IE20050638A1 - A device for use in bone fracture surgery - Google Patents

Abstract

A device (10) for use in bone fracture surgery comprises an elongate strap (11) having a plurality of ratchet teeth (12) on an upper surface (13), which is attachable to the bone pieces at two (14, 15) or more points with the elongate strap (11) being movable relative to at least one (15) of the attachment points. The elongate strap (11) is fixedly attached to a plate (16) and passes through an aperture in the body section (18) of a second plate (17). Pulling the elongate strap at the end (22) draws the strap (11) through the body section (18) resulting in bone attached to the first attachment point (14) being pulled towards the bone attached to the second attachment point (15). The pieces of bone are retained in the relevant position. The device (10) is far less cumbersome than conventional devices and allows greater access to the area being worked on by the surgical team, as well as minimising the trauma and risk of infection for the patient. <Figure 1>

Description

This invention relates to a device for use in bone fracture surgery and, in particular, to a device for holding together pieces of fractured bone following reduction. However, the device could have applications in other areas as hereinafter described.

A number of methods are known for holding together parts of a fractured bone during surgery and while healing of the bone takes place. Such methods include the use of bone holding forceps, which hold the bone in place, for example, while a fracture is being plated. However, such forceps may block or get in the way of the area being worked on by the surgical team and thus, make it more difficult to work on the area when fixing a plate to repair a fracture. These forceps are also often cumbersome to work with.

It is an object of the present invention to provide a device for use in bone fracture surgery which is less cumbersome than conventional devices and which allows greater access to the area being worked on by the surgical team.

Thus, the invention provides a device for holding together pieces of fractured bone, comprising an elongate strap, said strap being attachable to the bone pieces at two or more points, the attached strap being movable relative to at least one of said attachment points.

An advantage of the device according to the invention is that it can Ϊ * i «Έ-; SLf rEM 28 AB WE 23 J IE 750636 attachment points, can then be adjusted so as to move the pieces of fractured bone into the desired position and retain them in that position.

On non-weight bearing bones, the device according to the invention may be sufficient to hold the pieces of fractured bone during the healing process. In other cases, the device can be used as an aid to draw pieces of fractured bone together to enable an orthopaedic plate, or other similar orthopaedic device, to be fitted.

A further advantage of the device according to the invention is that it can be used secondary to, or in addition and in conjunction with, a bone holding forceps as in the case of a compound fracture.

Preferably, the strap has a plurality of ratchet teeth on at least one surface thereof, and wherein the attachment point to which the strap is relatively movable has a body section, having an aperture therein through which the strap is passable, and which aperture has a pawl mounted therein, which is engageable with the ratchet teeth.

The advantage of this feature is that the device lies flat and parallel to the bone and thus, does not unduly block the area being worked on by the surgical team.

Preferably, the ratchet and pawl arrangement results in the 20 distance between the attachment points being reduced as the strap passes through the aperture.

The advantage of this feature is that two pieces of bone may be brought together, for example so that they may be plated. ΙΕ ο50631 Alternatively, the ratchet and pawl arrangement results in the distance between the attachment points being increased as the strap passes through the aperture.

This feature would allow the separation of fractured bones which 5 may have overlapped.

Preferably, the strap is movable relative to a further attachment point in a direction opposite to that of the first attachment point to which the strap is relatively movable.

This feature allows bidirectional movement of the strap. An 10 advantage of this feature is that in confined spaces the device can be adjusted from either end.

This embodiment of the invention may be useful in other fields such as carpentry. The device could be used to manoeuvre and hold together joinery pieces while they are being joined together. It would be particularly useful for assembling a curved item made up of sections of wood, for example, in boat or aircraft construction, in particular for holding lamination on the convex surface thereof..

Preferably, the attachment points are in the form of plates.

In one embodiment, the strap is rotatably attachable to one of the plates.

This feature enables the strap to be pulled in any direction relative to one of the plates. 4<£θ50β3® In another embodiment, the strap is rotatably attachable to the plate by means of a cord.

In a further embodiment, the strap is rotatably attachable to the plate by means of a rivet.

In a still further embodiment, the strap is rotatably attachable to the plate by means of a ball and socket connection.

Preferably, one of the plates is adapted to accommodate the attachment of more than one strap.

This feature allows a number of pieces of fractured bone to be 10 aligned and held in place at the one time. Thus, one device could be used to hold the various pieces of fractured bone together rather than a number of separate devices.

Preferably, the surface of the strap facing the bone has means for spacing said strap from the bone.

This feature allows the device to glide over bone when being tightened. It also prevents the blood supply from being restricted.

Preferably, the spacing means are ridges.

Suitably, the ridges are in a broken or staggered configuration.

Preferably, the device is made of a material which is capable of 20 being absorbed by the body of a patient.

It 050 65® Suitably, the material is an absorbable polymeric material.

The advantage of this feature is that the device can be left inside a patient and will be absorbed by the body after the bone has healed.

