view
La figure 3 en est une vue partielle, similaire à la figure 2, dans une autre position que celle montrée par cette figure Figure 3 is a partial view, similar to Figure 2, in a position other than that shown in this figure
La figure 4 est une vue similaire à la figure 1 dans une autre position de cette pince que celle montrée par cette figure, et Figure 4 is a view similar to Figure 1 in another position of this clamp as that shown by this figure, and
La figure 5 est une vue en coupe selon la ligne VV de la figure 4 d'un ligament d'ostéosynthèse vertébrale équipé de moyens de liaison de ses extrémités, et des extrémités proximales des branches de la pince. Figure 5 is a VV cross sectional view along the line of FIG 4 of a vertebral osteosynthesis ligament equipped with connection means of its ends, and proximal ends of the limbs of the clamp.

La figure 5 représente un ligament d'ostéosynthèse vertébrale tel que décrit dans la demande de brevet français nO 93 05742. 5 shows a ligament vertebral osteosynthesis as described in the French patent application No. 93 05 742.

Ce ligament 2 comprend une plaque 3 de matériau résistant et malléable, apte à être fixée à l'une 2a des extrémités 2a, 2b du ligament 2, par des coutures, et un élément tubulaire 4 formant une cage, solidaire de la plaque 3, délimitant un conduit 5 dans lequel est disposée transversalement une came 6. This ligament 2 comprises a plate 3 of resistant malleable material, adapted to be fixed to one 2a of the ends 2a, 2b of the ligament 2 by stitching, and a tubular member 4 forming a cage, integral with the plate 3, defining a conduit 5 which is arranged transversely in a cam 6.

Cette came 6 peut pivoter sur elle-même entre une position effacée et une position active. The cam 6 can pivot on itself between a retracted position and an active position. En position effacée, elle permet l'engagement et [e coulissement de l'extrémité 2b du ligament 2 entre elle et la paroi de la cage 4, après que le ligament 2 ait été engagé autour des deux apophyses épineuses 7 des vertèbres délimitant l'articulation à traiter. In the retracted position, it allows the engagement and [e displacement of the end 2b of the two ligament between it and the wall of the cage 4, after the ligament 2 has been engaged around the two spinous processes of the vertebrae 7 delimiting the joint to be treated. En posi tion active, elle coince ladite extrémité 2b entre elle et cette paroi, pour interdire tout mouvement de l'extrémité 2b en sens inverse de son sens d'engagement. In active posi tion, it wedges said end 2b between itself and said wall, to prevent movement of the end 2b opposite direction to its direction of engagement.

La pince 10, représentée aux figures 1 à 4, est prévue pour mettre en tension le ligament 2, en permettant de contrôler parfaitement la tension exercée, et de maintenir cette tension le temps que s'opèrent les coutures des extrémités 2a, 2b l'une à l'autre ou les coutures de ces extrémités 2a, 2b au ligament 2 lui-même, et ce, dans le faible espace disponible. The clamp 10, shown in Figures 1 to 4, is provided for tensioning the ligament 2, allowing to control the tension exerted perfectly, and maintain this voltage the time as operating the seams of the ends 2a, 2b the to each other or the seams of these ends 2a, 2b ligament 2 itself, and this, in the small space available.

Cette pince 10 comprend deux branches 11, 12 pouvant pivoter l'une par rapport à l'autre autour d'un axe constitué par une vis 13. This clip 10 comprises two legs 11, 12 being pivotable relative to one another about an axis constituted by a screw 13.

La branche 11 est rectiligne et son extrémité proximale comprend une cavité lui permettant d'être engagée sur la cage 4, transversalement par rapport au ligament 2, en venant coiffer cette cage 4 sans jeu. The arm 11 is straight and its proximal end comprises a cavity allowing it to be engaged on the cage 4, transversely to the ligament 2 in capping this cage 4 without play.

Ainsi que le montre la figure 5, les parois latérales de la branche Il délimitant cette cavité comprennent deux nervures 14 parallèles à l'axe d'engagement de la branche il sur la cage 4, tandis que les parois latérales de la cage 4 comportent des encoches dans lesquelles ces nervures 14 sont aptes à être engagées et à coulisser. As shown in Figure 5, the side walls of the branch It delimiting said cavity comprise two ribs 14 parallel to the axis of engagement of the branch it on the cage 4, while the side walls of the cage 4 comprise grooves into which the ribs 14 are adapted to be engaged and slide.

