US2998007A - Internal tubular splint for the fixation of bone fractures and method of applying it - Google Patents

Internal tubular splint for the fixation of bone fractures and method of applying it Download PDF

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Publication number
US2998007A
US2998007A US566305A US56630556A US2998007A US 2998007 A US2998007 A US 2998007A US 566305 A US566305 A US 566305A US 56630556 A US56630556 A US 56630556A US 2998007 A US2998007 A US 2998007A
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splint
tube
bone
fixation
slots
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US566305A
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Herzog Kurt
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    • 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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7266—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly

Definitions

  • the present invention relates to a tubular internal splint for the fixation of fractured bones.
  • fractures may be treatedby the insertion of a splint into the osseous tube by knocking the splint through the upper fragment of bone (i.e. that nearer the body) beyond the point of fracture into the lower fragment of bone (i.e. that further from the body) and to leave the splint in position until the fracture has healed, and then to withdraw it.
  • Conventional splints of this kind are of an elastic material capable of both longitudinal and transverse deformation. To make full use of the elasticity of the material the cross section of the splint must be slightly compres sible during insertion to ensure that the splint firmly applies itself to the inner walls of the cavity by re-expanding after compression. This is necessary to guard against any subsequent relative displacement of the two fractured ends.
  • the desired fixation of the fractured bone cannot be adequately secured by using a split, transversely elastic, splint because the osseous tube is not an ideal tube inasmuch as its tubular cavity is constricted in the middle part of the bone and widens out towards either end.
  • a conventional splint of this kind will therefore only lie against the middle of the bone. If adequate contact is nevertheless to be enforced the dimensions of the splint in relation to the internal diameter of the osseous tube must be comparatively large. This entails the risk of splitting the bone and of the splint seizing on the internal osseous wall. Moreover, excessive pressure may give rise to undesirable infiammations and lead to the decomposition of the osseous structure itself.
  • the object of the tubular splint constructed according to the present invention to eliminate these decisive defects that are inherent in known types of internal splint. More particularly, the introduction of the splint into the osseous tube with the aid of a guide pin is to be rendered more safe, and capable of being performed without producing more than slight radial pressure upon the inner walls of the cavity. At the same time, the possibility must be created of preventing in the most effective possible way the occurrence of relative movement between the fractured ends of the bone once the fragments have been aligned, so as to promote the process of healing by allowing the fracture to be loaded axially by having Patented Aug. 29, 1961 to support the natural Weight at the earliest possible time. Moreover, the novel splint is to be adaptable more particularly to the internal fixation of tibial fractures in the case of which known splints fail or can be supplied only with greatest of difficulty.
  • the stated problem is solved by the provision of a tubular splint open at both ends and of a wall section suflicient to prevent transverse deformation under the conditions prevailing in an operation of this kind.
  • the splint walls are provided with longitudinal slots through which contact can be established between the portions of marrow entering the splint and the portions remaining outside.
  • the upper end of the tube is curved so that it can be easily forced into the bone from the tuberosity below the knee, and equally easily removed.
  • the lower end of the tube may be bevelled inside and out, the bevel surfaces being orientated in a direction which corresponds with that of the bend at the upper end of the splint.
  • the slits are arranged on the tube substantially along a line which begins on the inside of the upper bent end and extends symmetrically thereto in the downward direction. Additional slots on either side of this line may be disposed anywhere along the tube according to the nature of the fracture that is to be treated.
  • the slots offer the possibility of allowing elastically sprung, straight bent, or helically wound, wires to project from the inside of the tube and to anchor themselves in the cancellus (spong-iosa) in a manner calculated to prevent relative displacement of the fractured parts.
  • Insertion of the wires is performed by guiding for instance the bent end of the wire down the unslotted portion inside the tube, twisting the wire when its end is level with one of the slots, and pushing it out until it enters the spongiosa. If wires of siutable section are used two or more may be introduced in this manner and pushed out into the cancellus (spongiosa).
