MXPA98001405A - Intramedular nail with screws, which press the nail against the bone corticals, used in fractures, seudoartrosis and deviations of the mechanical axis, in long bones not submitted to the sea - Google Patents

Abstract

The present invention relates to intramedullary nails with screws, which press the bald against the cortical bones, for fractures, pseudoarthrosis and deviations of the mechanical axis, in bones not subject to gait, characterized in that it is formed of a nail of substantially cylindrical configuration, with a recess in the form of a flat face, along its length, one of the ends of said nail retaining its cylindricity at a final point, the continuation being on the same flat face, said end of the bald receiving a manipulator element, the which presents an internal profile coinciding with the external profile of the nail to prevent it from turning, said manipulator is fixed to the nail by means of a fixing element, which causes the three elements: nail, manipulator and fixer to form a unitary body, in such a way that On the flat part of the nail are supported blunt end screws, used to push the nail against the cortical bone and eliminate macromotion. fracture cough, producing micro-movements, which produce the callus

Description

INTRAMEDULAR NAIL WITH SCREWS THAT PRESS THE NAIL AGAINST THE BONE CORTICAL, USED IN FRAC TURES, PSEUDOARTHROSIS AND DEVIATIONS OF THE AXIS CANICO, IN LONG BONES NOT SUBJECT TO MARCH.

FIELD OF THE INVENTION The present invention relates to the so-called intramedullary nails by orthopedists, for the reduction of fractures, treatment of pseudoarthrosis, osteotomies and deviations of the mechanical axis, mainly in long bones not subject to walking.

BACKGROUND OF THE INVENTION Prior to the present invention, for the treatment of fractures, pseudoarthrosis, osteotomies, failure to consolidate fractures, and deviations from the mechanical axis, we used plasters, intramedullary nails without fixation and plates with screws placed on the surface of the bone. These procedures easily cause non-union of fractures, pseudoarthrosis or bone deviations that warrant further surgery. Frequently, especially in the screwed plates, that by the injury that produce to the periostium of the bone (blood contributor to the cortical) there are bony infections feared by the surgeon for its sequelae and difficulty in its treatment.

The use of treatments for this type of injuries by means of solid or hollow nails, with a series of holes in their longitudinal axis, of the state of the art also have a series of drawbacks that also make them inconvenient in the treatment of these types of injuries in the bones.

Because of the extremely strong fixation, the fixed nails with screws, these rigidly maintain the ends of the fracture and possibly movement can be performed without risk of moving the ends but with the disadvantage that they do not allow the micro-movements that stimulate the union of the bone.

In the procedure of placing the intramedullary nail in the bone it is necessary to manipulate it by pushing it and turning it to place it in its place, by the characteristics of the current nails, additional devices are required to carry out this manipulation as far as possible from the patient's body . These devices are relatively complex and make the surgical operation more difficult. In addition, by the way of fixing the nail to said manipulator devices external threads are required in the nails and the threading operation close to the body means a problem both to achieve the fixation by threading, and to avoid damaging with this threading operation the tissues in contact: bone marrow, nearby muscles and skin itself.

OBJECTIVES OF THE INVENTION The first objective of the present invention is to make possible an intramedullary nail that allows the treatment of fractures, pseudoarthrosis, etc., keeping the ends of the bone to be joined without macromotions, but with micro-movements that stimulate the union.

A second objective is to provide a nail of this type with the quality of understanding a very simple and easy to use manipulator device for pushing, pulling or turning the nail being manipulated, making the surgical operation easier.

Still a third objective is to allow a nail whose fixation of its manipulator diminish the damage caused to the tissues near the lesion to be treated.

And all those objectives and advantages that will become obvious after reading and understanding the present description DESCRIPTION OF THE INVENTION The nails of the present invention are part of a system formed of orthopedic nails and screws. The nails penetrate into the medullary cavity that have the types of bones already mentioned in the title. The stabilization of the lesions is done when said intramedullary nail is pushed against the inner wall of the medullary canal of the bone (cortical), by the screws. When the nail is pressed against the cortices by the screws, this prevents movements (macromotions) that do not allow consolidation of the fractures and allow micro-movements that activate the consolidation of the lesions.

The nails are semi-cylindrical, with a flat surface, where one of the ends of each screw will be fixed. Given the shape and special characteristics of each bone, the nails and screws the nails and screws must adapt to them with different thicknesses, lengths and even curvatures in one or both ends.

Due to the thickness of the different cortices and the muscular forces that act on the bones, the screws are of different lengths and thicknesses.

By way of illustration, but not limitation, we will now describe the embodiment of the invention represented in the appended figures, for a better understanding of the invention.

BRIEF DESCRIPTION OF THE INVENTION Figure 1 illustrates the manipulator that will allow to rotate, move longitudinally, both in one direction and in the opposite direction, for its fixation in the lesion or deviation to be treated.

Figure 2 shows the detail of the cross section made on the X-X 'axis of Figure 1.

Figure 3 shows the fixing screw of the nail manipulator to the nail.

Figure 4 illustrates the nail object of the present invention showing the curvature that enables the nail to exit the medullary canal of the bone through the cortex, also illustrating the end where the manipulator is fixed, also illustrating the flat part of the nail.

Figure 5 shows the detail of the end where the manipulator and the fixing screw are fixed.

DETAILED DESCRIPTION OF THE INVENTION Figure 1 shows the manipulator with the end that is fixed to the nail and having an outer conical profile EC and a bevelled end at the opposite end. The conical outer profile allows this manipulator to penetrate between the soft tissues that surround the bone in the area where this manipulator is going to be fixed to the nail. By the shape of this profile, the manipulator enters by separating the tissues without crushing or cutting. The PVM bevelled end of the manipulator allows better better grip by the surgeon without slipping.