A son extrémité distale, la branche 11 comporte un axe 15 autour duquel est engagé un ressort en épingle 16 et peut pivoter une crémaillère 17 munie de dents 18. At its distal end, the branch 11 has an axis 15 around which is engaged a spring pin 16 and may rotate a rack 17 provided with teeth 18.

La branche 12 est coudée à proximité de l'axe 13, du côté distal, et est équipée d'une mâchoire de serrage 20 apte à saisir, sans possibilité de glissement, I'extrémité 2b du ligament 2 après que cette extrémité 2b ait contourné les apophyses épineuses 7 et ait été engagée au travers de la cage 4. The leg 12 is angled near the axis 13, the distal side, and is equipped with a clamping jaw 20 adapted to grip without the possibility of sliding, I'extrémité 2b of the ligament 2 after this end 2b has bypassed the spinous processes and 7 has been engaged through the cage 4.

La mâchoire de serrage 20 est constituée, d'une part, par la partie proximale de la branche coudée 12 et, d'autre part, par un doigt 21 monté pivotant autour d'un axe 22 perpendiculaire à cette partie proximale, cet axe 22 étant porté par au moins une patte 23. The clamping jaw 20 is formed, firstly, by the proximal portion of the angled leg 12 and, on the other hand, by a pin 21 pivotably mounted about an axis 22 perpendicular to said proximal portion, said axis 22 being carried by at least one tab 23.

Le doigt 21 et la partie proximale de la branche 12 comprennent, du côté proximal de la pince par rapport à l'axe 22, deux évidements situés en face l'un de l'autre, recevant les extrémités d'un ressort héli coïdal 24. De l'autre côté de cet axe 22, le doigt 21 est chanfreiné et la branche 12 est percée d'un alésage taraudé dans lequel est engagée une vis 25. L'extrémité proximale de la vis 25 prend appui contre la partie chanfreinée du doigt 21, tandis que l'extrémité distale de la tige 25 est conformée pour recevoir un outil permettant sa manoeuvre en rotation, tel qu'une clé ou un tournevis. The finger 21 and the proximal portion of the arm 12 comprise, on the proximal side of the clamp relative to the axis 22, two recesses located opposite one another, receiving the ends of a spring heli coïdal 24 . on the other side of this axis 22, the finger 21 is chamfered and the branch 12 is pierced with a tapped bore in which is engaged a screw 25. the proximal end of the screw 25 abuts against the chamfered portion of the finger 21, while the distal end of the rod 25 is shaped to receive a tool for its operation in rotation, such as a wrench or screwdriver.

A son extrémité distale, la branche coudée 12 comprend une dent 26 apte à venir prendre appui contre l'une ou l'autre des dents 18 de la crémaillère 17. At its distal end, the angled leg 12 comprises a tooth 26 adapted to bear against one or other of the teeth 18 of the rack 17.

En pratique, la cavité de l'extrémité proximale de la branche rectiligne 11, une fois engagée sur la cage 4, permet de parfaitement immobiliser cette branche il par rapport au ligament 2, et de présenter la mâchoire de serrage 20 de l'autre branche 12 à proximité de l'extrémité 2b du ligament 2 que cette mâchoire 20 est destinée à saisir. In practice, the cavity of the proximal end of the straight leg 11, once engaged on the cage 4, makes it possible to immobilize this branch it perfectly with respect to the ligament 2 and to submit the clamping jaw 20 of the other branch 12 near the end 2b of the ligament 2 that the jaw 20 is intended to grasp.

L'engagement des nervures 14 dans les encoches des parois latérales de la cage 4 permet d'assurer le maintien de l'extrémité proximale de la branche 11 en position engagée sur cette cage 4. The engagement of the ribs 14 in the notches of the side walls of the cage 4 ensures the maintenance of the proximal end of the arm 11 in the engaged position on the cage 4.

La tige filetée 25 permet de manoeuvrer le doigt 21 dans le sens de la fermeture de la mâchoire 20, en s'opposant à l'action du ressort de rappel 24 qui, lui, tend à éloigner ledit doigt 21 de l'extrémité proximale de la branche Il lorsque la tige 25 est manoeuvrée dans l'autre sens. The screw 25 allows to maneuver the finger 21 in the direction of closure of the jaw 20, in opposition to the action of the return spring 24 which itself tends to move said finger 21 of the proximal end of It branch when the rod 25 is actuated in the other direction.

