WO1999047061A1 - Instrument for repositioning and fixation of wrist fractures - Google Patents

Instrument for repositioning and fixation of wrist fractures Download PDF

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Publication number
WO1999047061A1
WO1999047061A1 PCT/SE1999/000393 SE9900393W WO9947061A1 WO 1999047061 A1 WO1999047061 A1 WO 1999047061A1 SE 9900393 W SE9900393 W SE 9900393W WO 9947061 A1 WO9947061 A1 WO 9947061A1
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WO
WIPO (PCT)
Prior art keywords
ulna
distraction
instrument according
screw
relative
Prior art date
Application number
PCT/SE1999/000393
Other languages
French (fr)
Inventor
Carl-Göran HAGERT
Original Assignee
Scandimed International Ab
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Scandimed International Ab filed Critical Scandimed International Ab
Priority to AU29680/99A priority Critical patent/AU2968099A/en
Publication of WO1999047061A1 publication Critical patent/WO1999047061A1/en

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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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin

Definitions

  • the present invention relates to an instrument for repositioning and fixation of fractures on the radius of the forearm with its ulna as support.
  • the fracture is normally easy to correct but in practically every case a dislocation recurs, which many times leads to lasting disabilities in the hand and/or wrist.
  • the usual treatment includes a plaster brace only, but in cases with large dislocations or extensive breaking into splinters of the fracture surfaces, fixation is carried through with skin-penetrating screws in the forearm and in the metacarpal bone of the forefinger, and these screws are connected to a 20 cm long metallic rod.
  • This instrument is a so called external fixator.
  • the object of the present invention has been to provide an instrument which eliminates the abovementio- ned problems .
  • the instrument according to the invention has the characterizing features of subsequent claim 1. Since the instrument has said characterizing features, the following advantages are obtained: 1) the instrument permits repositioning and fixation of the proximal fragment at wrist fractures;
  • the instrument is easy for the patient to carry;
  • fig. 1 is a section through the forearm in a so called neutral position with the radius in frontal projection and the ulna in side or lateral projection and a dis ⁇ located fracture through the distal portion of the radius
  • fig. 2 illustrates the forearm of fig. 1 with the radius in lateral projection with its dislocated fracture and the ulna in frontal projection
  • fig. 3 illustrates the distal portion of the forearm of fig. 1 with the fracture reduced and the instru- ment according to the invention applied
  • fig. 4 is a section through portions of the instrument of fig. 3
  • fig. 5 illustrates the distal portion of the forearm of fig. 3 with an alternative embodiment of the instrument according to the invention.
  • the ulna of the forearm illustrated in the figures has reference numeral 1, the radius 2, the fracture in the radius 3 , the proximal fragment of the radius 4 and its distal fragment 5.
  • the proximal fragment 4 can, in relation to the ulna 1, be displaced in ulnar direction A (fig. 1) or in palmar direction B (fig. 2) .
  • the distal fragment 5 can, relative to the ulna 1, be rotated in radial direction C (fig. 1) and in dorsal direction D (fig. 2) .
  • an instrument 6 which, according to the invention, in its simplest form may consist of a single elongated distraction means 7 for removing the proximal fragment 4 of the radius 2 from the ulna 1, i.e. from a dislocation FS to normal position NS.
