GB880543A - Improvements in or relating to a fracture fixation appliance - Google Patents

Abstract

880,543. Fracture fixation appliance. DEYERLE, W. M. May 25, 1960, No. 18422/60. Class 81 (2). An appliance for use in the fixation of fractures in the upper region of the femur comprises an elongated nail for insertion into the femur to a selected distance from the surface of the femur head and a nail plate having a leg portion for securing to the femur shaft and a head portion by which the nail is held at a selected angle to the femur shaft and in which a plurality of holes extending along axes parallel to and spaced symmetrically radially of the nail axis which slidably receive and locate fixation pins which project into the femur. As shown, Fig. 3, the rear end of a threeflanged nail 24 enters a socket 22 in the head portion 17 of a plate 16 as far as a shoulder 23 and is retained by a screw bolt 28, and pins 30 are inserted in holes 29 arranged about the nail axis as shown in Fig. 4. In a modified plate the socket 22 extends completely through the head portion. In another embodiment the nail and plate are integral and in a still further embodiment the head portion of the plate is at an angle to the attachment portion. To set a fracture 14, a hole is drilled below the trochanter 11 at an angle of approximately 135 degrees to the axis of the femur shaft 10 using as a guide the nail plate, having a socket extending through it at that angle, on a jig 50, Fig. 9. The nail is then inserted manually in the hole almost to the fracture 14 and the nail plate 16 or jig put over its rear end. At least one pin 30 is then inserted into holes 29 in the plate or holes 55 in the jig and driven into the head 13 and optionally into the pelvis. If a jig has been used, the plate 16 is then put on and the nail 24 is driven through the fracture into the head 13 to within ¢ to ¥ inch of its surface. The remaining pins 30 are inserted and driven to as near the surface of the head as possible, the pins driven into the pelvis being withdrawn to the same position, and taps 31 are screwed on the pin ends. In the embodiment in which the head portion of the plate is at an angle to the leg portion, the nail 24 is driven to its final position by means of a shaft 58 screwed into the nail and slidable within a sleeve 56, itself slidable within the jig 50, and the pins 30 are inserted before the plate is bolted to the nail and the femur shaft.