FR2781360A1 - Bone nail fixing for surgery has plate with angled bore for clamping screw and end stop - Google Patents

Bone nail fixing for surgery has plate with angled bore for clamping screw and end stop Download PDF

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Publication number
FR2781360A1
FR2781360A1 FR9809425A FR9809425A FR2781360A1 FR 2781360 A1 FR2781360 A1 FR 2781360A1 FR 9809425 A FR9809425 A FR 9809425A FR 9809425 A FR9809425 A FR 9809425A FR 2781360 A1 FR2781360 A1 FR 2781360A1
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France
Prior art keywords
nail
blade
plate
clamping screw
surgery
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Granted
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FR9809425A
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French (fr)
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FR2781360B1 (en
Inventor
Raymond Massaad
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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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—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
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • 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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7208—Flexible pins, e.g. ENDER pins

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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

The bone nail fixing has a plate (1) of selected length and thickness formed with a dovetail groove (4) over its length. The proximal end of the plate has a transverse stop and its distal end (6) is tapered and pointed with an oblique threaded bore for a clamping screw (3).

Description

l "Dispositif de fixation en chirurgie orthopédique et traumatologique au"Fixing device in orthopedic and trauma surgery to

moyen d'une lame - clou - verrouillé" La présente invention concerne un dispositif de fixation, en  means of a blade - nail - locked "The present invention relates to a fixing device, in

chirurgie orthopédique et traumatologique, au moyen d'une lame-clou-  orthopedic and trauma surgery, using a nail blade

verrouillé, adapté aux fractures de l'extrémité supérieure du fémur surtout  locked, suitable for fractures of the upper end of the femur especially

fréquentes chez les personnes âgées.  common in the elderly.

Le principe mécanique de la lame-clou-verrouillé est basé sur le même principe biomécanique du segment Coxofémorale qui est celui d'une grue de construction. Ce principe, confirmé par les études biomécaniques de Pauwels, montrent que cette grue réunit les conditions nécessaires à la  The mechanical principle of the blade-nail-locked is based on the same biomechanical principle of the Coxofemoral segment which is that of a construction crane. This principle, confirmed by Pauwels biomechanical studies, shows that this crane meets the conditions necessary for the

diminution au minimum des contraintes sur la section de l'os tubulaire.  minimization of stresses on the section of the tubular bone.

Pendant la période d'appui unilatéral durant la marche, le centre de gravité du corps se déplace vers la jambe oscillante, puisque le bassin est maintenu en position horizontale par la contraction des abducteurs du membre chargé, il forme avec le fémur un système rigide de soutènement ayant l'aspect d'une grue. Par conséquent, la diaphyse fémorale est sollicitée fortement en flexion par le poids partiel du corps. Le tractus iliotibial est latéral par rapport au fémur lorsqu'il est tendu, il agit comme un hauban et fournit une contre flexion. En effet, la contre flexion peut réduire les contraintes provoquées par  During the period of unilateral support during walking, the center of gravity of the body moves towards the oscillating leg, since the pelvis is kept in horizontal position by the contraction of the abductors of the loaded member, it forms with the femur a rigid system of support looking like a crane. As a result, the femoral shaft is stressed in flexion by the partial weight of the body. The iliotibial tract is lateral to the femur when it is stretched, it acts like a shroud and provides counter flexion. Indeed, the counter flexion can reduce the stresses caused by

la flexion au niveau du fémur.flexion at the femur.

Une étude comparative entre: 1) Le schéma d'une grue de construction avec sa colonne, son  A comparative study between: 1) The diagram of a construction crane with its column, its

hauban et sa traverse incurvée.shroud and its curved crosspiece.

2) Les trajectoires des contraintes de compression et de traction au niveau de l'os tubulaire ainsi que la répartition de la densité de l'os spongieux dans l'extrémité supérieure du fémur.  2) The trajectories of the compressive and tensile stresses at the level of the tubular bone as well as the distribution of the density of the cancellous bone in the upper end of the femur.

