MXPA98000009A - Orthopedic apparatus, particularly for the surgical correction of hue deformations - Google Patents

Abstract

The present invention relates to orthopedic apparatus comprising an externally positionable longitudinal rod substantially parallel to a bone for correction, a first clamp movably anchored to the rod to hold drill guides for insertable screws in one in a proximal portion of bone, and minus one second clamp movably anchored to the rod to hold drill guides for insertable screws in a distal portion of the bone, the first and second clamps are oriented and selectively insurable, prior to surgical intervention, at predetermined angular positions with respect to the longitudinal rod which corresponds to the angular deformations of the bone, and is therefore repositionable with respect to the rod to manipulate the bone to a correct shape and retain the bone in the correct way, the first clamp has a supporting portion for the drill guides and means of po Preferential positioning to hold the support portion in an operative position with respect to the rod, the preferential positioning means have resiliently compressible stopping means to allow pivotal movement of the first clamp in the opposite direction of the operative position when enough is applied outside. from pivoting to the torpor portion

Description

ORTHOPEDIC APPARATUS. PARTICULARLY FOR THE SURGICAL CORRECTION OF DEFORMATIONS OF BONES TECHNICAL FIELD The present mention refers to an orthopedic apparatus, particularly for the surgical correction of bone deformations, for example of the tibia and the femur.

PREVIOUS TECHNIQUE It is known that adjustable external fixation devices are commonly used to correct certain angular and longitudinal deformations of long bones. Said devices essentially comprise groups of bone screws fixed in the portions of the bones affected by angular defects and fastened by clamps which in turn are slidably mounted on longitudinal guides that can be externally placed on the end to be reconstructed. The correction is usually carried out gradually with the help of compressor-distractor devices that act on the movable clamps while the bone lime regenerates itself allowing some degree of deformation. This methodology, however very effective, requires correction times that are very prolific and do not give any immediate result for the patient.

D ESCRI PCIÓ N OF THE I NVEN C ION The present invention according to a preferred aspect proposes to carry out an immediate and immediate correction in the operating room of the defects obtained pre-imperatively by the surgeon by means of normal radiological procedures. With this primary purpose in mind, an orthopedic apparatus is provided, particularly the surgical correction of angular and longitudinal defects of the bones of limbs of the femur and tibia type, comprising a longitudinal rod that can be placed externally substantially parallel to a bone. its correction, a first clamp movably attached to said rod to support the drill guides for the screws that can be inserted in a proximal portion of the bone and at least a second clamp movably attached to said rod to support the drill guides for screws which can be inserted in a distal portion of the bone, said first and second clamps being selectively adjustable and lockable before the surgical intervention in the predetermined angular positions with respect to the longitudinal rod corresponding to the angular deformations of the bone, and being able to return to Place with respect to the rod in the correct angular positions after osteosynthesis of the proximal and distal portions of the bone in order to eliminate the angular deformations of the bone.

BRIEF DESCRIPTION OF THE DRAWINGS The features and advantages of the invention will be apparent from the description of some preferred but not exclusive embodiments of the apparatus according to the invention, illustrated for illustrative and non-limiting purposes with the help of the accompanying drawing sheets in which; Figure 1 illustrates a general front elevation view of the brace according to a preferred aspect of the invention applied to a bone that will be corrected; Figure 2 illustrates an enlarged scale detail of the apparatus of Figure 1; Figure 3 illustrates a top plan view of the detail of Figure 2; Figure 4 illustrates a sectional view of Figure 1 taken in accordance with the plane M I-M I and shows another enlarged scale detail of the apparatus of Figure 1; Figure 5 illustrates a bottom view of the detail of Figure 4.

M ANUAL WAYS TO CARRY OUT I NVEN C IO N With reference to the cited figures, an orthopedic apparatus for use in the operating room according to a preferred aspect of the invention, globally denoted by the reference number 1, essentially comprises a longitudinal rod 2 on which they are movably mounted. a first end clamp 3 and a second end clamp 4, for supporting the drill guides for bone screws (not shown in the drawings), The rod 2 defines a longitudinal axis Y, and has a semicircular cross section and a flat face 5 with a central longitudinal slot 6 and an elongated hole 7 which extends almost the entire length of the rod..