  • a simple form of distraction means 7 is a screw 8 having an outer portion 9, e.g. a screw head 10, adapted for cooperation with a screw driving tool (not shown) .
  • a first part 11 with circular cross-section is associated with the screw head 10 and includes suitable first means for fixing the screw 8 to the ulna 1.
  • This first means can be external threads 12 which preferably are of self- -tapping type for cutting threads in the ulna 1.
  • a se- cond part 13 is associated with the first part 11 and both parts 11, 13 have such length that the distraction means 7 can perform said removal of the proximal fragment 4.
  • the second part 13 has other, second means 14 for fixing the proximal fragment 4 in order to prevent movement, e.g. lateral movement and/or rotation thereof relative to the distraction means 7.
  • This second means may be an inner end portion 14 which is adapted to engage the surface 15 of the part of the proximal fragment 4 facing the ulna 1.
  • the instrument 6 may further comprise an elongated fixing means 16 for preventing the distal fragment 5 from moving in radial rotation C and/or dorsal rotation D relative to the ulna 1.
  • the fixing means 16 may also be used, at insertion thereof in the distal fragment 5, to reduce or set said fragment regarding the rotative dislocation in two planes.
  • said latter means may comprise one or more passages 17, 18 through which the elongated fixing means 16 can be inserted.
  • the passa- ges 17, 18 can extend diagonally through the screw head 10 and be directed in such a way that a fixing means 16 running through such a passage 17 or 18, extends with an angle between the longitudinal centre line CI of the distraction means 7 and the longitudinal centre line C2 of the fixing means 16 within an interval of 30-45°, preferably about 40° (as shown in fig. 4) .
  • the angle ⁇ (fig. 4 ) between the two passages 17, 18 may be 60-90°, i.e. twice the angle .
  • the fixing means 16 may be an elongated wire 19 (or tin rod) , the first part 20 of which is located in one of the passages 17 or 18 and can be fixed therein to the distraction means 7 by means of a mounting means 21, e.g. a screw after a second part 22 of the wire has been inserted into the distal fragment 5.
  • FIG. 5 An alternative to the instrument described above is illustrated in fig. 5 in which the reference numerals for the members having the same function have been maintained from the instrument according to figs. 3 and 4.
  • the distraction means 7 of fig. 5 is also a screw 8 having an outer portion 9 , a first and a second part 11 and 13 and an inner end portion 14.
  • the screw head 10 in the embodiment of figs. 3 and 4 is lacking at the embodiment of fig. 5, which means that the entire distraction means 7 can be located under the skin with less risk for infections .
  • the inner end portion 14 also has a transverse recess 23 , whereby two points 24, 25 are defined which are adapted to engage the surface 15.
  • the instrument 6 of fig. 5 includes a fixing means 16 which is designed in another way than the wire 19 and which unlike the wire 19 is not attached to the distraction means 7 but directly to the ulna 1.
  • the fixing means 16 according to the embodiment of fig. 5 consists of a screw 26 having an outer portion 27, a first part 28 for fixation of the fixing means 16 to the ulna 1 and a second part 29 which is adapted to project into the distal fragment 5 of the radius 2.
  • the outer portion 27 of the screw 26 is preferably designed for cooperation with a screw driving tool in order to screw in and unscrew the screw 26 from the ulna 1 with ease.
  • the first part 28 of the screw 26 is provided with external threads 30, preferably of the self-tapping type, for fixing the screw 26 to the ulna 1.
  • the second part 29 of the screw 26 however, has no threads and is 6 .
