JPH03504456A - Unilateral extendable lateral fixator for treating bone diseases - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Unilateral extendable lateral fixator for treating bone diseases FIELD OF THE INVENTION The present invention relates to a unilateral extendable external fixator for treating bone disease.

Such orthopedic devices are used for axially lateral fixation of bones or bone parts. It is described in patent 4.312.336.

Unilateral screw fixation devices have already been described in various ways for treating diseases of the bones of the extremities. ing. A large number of different bone diseases place various demands for lateral fixation. . A unit system that can meet various requirements would therefore be advantageous. child The device described here fulfills the numerous challenges of lateral fixation. In addition, single and bifocal extensions as well as motor control are available. Controlled prolongation and temporary stimulation are possible. In addition, the above device allows for continuous cutting. Switching can be performed in all directions of movement.

For example, as described in German patent specification 3543042 (positive shaft fixed), Comparable orthopedic devices only cover a portion of the aforementioned applications, especially in this case. Until now two-stage breakage, bifocal extension and continuous switching as well as motor controlled Extension and fragment movement are not possible with a single fixture. For these applications, until now , an installation that requires puncturing the skin from relatively many directions and is technically difficult to handle. Fixtures were needed. With conventional orthopedic devices that can be controlled at will, It was also a disadvantage that, depending on the location of application, it was necessary to use completely new instruments. Na For example, a single instrument could not care for or lengthen a fracture.

Previous systems require additional attachment of various components to the fixture during treatment. Another disadvantage is that the fixation device requires a large amount of time, which often results in parts of the fixture being lost during treatment. This resulted in unnecessary extra costs.

Therefore, the problem on which the present invention is based is to enable unilateral extension to treat bone diseases. The objective is to propose an external fixation device, in which the relevant bone parts are fixed with the clamp jaws. can be adjusted arbitrarily via bone screws held in, fixed and tightened together , can be displaced in a limited manner, and can be guided and moved without twisting. There are many things.

To solve this problem, the invention provides at least One piston is arranged in each case so that it can be extended, with the outer end of the inner piston Various connecting parts may be rotatably fixed to the part.

Within the scope of the invention, only two pistons are provided in the central part, and these pistons are In the same way, two other pistons are placed inside so that they can be drawn out. Plan. The connecting part is fixed to the innermost piston.

According to the orthopedic device shown here, a special payout with double insertion preparatory is possible. for the lower limb due to its flexibility as well as due to the high stability of the hinged connection against bending loads. Make do with a single fixture type as well as a separate fixture type for the upper extremity be able to.

This is especially true when it comes to maintaining inventory in an orthopedic or disaster surgery clinic. On the other hand, this orthopedic shows that the field of application of the fixture is much larger than that of a comparable single fixture; Orthopedic devices should be designed according to the structural unit principle before the start of treatment with appropriate questions raised. Therefore, it is structurally designed to accommodate various parts. after that, There is no risk of losing individual parts of the fixture as no parts are removed during treatment. .

The benefits that can be achieved can be summarized as follows:

The orthopedic devices described herein are sized for the lower extremity and for the upper extremity, respectively. thus achieving therapeutic potential for all bone diseases for which it has application as a fixation device. . Do not screw or unscrew components to orthopedic equipment during treatment. There is no risk of losing individual parts during treatment, and handling is technically easy to understand. And it's easy. Nevertheless, this orthopedic device allows for greater application can cover the field.

A particularly advantageous embodiment of the unilateral extendable external fastener according to the invention is set out in the claims Are listed.

Extendable piston allows for a defined position regarding the central part and both pistons. It can be adjusted to the desired length. Clamp pins are attached to various connecting parts on the piston. A bone screw clamp can be attached to the clamp pin. is fixed with a screw. As connecting parts, various parts can be connected according to a particularly advantageous embodiment. A component that can be inserted into the piston end using a clamp pin and secured with a screw. Hinged joint allowing arbitrary spatial adjustment and fixation of screw clamp pins is provided. These cost screw clamps can be used longitudinally and/or It can be screwed laterally (as a so-called T-jet).