  • the slots on the inside of the upper bent portion are particularly convenient for withdrawing the splint from the bone, a matter of especial significance in the treatment of a tibial fracture because the extracting hook can be inserted from the front of the bone without a great deal of preliminary probing. If the hook is suitable for insertion into the tube, probing to find the slot will be practically unnecessary.
  • the back of the bent portion of the tube contains a further opening in line with the tube axis which provides a passage for the guide pin.
  • FIG. 1 is a general view of the splint
  • FIG. 2 shows the lower end of the tube in section, with an outline indicating the inner osseous wall
  • FIG. 3 shows the splint inserted into a fractured femur
  • FIG. 4 shows the splint inside a femur fractured near the knee
  • FIG. 4a is a detailed perspective view of an upper end of the splint and its associated parts
  • FIG. 5 shows the splint inside a tibia likewise fractured near the knee.
  • the splint 1 consists of a drawn steel tube. As is customary in such applications the steel is corrosion resistant. For an external diameter of say 8 mm. the wall thickness of the tube would be 1.5 mm. and would therefore resist deformation under radial load.
  • the tube is open at both ends, the upper extremity being curved as shown at 2. Along a line 3, indicated by dots and dashes,
  • longitudinal slots 4 are provided in the tube wall, which may have been milled or sawn out in the usual manner. They can therefore be provided in greater or lesser number and have varying lengths according to the natureof the application taken in view.
  • the extraction hook engages the slots 5 when the splint is to be removed from the bone. The most convenient method is to insert the hook into the inside of the tube and it will be readily understood that engagement can be eflected without much preliminary probing. It is an advantage to provide two slots 5, one being a reserve slot if the other should tear out during extraction.
  • Two further slots 6 are arranged on either side of the line 3. Their purpose will be hereinafter described.
  • the conformation and disposition of the slots may, of course, dilfer from that shown in the example.
  • the slot 7 on the back of the bent portion aligns with the main axis of the splint.
  • This slot provides a passage for the guide pin, more particularly in the case of fractures near the joint when it is important to guide the splint until it has been driven onto position without hitting the guide pin.
  • the hammer blows can be confined to the end of the tube.
  • the lower end of the tube has two bevelled edges 8 and 9 the incidence of the bevelled surfaces being in conformity with the direction of the bond 2.
  • the inner bevel 8 prevents the tube from seizing on the previously inserted guide pin 10 and allows it to slip down smoothly.
  • the outside bevel 9 assures a smooth sliding movement down the bone wall 11, for instance the rear wall of a tibia.
  • FIG. 3 shows the splint inserted into a femur 12 fractured at 13.
  • the position shown in the drawing is that the lower fragment 14 has been set and aligned with the upper fragment 15 by means of a guide pin (cf. FIGS. 2, 10) and the splint 1 driven along the guide pin into the lower'fragment 14.
  • the drawing shows the splint after the guide pin has been withdrawn.
  • Two spring wires 16 and 17 have been pushed down the inside of the tube, their leading ends 16' and 17 sliding down the inside wall where no slots are provided, so that they cannot pass to'the outside through the slots 4 and 5. As soon as the Wires have been pushed down for enough to be level with slots 6 they are twisted and pushed through the said slots to the outside.
  • FIG. 4 it is also possible to force wires 2% and 21 through slots in such manner as to perforate both compact (compacta) and soft tissues.
  • 22 indicates a wire which has been pushed right through the bone of the lower part 14 of the fractured member into the soft tissues.
  • 23 shows the manner in which the lower end of the wire can be deformed and looped back and the upper end 24 twisted over the edge of the splint 1 to ensure a really reliable anchorage.
  • This procedure also allows the surfaces 13, of the fracture to be axially drawn tightly together.
  • a suitable external retaining pin can be passed through the slot 5 and a corresponding slot in the opposite wall of the tubular splint 1.
