NO903506L - DRAFT APPLIANCE FOR AA MAINTAINING ORIENTATION OF USED LINK. - Google Patents
DRAFT APPLIANCE FOR AA MAINTAINING ORIENTATION OF USED LINK. Download PDFInfo
- Publication number
- NO903506L NO903506L NO90903506A NO903506A NO903506L NO 903506 L NO903506 L NO 903506L NO 90903506 A NO90903506 A NO 90903506A NO 903506 A NO903506 A NO 903506A NO 903506 L NO903506 L NO 903506L
- Authority
- NO
- Norway
- Prior art keywords
- distraction device
- pin
- pins
- stated
- yielding
- Prior art date
Links
- 210000000988 bone and bone Anatomy 0.000 claims description 7
- 230000035876 healing Effects 0.000 claims description 5
- 229910001220 stainless steel Inorganic materials 0.000 claims description 4
- WYTGDNHDOZPMIW-RCBQFDQVSA-N alstonine Natural products C1=CC2=C3C=CC=CC3=NC2=C2N1C[C@H]1[C@H](C)OC=C(C(=O)OC)[C@H]1C2 WYTGDNHDOZPMIW-RCBQFDQVSA-N 0.000 claims description 3
- 238000003780 insertion Methods 0.000 claims description 3
- 230000037431 insertion Effects 0.000 claims description 3
- 239000010935 stainless steel Substances 0.000 claims description 3
- 230000003100 immobilizing effect Effects 0.000 claims description 2
- 208000027418 Wounds and injury Diseases 0.000 description 4
- 230000006378 damage Effects 0.000 description 4
- 208000014674 injury Diseases 0.000 description 4
- 230000000694 effects Effects 0.000 description 3
- 210000002303 tibia Anatomy 0.000 description 3
- 208000010392 Bone Fractures Diseases 0.000 description 2
- 208000002658 Intra-Articular Fractures Diseases 0.000 description 2
- 206010060820 Joint injury Diseases 0.000 description 2
- 210000001145 finger joint Anatomy 0.000 description 2
- 206010002091 Anaesthesia Diseases 0.000 description 1
- 238000001949 anaesthesia Methods 0.000 description 1
- 230000037005 anaesthesia Effects 0.000 description 1
- 208000022542 ankle injury Diseases 0.000 description 1
- 238000011882 arthroplasty Methods 0.000 description 1
- 230000009286 beneficial effect Effects 0.000 description 1
- 210000004439 collateral ligament Anatomy 0.000 description 1
- 230000006835 compression Effects 0.000 description 1
- 238000007906 compression Methods 0.000 description 1
- 238000006073 displacement reaction Methods 0.000 description 1
- 239000012634 fragment Substances 0.000 description 1
- 238000002695 general anesthesia Methods 0.000 description 1
- 238000007689 inspection Methods 0.000 description 1
- 230000001788 irregular Effects 0.000 description 1
- 238000002690 local anesthesia Methods 0.000 description 1
- 210000000811 metacarpophalangeal joint Anatomy 0.000 description 1
- 239000000178 monomer Substances 0.000 description 1
- 230000035515 penetration Effects 0.000 description 1
- 229920000642 polymer Polymers 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6425—Devices extending alongside the bones to be positioned specially adapted to be fitted across a bone joint
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6441—Bilateral fixators, i.e. with both ends of pins or wires clamped
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B2017/606—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors with resilient spring element
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- General Health & Medical Sciences (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Prostheses (AREA)
- Vehicle Body Suspensions (AREA)
- Pivots And Pivotal Connections (AREA)
- Load-Engaging Elements For Cranes (AREA)
Description
Denne oppfinnelse vedrører distraksjonsapparat for å opprettholde brukne ledd under heling og har en hoved, dog ikke på noen måte eksklusiv, anvendelse i behandlingen av intra-artikkulære frakturdislokasjoner av leddene i hånden. Leddskader resulterer ofte i forflyttningen av de innvendige komponenter i leddet og av benfragmenter som er blitt brudt og feilplassert ved skaden. This invention relates to distraction apparatus for maintaining broken joints during healing and has a main, though by no means exclusive, application in the treatment of intra-articular fracture dislocations of the joints in the hand. Joint injuries often result in the displacement of the internal components of the joint and of bone fragments that have been broken and misplaced by the injury.