Cette tige 25 a une longueur telle que son extrémité libre soit aisément accessible au praticien. This rod 25 has a length such that its free end is easily accessible to the practitioner. Par sa longueur, elle permet une manoeuvre aisée de la fermeture de la mâchoire 20 et un serrage du ligament 2 qui élimine tout risque de glissement. By length, it allows an easy operation of the closure of the jaw 20 and clamping the ligament 2 which eliminates any risk of slipping.

Lorsque les branches 11, 12 de la pince 10 sont pivotées dans le sens du rapprochement de leurs parties distales, c'est-à-dire lorsqu'elles sont amenées de la position qu'elles occupent sur la figure 1 à celle qu'elles occupent sur la figure 4, il est réalisé une mise en tension du ligament 2 par traction de son extrémité 2b. When the branches 11, 12 of the clamp 10 are pivoted in the direction of approximation their distal parts, that is to say when they are brought from the position they occupy in Figure 1 in that they occupy in Figure 4, there is provided a tensioning of the ligament 2 by pulling its end 2b. La dent 26 de la branche 12 vient se crocheter derrière l'une ou l'autre des dents 18 de la crémaillère 17, pour maintenir les branches 11, 12 dans une position relative déterminée. The tooth 26 of the arm 12 comes to hook behind one or other of the teeth 18 of the rack 17 to maintain the legs 11, 12 in a specific relative position. Ainsi, il est possible de régler, en atteignant telle ou telle position déterminée par le crochetage de la dent 26 derrière l'une ou l'autre des dents 18, la tension conférée au ligament 2, et de maintenir le ligament sous tension le temps que les coutures précitées soient réalisées. Thus, it is possible to control, reaching a particular position determined by the hooking tooth 26 behind one or other of the teeth 18, the tension imparted to the ligament 2, and maintain the power ligament time the abovementioned seams are realized.

II va de soi que l'invention n'est pas limitée à la forme de réalisation particulière de cette pince qui vient d'être décrite à titre d'exemple mais qu'elle en embrasse, au contraire, toutes les variantes de réalisation. It goes without saying that the invention is not limited to the particular embodiment of this clamp which has just been described by way of example but encompasses, on the contrary, all embodiments.

Claims (6)