  • the second part 29 may have an inner end portion 31 which preferably is similarly designed as the end portion 14 of the distraction means 7. Hereby, it is prevented that the distal fragment 5 can move relative to the screw 26.
  • the inner end portion 31 may have a transverse recess 32, whereby two points 33, 34 are defined which can engage the distal fragment 5.
  • the screw 26 is located a short distance from the screw 8 and the angle ⁇ between the screws 8 and 26 can be as large as between the distraction means 7 and the wire 19 at the embodiment of figs. 3 and 4.
  • the screw 26 is substantially longer than the screw 8 and the screws 8 , 26 may have the same diameter on the external threads 12, 30 and the same diameter on untapped parts.
  • the outer portions 9, 27 may have the same shape.
  • the distractions 7 and the fixing means 16 may have longitudinal passages 35, 36 (indicated with dashed and dotted lines in fig. 5) for threading onto elongated guide means 37, 38 which have been applied in advance. These guide means 37, 38 are adapted to facilitate mounting of the screws 8, 26.
  • the instrument 6 is applied by the following proce- dure, whereby the instrument 6 of fig. 5 has been chosen as example:
  • a bore hole Hi is prepared in the ulna 1 about 4-5 cm up from the wrist from the outer edge of the ulna 1 and in right angle or perpendicular to the longitudinal axis of the ulna 4; 3) the distraction means 7 is inserted with a good half of its length such that it runs through the cross- 7 .
  • the proximal fragment 4 of the radius 2 is lif- ted upwards with a special lifting hook (not shown) in dorsal direction F and the distraction means 7 is advanced or driven farther in such that it engages and gets a grip of the surface 15 of the proximal fragment 5 facing the ulna 1; 5) continued advancing of the distraction means 7 occurs, whereby the proximal fragment 4 is moved in radial direction G relative to the ulna 1, such that it reaches its normal position NS relative to the ulna 1 and is stabilized in this normal position NS by the distraction means;
  • both fragments 4 and 5 of the fracture of the radius are thereby fixed against the ulna 1 and the draw in the longitudinal direction of the forearm is removed.
  • the invention is not limited to the two embodiments described above but may vary within the scope of the 8 .
  • the distraction means 7 may be designed in other ways than as a screw 8
  • the distraction means 7 may further comprise a first part 11 with other means than external threads 12 for its fixation in the ulna 1
  • the inner end portion 14 may be designed in other ways for engagement with the surface 15 of the proximal fragment 4.
  • said means may be designed in other ways than as a wire 19 or a screw 26 and if it is a screw, it may have other means than external threads 30 for its fixation to the ulna 1.
  • the screw 8 defining the distraction means 7 and the screw 26 defining the elongated fixing means 16 may have the same diameter on the external threads 12 and 30 respectively, and identical or substantially identical outer portions 9 and 27 respectively, for the screw driving tool. Furthermore, the screw 26 constituting the fixing means 16 may have a substantially greater length than the screw 8 providing the distraction means 7. It should also be mentioned that the inner portion 14 of the distraction means 7 , by engaging or interfere with the surface of the proximal fragment 4 of the radius 2 , prevents or at least obstructs rotation of the distraction means 7 counter clockwise relative to the ulna 1 so that undesired unscrewing of said distraction means 7 from the ulna 1 is prevented or at least obstructed. At the embodiment of figs. 3 and 4, the elongated fixing means 16 prevents, thanks to its cooperation with the distraction means 7, rotation of said distraction means 7 relative to the ulna 1.