Preferably, the longitudinal groove 6 has a trapezoidal shape with the smaller side facing the flat face 5. The first bracket 3 is substantially T-shaped with a portion 8 for connection to the rod 2 provided on its opposite faces with spikes of the tail of my plane 9, 1 0 configured inversely with respect to the longitudinal slot 6. The clamp 3 fastened to the rod by means of one of its pins 9, 10 inserted in the slot 6, in proximity to one of its longitudinal ends and is blocked by means of a screw with a pin 1 1. A support portion 12, for the piercing guides of the insertable bone screws in the proximal portion of the bone is attached to the connecting portion 8, and in turn is formed by a substantially flat base plate 1 3 with two depressions 14 on which a cover 1 6 is also obtained with depressions 1 7 which are hinged in 1 5. The cover 16 is locked against the base by means of a screw with a knob 18 so as to close the drill guides for the screws, with variable inclinations between the depressions 14, 1 7. The portion 1 2 is joined to the potion 8 of the bracket 3 by means of an intermediate element 19 having a first hinge axis A and a second hinge axis B substantially perpendicular to with respect to each other and with respect to the Y axis when the clamp 3 is attached to the rod 2. To selectively block the angular position of the intermediate element 19 with respect to the connecting portion 8 around the axis B, a first eccentric retainer 20 is provided with a fixed hexagonal head. In order to selectively lock the angular position of the intermediate element 19 with respect to the support portion 12 about the axis A, a second eccentric retainer 20 'is provided having also a fixed hexagonal head. In order to keep the two axis A, B in preferential position here, spherical positioning means 21 elastically compressed by a spring against a seat of inverse configuration formed on each axis. Separating means are also provided consisting of a screw 22 which is screwed into a threaded hole formed in the central part of the plate 13 and having a fixed hexagonal head 23 and a butt end 24 bearing on the bone. Other spacer means for rigidly holding the portion of the bone in position during piercing, are constituted by Kirschner wires, not shown in the drawings, fixed in the bone and passing through the calibrated holes 25 provided in the base plate 13 and calibrated holes 26 provided in cover 16.

The second clamp 4 is essentially constituted by a second support portion 27, itself formed by a base 28 on which a cover 30 is hinged at 29. The base of the cover has cladding seats 31 for holding the drill guides for the insertable screws in the distal portion of the bone, not shown in the drawings, by means of a closing action provided by a screw with a knob 32. The base 28 has a protruding appendix 33 with an end pin 34 inserted in a groove arched with the center C formed in a transverse circular arc element 36 having on one of its planar faces a graduated scale 37 for measuring the torsion angle of the clamp. The center C of the slot 35 should approximately coincide with the axis of the bone when the bracket 4 is mounted on the rod 2 and defines a third axis of correction, perpendicular to the first of the two distal portions A, B, of bone affected by torsion By blocking the angular position of the clamp 4, a screw with knob 38 is provided, which is screwed onto the appendix 33. Separating means are provided, consisting of a screw 39 that are screwed into a threaded hole formed in the appendix 28 and having adapted ends to be supported on the distal portion of the bone that will be corrected. At the extremities of the flat element 36, connection pins 40, 40 'are formed which allow a right or left mounting on the rod 2 according to the requirements. The pins 40, 40 'can be inserted into the slot 6 of the rod 2 and locked in position by means of a screw with knob 41 which is screwed into respective threaded holes 42, 43 formed in correspondence with the pins 40, 40 '. In operation, the surgeon obtains with X-rays on multiple planes the angles and angular defects of the proximal portion and of the torsional defects of the distal portion and then imposes and blocks said angles on the clamps 3, 4 and mounts the latter on the rod 2. After perforating the bone in correspondence with the proximal and distal portions, it is carried out using the perforation guides blocked on the clamps 3, 4. The osteotomy of the bone is then carried out in correspondence with the proximal portions. and distal and the clamps are returned to their correct position towards the support position imposed by the preferential placement means eliminating the angular defects of the bone. Finally, the clamps of the apparatus are replaced with those of an external fixator that holds the limb during the entire period of growth of the bone callus until full recovery.

