JP2022099392A - Fracture fixation system and method - Google Patents

Abstract

To provide a system and method for fracture fixation.SOLUTION: A fracture fixation system includes plates 101, 102. The plates have a laterally extending bore passing therethrough and configured to receive a first wire 108 when the plates are placed in contact with a bone 109. The plates have a recess for receiving and securing a first end of the first wire, and include an entry hole and an exit hole 114 at opposite ends of a first bore to allow the first wire to pass through the plates. A screw 111 is configured to capture the wire in the first bore to maintain desired tension on the first wire.SELECTED DRAWING: Figure 2

Description

Detailed description of the invention

Cross-reference to related applications This application is a related application of US Provisional Patent Application No. 62 / 856,676 entitled "Cerclage System and Method" filed June 24, 2019, which is a reference. Is incorporated in the present application as a whole.

Background of the present invention

Background Information Femoral fractures may occur spontaneously or medically during complete hip arthroplasty. Depending on the fracture pattern, the fastening method alone, the fastening method using one or more plates, the fastening method using struts, the fastening method using the dilated hip joint stem, or the combination of the plates, struts and / or the dilated hip joint stem can be used. The fastening method used may be used for bone fixation. However, the problem with fastening methods is that bone fusion may be inadequate without the use of additional support devices. The use of additional supports may or may not be desirable, especially with complete hip arthroplasty. In femoral fractures, high loads on the fastening wires can result in erosion of adjacent bones and loss of fixation due to wire movement.

There is a need for fastening devices that improve bone fusion while at the same time providing tension on the fastening wire.

The above and other objects, features and advantages of the present invention will become apparent when combined with the following detailed description of the various aspects of the invention and the accompanying drawings.

FIG. 1 is a posterior perspective view of a fracture fixation system connected to the femur according to an aspect of the present invention.

FIG. 2 is an anterior perspective view of the fracture fixation system of FIG. 1 connected to the femur according to an aspect of the present invention.

FIG. 3-6 is a diagram showing tension-applied drums according to the embodiment of the present invention from various viewpoints.

7-10 are views showing the fracture fixation system of FIG. 1 connected to the femur according to the aspect of the present invention from various viewpoints.

11-14 are views showing, from various perspectives, the fracture fixation system of FIG. 1 connected to the femur, in which a tensioning drum is attached to the outer plate of the system, according to aspects of the invention. ..

15-19 are views showing the outer plate of the fracture fixation system of FIG. 1 according to aspects of the present invention from various perspectives.

FIG. 20 is a perspective view showing an outer plate with a tensioning drum attached to the fracture fixation system of FIG. 1 according to aspects of the invention.

21-25 are perspective views showing a portion of the outer plate of the fracture fixation system of FIG. 1 according to aspects of the present invention from various perspectives.

The present invention will be discussed in detail below with reference to various exemplary embodiments according to the invention with reference to the accompanying drawings. In the following detailed description, a number of specific details will be described so that the present invention may be fully understood. However, it will be apparent to those skilled in the art that the present invention may be practiced without these specific details. In other examples, well-known structures are not shown in detail in order to avoid unnecessarily obscuring the invention.

Accordingly, all implementations described below are exemplary implementations provided to allow one of ordinary skill in the art to make or use embodiments of the disclosed content, and are the scope of the disclosed content as defined by the claims. Is not intended to limit. As used herein, the term "exemplary" or "exemplary" means "serving as an example, an example, or an example." Any implementation described herein as "exemplary" or "exemplary" should not necessarily be construed as preferred or advantageous over other implementations. Further, in this description, the terms "upper", "lower", "left", "back", "right", "front", "vertical", "horizontal", and these. Derivatives of are related to the invention in the orientation of FIG.

The following description refers to the systems, methods, and devices used in fastening and fixing the femur. However, those skilled in the art will recognize that other bone immobilizations are suitable for use with the systems, methods, and devices described above. Similarly, the various drawings, steps, procedures, and workflows are shown merely as examples, and the described systems, methods, or appliances perform their respective tasks in different time configurations or sequences. It does not limit the production of results at all. The teaching content of the present invention is applicable to all bone-related fastening methods.