  • FIG. 4 further discloses that the upper end of the tubular splint need not be bent for the treatment of a fractured femur.
  • FIG. 5 shows a, tibia 25 fractured at 13 near the knee joint.
  • the internal splint 1 has been inserted into the osseous tube, and a wire 26 bent back at an acute angle has been pushed into the splint and then threaded through a slot 28 by withdrawing it in the upward direction.
  • the wire can be pulled into the cancellus (spongiosa) of the upper part of the bone.
  • Removal of the wire is effected by first pushing it downwards into the splint 1 and then extracting it together with the splint.
  • the bent upper portion of the splint prevents it from twisting in the upper part of the bone especially if it is allowed slightly to project-perhaps 1 to 2 mm.-from the top of the bone.
  • An internal tubular splint for the fixation of long medullated bones that have fractured said splint being open at each end and being transversely undeformable during insertion into the bone, one end' of said splint being curved, said splint having at least one longitudinal slot along the inner line of the curve and at least one longitudinal slot along the outer line of the curve, a plurality of longitudinal slots aligned along the line of the tube continuing. the inner line of the said curve and an additional aligned slots which are along the uncurved portion of the splint and along lines not co-incident with the lineofsaid first mentioned aligned slots.
  • a tubular internal splint for longitudinally setting fractured long medullated bones said splint having a wall strength sufficient to prevent transverse deformation, said splint being open at both ends, the tubular wall of the splint having a, continuous longitudinal area and a plurality of separate longitudinal slots to permit elastic anchoring wires passing alongthe said area and then being turned to pass through selected slots from the tubular wall, said tubular wallhaving in the region, of its lower open end an external bevel and having at its opposite peripheral zone an internal, bevel.
  • a tubular internal splint according to claim 2 said longitudinal slots opening forwardly, rearwardly and sidewardly in the wall of the splint.
  • splint device for the fixation of long tubular medullated bones that have been fractured, comprising in combination a tubular internal splint for insertion along the length of the bone and at least one anchoring element therefor, said tubular splint having a wall which remains transversely rigid during insertion into the bone and being open at both ends and having closed-ended longitudinal slots in and a continuous unslotted part along said wall, and said anchoring element being an elongated resilient element longitudinally displaceably arranged in elastically flexed condition in the inside of the splint with its leading end slidable along said continuous unslotted part. of the inside of said wall of the splint and insertable through one of said closed ended longitudinal slots.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Neurology (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)
US566305A 1955-02-19 1956-02-17 Internal tubular splint for the fixation of bone fractures and method of applying it Expired - Lifetime US2998007A (en)

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
DEH23046A DE1054659B (de) 1955-02-19 1955-02-19 Rohrfoermiger Knochennagel

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Cited By (58)

* Cited by examiner, † Cited by third party
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US3791380A (en) * 1971-12-13 1974-02-12 G Dawidowski Method and apparatus of immobilizing a fractured femur