3) L'ostéosynthèse d'une fracture par lame-clou-verrouillé.  3) Osteosynthesis of a blade-nail-locked fracture.

Cette comparaison montre une parfaite similitude o la lame représente le hauban et les travées de traction; la vis et l'extrémité proximale du clou représentent la traverse incurvée, et les travées de compression. Et  This comparison shows a perfect similarity where the blade represents the shroud and the traction spans; the screw and the proximal end of the nail represent the curved crosspiece, and the compression spans. And

enfin les tiges du clou représentent la colonne de la grue.  finally the rods of the nail represent the column of the crane.

Ce principe biomécanique de l'invention permet au dispositif de fixation par lame-clou-verrouillé de répondre aux critères du matériel idéal d'ostéosynthèse, il assure:  This biomechanical principle of the invention allows the fixing device by blade-nail-locked to meet the criteria of the ideal osteosynthesis material, it ensures:

- Une ostéosynthèse stable, solide et élastique.  - A stable, solid and elastic osteosynthesis.

- Une technique chirurgicale simple et non invasive respectant la  - A simple and non-invasive surgical technique respecting the

fracture et son milieu biologique.fracture and its biological environment.

- Un coût faible de l'intervention par rapport à d'autres matériels  - Low cost of intervention compared to other materials

d'ostéosynthèses existants.of existing osteosyntheses.

Ces caractéristiques du dispositif de fixation pour les fractures de l'extrémité supérieure du fémur chez les personnes âgées permettent:  These characteristics of the fixation device for fractures of the upper end of the femur in the elderly allow:

- Un appui total et immédiat du patient sur le membre opéré.  - Full and immediate support of the patient on the operated limb.

- Une consolidation osseuse rapide.- Rapid bone consolidation.

- Une technique chirurgicale très facile.  - A very easy surgical technique.

- Une petite incision cutanée (trois points de suture) sans  - A small skin incision (three stitches) without

désinsertion musculaire.muscle disinsertion.

- Une intervention sous anesthésie locale.  - An intervention under local anesthesia.

- Un temps opératoire réduit (15 à 30 min.).  - Reduced operating time (15 to 30 min.).

- Une perte sanguine minime ne nécessitant pas une transfusion sanguine.  - Minimal blood loss not requiring a blood transfusion.

- Une convalescence rapide du patient.  - Rapid recovery of the patient.

- Un séjour réduit à l'hôpital (2 à 3 jours).  - A reduced stay in hospital (2 to 3 days).

Ce but est atteint par l'invention selon laquelle (fig.1): Une lame 1 possède une rainure en queue-d'aronde sur toute sa longueur et munie d'un trou oblique taraudé. Un clou 2 constitué dans sa partie proximale d'un axe doublement coudé, muni d'une rainure en queue-d'aronde et d'un trou taraudé, et se prolongeant par deux ou trois tiges circulaires constituant la partie distale du clou. Le verrouillage se fera par une vis 3 reliant le clou et la  This object is achieved by the invention according to which (fig.1): A blade 1 has a dovetail groove over its entire length and provided with a tapped oblique hole. A nail 2 formed in its proximal part of a double bent axis, provided with a dovetail groove and a tapped hole, and extended by two or three circular rods constituting the distal part of the nail. The locking will be done by a screw 3 connecting the nail and the

lame à travers leurs trous taraudés.  blade through their tapped holes.

D'autres avantages et caractéristiques ressortiront de la description  Other advantages and characteristics will emerge from the description

suivante d'une forme de réalisation de la lame-clou-verrouillé adaptée aux fractures de l'extrémité supérieure du fémur. Les détails représentés n'étant pas limitatifs et pouvant être variés selon les cas particuliers d'application en se référant aux dessins annexés sur lesquels: - La figure 1 représente le schéma d'une ostéosynthèse de fracture  following of an embodiment of the blade-nail-locked adapted to fractures of the upper end of the femur. The details shown are not limiting and can be varied according to the specific cases of application with reference to the accompanying drawings in which: - Figure 1 shows the diagram of a fracture osteosynthesis

de l'extrémité supérieure du fémur par lame-clou-verrouillé.  from the upper end of the femur by blade-nail-locked.