Moreover, it is not intended to be bound by any explicit or implied theory set forth in the technical field, background, outline, or detailed description below. Further, it should be understood that the particular devices and methods exemplified in the accompanying drawings and described in the following specification are merely exemplary embodiments of the concepts of the invention. Therefore, certain dimensions and other physical properties for embodiments disclosed herein should not be considered limiting unless otherwise stated.

The various embodiments described herein provide systems, devices, devices, and methods for fracture fixation. Various drawings and descriptions may refer to femoral fracture fixation. However, those skilled in the art may find that subsequent systems, devices, devices, and methods for fracture fixation are specific femoral bone fractures, such as Vancouver classification grade B and distal femoral bone fractures around the hip prosthesis, or others. Bone fractures such as major trochanteric fractures; distal, proximal, and stem fractures of the tibia; humeral head fractures; peroneal fractures; elbow head fractures; and other bone fractures, fractures It will be understood that it can be used for surgical or those with deformities that require compressive and / or corrective forces.

With reference to the drawings, similar reference numbers are used to indicate similar or similar components throughout several drawings, and especially with reference to FIGS. 1-2, 7-10, and 15-19. The fracture fixing system 100 is attached to the bone, that is, the femur 109, with the positions of the femurs 109 on both sides of the fracture portion 110 adjusted. The fracture fixation system 100 comprises a medial plate 101 positioned longitudinally on the medial surface 142 of the femur 109 and a lateral plate 102 positioned longitudinally on the lateral surface 144 of the femur 109. Have. The inner plate 101 and the outer plate 102 are drawn on opposite sides of the femur 109 and connected by a connecting wire or a fastening wire 108, and the fracture portion 110 is located between the inner plate 101 and the outer plate 102. There is. The medial plate 101 has, for example, an elongated plate with slots or holes 103 for lateral wires and has a lateral curvature close to the circumferential curvature of the inner surface 142 of the femur 109. , May be a fastening assist device. The outer plate 102 can also have, for example, a curvature close to the circumferential curvature of the lateral surface of the femur 109. The outer plate 102 uses, for example, a bone screw 111 that passes through the outer plate 102 and is inserted into the femur 109, with the bone screw 111 placed farther from the head than the fracture portion 110. It can be further connected to the bone 109. The bone screw 111 can extend, for example, through the outer plate 102 and through the inner surface 142 of the femur 109.

With reference to FIGS. 1-2, 7-10, and 15-19, the outer plate 102 further has a first portion 125, a second portion 124, an upper surface 122, a bottom surface 123, a first side surface 126, And has a second side surface 127. The first portion 125 may be connected to the inner plate 101 and near the fracture portion 110, for example, using fastening wires 108. The first portion 125 includes a set screw 120 received in the threaded opening, a fastening wire hole or fastening wire inlet hole 115, a wire outlet hole 114, a strut hole 130, and a wire mounting notch or fastening recess. Has 104. The second portion 124 extends longitudinally from the first portion 125 toward the distal side of the femoral head 119. The second portion 124 may have, for example, a plurality of holes 112 through which a plurality of bone screws (eg, bone screws 111 shown in large numbers as examples) can be inserted into the femur 109.

Referring to FIGS. 3-6 and 20, the drum 210 has a threaded connection in which a lower end 203 with a threaded opening 205 is engaged with an upper end or a drive end 201 with a threaded 204. Has 206. The drive end 201 is illustrated as having a screw head 209, which may be, for example, square in shape and engageable with a nut driver or other tool for driving the drum 210. .. The drive end 201 can be rotated clockwise, for example, manually or with such a nut driver. By rotating the drive end 201, for example, the drive end 201 and the lower end 203 can be closed together. When the fastening wire 108 is passed through the cross hole 208 and the drive end portion 201 is rotated, for example, the fastening wire 108 is tightened between the lower end portion 203 and the drive end portion 201 so that the fastening wire 108 does not move. It may be. The drum 210 further comprises, for example, a nesting 202 disposed between the lower end 203 and the drive end 201, and when the drive end 201 is rotated, the rotational movement is not transmitted as a rotational movement to the fastening wire 108. Wire pressure may be applied. Such linear pressure causes the arrangement of the fastening wires 108 to cross holes 208, for example, by friction where the fastening wires 108 come into contact and where the fastening wires 108 are located between the nest 202 and the lower end 203. Can be used to keep in. When the drive end is continuously rotated, for example, the drum 210 is rotated with the fastening wire 108 extending through the hole 208, whereby the fastening wire 108 is wound around the drum 210, whereby the fastening wire 108 is wound. The tension can be increased. While the drum 210 is rotating, the linear pressure is maintained by the nesting 202 on the fastening wire 108 and no rotational pressure is applied to the fastening wire 108 inside the drum 210. Tension regulation and maintenance can help hold bone fragments in place during surgical procedures and after undergoing anatomical loading.