US3846846A (en) * 1972-09-28 1974-11-12 Fischer Artur Hip joint prosthesis
US3986504A (en) * 1974-10-25 1976-10-19 Rafael Pares Avila Internal fixation device for securing two fractured bone joints together
US4011863A (en) * 1976-07-19 1977-03-15 Zickel Robert E Supracondylar prosthetic nail
US4055172A (en) * 1973-07-18 1977-10-25 Josef Ender Nail and set for correctly resetting fractured bones for their immediate re-use
US4135507A (en) * 1977-05-20 1979-01-23 Harris Leslie J Condylocephalic nail for fixation of pertrochanteric fractures
US4169470A (en) * 1977-10-19 1979-10-02 Ender Hans G Surgical nail for use in setting bone fractures, and tool for emplacing same
US4457301A (en) * 1982-06-18 1984-07-03 Howmedica Inc. Intramedullary fixation device
US4475545A (en) * 1982-12-06 1984-10-09 Ender Hans G Bone-nail
US4503847A (en) * 1982-01-15 1985-03-12 Howmedica, Inc. Prosthetic nail
US4854312A (en) * 1988-04-13 1989-08-08 The University Of Toledo Expanding intramedullary nail
EP0332857A1 (fr) * 1988-03-14 1989-09-20 Synthes Ag Chur Clou endo-médullaire tibial pour le traitement des fractures de la jambe
EP0517435A1 (fr) * 1991-06-01 1992-12-09 Orthopaedic Research Limited Halifax Dispositif intramédullaire pour l'ostéosynthèse
GB2256802B (en) * 1991-06-01 1995-10-25 Dr Subhash Chandra Halder Improvements in or relating to bone support
WO1995031942A1 (fr) * 1994-05-20 1995-11-30 Francesco Saverio Santori Dispositif intramedullaire permettant l'enclouage d'os longs
US5478342A (en) * 1994-06-30 1995-12-26 Spinetech, Inc. Reversible bone screw lock
EP0738502A2 (fr) * 1995-04-20 1996-10-23 Halifax Orthopaedic Research Limited Support intramédullaire d'un os
US5603715A (en) * 1992-03-20 1997-02-18 Kessler; Sigurd Medullary pin
EP0922437A1 (fr) * 1997-12-11 1999-06-16 ORTOMEDICAL S.p.A. Clou intramédullaire destiné à l'ostéosynthèse de fractures osseuses
EP1090596A1 (fr) * 1999-08-30 2001-04-11 Sulzer Orthopedics Ltd. Clou intermédullaire pour l'humerus
US6261289B1 (en) * 1998-10-26 2001-07-17 Mark Levy Expandable orthopedic device
WO2002011632A1 (fr) * 2000-08-09 2002-02-14 Henrik Hansson Dispositif et moyen de fixation pour fixer des fragments osseux et reduire des fractures osseuses
WO2002071961A1 (fr) * 2001-02-15 2002-09-19 Carrilho De Castro Ilton Jose Clou verrouille par interpenetration en osteosynthese
US6554833B2 (en) 1998-10-26 2003-04-29 Expanding Orthopedics, Inc. Expandable orthopedic device
WO2004049963A1 (fr) * 2002-12-04 2004-06-17 Henrik Hansson Dispositif comportant des moyens de fixation en vue de fixer des fragments d'os au niveau de fractures osseuses
GB2404342A (en) * 2003-07-31 2005-02-02 Vineet Dev Tandon Inramedullary Nail
US20050159749A1 (en) * 2004-01-16 2005-07-21 Expanding Orthopedics, Inc. Bone fracture treatment devices and methods of their use
US7052498B2 (en) 1998-10-26 2006-05-30 Expanding Orthopedics, Inc. Expandable orthopedic device
WO2006124764A1 (fr) * 2005-05-18 2006-11-23 Sonoma Orthopedic Products, Inc. Dispositifs de fixation des os a effraction minimale, systemes et methodes d'utilisation
US20070083205A1 (en) * 2005-09-26 2007-04-12 Mohamed Attawia Tissue augmentation, stabilization and regeneration Technique
US20080009869A1 (en) * 2004-12-31 2008-01-10 Andre Schlienger Intramedullary nail
US20080255560A1 (en) * 2004-05-21 2008-10-16 Myers Surgical Solutions, Llc Fracture Fixation and Site Stabilization System
EP2292166A1 (fr) * 1998-09-10 2011-03-09 DePuy Products, Inc. Système de fixation de fracture
US7909825B2 (en) 2006-11-22 2011-03-22 Sonoma Orthepedic Products, Inc. Fracture fixation device, tools and methods
US20110087227A1 (en) * 2008-12-18 2011-04-14 Mazur Kal U Bone fixation device, tools and methods