- La figure 2 représente la lame: Fig. 2A Vue en plan Fig. 2B Vue latérale Fig. 2C Coupe transversale de la lame selon A-B - La figure 3 représente le clou: Fig. 3A Vue en plan  - Figure 2 shows the blade: Fig. 2A Plan view Fig. 2B Side view Fig. 2C Cross section of the blade according to A-B - Figure 3 shows the nail: Fig. 3A Plan view

Fig. 3B Vue latérale.Fig. 3B Side view.

L'invention prévoit la formation d'une lame-clou-verrouillé de diverses longueurs et formes: - Une lame 1 de longueur et d'épaisseur variables possédant une  The invention provides for the formation of a blade-nail-locked of various lengths and shapes: - A blade 1 of variable length and thickness having a

rainure longitudinale 4 en queue-d'aronde sur toute sa longueur.  longitudinal groove 4 in dovetail over its entire length.

A son extrémité proximale la lame s'arrête par un buttoir transversal 5, son extrémité distale 6 est effilée et pointue munie d'un trou taraudé oblique 7 permettant de recevoir le pas d'une  At its proximal end the blade stops by a transverse abutment 5, its distal end 6 is tapered and pointed provided with an oblique tapped hole 7 making it possible to receive the pitch of a

vis à spongieuse 3 (fig. 2).cancellous screw 3 (fig. 2).

- Un clou 2 divisé en deux parties (fig.3) a) Une partie proximale formée d'un axe 8 de diamètre variable, coudé à ses deux extrémités à angle variable. Son extrémité supérieure se termine par une empreinte circulaire 9 et une  - A nail 2 divided into two parts (fig.3) a) A proximal part formed by an axis 8 of variable diameter, bent at its two ends at variable angle. Its upper end ends in a circular imprint 9 and a

rainure en queue-d'aronde permettant de recevoir la lame 1.  dovetail groove for receiving the blade 1.

Son extrémité inférieure possède un trou transversal taraudé 11 permettant de recevoir le pas d'une vis à spongieuse 3, et se prolongeant par deux ou trois tiges circulaires 12 formant la  Its lower end has a threaded transverse hole 11 making it possible to receive the pitch of a cancellous screw 3, and extending by two or three circular rods 12 forming the

partie distale du clou.distal part of the nail.

b) Une partie distale du clou est formée de deux ou trois tiges circulaires 12 de longueur et diamètre variables sont soit soudées soit vissées à l'extrémité inférieure de la partie  b) A distal part of the nail is formed of two or three circular rods 12 of variable length and diameter are either welded or screwed to the lower end of the part

proximale 13 du clou.proximal 13 of the nail.

Technique opératoire: Il s'agit d'une ostéosynthèse à foyer fermé d'une fracture pertrochantériènne de l'extrémité supérieure du fémur: L'intervention est pratiquée soit sous anesthésie locale, soit sous  Operative technique: This involves closed osteosynthesis of a pertrochanteric fracture of the upper end of the femur: The intervention is performed either under local anesthesia or under

anesthésie locorégionale.locoregional anesthesia.

- Le patient est en décubitus dorsal sur table orthopédique - Une incision cutanée postéro-externe de deux ou trois centimètre  - The patient is supine on the orthopedic table - A postero-external skin incision of two or three centimeters

en regard du grand trochanter.opposite the great trochanter.

- Incision du tissus sous cutané et du fascia lata.  - Incision of subcutaneous tissue and fascia lata.