In the part of the manipulator where there is a conical profile externally, as can be seen in figure 2, there are rectangular projections on its interior cylindrical surface, which are where they fit the rectangular rectangular recesses of the nail at its end. it is out of the bone. The manipulator comprises an internal longitudinal circular channel through which the fixator illustrated in Figure 3 will pass, sensibly elongated.

The fixator has an externally threaded end with the diameter of the crest of the rope of the same outer diameter as the central part of the PCF fixator which is completely smooth. The outer diameter of the central part and the threaded end of the fastener is slightly less than the inner diameter of the longitudinal inner channel of the manipulator so that the threaded end and the central part of said fastener can slide easily into the inner channel of the manipulator. At the opposite end to the threaded end, the fixator has a stepped outside diameter greater than the rest of the fixator, its beveled surface having the surgeon rotate this fastener to screw it and unscrew it from the nail, without it slipping.

In Figure 4 you can see the nail with the two straight parts at different angles, the longest that is lodged in the medullary canal of the bone to be treated and the shortest one that will be outside the bone and in whose end will be fixed by the manipulator. The cross section of said nail is generally semi-cylindrical with a flat part where the screws that will cross the cortex of the bone to be treated will contact, they will press the nail against the wall of the medullary canal opposite the place where the nails went through.

The end that protrudes from the nail is shorter and is at a predetermined angle. At this end there is, in the peripheral part, a recess that will coincide with the rectangular projections in the inner channel of the manipulator at its end where the outside has the truncated profile. Likewise, on its transverse face, this end of the nail has a central internal thread where the manipulator's fixator is screwed.

In figure 5 you can see the details of the end of the nail that protrudes from the bone, being able to see both the recesses and the beginning of the internal thread.

The use of the nail is done in the following way. The nail is first held with the manipulator fixed to it by the fixator. For its placement, an incision is made far from the lesion in the area of the bone where the nail will be inserted, deepening the incision to the bone. An opening is made in the cortical bone at this point until reaching the medullary canal. The nail is introduced into the medullary canal by passing the two fragments (with image intensifier when done at a closed focus or opening the focus of the fracture when it is open focus) by pushing, turning and pulling by means of the manipulator. The soft tissues are opened at the point where the screws that fix the nail will be inserted in one segment of the bone as well as in the other. The screws are introduced, turning the nail so that the end of these contact the flat part of the nail, the nail is fixed and the wounds are closed both from the open focus, in its case, as well as from the screws and the incision made for the introduction of the nail. Once the nail is fixed, and the manipulator has fulfilled its purpose, it is unscrewed and removed, leaving only part of the shorter end of the nail exposed.

The length dimensions of the longest part of the nail will depend on the characteristics of the bone to be treated, being a long bone or requiring more support a nail with its longest part, longer than in a shorter bone will be used or that does not require to support important efforts.

The angle between the longest part of the nail and the shortest part will depend on each application, the place where the fracture is located, where the incision must be made for the introduction of the nail, among other aspects.

Finally, the shortest part will also have a variable length depending on the thickness of the soft tissue that surrounds the area where the nail will be inserted and on which part of the body this area is located.

In another embodiment of the invention, the coupling of the shorter end of the nail with the manipulator will be done by means of internal grooves of the manipulator coinciding with external grooves of the nail. Other specific embodiments of the invention may be apparent to those skilled in the art from a consideration of this description or practice of the invention disclosed herein. It is understood that the specification and specific embodiments are considered as examples only, with the true scope and spirit of the invention being indicated by the following claims.

Claims (1)

R E I V I N D I C A C I O N S Having described the invention, it is considered as a novelty and therefore the content of the following clauses is claimed as a novelty.

1) Intramedullary nail with screws that press the nail against the bony cortices, used in fractures, pseudoarthrosis and deviations of the mechanical axis, in long bones not subject to walking of the type that does not include holes for its fixation by screw and includes a manipulator for pushing, turning and pulling the nail into the medullary canal of the bone to be treated, said nail having a long part and a shorter one, characterized in that the nail is of semi-cylindrical cross section with a flat part in the place where the screws they will push against the cortical bone; the manipulator is a piece with an end of greater dimension in its diameter and less in length, than the opposite end, having the end with greater diameter and shorter length an external configuration frustoconical and the opposite end having an engraving to decrease the risk of slipping out of hand; said manipulator will be fixed to the shorter end of the nail by means of recesses in the nail or manipulator and projections in the nail or manipulator, respectively, and a fastener that traverses longitudinally the manipulator and is screwed in the internal thread of the transverse face of the end shorter. ) Intramedullary nail with screws that press the nail against the cortical bone, used in fractures, pseudoarthrosis and deviations of the mechanical axis, in long bones not subject to gait, as claimed in the previous clause, characterized in that the fixator of the manipulator comprises at its opposite end to the thread, a part with the diameter greater than the outer diameter of the manipulator at its beveled end, this part being where the fixer will be taken to make it rotate and screw it to the nail. SUMMARIZES The present invention is related to a new intramedullary nail with screws that press the nail against the bone cortices, used in fractures, pseudoarthrosis and deviations of the mechanical axis, in long bones not subject to gait, with the quality of keeping the ends of the bone unite without macromotions, but with micromovements that stimulate the union, with a very simple and easy to use manipulator device to push, pull or rotate the nail that is being manipulated, making the surgical operation easier and diminishing the damages caused to the soft tissues close to the injury to be treated. Said nail is characterized in that it comprises a manipulator consisting of a piece with an end of greater dimension in its diameter and smaller in length, than the opposite end, the end having a larger diameter and shorter length having an external frustoconical configuration and the end opposite having an engraving to reduce the risk of slipping of the hand.