US8128627B2 (en) 2007-03-22 2012-03-06 Sonoma Orthopedic Products, Inc. Segmented intramedullary system and apparatus
US20120165950A1 (en) * 2010-12-23 2012-06-28 Rainer Baumgart Implantable prosthesis for replacing a human hip or knee joint and the adjoining bone sections
US20120259373A1 (en) * 2009-08-27 2012-10-11 Houdin Dehnad Bone implants for the treatment of infection
US8287541B2 (en) 2005-05-18 2012-10-16 Sonoma Orthopedic Products, Inc. Fracture fixation device, tools and methods
US20130274747A1 (en) * 2012-04-13 2013-10-17 Orthopedic Designs North American, Inc. Intramedullary Nail System with Tang Fixation after Lock Screw Placement
US8663224B2 (en) 2010-09-09 2014-03-04 DePuy Synthes Products, LLC Surgical nail
US20140066932A1 (en) * 2012-08-30 2014-03-06 Andreas Appenzeller Intramedullary Fixation Assembly
US8961516B2 (en) 2005-05-18 2015-02-24 Sonoma Orthopedic Products, Inc. Straight intramedullary fracture fixation devices and methods
US8979846B2 (en) 2004-04-12 2015-03-17 Navin N Thakkar Flexible nail assembly for fractures of long bones
US9060820B2 (en) 2005-05-18 2015-06-23 Sonoma Orthopedic Products, Inc. Segmented intramedullary fracture fixation devices and methods
US9138219B2 (en) 2010-12-29 2015-09-22 Tarsus Medical Inc. Methods and devices for treating a syndesmosis injury
US9155574B2 (en) 2006-05-17 2015-10-13 Sonoma Orthopedic Products, Inc. Bone fixation device, tools and methods
US9433449B2 (en) 2012-04-13 2016-09-06 Orthopedic Designs North America, Inc Intramedullary nail system including tang-deployment screw with male interface
US9452242B2 (en) 2014-06-11 2016-09-27 Silver Bullet Therapeutics, Inc. Enhancement of antimicrobial silver, silver coatings, or silver platings
US9770278B2 (en) 2014-01-17 2017-09-26 Arthrex, Inc. Dual tip guide wire
US9789298B2 (en) 2010-11-12 2017-10-17 Silver Bullet Therapeutics, Inc. Bone implant and systems that controllably releases silver
US9814499B2 (en) 2014-09-30 2017-11-14 Arthrex, Inc. Intramedullary fracture fixation devices and methods
US9821094B2 (en) 2014-06-11 2017-11-21 Silver Bullet Therapeutics, Inc. Coatings for the controllable release of antimicrobial metal ions
US9937055B1 (en) 2016-11-28 2018-04-10 Spine Wave, Inc. Scoring implant trial and implant inserter for spinal fusion system
US9968464B2 (en) 2014-01-17 2018-05-15 Spine Wave, Inc. Spinal fusion system
US10265435B2 (en) 2009-08-27 2019-04-23 Silver Bullet Therapeutics, Inc. Bone implant and systems and coatings for the controllable release of antimicrobial metal ions
US10888435B2 (en) 2017-10-05 2021-01-12 Spine Wave, Inc. Modular inserter for anterior cervical cage
US20210177465A1 (en) * 2018-08-18 2021-06-17 University Of Saskatchewan Implant for bone fracture stabilization

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AU593008B2 (en) * 1985-08-27 1990-02-01 Zimmer S.A. Boring sensor for intramedullary nail and corresponding intramedullary nail
FR2602665B1 (fr) * 1986-08-13 1988-11-04 Zimmer Sa Sonde de percage pour un clou intramedullaire et clou intramedullaire approprie
FR2586554B1 (fr) * 1985-08-27 1988-05-20 Zimmer Sa Sonde de guidage, de positionnement et de percage pour clou medullaire et clou medullaire approprie
DE3734108A1 (de) * 1987-10-06 1989-04-20 Mecron Med Prod Gmbh Marknagel fuer die behandlung von knochenbruechen
DE3734111A1 (de) * 1987-10-06 1989-04-20 Mecron Med Prod Gmbh Marknagel fuer die behandlung von knochenbruechen nach dem prinzip der markraumnagelung und marknagel-werkzeug
US5281225A (en) * 1989-06-07 1994-01-25 Guglielmo Vicenzi Intramedullary pin with self-locking end for metadiaphyseal fractures of long bones
FR2668920A1 (fr) * 1990-11-14 1992-05-15 Medic Instr Implant pour os fracture et gabarit de pose.
