Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
  • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
  • A61B17/17—Guides or aligning means for drills, mills, pins or wires
  • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
• • 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
  • A61B17/74—Devices for the head or neck or trochanter of the femur
  • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
  • A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
• • 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
  • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30329—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2002/30331—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementarily-shaped recess, e.g. held by friction fit
  • A61F2002/30332—Conically- or frustoconically-shaped protrusion and recess
  • A61F2002/30339—Double cones, i.e. connecting element having two conical connections, one at each of its opposite ends
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
  • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
  • A61F2002/30604—Special structural features of bone or joint prostheses not otherwise provided for modular
  • A61F2002/30616—Sets comprising a plurality of prosthetic parts of different sizes or orientations
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/32—Joints for the hip
  • A61F2/36—Femoral heads ; Femoral endoprostheses
  • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
  • A61F2002/3625—Necks
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
  • A61F2/02—Prostheses implantable into the body
  • A61F2/30—Joints
  • A61F2/32—Joints for the hip
  • A61F2/36—Femoral heads ; Femoral endoprostheses
  • A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
  • A61F2002/3652—Connections of necks to shafts
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
  • A61F2220/00—Fixations or connections for prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
  • A61F2220/0025—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements
  • A61F2220/0033—Connections or couplings between prosthetic parts, e.g. between modular parts; Connecting elements made by longitudinally pushing a protrusion into a complementary-shaped recess, e.g. held by friction fit