Furthermore, as a connecting part, it can be inserted into the piston end using a clamp pin as well. A female screw for screwing the screw clamp against the bracket. It is advantageous to provide a rigid intermediate part that supports the same.

Similarly, as a connecting part, it can be attached thereto via a self-locking worm drive. So-called switching to achieve a limited pivoting movement of the mounted platform A retaining member is provided.

Furthermore, a hinge joint that can be clamped at any position is provided as a connecting part. , and this hinge joint is in the plane of the hinge tilting movement when the clamp is loosened. to help move the joint.

The rhythmic movement of the piston in and out causes the fracture to expand through the shear flanged screw. micro-movements and thus a temporary stimulation effect, which can be carried out in various ways. For example, it is possible to control a flange-jointed step motor. and rotate the adjusting nut clockwise and counterclockwise at the desired rhythm. can be done. This causes the piston to move correspondingly inward and outward. A micromovement is applied that moves and thus expands the fracture site.

A rotatable adjusting nut allows for the adjustment of the piston in relation to the central part, as mentioned above. Coordination is achieved.

In principle, quick to adapt to anatomical relationships or for moving purposes Removal from the central part, which rests on top of the piston to allow for easy adjustment It is possible to provide a possible adjustment nut.

The present invention will now be explained in detail with reference to the accompanying drawings.

In the drawing, Figure 1 shows the central part of the outer fixture and both pistons partially cut away; The figure shows a partially cutaway view of the various parts of the outer fixture; Figure 3 is shown in Figure 2; Figure 4 shows the rigid intermediate part and Figure 4 shows the rigid intermediate part in side view and partially cut away. 5 shows a clampable hinged joint, and FIG. 6 shows an adjusting nut 8 according to FIG. FIG. 7 shows a cross section of the ring 12, and FIG. 7 shows the adjustment nut 8 and ring 12 shown in FIG. 8 shows a partially cut away view of another central part, and FIG. 9 shows a pin Fig. 10 shows a plan view of the central part shown in Fig. 1 with the stone 3 inserted; shows section I-1 according to FIG.

FIG. 1 shows essentially the central part 1 and the pistons 3 and 4 of the outer fixture. It is. The inner wall of the tubular central part 1 is provided with an inner spline 2, in which , a hollow-bore piston 3 fits around it over its entire length. guided by having external spline teeth 7. At the same time, repeat with central part 1. The removable piston 3 is secured against twisting on the one hand and both Free axial movement of the parts is guaranteed. This is especially shown separately. , it is clear from the description that both piston 3 and piston 4 cooperate with the central part l. .

The solid piston 4 opposite the piston 3 is also provided with external spline teeth 7 over its entire length. is provided.

To guide it, correspondingly cut teeth are fitted and joined to the tubular end of the central part 1. A fitted sleeve 5 is useful.

Both pistons 3 and 4 are almost completely connected to the central part l or to each other (4 to 3) can sink to

Thereby, the minimum length extension of the outer fasteners corresponds to the length of the central part 1. achievement The maximum possible length is achieved by paying out pistons 3 and 4 on both sides; The central part 1 then becomes longer by approximately a factor of 3. Then, axial guidance and force The necessary splines at both central part ends are necessary to ensure transmission. The overlap operates in a reduced manner.

Both in order to allow limited extension and shortening of the external fixator even under the action of forces. The piston 3 or 4 has a screw 51 or 52 are preferably provided with the same lead. Corresponding internal thread formed An adjusting nut 74 or 75 pivots the piston 3 or 4 relative to the central part 1. It can be adjusted in the direction. In this case, the adjustability is limited to both pistons 3 or are unrelated to each other for 4.

Both adjusting nuts 74 and 75 have an internal thread formed by different cross sections. are the same. The way this adjusting nut 74 or 75 works is shown in Figures 9 and 10. This will be explained in more detail below. The adjusting nut is arranged via one or more sliding blocks. be internalized.