    REVENDICATIONS
  1. 1. Pince chirurgicale pour la mise en tension d'un ligament d'ostéosynthèse, la pince étant du type comprenant deux branches pivotantes l'une par rapport à l'autre autour d'un axe et le ligament étant du type dont une des extrémités comprend des moyens d'engagement et de rétention de son autre extrémité, caractérisée en ce qu'elle comprend une branche (11) sensiblement rectiligne, conformée pour être immobilisée par rapport à l'extrémité (2b) du ligament (2) équipé des dits moyens d'engagement et de rétention (4, 5, 6), et une branche coudée (12) équipée d'une mâchoire de serrage (20) apte à saisir, sans possibilité de glissement, L'autre extrémité (2a) du ligament (2), après que cette extrémité ait contourné les parties osseuses devant être maintenues par le ligament et ait été engagée au travers des dits moyens (4, 5,6), les extrémités proxi males des deux branches (11, 12) pouvant être amenées dans une position rapprochée l'une de l'autre, d 1. A surgical clip for tensioning a ligament fixation, the clip being of the type comprising two pivoting arms relative to each other about an axis and the ligament being of the type having one end comprises means for engagement and retention of its other end, characterized in that it comprises a branch (11) substantially rectilinear, shaped to be immobilized relative to the end (2b) of the ligament (2) with the said engagement means and retention (4, 5, 6) and a bent leg (12) equipped with a clamping jaw (20) adapted to grip without the possibility of sliding, the other end (2a) of the ligament (2) after this end has bypassed the bone parts to be maintained by the ligament and has been engaged through the said means (4, 5.6), the proxi male ends of the two branches (11, 12) being brought into a position close to each other, d ans laquelle elles sont sensiblement parallèles, et être écartées l'une de l'autre par pivotement d'un branche (12) par rapport à l'autre (11). years which they are substantially parallel, and be spaced apart from each other by pivoting of a leg (12) relative to another (11).
  2. 2. Pince selon la revendication 1, caractérisée en ce qu'elle est équipée de moyens (15 à 18); 2. Clamp according to claim 1, characterized in that it is equipped with means (15 to 18); (26) permettant de maintenir les branches (11, 12) dans une pluralité de positions relatives déterminées. (26) for holding the legs (11, 12) in a plurality of relative positions determined.
  3. 3. Pince selon la revendication 1 ou la revendication 2, caractérisée en ce que l'extrémité de la branche rectiligne (11) comprend une cavité lui permettant, par engagement selon une direction perpendiculaire au ligament (2), de venir coiffer sans possibilité de jeu la cage tubulaire (4) que comprend avantageusement l'extrémité (2b) du ligament comprenant les moyens (4, 5, 6) précités. 3. Clamp according to claim 1 or claim 2, characterized in that the end of the straight leg (11) comprises a recess enabling it, by engagement in a direction perpendicular to the ligament (2) to fit over without the possibility of play the tubular cage (4) which advantageously comprises the end (2b) of the ligament comprising the means (4, 5, 6) above.
  4. 4. Pince selon l'une des revendications 1 à 3, caractérisée en ce que la mâchoire de serrage (20) est constituée, d'une part, par la partie proximale de la branche coudée (12) et, d'autre part, par un doigt (21) monté pivotant autour d'un axe perpendiculaire à cette partie proximale, ce doigt (21) étant actionné, drun côté de l'axe, par un ressort qui tend à l'éloigner de l'extrémité proximale de la branche coudée (12) et, de l'autre côté de cet axe, par une tige filetée (25) traversant un alésage taraudé aménagé dans la partie proximale de la branche coudée, qui permet, lorsqu'elle est serrée, de rapprocher l'extrémité proximale du doigt (21) de l'extrémité proximale de la branche coudée (12), la tige (25) ayant une longueur telle que son extrémité libre soit aisément accessible au praticien et étant conformée à cette extrémité libre pour recevoir un outil tel qu'une clé ou un tournevis, permettant sa manoeuvre en rotation. 4. Clamp according to one of claims 1 to 3, characterized in that the clamping jaw (20) is formed, firstly, by the proximal portion of the angled leg (12) and, on the other hand, by a finger (21) pivotally mounted about an axis perpendicular to said proximal portion, said finger (21) being actuated, drun side of the axis, by a spring which tends to move it away from the proximal end of the angled leg (12) and, on the other side of this axis, by a threaded rod (25) passing through a threaded bore formed in the proximal portion of the angled leg, which, when tightened, to approximate the proximal end of the finger (21) from the proximal end of the angled leg (12), the rod (25) having a length such that its free end is easily accessible to the practitioner and being shaped to the free end for receiving a tool such a wrench or screwdriver, allowing its operation in rotation.
  5. 5. Pince selon la revendication 3 ou la revendication 4, caractérisée en ce qu'elle comprend des moyens (14) pour assurer le maintien de l'extrémité proximale de la branche rectiligne (11) en position engagée sur la cage (4) que comprend l'extrémité (2b) du ligament (2). 5. Gripper according to claim 3 or claim 4, characterized in that it comprises means (14) for maintaining the proximal end of the straight leg (11) in the engaged position on the cage (4) that comprises the end (2b) of the ligament (2).
  6. 6. Pince selon la revendication 5, caractérisée en ce que les parois de la branche rectiligne (11) délimitant la cavité comportent des nervures (14) parallèles à l'axe d'engagement de l'extrémité proximale sur la cage (4), et en ce que les parois latérales de la cage (4) comprennent des encoches dans lesquelles ces nervures (14) s'engagent lors de la mise en place de cette extrémité proximale sur la cage (4). 6. Clamp according to claim 5, characterized in that the walls of the rectilinear branch (11) delimiting the cavity comprise ribs (14) parallel to the axis of engagement of the proximal end of the cage (4), and in that the side walls of the cage (4) comprise notches in which these ribs (14) engage during the establishment of the proximal end of the cage (4).
FR9309317A 1993-07-23 1993-07-23 Tweezers for tensioning of a ligament fixation. Expired - Fee Related FR2707864B1 (en)

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Application Number Priority Date Filing Date Title
FR9309317A FR2707864B1 (en) 1993-07-23 1993-07-23 Tweezers for tensioning of a ligament fixation.

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FR2707864A1 true true FR2707864A1 (en) 1995-01-27
FR2707864B1 FR2707864B1 (en) 1996-07-19

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