Thus, a second surgical procedure is not required to remove the device once the bone has healed, which would minimise trauma and risk of infection for the patient as well as reducing pressure on operating theatres. Another advantage is that devices made of these materials transfer stress over time to the damaged area, allowing healing of the tissues.

Examples, of suitable absorbable polymeric materials are biodegradable polymers such as polyamides, polyesters, polylactones, polypropylene fumarates), polyorthoesters; polyurethanes and copolymers thereof.

Preferably, the strap is made of a pliable material.

This feature allows the device to follow the contours of the bone.

Also, this feature could be particularly useful in the treatment of skull fractures. Often fractures of the skull are accompanied by swelling of the brain and if the pieces of fractured bone were held together by a rigid joining device, and further swelling of the brain occurred, the rigid joining device could damage the brain. Whereas, since the device according to the invention can be pliable, it can accommodate movement of the skull as a consequence of further brain swelling, thus, lessening the possibility of brain damage.

Also preferably, the surface of the strap bearing the ratchet teeth has a larger, secondary set of ratchet teeth thereon.

This larger, secondary ratchet can be used to achieve greater tension.

Preferably, the strap has a plurality of holes along the length thereof.

These holes can receive screws or rivets in order to attach the strap to the bone.

Preferably, the plate, when present, has a plurality of holes.

Again, these holes can receive screws or rivets in order to attach the plate to the bone.

In a further embodiment, the strap has a drawstring attached to one or each end.

This feature allows adjustment of the device. It also allows 15 adjustment of the device, if the drawstring is left outside the body after surgery. This is advantageous as the body does not have to be reopened to adjust the device. This would mean that a second or subsequent surgical procedure would not be needed which would minimise trauma and risk of infection for the patient as well as reducing pressure on operating theatres, apart possibly from a procedure carried out under local anaesthetic. 7 IE o 5 0 e Again this feature could be particularly useful in the treatment of skull fractures. Since the device can be adjusted from outside the body, post-operatively, suitable adjustments can be made in response to any subsidence of brain swelling.

The invention will be further illustrated by the following description of embodiments thereof, given by way of example only with reference to the accompanying drawings in which: Fig. 1 is a plan view from above of a device according to the invention; Fig.2 is a cross-section on line II - II of Fig. 1; Fig. 3 is a plan view from above of a second embodiment of a device according to the invention; Fig. 4 is a plan view from above of a third embodiment of a device according to the invention; Fig. 5 is a plan view from above of a fourth embodiment of a device according to the invention; and Fig. 6 is a plan view of a fifth embodiment of a device according to the invention overlying a bone fracture.

Referring to Figs. 1 and 2 there is illustrated, generally at 10, a device for holding together pieces of fractured bone, having an elongate strap 11, said strap 11, having a plurality of ratchet teeth 12, on an upper IE v 5 Ο β 3β surface 13 thereof. The device 10 is made from Nylon-66 (polyhexamethylene adipamide) (Nylon-66 is a Trade Mark), which is a physiologically acceptable material. The strap 11 is attached to the pieces of bone (not shown) by means of a pair of attachment points 14, .

Attachment point 14 is in the form of a plate 16 to which the strap 11 is attached. Attachment point 15 is in the form of a plate 17 to which a body section 18 is attached. The body section 18 has an aperture 19 therein (Fig. 2) through which the strap 11 is movable, and which aperture 19 has a pawl 20 (Fig. 2) mounted therein, adapted to engage the ratchet teeth 12. The strap 11, has a plurality of holes 21 along its length, said holes being capable of receiving screws or rivets in order to attach the strap to the bone (not shown).

In use the device 10 is attached to pieces of fractured bone (not shown) and pulling the strap 11 at end 22 will draw the strap 11 through the body section 18 resulting in the bone attached to the attachment point 14 being pulled towards the bone attached to the attachment point 15 in the direction of arrow A, thereby bringing the pieces of fractured bone together and holding them in place.

Referring to Fig. 3 there is illustrated, generally at 30, a second embodiment of the device according to the invention, having an elongate strap 31, said strap 31, having a plurality of ratchet teeth 32, on an upper surface 33 thereof. The device 30 is made from Nylon-66 (polyhexamethylene adipamide).

IE 050638 * The strap 31 is attached to the pieces of bone (not shown) by means of a pair of attachment points 34, 35. Attachment points 34, 35 are in the form of plates 36, 37 respectively, to which body sections 38, 39 respectively, are attached. The body sections 38,39, have apertures 40,41, respectively therein through which the strap 31 is movable, and which apertures 40,41 have a pawl (not shown) mounted therein, adapted to engage the ratchet teeth 32. The strap 31 is divided at point 42 into two sections 43 and 44. The ratchet teeth 32 on section 43 are orientated such that in use, the strap 31 is movable through the body section 38 in the direction of arrow B. The ratchet teeth 32 on section 44 are orientated in the opposite direction such that in use, the strap 31 is movable through the body section 39 in the direction of arrow C. This arrangement results in bidirectional movement of the strap 31. Thus, the distance between the attachment points 34,35 can be adjusted by pulling on either of ends 45 or 46 of strap 31.