Ved behandlingen av slike skader kreves det ofte å skape traksjon over et ledd slik at komponentene derav holdes i passende relative anbringelser under helingsprosessen. Imidlertid er det også fordelaktig i visse tilfeller å tillate forsiktig styrt bevegelse av leddet som hjelper til å forme de uregelmessige overflater og hindre eventuell stivhet. In the treatment of such injuries, it is often required to create traction over a joint so that its components are held in appropriate relative positions during the healing process. However, it is also beneficial in certain cases to allow carefully controlled movement of the joint which helps to shape the irregular surfaces and prevent possible stiffness.
Et formål med den foreliggende oppfinnelse er å tilveiebringe et distraksjonsapparat for intra-artikkulære falangeale og metakarpo-falangeale frakturer, som er lett å anvende med redusert operativ tid, er allsidig med hensyn til omfanget som graden av distraksjon kan lett endres under helingsprosessen, og som tillater noe bevegelse på stedet. An object of the present invention is to provide a distraction device for intra-articular phalangeal and metacarpophalangeal fractures, which is easy to use with reduced operative time, is versatile with regard to the extent to which the degree of distraction can be easily changed during the healing process, and which allowing some movement on site.
Ifølge den foreliggende oppfinnelse er det tilveiebragt distraksjonsapparat for å fastholde ledd som har brudd under heling, omfattende minst to stifter som har deler for innføring i ben, en proksimal til og den andre distal til det skadede sted, med det resterende av lengden av stiftene ragende eksternt og generelt normalt til aksen gjennom stedet, og ettergivende midler for å bestemme og på ettergivende måte opprettholde den relative avstand mellom de innførte deler av stiftene, for derved å fastholde komponentene i leddet, kjennetegnet ved et par ettergivende forbindelseselementer som er tilpasset for å feste eksternt og direkte til og mellom stiftene ved adskilte posisjoner derpå. According to the present invention, there is provided a distraction device for immobilizing a fractured joint during healing, comprising at least two pins having portions for insertion into bone, one proximal to and the other distal to the injured site, with the remainder of the length of the pins protruding externally and generally normal to the axis through the site, and resilient means for determining and resiliently maintaining the relative distance between the inserted parts of the pins, thereby retaining the components in the joint, characterized by a pair of resilient connecting elements adapted to attach externally and directly to and between the pins at separate positions thereon.
Utførelsesformer av oppfinnelsen skal nå beskrives, kun i eksempels form, med henvisning til de vedlagte tegninger der: Fig. 1 illustrerer en stift som danner del av anordningen, Fig. 2 er et forstørret riss av en ende av stiften som er vist i fig. 1, Fig. 3 er et tilsvarende forstørret riss av del av et forbindelsesorgan som danner del av apparatet, Fig. 4 og 5 skjematisk viser hvorledes apparatet anvendes på et fingerledd, og Fig. 6 og 7 tilsvarende illustrerer hvorledes en modifisert form av apparatet kan anvendes hhv. på en ankelskade og på en tibial platåskade. Embodiments of the invention will now be described, by way of example only, with reference to the attached drawings where: Fig. 1 illustrates a pin which forms part of the device, Fig. 2 is an enlarged view of one end of the pin shown in fig. 1, Fig. 3 is a correspondingly enlarged view of part of a connecting member which forms part of the device, Figs. 4 and 5 schematically show how the device is used on a finger joint, and Figs. 6 and 7 correspondingly illustrate how a modified form of the device can used respectively on an ankle injury and on a tibial plateau injury.
Idet det vises til fig. 1-3, omfatter apparatet I alt vesentlig et par stifter 10 av meget rengjort rustfritt stål, rundt 98 mm i lengde og med en hoveddel av sin lengde ca. 2 mm i diameter. Slik det kan ses delvis I fig. 2, er i en enderegion 11 av hver stift dens diameter redusert til 1,5 mm over en lengde av rundt 10 mm fra en avsmalnet eller konisk ende 12. Referring to fig. 1-3, the device essentially comprises a pair of pins 10 of highly cleaned stainless steel, around 98 mm in length and with a main part of its length approx. 2 mm in diameter. As can be seen partially in fig. 2, in an end region 11 of each pin its diameter is reduced to 1.5 mm over a length of about 10 mm from a tapered or tapered end 12.
En underkuttet ringformet skulder 13 er tilveiebragt ved posisjonen som er adskilt fra enden 12 hvor diameteren av stiften er redusert. An undercut annular shoulder 13 is provided at the position separated from the end 12 where the diameter of the pin is reduced.