- Trépanation de l'os au niveau de la face externe du grand trochanter. Introduction du clou 2 par l'extrémité inférieure de sa partie distale au moyen d'un matériel ancillaire (non décrit) fixant le clou par la  - Trepanation of the bone at the level of the external face of the greater trochanter. Introduction of nail 2 through the lower end of its distal part by means of ancillary equipment (not described) fixing the nail by the

partie supérieure de son extrémité proximale.  upper part of its proximal end.

- Introduction de la lame à travers de la rainure du clou 10.  - Introduction of the blade through the groove of the nail 10.

- Verrouillage du dispositif par une vis 3 spongieuse passant à travers le trou taraudé du clou 11 et celui de la lame 7 à l'aide d'un viseur fixé sur la partie supérieure de l'extrémité proximale  - Locking of the device by a spongy screw 3 passing through the tapped hole of the nail 11 and that of the blade 7 using a viewfinder fixed on the upper part of the proximal end

du clou.of the nail.

Claims (3)

REVENDICATIONS ) Dispositif de fixation des fractures de l'extrémité supérieure du fémur au moyen d'une lame-clou-verrouillé caractérisé en ce que la lame 1 de longueur et d'épaisseur variables, possède une rainure en queue- d'aronde 4 sur toute sa longueur. Son extrémité proximale se termine par un buttoir transversal et son extrémité distale 6 est effilée et pointue munie d'un trou  ) Device for fixing fractures of the upper end of the femur by means of a blade-nail-locked characterized in that the blade 1 of variable length and thickness, has a dovetail groove 4 over all its length. Its proximal end ends with a transverse abutment and its distal end 6 is tapered and pointed with a hole oblique taraudé.oblique tapped. 2 ) Dispositif selon la revendication 1 caractérisé en ce que le clou dans sa partie proximale est constitué d'un axe de diamètre variable 8 coudé à ses deux extrémités à angle variable. Son extrémité supérieure possède une empreinte circulaire 9 et une rainure en queue-d'aronde 10. Son extrémité  2) Device according to claim 1 characterized in that the nail in its proximal part consists of an axis of variable diameter 8 bent at its two ends at variable angle. Its upper end has a circular imprint 9 and a dovetail groove 10. Its end inférieure possède un trou transversal taraudé 11.  bottom has a threaded transverse hole 11. 3 ) Dispositif selon les revendications 1 et 2 caractérisé en ce que  3) Device according to claims 1 and 2 characterized in that la partie distale du clou est formé de deux ou trois tiges circulaires 12 de diamètre et de longueur variables, attachées soit par soudure soit par vissage à  the distal part of the nail is formed by two or three circular rods 12 of variable diameter and length, attached either by welding or by screwing to l'extrémité inférieure de la partie proximale du clou 13.  the lower end of the proximal part of the nail 13.
FR9809425A 1998-07-23 1998-07-23 FIXING DEVICE IN ORTHOPEDIC AND TRAUMATOLOGICAL SURGERY USING A NAIL-BLADE BLADE Expired - Fee Related FR2781360B1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
FR9809425A FR2781360B1 (en) 1998-07-23 1998-07-23 FIXING DEVICE IN ORTHOPEDIC AND TRAUMATOLOGICAL SURGERY USING A NAIL-BLADE BLADE

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
FR9809425A FR2781360B1 (en) 1998-07-23 1998-07-23 FIXING DEVICE IN ORTHOPEDIC AND TRAUMATOLOGICAL SURGERY USING A NAIL-BLADE BLADE

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FR2781360A1 true FR2781360A1 (en) 2000-01-28
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Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003015649A1 (en) * 2001-08-17 2003-02-27 Tantum Ag Intramedular osteosynthesis device for repairing lateral fractures of the femur extending to the centre thereof
ES2251888A1 (en) * 2005-11-08 2006-05-01 Carlos Enrique Morales Berenguer Delta-shaped device for the treatment of trochanteric and subtrochanteric fractures of the femur
DE102009010328A1 (en) * 2009-02-25 2010-08-26 Dieter Marquardt Medizintechnik Gmbh Humerus nail for supporting fractures of humerus of patient, has retainer provided in stabilization element to retain section of fixing elements arranged in one of boreholes for connecting stabilization element with fixing elements
US20110218585A1 (en) * 2010-03-08 2011-09-08 Krinke Todd A Apparatus and methods for bone repair
US9788870B2 (en) 2008-01-14 2017-10-17 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9848889B2 (en) 2010-01-20 2017-12-26 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US20180028241A1 (en) * 2016-07-28 2018-02-01 Michael S Levy Humeral nail having a bracket
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2523614A4 (en) 2010-01-15 2017-02-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
CN105361942B (en) 2010-03-08 2018-01-09 康文图斯整形外科公司 For fixing the device and method of bone implant