Definitions

• the invention relates more particularly to the reduction and fixation of fractures of the upper end of the femur, without excluding other bone ends.
• osteosynthesis solutions can be considered. Mention may be made, for example, of pins, nails and plates arranged to receive a cephalic screw.
• the invention relates more particularly, the plates
• these plates have a shaped support portion to be fixed at the level of the diaphysis of the bone.
• the upper end of the support part has a hollow hollow sleeve, also known as a barrel. This barrel is oriented angularly with respect to the support part and receives the cephalic screw.
• the barrel and the support part constitute a monobloc element.
• connection between the two constituent parts is likely to be embedded in the upper end of the femur, causing a fracture.
• the object of the invention is to remedy these drawbacks in a simple, safe, efficient and rational manner.
• the problem which the invention proposes to solve is to design a set of implants which is particularly suitable for 35 osteosynthesis of the femur bone to significantly reduce the stock, while respecting precisely the major axis of the cervix.
• the assembly comprises in combination, in a modular and interchangeable manner:
• the end of the plate has angularly, a centering surface shaped to receive with locking capacity in translation and in rotation, a coupling sleeve .
• the centering surface is constituted by a conical bore cooperating with a complementary conical surface, formed at one of the ends of the sleeve.
• either the conical bearing is formed in coaxial alignment with the body of the sleeve.
• a lug appears in overflow at the level of the connection part between the conical bearing surface and the body of the sleeve. , to cooperate with arrangements formed at the end of the centering surface.
• the arrangements consist of two diametrically opposite notches.
• the cephalic screw must be placed in the middle of the neck, along its long axis, which, in general, makes an angle of 130 ° with the diaphysis. It is therefore the cephalic screw which gives place to the barrel and consequently to the support plate.
• a spindle which acts as a guide and which is oriented by a viewfinder, most often held manually.
• An image intensifier is used to try to determine this axis.
• the viewfinder allows you to push in the spindle at the angle it gives.
• Holding the viewfinder in your hand is not very precise. If the aiming is carried out incorrectly, that is to say when the aiming angle does not exactly correspond to the angle formed between the barrel and the support plate, the latter cannot be applied against the diaphysis femoral. Yes despite everything, we want to apply the plate to the diaphysis, the barrel is subjected to a reaction force which acts in a harmful way on the fracture site.
• a device which comprises a viewfinder equipped with an angularly orientable block, arranged to receive according to different positions, an aiming pin to determine the axis of the neck, said viewfinder being held in position by a spacer device cooperating with the faces of the bone and the soft parts.
• the viewfinder comprises a base on which is mounted with the ability to move in translation and adjust in position, a support receiving the orientable block mounted with the ability to adjust the angle on two profiled arms. in an arc.
• Another problem which the invention proposes to solve is to keep the viewfinder in place, while having both hands free.
• the spacer device has two gripping arms coupled to a support member cooperating with the viewfinder, the faces of the bone and the soft parts, said legs acting by elasticity on said member being held in the locking position with the organ by an adjustable angular locking system.
• Figure 1 is a perspective view showing the main elements of the prosthetic assembly according to the invention.
• Figure 2 is a sectional view showing the reduction of a trochanteric fracture using the prosthetic assembly.
• Figure 3 is a sectional view showing the different angular orientations of the sleeves relative to the plate.
• Figure 4 is a cross-sectional view taken along line 4.4 of Figure 2.
• Figure 5 is a perspective view showing the main elements of the delivery device.
• Figure 6 shows the use of the device for aiming the long axis.
• Figure 7 is a cross-sectional view taken along line 7.7 of Figure 6.
• the prosthetic assembly according to the invention comprises a series of support plates (1), a series of coupling sleeves (2), and a series of cephalic screws (3).
• Each of the support plates (1) has, in a known manner, a series of holes (1a) for fixing it at the level of the femoral shaft.
• the cross section of the plate (1) is very slightly concave to adapt to the anatomical shape of the femur.
• the upper end of the plate (1) has angularly, a centering surface (1b).
• This litter (1b) is shaped to allow coupling in a removable manner, sleeves (2), with locking capacity in translation and in rotation.
• the centering surface (1b) has a through conical bore (1 b1) cooperating with a complementary conical surface (2a) formed at one end of the sleeve corresponding (2).
• This assembly by cones (1 b1) (2a) ensures the locking in translation of the sleeve (2) relative to the plate (1).
• the coupling sleeve (2) is executed in different dimensions and is arranged to be oriented in different angular positions, relative to the centering surface
• the conical centering surface (2a) is either formed in coaxial alignment with the body (2b) of the sleeve (2), or angularly offset relative to the body ( Figures 1 and 3).
• the angulation between the bearing surface (2a) and the body (2b) can be 3 °, 6 ° and 10 °.
• the angulation between the centering surface (1 b) and the plate (1) is of the order of 130 °, corresponding to the anatomical angle between the major axis of the neck and the external side of the femur.
• each of said sleeves (2) has a lug ( 2c) intended to cooperate with arrangements formed at the end of said centering surface (1b).
• the cephalic screws (3) are produced in a perfectly known manner -, Q, with a threaded head (3a) and a rod (3b) mounted to slide freely in the bore (2d) of the corresponding sleeve (2) and of the centering surface (1b), the bore of which opens into the support plate (1a).
• the rod (3b) is locked in rotation by means of flats (3b1) cooperating with flats formed in the bore (2d) of the sleeve (2).
• a device which essentially comprises a viewfinder (4) and a spacer device (5).
• the viewfinder (4) comprises a base (4a) on which is mounted with capacity for movement in translation and for position adjustment, a support (4b).
• the support (4b) is mounted to slide freely in the base (4a) by a dovetail system, while a screw (6), engaged in a lumen of said support, ensures the locking in translation .
• an orientable block (4c) On the support (4b) is mounted an orientable block (4c) arranged to receive at different positions, an aiming rod (7) to determine the axis of the neck.
• the block (4c) is articulated at the end of the support (4b) and cooperates with two arms profiled in an arc (4d) while being angularly blocked therein in a corresponding lumen, by means of a system 5 quote.
• the block (4c) has a series of holes (4c1) arranged in alignment, but offset angularly relative to the perpendicular plane passing through the major axis of the viewfinder.
• the holes (4c1) are offset by + 5 °, + 10 °, - 5 °, - 10 °.
• the spacer (5) has two gripping branches (5a) and
• the member (5c) has a cross section in the shape of an inverted U to cover the cross section of the viewfinder (4), in particular of the support (4b) by presenting two wings (5c1) and
• each of the wings has, overflowing their internal faces, pins (5c3) intended to grip the bone.
• the 5 branches (5a) and (5b) act by elasticity on the member (5c), in particular on the vertical wings (5c1) and (5c2) of this member.
• the retractor (5) is slid into the open position on the faces of the bone between the latter and the soft parts.
• a bearing action on the branches (5a) (5b) has the effect of bringing the wings (5c1) (5c2) by elasticity thereby ensuring the 5 securing the viewfinder (4) on the bone.
• the system (8) (9) maintains the position.
• the viewfinder (4) is placed on the bone, being held there by the retractor (5).
• the orientable block (4c) is adjusted to the desired angulation (generally 130 ° thus corresponding to the cervico-diaphyseal angle).
• a pin is placed in the hole (O) of the block, while an image intensifier makes it possible to check whether the point of penetration of the pin is correct. If it is too high, the base is moved back relative to the support.
• the spindle After having correctly determined the penetration orifice, the spindle is pushed in, following it to the amplifier. If the front axis is not perfect, we change the angulation of the blade holder and we then know the new anguiation. After checking the spindle from the front, the amplifier checks the profile position. If the spindle is not strictly in the axis of the neck, it is removed and placed at + 5 or - 5 ° in ( fe orientable block. Since the plane of the spindle is stationary, any aiming of + 10 ° to - 10 ° is necessarily perfect on the face.

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• Health & Medical Sciences (AREA)
• Surgery (AREA)
• Life Sciences & Earth Sciences (AREA)
• Orthopedic Medicine & Surgery (AREA)
• Biomedical Technology (AREA)
• Public Health (AREA)
• Veterinary Medicine (AREA)
• Engineering & Computer Science (AREA)
• Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
• Heart & Thoracic Surgery (AREA)
• Medical Informatics (AREA)
• Molecular Biology (AREA)
• Animal Behavior & Ethology (AREA)
• General Health & Medical Sciences (AREA)
• Dentistry (AREA)
• Oral & Maxillofacial Surgery (AREA)
• Neurology (AREA)
• Prostheses (AREA)
• Surgical Instruments (AREA)

Priority Applications (1)

Applications Claiming Priority (2)

Publications (1)

Family

ID=9426536

Family Applications (1)

Country Status (4)

Cited By (13)

Families Citing this family (19)

Citations (7)

• 1992
  • 1992-02-05 FR FR9201529A patent/FR2686788A1/fr not_active Withdrawn
• 1993
  • 1993-01-29 JP JP5513819A patent/JPH06509490A/ja active Pending
  • 1993-01-29 EP EP93904137A patent/EP0578807A1/de not_active Withdrawn
  • 1993-01-29 WO PCT/FR1993/000095 patent/WO1993015678A1/fr not_active Application Discontinuation

Patent Citations (7)

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