Slik det skal beskrives i forhold til fig. 4 og 5, vil lengden av delen 11 som har redusert diameter bli valgt i hht. den ønskede dybde av bengjennomtrengning, og skulderen 13 hindrer stiften fra å passere ytterligere gjennom benet. As it will be described in relation to fig. 4 and 5, the length of the part 11 which has a reduced diameter will be chosen according to the desired depth of bone penetration, and the shoulder 13 prevents the pin from passing further through the bone.
Langs den resterende lengden av hver stift 10 ved 1 cm intervaller, er dens diameter redusert ved hjelp av spor 14 som har ca. 0,5 mm dybde. Along the remaining length of each pin 10 at 1 cm intervals, its diameter is reduced by means of grooves 14 having approx. 0.5 mm depth.
Fig. 3 illustrerer del av en I et par trådfjærer 15 av rustfritt stål som er formet i en serpentinmåte som gir vekselvis smale og brede seksjoner 16 og 17 med bredde hhv. 1,5 mm og 2,5 mm. Hver fjær 15 har rundt 8 turn gjennom sin lengde, og av paret av fjærer som er tilveiebragt i apparatet vil en være en tråd som er 1 mm i diameter, mens den andre vil være mindre med ca. 0,7 mm i diameter. Fig. 3 illustrates part of a I pair of wire springs 15 of stainless steel which are shaped in a serpentine manner which gives alternately narrow and wide sections 16 and 17 with widths resp. 1.5 mm and 2.5 mm. Each spring 15 has around 8 turns throughout its length, and of the pair of springs provided in the apparatus, one will be a wire 1 mm in diameter, while the other will be smaller by approx. 0.7 mm in diameter.
Idet det nå vises til fig. 4 og 5, er apparatet i dette eksempel anvendt på et fingerledd med brudd, ved initielt å innføre endene 12 av stiftene 10 inn i og gjennom benet, proksimalt og distalt relativt skadestedet 18. I det eksempel som er vist har partiene 11 på de to stiftene med redusert diameter forskjellige lengder for derved å rage fullstendig gjennom to forskjellige tykkelser av ben uten å strekke seg forbi dette. Referring now to fig. 4 and 5, the device in this example is used on a finger joint with a fracture, by initially introducing the ends 12 of the pins 10 into and through the bone, proximally and distally relative to the site of injury 18. In the example shown, the parts 11 on the two the reduced diameter pins different lengths to thereby protrude completely through two different thicknesses of bone without extending beyond this.
Innføringen av stiftene vil finne sted under generell eller lokal bedøvelse (anestesi), og så mens strekk tilføres fingeren, blir den tykkere av de to fjærene 15 festet til og mellom stiftene 10, idet dens posisjon langs disse bestemmes ved stedet i de første eller andre spor 14 nær fingeren. Dette har virkningen av å bevege de frie endene av stiftene fra hverandre, og deretter blir den andre og mer ettergivende av de to fjærene 15 påført for derved å tvinge de frie endene av stiftene sammen i en kontrollert utstrekning for å utføre den ønskede mengde av distraksjon av leddet. Graden av distraksjon kan initielt fikseres og deretter endres lett ved å bevege de to fjærene nærmere eller å adskille de ytterligere langs trådene, eller ved å justere antallet av turn for en eller begge fjærer mellom stiftene. Den endelige posisjonen kan kontrolleres ved hjelp av røntgen, og så snart komponenten i leddet med brudd holdes i riktig innbyrdes forhold, kan en steril polstret bandasje påføres den skadede fingeren. Fjærene 15 kan festes ved å tilføre en liten mengde av blandet hurtigsettende polymer og monomer hvor fjærene er festet til stiftene, og de for store lengder av The introduction of the staples will take place under general or local anesthesia (anaesthesia), and then while tension is applied to the finger, the thicker of the two springs 15 is attached to and between the staples 10, its position along these being determined by the location in the first or second track 14 near the finger. This has the effect of moving the free ends of the staples apart and then the second and more compliant of the two springs 15 is applied to thereby force the free ends of the staples together to a controlled extent to effect the desired amount of distraction of the joint. The degree of distraction can be initially fixed and then easily changed by moving the two springs closer or further apart along the threads, or by adjusting the number of turns of one or both springs between the pins. The final position can be checked by X-ray, and once the component of the fractured joint is held in proper relationship, a sterile padded bandage can be applied to the injured finger. The springs 15 can be attached by adding a small amount of mixed quick-setting polymer and monomer where the springs are attached to the pins, and those for large lengths of
r< r<
tråden og fjærene kan fjernes ved kutting slik at den polstrede bandasjen kan omslutte hele apparatet. Apparatet har liten vekt og er av minimal hindring slik at pasienten kan fortsette normale aktiviteter og kan ses av legen med regelmessige intervaller når ytterligere røntgeninspeksjoner kan foretas for å bestemme utviklingen av behandlingen. Så snart leddet er helet, blir fjærene og stiftene fjernet, hvilket etterlater det helede leddet I en selv-understøttende modus. the wire and springs can be removed by cutting so that the padded bandage can enclose the entire appliance. The device is light weight and of minimal hindrance so that the patient can continue normal activities and can be seen by the doctor at regular intervals when further X-ray inspections can be made to determine the progress of the treatment. Once the joint is healed, the springs and pins are removed, leaving the healed joint in a self-supporting mode.