The adjusting nut 74 or 75 is rotatably connected to the central part 1. Adjustment na Rotation of the bolt 74 or 75 causes the associated piston 3 or 4 to move according to the direction. Extended or retracted.

FIG. 2 shows the different parts of the outer fixture partially configured apart from each other. It is shown cut away.

FIG. 3 shows the parts shown in FIG. 2 in side view.

FIGS. 2 and 3 will now be explained. Figures 4 and 5 show another possible combination of external fasteners. Shows the connection part.

At the outer end of the piston 3 or 4, according to FIG. 1, there is a hole 14 or 15. 2, 3, 4, and 5. Items can be placed in the bin 16.

The pin 16 has an annular groove 17 with beveled sides, into which the pin 16 has an annular groove 17 with beveled sides. A correspondingly beveled set screw 18 or 19 can be engaged at the end. (FIG. 1), a pin 16 with a screw I8 or 19 introduced into the hole 14 or 15 As soon as it engages the annular groove of the bottle, it is prevented from sliding out, and only then However, free rotation is maintained.

The end face of the piston 3 or 4 has radial undulations similar to serrations on one side. There are 20 or 21. Corresponding undulations 22 or 23 of the connecting part It exists at the bottom. When set screw 18 or 19 is turned fully in, the screw and the slope of the annular groove pull additional parts (connecting parts) against the end surface of the piston. fully realized, whereby the radial serrations of both parts are then Prevent each other from twisting.

The part shown at the top of Figures 2 and 3 is the cost screw clamp 5F 61. , this clamp jaw is screwed downward by a hexagon socket head screw 26 located in the axial direction. Fastening to the arranged connecting parts or to the connecting parts shown in FIGS. 4 and 5. Can be done. To ensure that the gear a61 does not rotate relative to the respective additional parts. For this purpose, there is a long groove 31 on the lower side in the area of the screw, and this long groove has a connecting part. A corresponding long key 32 on the communicating side engages. The clamp jaw 61 is a screw It is divided longitudinally in the middle above the head. Clamp jaws are both split It has semicircular grooves on its surface, and these grooves run transversely to the intermediate axis of the jia a-61. and serves to receive the bone screws 27 and 28. The clamp is on the top This is done by screwing.

The bottom part of Figures 2 and 3 shows the clamp jaw 61 rotated by 90 degrees. shown so that the connecting plane of both bone screws is in the lateral fixator midplane. It exists perpendicularly to the In this case, clamp jig 5-61 and the respective connecting parts The screw connection with the jaw is made by a hexagonal socket screw located at the bottom of the jaw. here Also, there is a groove 30 at the clamping point to ensure that it does not rotate.

At the bottom of FIGS. 2 and 3, the clamp jaw 61 shown as the uppermost part is cut out. It exists as a connecting part of the replacement member 61. Along with this part, the worm shaft 3 3 and a worm wheel 34 through a self-locking worm drive. A limited pivoting movement of the platform 35 is achieved. This platform For example, place the clamp jig 5F-61 shown above on top of the frame 35 to prevent relative rotation. It can be fixed with a screw. The worm has a hexagonal hole on its shaft end for operation. It has a head.

In the lower range of FIG. 2, a hinge connecting part 59 is shown as the second part from below. This connecting part is a cardan that can be fixed in principle, and this cardan is , which can also be clamped and, in combination with the rotatability of the lamp pin 16, can be screwed. A circle with a slit in the range that allows Lamborgygo-61 to rotate. A shaped segment 36 surrounds a cylindrical inner part 37. circular segment 36 A through screw 38 guided in the slit passes through the inner part 37 and with it This inner part is rotatable around its axis of rotation within a defined angular range. Ru. Clamping of the inner part 37 takes place via a hexagon socket head screw, with the nut 3 9 has a shape adapted to the convex outside of the circular segment 36 and a slit guide. The protruding key prevents rotation relative to its bearing surface. This allows the opposing holding part to The clamping screw 38 with only the key can then be pulled out.