As illustrated in FIGS. 21-25, with reference to the first portion 125 of the outer plate 102, the fastening wire inlet hole 115 is arranged and drawn on the first side surface 126, and the wire exit hole 114 is the upper surface 122. Is located in. The wire inlet hole 115 and the wire outlet hole 114 extend to meet in the first portion 125 of the outer plate, forming an inclined hole or tunnel between them. The set screw 120 is illustrated in a state where it is fitted into the upper surface 122 and intersects with a hole between the wire inlet hole 115 and the wire outlet hole 114. The fastening wire 108 is illustrated with a fastening wire tip or a fastening wire first end 118 and a free end 116. The retaining recess 104 is configured to capture the fastening wire tip 118 (eg, shaped and sized), eg, from the bottom surface 123, when the fastening wire 108 is under tension. It may be a slot or opening extending to the side surface 127 of 2. The strut hole 130 extends from the top surface 125 towards the bottom surface 124 and is configured to accept the insertion of the strut 207 of the drum 210 (eg, shaped and sized).

With respect to FIGS. 1-25, the method of fracture fixation includes a step of adjusting the position of the opposing surfaces of the fracture portion 110 and a step of attaching the outer plate 102 to the outer surface 144. The first end 118 of the fastening wire can be inserted into the retaining recess 104. The free end 116 may be inserted, for example, through the lateral wire slot 103 of the inner plate 101 with the inner plate 101 placed on the inner side surface 142. The free end 116 can travel, for example, around the femur 109, be inserted into the inlet hole 115, and exit the exit hole 114. The drum 210 can be engaged with the outer plate 102, for example, with the strut 207 inserted in the strut hole 130. The free end 116 can be inserted through the cross hole 208, and by rotating the upper drive end 201, a linear force for tightening the fastening wire 108 without rotational movement is applied. The fastening wire 108 may then be pulled by winding the free end 116 of the fastening wire 108 around the drum 210 and turning the upper drive unit 201 to rotate the drum 210 to further wind the fastening wire 108. Such rotation exerts tension on the fastening wire 108 and allows the fastening wire 118 to be installed in the fastening recess 104. When the desired tension is reached, the set screw 120 is tightened (eg into the threaded hole of the outer plate 102) to capture or tighten the fastening wire 108 inside the hole extending from the inlet hole 115 to the outlet hole 114. be able to. In order to maintain tension on the fastening wire 108, the free end 116 of the wire may be installed, for example, on the outer plate 102 or a crimp portion (not shown) or holder in the vicinity thereof.

With respect to FIGS. 1-25, a plurality of fastening wires (eg, a plurality of fastening wires 108 shown as an example) may be used, for example, to engage the inner plate 101 and the outer plate 102. A plurality of bone screws (eg, a plurality of bone screws 111 shown as an example) may be inserted into the plurality of bone screw holes 112 for attaching the outer plate 102 to the femur 109, for example. As shown, the inner plate 101 may have, for example, a plurality of lateral wire slots (eg, a plurality of wire slots 103, as illustrated). The inner plate 101 may be, for example, an auxiliary device for fastening two wires or an auxiliary device for fastening three wires. As further illustrated, the outer plate 102 may include, for example, a plurality of set screws (eg, a plurality of set screws 120 shown as an example) and a plurality of fastening inlet holes (eg, a plurality of fastening wire inlet holes shown as an example). 115), a plurality of wire outlet holes (eg, a plurality of wire outlet holes 114 illustrated as an example), a plurality of strut holes (eg, a plurality of strut holes 130 illustrated as an example), and a plurality of retaining recesses (eg, a plurality of retaining recesses). As an example, it may have a plurality of anchoring recesses 104) shown in the figure.