Referring to Fig. 4, there is illustrated, generally at 50, a third embodiment of the device according to the invention, having an elongate strap 51, said strap 51, having a plurality of ratchet teeth 52, on an upper surface 53 thereof. The device 50 is made from Nylon-66 (polyhexamethylene adipamide). The strap 51 is attached to the pieces of bone (not shown) by means of a pair of attachment points 54, 55. Attachment point 54 is in the form of a plate 56 to which the strap 51 is attached. Attachment point 55 is in the form of a plate 57 to which a body section 58 is attached. The body section 58 has an aperture 59 therein through which the strap 51 is movable, and which aperture 59 has ΙΕ 050β3β a pawl (not shown) mounted therein, adapted to engage the ratchet teeth 52. A drawstring 60 is attached to one end 61 of the strap 51.

In use the device 50 is attached to pieces of fractured bone (not shown) and pulling the drawstring 60 attached at end 61 will draw the strap 51 through the body section 58 resulting in the bone attached to attachment point 54 being pulled towards the bone attached to attachment point 55 in the direction of arrow D, thereby bringing the pieces of fractured bone together and holding them in place. This feature allows adjustment of the device post-operatively, if the drawstring 60 is left outside the body after surgery.

Referring to Fig. 5 there is illustrated, generally at 70, a fourth embodiment of the device according to the invention, wherein a plurality of elongate straps 71 is rotatably attachable to a common plate 72 at point 73 by a nylon cord 74. The straps 71 are movable relative to an attachment point 75 in a similar fashion to the embodiment of Fig. 1. This arrangement allows a number of pieces of fractured bone to be aligned and held in place at the one time. Thus, one device 70 can be used to hold the various pieces of fractured bone together rather than a number of separate devices.

Referring to Fig. 6 there is illustrated, generally at 80, a fifth embodiment of the device according to the invention, wherein a device 80 is similar to the embodiment in Fig. 3 but with the addition of a fracture covering plate 81 attached to the strap 82 and positionable over a fracture site 83. The fracture covering plate 81 prevents the pieces of fractured bone overlapping when the device 80 is being adjusted in use.

Claims (19)

1. Claims: 1. A device for holding together pieces of fractured bone, 5 comprising an elongate strap, said strap being attachable to the bone pieces at two or more points, the attached strap being movable relative to at least one of said attachment points.

2. A device according to Claim 1, wherein the strap has a plurality of ratchet teeth on at least one surface thereof, and wherein the 10 attachment point to which the strap is relatively movable has a body section, having an aperture therein through which the strap is passable, and which aperture has a pawl mounted therein, which is engageable with the ratchet teeth.

3. A device according to Claim 2, wherein the ratchet and 15 pawl arrangement results in the distance between the attachment points being reduced as the strap passes through the aperture.

4. A device according to Claim 2, wherein the ratchet and pawl arrangement results in the distance between the attachment points being increased as the strap passes through the aperture. 20 5. A device according to any one of Claims 2 to 4, wherein the strap is movable relative to a further attachment point in a direction IE 0506JI opposite to that of the first attachment point to which the strap is relatively movable. 6. A device according to any preceding claim, wherein the attachment points are in the form of plates.

5. 7. A device according to Claim 6, wherein the strap is rotatably attachable to one of the plates.

6. 8. A device according to Claim 7, wherein the strap is rotatably attachable to the plate by means of a cord.

7. 9. A device according to Claim 7, wherein the strap is 10 rotatably attachable to the plate by means of a rivet.

8. 10. A device according to Claim 7, wherein the strap is rotatably attachable to the plate by means of a ball and socket connection.

9. 11. A device according to any of Claims 6 to 10, wherein one of 15 the plates is adapted to accommodate the attachment of more than one strap.

10. 12. A device according to any preceding claim, wherein the surface of the strap facing the bone has means for spacing said strap from the bone.

11. 13. A device according to Claim 12, wherein the spacing means are ridges. IE 050βϊ®

12. 14. A device according to any preceding claim, wherein the device is made of a material which is capable of being absorbed by the body of a patient.

13. 15. A device according to Claim 14, wherein the material is an 5 absorbable polymeric material.

14. 16. A device according to any preceding claim, wherein the strap is made of a pliable material.

15. 17. A device according to any preceding claim, wherein the surface of the strap bearing the ratchet teeth has a larger, secondary set 10 of ratchet teeth thereon.

16. 18. A device according to any preceding claim, wherein the strap has a plurality of holes along the length thereof.

17. 19. A device according to Claim 6, wherein the plate has a plurality of holes. 15

18. 20. A device according to any preceding claim, wherein the strap has a drawstring attached to one or each end.

19. 21. A device according to Claim 1, substantially as hereinbefore described with particular reference to and as illustrated in the accompanying drawings.