FR2722395B1 (fr) * 1994-07-18 1996-11-15 Bellon Jacques Broche a effet expansif pour osteosynthese centro-medullaire

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FR893401A (fr) * 1940-02-05 1944-06-08 Cheville ou clou d'enchevillement pour os tubulaires
US2239088A (en) * 1940-03-30 1941-04-22 Joe J Ettinger Fracture nail
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US2396276A (en) * 1943-06-11 1946-03-12 Bocjl Corp Expansible prong device
US2631584A (en) * 1948-07-22 1953-03-17 Alfred T Purificato Fracture securing instrument
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Cited By (100)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US3791380A (en) * 1971-12-13 1974-02-12 G Dawidowski Method and apparatus of immobilizing a fractured femur
US3846846A (en) * 1972-09-28 1974-11-12 Fischer Artur Hip joint prosthesis
US4055172A (en) * 1973-07-18 1977-10-25 Josef Ender Nail and set for correctly resetting fractured bones for their immediate re-use
US3986504A (en) * 1974-10-25 1976-10-19 Rafael Pares Avila Internal fixation device for securing two fractured bone joints together
US4011863A (en) * 1976-07-19 1977-03-15 Zickel Robert E Supracondylar prosthetic nail
US4135507A (en) * 1977-05-20 1979-01-23 Harris Leslie J Condylocephalic nail for fixation of pertrochanteric fractures
US4169470A (en) * 1977-10-19 1979-10-02 Ender Hans G Surgical nail for use in setting bone fractures, and tool for emplacing same
US4503847A (en) * 1982-01-15 1985-03-12 Howmedica, Inc. Prosthetic nail
US4457301A (en) * 1982-06-18 1984-07-03 Howmedica Inc. Intramedullary fixation device
US4475545A (en) * 1982-12-06 1984-10-09 Ender Hans G Bone-nail
EP0332857A1 (fr) * 1988-03-14 1989-09-20 Synthes Ag Chur Clou endo-médullaire tibial pour le traitement des fractures de la jambe
US4854312A (en) * 1988-04-13 1989-08-08 The University Of Toledo Expanding intramedullary nail
EP0517435A1 (fr) * 1991-06-01 1992-12-09 Orthopaedic Research Limited Halifax Dispositif intramédullaire pour l'ostéosynthèse
GB2256802B (en) * 1991-06-01 1995-10-25 Dr Subhash Chandra Halder Improvements in or relating to bone support
US5603715A (en) * 1992-03-20 1997-02-18 Kessler; Sigurd Medullary pin
WO1995031942A1 (fr) * 1994-05-20 1995-11-30 Francesco Saverio Santori Dispositif intramedullaire permettant l'enclouage d'os longs
US5478342A (en) * 1994-06-30 1995-12-26 Spinetech, Inc. Reversible bone screw lock
EP0738502A2 (fr) * 1995-04-20 1996-10-23 Halifax Orthopaedic Research Limited Support intramédullaire d'un os
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EP0922437A1 (fr) * 1997-12-11 1999-06-16 ORTOMEDICAL S.p.A. Clou intramédullaire destiné à l'ostéosynthèse de fractures osseuses
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DE1054659B (de) 1959-04-09
FR1146824A (fr) 1957-11-15

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