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1244492A (en) * 1967-11-08 1971-09-02 Jose Luis Orlich Apparatus for fixing fractures of the femur
DE8812157U1 (en) * 1988-09-26 1988-11-10 Waldemar Link Gmbh & Co, 2000 Hamburg Bone-supporting implant
DE3722852A1 (en) * 1987-07-10 1989-01-19 Kernforschungsz Karlsruhe Implant for the treatment of bone fractures
EP0551846A1 (en) * 1992-01-14 1993-07-21 Andrea Zoli Intramedullary pin for dynamic osteosynthesis in the femoral trochanteric region

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GB1244492A (en) * 1967-11-08 1971-09-02 Jose Luis Orlich Apparatus for fixing fractures of the femur
DE3722852A1 (en) * 1987-07-10 1989-01-19 Kernforschungsz Karlsruhe Implant for the treatment of bone fractures
DE8812157U1 (en) * 1988-09-26 1988-11-10 Waldemar Link Gmbh & Co, 2000 Hamburg Bone-supporting implant
EP0551846A1 (en) * 1992-01-14 1993-07-21 Andrea Zoli Intramedullary pin for dynamic osteosynthesis in the femoral trochanteric region

Cited By (18)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2003015649A1 (en) * 2001-08-17 2003-02-27 Tantum Ag Intramedular osteosynthesis device for repairing lateral fractures of the femur extending to the centre thereof
ES2251888A1 (en) * 2005-11-08 2006-05-01 Carlos Enrique Morales Berenguer Delta-shaped device for the treatment of trochanteric and subtrochanteric fractures of the femur
WO2007054591A1 (en) * 2005-11-08 2007-05-18 Morales Berenguer Carlos Enriq Delta-shaped device for the treatment of trochanteric and subtrochanteric fractures of the femur
US9788870B2 (en) 2008-01-14 2017-10-17 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US11399878B2 (en) 2008-01-14 2022-08-02 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US10603087B2 (en) 2008-01-14 2020-03-31 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
DE102009010328A1 (en) * 2009-02-25 2010-08-26 Dieter Marquardt Medizintechnik Gmbh Humerus nail for supporting fractures of humerus of patient, has retainer provided in stabilization element to retain section of fixing elements arranged in one of boreholes for connecting stabilization element with fixing elements
EP2258290B1 (en) * 2009-02-25 2013-07-31 Dieter Marquardt Medizintechnik GmbH Humeral nail for humerus fractures
US9848889B2 (en) 2010-01-20 2017-12-26 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US20110218585A1 (en) * 2010-03-08 2011-09-08 Krinke Todd A Apparatus and methods for bone repair
US10076342B2 (en) 2013-12-12 2018-09-18 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US20180193069A1 (en) * 2016-07-28 2018-07-12 Michael S. Levy Humeral nail having a bracket
US9907586B2 (en) * 2016-07-28 2018-03-06 Michael S Levy Humeral nail having a bracket
US10758279B2 (en) * 2016-07-28 2020-09-01 Michael S. Levy Humeral nail having a bracket
US20210085376A1 (en) * 2016-07-28 2021-03-25 Michael S. Levy Surgical nail having a fixation bracket
US20180028241A1 (en) * 2016-07-28 2018-02-01 Michael S Levy Humeral nail having a bracket
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone

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