The slit-shaped recess of the inner part 37 has a four-sided angle of 4°, and this four-sided angle is , can be rotated toward both sides in a plane that is perpendicular to the cylinder axis. and can also be clamped by a through screw 38 to improve zero-turn stability. In addition, there are radial undulations in the area of the screw hole 38, and also on both sides of the tetrahedral angle 40. It is also provided on the inside of a cylindrical recess 37 oriented towards. The four-sided corner 40 has a female thread. The clamp jig g61 can be screwed into the clamp jig g61 with a screw.

The central part of the outer fixator shown in FIGS. 2 and 3 shows a bone segment fixator 63. A ring 42 adapted to the outer diameter of the central part l receives the adjusting nand on the central part l. A cylinder with an internal thread is attached around a circular ring that can be attached to any position after installation. There is a part 43 shaped like this. A correspondingly formed platform around the central part l A circular ring 42 in which a form 44 surrounds the part 43 and runs underneath it. It has a recess in the range. Now the screw 45 connects the upper clamping screw = 146 and Pressure is applied to the platform 44 through the bone screws 64 and 65 located therebetween. is clamped in the desired position on the central part 1. At this time, Clamp jig G-46 can be rotated around the screw 450 axis within a predetermined angle range. This allows the bone screws 64 and 65 that hold the bone portion to be oriented. can. The underside of clamp jaws 46 and and its bearing portion 43 has radial serrations that engage with each other during clamping. Existing.

4 is used in place of the intermediate part 62 or 59 shown in FIGS. 2 and 3. The rigid intermediate piece 66 shown in FIG. It has the pin 16 described above as a pump pin.

On the other hand, there is a female screw 25 and a key 50, which saves the above cost. The lamp assembly yi 61 can be secured with screws to prevent it from twisting. this middle Part 66 also has corrugations 23.

In FIG. 5, a clampable hinge joint 67 is shown. This hinge joint 6 7 can be clamped at any position, and the hinge tilts when the clamp is loosened. Helps move the joint in the plane of motion.

A pivotable quadrangle 68 is fixedly connected to a pivot bolt 69, which pivot bolt Beyond the 0 part 70 supported on the part 70 gripping around the tetrahedral corner 68 in a U shape The end of the pivot bolt 69 protruding from the The two sides are milled flat. Radial serration on one side A disc 71 provided with a bolt is inserted through a hole formed corresponding to the cross section of the bolt. It is attached to the pivot bolt 69 so as not to rotate.

A helical spring 73 wound around the pivot bolt 69 between the part 70 and the disc 71 is connected to the disc. 71 is held at a distance from the component 70. It has radial serrations that similarly fit on the side that has been cut. Now the disc 71 is When pressed against the serrations by the fitting 72, the entire joint 67 is closed. in front As mentioned with respect to Figures 2 and 3 of the problem, the square corner 68 and the part 70 have their In each case, a receptacle or pin 16 for a pin connection is provided.

At the front of the partially cut away central part 1 shown in FIG. A socket 8 or 9 is present at each end of the central part. Now, both of these tones The functions of the adjustment nuts 8 and 9 will be described with reference to FIGS. 6, 7 and 8.

A solid piston not shown in FIG. 8 and corresponding to the solid piston 4 shown in FIG. To guide the ton, a sleeve 5 correspondingly toothed on the inside serves, and this The sleeve is adapted to the tubular end of the central part 1. This sleeve 5 is a set screw 6, which set screw is rotated correspondingly into the internal threaded hole it passes through. The inner part of the sleeve 5 emerges from the inside of the contour and therefore additionally The solid piston 4 can be clamped.

Both adjusting nuts 8 and 9 are present on the raised outer part of the piston 3 or 4 It has a female thread corresponding to thread pitch 51 or 52. This adjustment napht 8 and 9 This allows for axial adjustment of the pistons 3 and 4 relative to the central part 1.