In another embodiment of fracture fixation, the system 100 may have, for example, at least two plates of the type described by the inner plate 101 and / or the outer plate 102.

Aspects of the invention described herein include bone fixation at the fracture to promote bone fusion of the femur 109. The same embodiment also includes bone fixation at the fracture site to promote bone fusion in the femur in which a hip replacement stem (not shown) is inserted into the femur 109.

Although some aspects of the invention have been described and illustrated herein, other embodiments may be provided by one of ordinary skill in the art to achieve the same object. Therefore, it is intended to treat all such alternative aspects as being included in the true intent and scope of the invention.

Claims (18)

Fracture fixation system
A plate that has a laterally extending hole through the plate and the laterally extending hole is configured to receive a first wire when the plate is placed in contact with the bone. When,
The plate has a recess for receiving and fixing the first end of the first wire.
The plate is provided with inlet and outlet holes at both ends of the first hole that allows the first wire to pass through the plate.
A system comprising a screw for capturing the first wire in the first hole to maintain the desired tension on the first wire. The first hole is the first of a plurality of laterally extending holes through the plate, the first wire for connecting the plate to the bone to hold the bone. The system according to claim 1, which is the first wire among the plurality of wires passing through the plurality of holes. A second plate located on the opposite side of the bone that allows the first wire to pass through so that the first and second plates are fixed to the bone when the first wire is tightened. The system of claim 1, further comprising a second plate having a second hole configured in. The system of claim 1, further comprising a fastener configured to tension the first wire. The fastener comprises a column configured to be received in the column hole of the plate and a crossing hole configured to allow the first wire to pass through, the fastener being the first wire. The system according to claim 4, wherein the system is rotatable in a strut hole for tightening around a fastener. 5. The system of claim 5, wherein the fastener comprises a lower end and a drive end that can be screwed together so that the drive end is screwed into the cavity of the lower end. .. The system of claim 6, wherein the lower end comprises an inlet and an outlet of a hole that borders the crossed hole. Further nesting between the lower end and the drive end to hold the first wire in the cross hole and prevent the first wire from moving in the cross hole. The system according to claim 7. The system according to claim 8, wherein the nesting exerts a linear force to tighten the first wire when the lower end is screwed with the drive end. The plate comprises a first portion with a plurality of laterally extending holes and a second portion with a plurality of openings for receiving a plurality of screws for connecting the plate to the bone. The system according to claim 1. It is a method of fastening and fixing,
With the step of adjusting the position of the opposite part of the fractured bone for reduction of the bone;
With the step of placing the plate on the fractured bone;
With the step of attaching the first end of the wire to the plate and wrapping the wire around the bone;
With the step of passing a wire through the hole in the plate from the inlet hole to the outlet hole;
With the step of tightening the wire to apply tension to the bone;
A method comprising fixing a second end of a wire to a plate. The hole is the first of a plurality of laterally extending holes through the plate, and the step of connecting the ends of the plurality of other wires to the plate and the other wire. 11. The method of claim 11, further comprising passing through a plurality of laterally extending holes and connecting the opposite ends of the plurality of other wires to the plate to secure the bone. The step of attaching the first end of the wire comprises inserting the first wire into the recess of the plate, and the step of connecting the second end includes the second end using a screw. 11. The method of claim 11, comprising connecting to a plate. The tightening step comprises passing the wire through a crossing hole of the fastener having an end received in the column hole of the plate and rotating the fastener to tension the wire. The method according to claim 11. 15. The 14th aspect of the invention, wherein the fastener has a lower end and a drive end that can be screwed together so that the drive end is screwed into the cavity of the lower end. Method. The fastener is provided with a nest between the lower end and the drive end, and the lower end and the drive end are used to move the first wire in the cross hole. 15. The method of claim 15, further comprising engaging the drive end with the lower end to hold the wire in a nest between. The method of claim 1, wherein the step of wrapping the wire around the bone comprises passing the wire through a second hole in a second plate opposite the bone to the plate. The method of claim 1, further comprising fixing the plate to the bone with a screw through the opening of the plate.

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