Distraksjonsapparatet som her er beskrevet kan anvendes i eksisjonartoplasti av de proksimale interfalangeale eller de metakarpo-falangeale ledd, så lenge som de kollatterale ligamenter ikke rives opp. Det kan anvendes i tilfeller med falangeale brudd eller metakarpale brudd ved å anvende forsiktig distraksjon initielt for å opprettholde reduksjon over en passende periode som følges av forsiktig kompressjon inntil benforeningen er oppnådd. The distraction device described here can be used in excision arthroplasty of the proximal interphalangeal or metacarpophalangeal joints, as long as the collateral ligaments are not torn open. It can be used in cases of phalangeal fractures or metacarpal fractures by applying gentle distraction initially to maintain reduction over an appropriate period followed by gentle compression until bony union is achieved.
Ved på passende måte å øke målestokken av delene i appa-raturen, kan den anvendes på andre intra-artikulære brudd, slik som de som er vist I fig. 6 og 7, f.eks. splintrings-brudd av den distale enden av radius, distalenden av skinnbenet (tibia) eller av skinnbensplatået (tibialplatået). I disse tilfeller kan stiftene 10a, for plassering, gjenges sentralt, slik som vist ved 20, og strekke seg gjennom stedet for mottagelse av fjærer 15a mellom respektive hosliggende sporforsynte enderegioner av de to stiftene. I denne utførelsesform er diameterene av stiftene 10a konstante (bortsett fra sporene 14) idet minste mellom basisen av den koniske enden og den fjerntliggende enden av den gjengede delen 20. By suitably scaling up the parts of the apparatus, it can be applied to other intra-articular fractures, such as those shown in fig. 6 and 7, e.g. splinting-fracture of the distal end of the radius, the distal end of the shinbone (tibia) or of the shinbone plateau (tibial plateau). In these cases, the pins 10a, for placement, can be threaded centrally, as shown at 20, and extend through the location for receiving springs 15a between respective adjacent grooved end regions of the two pins. In this embodiment, the diameters of the pins 10a are constant (except for the grooves 14) being the smallest between the base of the tapered end and the distal end of the threaded portion 20.
Claims (8)
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| GB888803680A GB8803680D0 (en) | 1988-02-17 | 1988-02-17 | Distraction compression spring system treatment of intra-articular fractures |
| PCT/GB1989/000170 WO1989007421A1 (en) | 1988-02-17 | 1989-02-17 | Distraction apparatus for maintaining fractured joint orientation |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| NO903506D0 NO903506D0 (en) | 1990-08-09 |
| NO903506L true NO903506L (en) | 1990-08-09 |
Family
ID=26293502
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| NO90903506A NO903506L (en) | 1988-02-17 | 1990-08-09 | DRAFT APPLIANCE FOR AA MAINTAINING ORIENTATION OF USED LINK. |
Country Status (2)
| Country | Link |
|---|---|
| AU (1) | AU624364B2 (en) |
| NO (1) | NO903506L (en) |
Family Cites Families (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| GB1472097A (en) * | 1974-12-11 | 1977-04-27 | Rizh Nii Travmatol I Ortoped | Surgical compression-distraction instrument |
-
1989
- 1989-02-17 AU AU31904/89A patent/AU624364B2/en not_active Ceased
-
1990
- 1990-08-09 NO NO90903506A patent/NO903506L/en unknown
Also Published As
| Publication number | Publication date |
|---|---|
| AU624364B2 (en) | 1992-06-11 |
| NO903506D0 (en) | 1990-08-09 |
| AU3190489A (en) | 1989-09-06 |
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