Both adjusting nuts 8 and 9 have an internal thread formed by different piston cross sections. and are the same. Nuts 8 and 9 surround the relevant ends of the central part 1 in a collar-like manner. I'm here. This collar is provided with a hole 10 around its periphery which serves to receive a ball 60. The inwardly tapering hole 10 allows the ball 60 to partially exit. prevents the ball from falling out of it.

Around both central part ends a semicircular annular groove 11 runs at the level of the spherical midplane. Therefore, the ball 60 can travel within it. Therefore, adjusting nut 8 or 9 is rotatably connected to the central part 1.

A ring 12 surrounding the collar (adjusting nut 8 or 9) prevents the ball 60 from retreating. This ring is rotatably fixed by a snap ring.

Rotation of the adjusting nut 8 or 9 causes the associated piston 3 or 4 to follow the direction. go in and out.

Adjustment nut 8 or 9 for the purpose of mounting or moving the instrument loosening the axial connection between the piston 3 or 4 and the central part 1 provided by It is preferable. For this purpose, the ring 12 is arranged around the ring 12 according to FIGS. 6 and 7. It has holes 53 that narrow outward in a conical shape by a number corresponding to the number and position of the balls. Since these holes are shifted by the same amount in the circumferential direction, one ring 12 is rotated. Sometimes it coincides with the hole 10 of the collar part (adjusting nut 8 or 9), and the ball release 60 is It allows it to retreat in the centrifugal direction without falling off. Figures 6 and 7 show the adjustment nuts. 8 is shown. However, the adjusting nut 9 can also be assembled similarly and It cooperates with a corresponding ring 12.

According to the screw 54 present in the collar at the level of the midplane of the sphere, the pair of outer circumferences of the ring 12 The passage of the rotating ring 12 can be restricted and stopped using a corresponding recess 56. Wear. By means of a set screw 55 located radially in the thread plane of the adjusting nut 8 or 9. and insert the nut 8 or 9 loosened from the central part 1 onto any of the pistons 3 or 4. Can be fixed in position. This allows the bone section supported by the lateral fixator to limited movement is possible. Depending on the selected axial passage section, the Only a deforming force of the same magnitude is applied to the bone.

In place of these previously described adjusting nuts 8 and 9 according to FIG. 8, the adjustment according to FIG. Nuts 74 and 75 are shown and their mode of action can now be seen in Figures 1 and 9. This will be explained in detail with reference to FIG. FIG. 9 shows the piston 3 retracted. A plan view of the central part 1 is shown, in which the adjusting nut 74 can be seen. Wear. The mode of action of the adjusting nuts 75 is similar and will no longer be described individually.

In this embodiment, for example, one or more sliding blocks 76 are placed above the piston 3. can run within at least one or more grooves of the key profile.

A recess in the form of a circular ring section in the area of the thread of the adjusting nut 74 allows the sliding block to The lock 76 forcibly follows the axial movement of the adjusting nut 74 on the piston 3. During ~ The centrally projecting tongue of the sliding block 76 likewise has a recess. This includes half The screws 77 of the radially mounted central part 1 are engaged so that they do not slip. Prevents axial movement of block 76.

Therefore, rotating the adjusting nut 74 causes the associated piston 3 to move out according to the direction. It will move to the side or inward. When screw 77 is firmly screwed in, this The screw ensures that the sliding block 76 is pressed into the keyway and thus prevents the axial movement of the piston 3. blocking the possibility of movement or preventing rotation of the adjusting nut 74.

Rotating the screw 77 outwards in the central part 1 causes the associated piston 3 to move in the central part l. Can be withdrawn from for quick adjustment purposes.