Claims (13)

1. REI VI N DI CAC I O N ES 1 . An orthopedic device, particularly for the surgical correction of angular and longitudinal defects of the limb bones, of the femur and thymus type, characterized in that it comprises a longitudinal rod that can be placed externally substantially parallel to a bone for correction, a first clamp movably attached to the rod to support the piercing guides for insertable screws in a proximal portion of the bone and at least one second clamp movably attached to the rod to support the piercing guides for insertable screws in a portion distal bone, said first and second clamps being orientable and selectively lockable, prior to surgical intervention, in predetermined angular positions with respect to the longitudinal rod corresponding to the angular deformations of the bone and being able to reposition the rod in angular positions correct after of the osteosynthesis of the proximal and distal portions of the bone so that they eliminate the angular deformations of the bone.
2. 2. The brace according to claim 1, characterized in that the first bracket has a support portion for the drill guides attached to a first portion for connection to the bracket by means of first and second mutually perpendicular hinged axes.
3. 3. The orthopedic apparatus according to claim 1, characterized in that the connecting portion of the first clamp is fastened to the vari l so that the first and second hinged axes are perpendicular to the longitudinal axis of the rod.
4. 4. The orthopedic apparatus according to claim 1, characterized in that the first clamp has preferential positioning means for maintaining the support portion in operative position substantially orthogonal to the rod.
5. 5. The orthopedic apparatus according to claim 2, characterized in that the preferential positioning means are of the ball type elastically compressed in a center seat formed on each hinged axis.
6. 6. The brace according to claim 5, characterized in that the support portion comprises a base plate, a cover hinged on the base and a locking knob to lock the cover against the base by closing the perforation guides between them.
7. 7. The brace according to claim 6, characterized in that the first bracket has adjustable spacer means for positioning the bracket portion with respect to the surface portion of the bone.
8. 8. The brace according to claim 7, characterized in that the spacer means comprises a screw bolt on the side in a threaded hole provided in a substantially central position of the base plate.
9. 9. The brace according to claim 7, characterized in that the spacer means comprises one or more Kirschner wires insertable in the proximal portion of the bone in calibrated holes formed in the base plate and in the cover.
10. 10. The brace according to claim 1, characterized in that the second bracket comprises a second support portion for the drill guides connected to a second portion for connecting to the rod by means of arcuate circular guide means with an axis substantially coincident with the axis of the bone that will be corrected. eleven .
11. The orthopedic apparatus according to claim 10, characterized in that the circular arched guide means extend in a transverse plane when the second connection portion is fastened to the rod.
12. 12. The brace according to claim 1, characterized in that the second support portion comprises a base and a cover, as well as screw spacing means for maintaining the second bracket at a predetermined distance with respect to the distal portion of the bracket. bone that is going to be corrected.
13. 13. The orthopedic apparatus according to claim 1 2, characterized in that the rod has a longitudinal seat with a substantially trapezoidal cross section for slidably holding the first and second dovetail connection portions of the clamps. RESU M IN OF THE I NVENTION An orthopedic device, particularly for the surgical correction of angular and longitudinal defects of the limb bones, of the femur and thymus type, comprising a longitudinal rod (2) externally movable substantially parallel to a bone for correction, a first clamp (3) movably attached to the rod (2) to support the drill guides for insertable screws in a proximal portion of the bone and at least one second clamp (4) movably attached to the rod to support the drill guides for insertable screws in a distal portion of the bone. The first and second clamps are orientable and selectively lockable, prior to surgical intervention, at predetermined angular positions with respect to the rod (2) which corresponds to the angular deformations of the bone and can be repositioned with respect to the rod in the correct angular positions after the osteosynthesis of the proximal and distal portions of the bone so that they eliminate the angular deformations of the bone.