FIG.4 FIG.5 FIG.6 FIG.8 international search report □□1PC/EP 90100354 International Investigation Report 11wmg-m pm+ew f-1--basket---@Is Ilw pm+w +1--Ichiaki cjaea km m　-Haichiп|wwm npa n- TI+e-hat 1twa-wa thlEwegeam P-01Rce ED P-M nJ*J94The--mliwImwqkakke1m-1-mA+ continuation of m1-fnm1m--d-brother-in-law page 1 Priority claim [Phase] July 26, 1989 [Phase] European Patent Organization (E@Ming. Person: Valid Wolfgang P) [Phase] 89113809.1 Federal Republic of Germany, Day-6900 Heidelberg 1, Reisberg, 7

Claims (15)

[Claims] 1. In a unilateral extendable external fixation device for treating bone diseases, a tubular inner At least one piston (3 or 4) on each side repeats from the central part (1). The outer end of the inner piston (3; 4) is arranged to be removable, with various connections An external fixture characterized in that the parts are rotatably fixable. 2. At the outer end of each inner piston (3; 4) there is a clamp pin (16) of the connecting part. A central hole (14; 15) is present in which it is possible to fixate the bone screw clamp. characterized in that the jaw (61) can be screwed onto this connecting part, External fastener according to claim 1. 3. In order to prevent relative rotation between the central part (1) and the connecting parts, on the one hand There are teeth (20; 21) on the end face side of each end of the piston (3; 4), and on the other hand There are matching teeth (22; 23) on the corresponding lower side of the connecting part. External fastener according to claim 1 or 2, characterized in that: 4. At least one piston (3) is hollowly bored so that the opposing pistons (3) Claimed piston (4), characterized in that the piston (4) can be completely submerged therein. External fixation according to range 1, 2 or 3. 5. No relative rotation between the central part (1) and the extendable piston (3; 4) A connection exists between the outer part of the central part (1) and the piston (3; 4). At least two or more grooves are present and the associated inner piston (3; 4) having around its periphery a corresponding number of loose or rigid parts (7) running in this groove External fastener according to at least one of the preceding claims, characterized in that: 6. Thread leads (51, 52) are provided in the portion (7) existing on the circumference of the piston. and the adjusting nuts (8; 9; 74; 75) present in the central part (1) (51, 52) and thus a limited axial displacement of the pistons (3; 4). of the previous claim, characterized in that the positioning or fixation is realized with respect to the central part (1). an external fixture according to at least one of the ranges; 7. a control rotatably mounted on at least one end of the central part (1); The alignment nuts (8; 9; 74; 75) are attached to the threaded leads (51, 52) on the outer circumference of the piston. ) and thus realize an axial adjustment of the piston Ingredients. 8. An annular adjusting nut is releasably mounted on the piston (3; 4) from the central part (1). The screws on the adjusting nut correspond to the screws on the outside of the piston. An external fixation device according to at least one of the preceding claims, characterized in that: 9. Bone screw clamping jaws (61) can be installed longitudinally or laterally External fastener according to at least one of the preceding claims, characterized in that: 10. In the central part (1) a circular ring (42) carrying a bone part fixation device (63) at least one of the preceding claims characterized in that the External fixation by one. 11. The clamp pin (16) allows it to be inserted into the end of the piston (3; 4). The lesser of the preceding claims, characterized in that it has a hinged connecting part (59). External fixation by at least one. 12. The clamp pin (16) allows it to be inserted into the end of the piston (3; 4). characterized in that a certain rigid intermediate part (66) is provided as a connecting part, An external fastener according to at least one of the preceding claims. 13. The clamp pin (16) allows it to be inserted into the end of the piston (3; 4). A hinge joint (67) that can be clamped at any position is used as a connecting part (1). An external fixation device according to at least one of the preceding claims, characterized in that it has: 14. of the platform (35) via a self-locking worm drive It has a switching member (62) as a connecting part that allows a limited pivoting movement; This switching member is attached to the end of the piston (3; 4) by means of a clamp pin (16). According to at least one of the preceding claims, characterized in that it is pluggable. External fixture. 15. Control unit and power supply, which can be connected via a flange to the central part (1) A step motor having a section is connected via a pinion to an adjusting nut (8; 9; 74; 75) and generates a predetermined pulse per unit time. Other than according to at least one of the preceding claims, characterized in that the side fixture.