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  • Orthopedic Medicine & Surgery (AREA)
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Abstract

The present invention relates to an instrument for repositioning and fixation of fractures on the radius of the forearm with the ulna thereof as support. The instrument (6) comprises an elongated distraction means (7) having a first part (11) which is adapted for fixing said distraction means (7) to the ulna (1) and a second part (13) which is adapted to move and stabilize the proximal fragment (4) of the radius (2) relative to the ulna (1). The second part (13) is displaceable through a hole (H1) therefor provided in the ulna (1) until said second part (13) cooperates with the proximal fragment (4) of the radius (2) for moving said proximal fragment (4) from its dislocation (FS) to its normal position (NS) relative to the ulna (1). The first part (11) has first means (12) for fixing said distraction means (7) relative to the ulna (1) and the second part (13) has second means (14) for fixing the proximal fragment (4) of the radius (2) relative to said distraction means (7).

Description

1 .
Instrument for repositioning and fixation of wrist frac¬ tures .
The present invention relates to an instrument for repositioning and fixation of fractures on the radius of the forearm with its ulna as support.
Fractures on the radius of the forearm at the wrist, a so called distal radius fracture or Colles ' fracture, are the most common of all fractures with over 20.000 cases every year in Sweden only.
The fracture is normally easy to correct but in practically every case a dislocation recurs, which many times leads to lasting disabilities in the hand and/or wrist.
The usual treatment includes a plaster brace only, but in cases with large dislocations or extensive breaking into splinters of the fracture surfaces, fixation is carried through with skin-penetrating screws in the forearm and in the metacarpal bone of the forefinger, and these screws are connected to a 20 cm long metallic rod. This instrument is a so called external fixator.
In other cases pinning is carried through with skin- -penetrating pins. Particularly difficult cases, especially young people, might require surgery during which the fracture is completely exposed and the fragments joined by means of a plate and screws from various manufacturers . The classic description of the various dislocations of distal radius fractures or Colles ' fractures are related only to the distal fragment, while the proximal fragment in this connection is left without consideration. Consequently, all treatment has also been concen- trated upon resetting the dislocation of the distal fracture fragment, while the proximal fracture fragment has never been described as displaced and therefore, has never been included in the treatment. Close analyses of radiographs shows however, that the proximal fragment is also displaced. According to all methods of treatment hitherto used, the displacement of this fragment is never corrected. X-ray analyses show that the dislocation of the fracture thereby is never entirely cor- rected in all directions and the fracture fragments never satisfactory stabilized. This results in that the fracture too often will relocate in its originally erroneous position, particularly when only a plaster cast has been wrapped around the fracture. Treatment with the previously described external fixator is substantially more reliable for preventing displacement in the fracture, but except for being very troublesome for the patient to carry in 4-5 weeks for healing of the fracture, it is also afflicted with seve- ral different complications such as infection at the skin-penetrating screws and stiffening of the interpha- langeal joints. The frequency of complications is established for different materials to lie between 15 and 30%. The object of the present invention has been to provide an instrument which eliminates the abovementio- ned problems . The instrument according to the invention has the characterizing features of subsequent claim 1. Since the instrument has said characterizing features, the following advantages are obtained: 1) the instrument permits repositioning and fixation of the proximal fragment at wrist fractures;
2) the instrument is simple to handle for the surgeon;
3) the application is not really a surgical inter- vention - it should even be possible to carry through under local anesthesia in an emergency room, which means that the patient does not require care on a ward;
4) the instrument is easy for the patient to carry;
5) the instrument is removed under local anesthesia in a consulting room 4-5 weeks later.
The invention will be further described below with reference to the accompanying drawings, in which fig. 1 is a section through the forearm in a so called neutral position with the radius in frontal projection and the ulna in side or lateral projection and a dis¬ located fracture through the distal portion of the radius; fig. 2 illustrates the forearm of fig. 1 with the radius in lateral projection with its dislocated fracture and the ulna in frontal projection; fig. 3 illustrates the distal portion of the forearm of fig. 1 with the fracture reduced and the instru- ment according to the invention applied; fig. 4 is a section through portions of the instrument of fig. 3; and fig. 5 illustrates the distal portion of the forearm of fig. 3 with an alternative embodiment of the instrument according to the invention.
The ulna of the forearm illustrated in the figures has reference numeral 1, the radius 2, the fracture in the radius 3 , the proximal fragment of the radius 4 and its distal fragment 5. The proximal fragment 4 can, in relation to the ulna 1, be displaced in ulnar direction A (fig. 1) or in palmar direction B (fig. 2) .
The distal fragment 5 can, relative to the ulna 1, be rotated in radial direction C (fig. 1) and in dorsal direction D (fig. 2) .
In order to carry through distraction and stabilization of the proximal fragment 4 of the radius 2 and eventually also move its distal fragment 5 with the ulna 1 as support, an instrument 6 is used which, according to the invention, in its simplest form may consist of a single elongated distraction means 7 for removing the proximal fragment 4 of the radius 2 from the ulna 1, i.e. from a dislocation FS to normal position NS. A simple form of distraction means 7 is a screw 8 having an outer portion 9, e.g. a screw head 10, adapted for cooperation with a screw driving tool (not shown) . A first part 11 with circular cross-section is associated with the screw head 10 and includes suitable first means for fixing the screw 8 to the ulna 1. This first means can be external threads 12 which preferably are of self- -tapping type for cutting threads in the ulna 1. A se- cond part 13 is associated with the first part 11 and both parts 11, 13 have such length that the distraction means 7 can perform said removal of the proximal fragment 4. The second part 13 has other, second means 14 for fixing the proximal fragment 4 in order to prevent movement, e.g. lateral movement and/or rotation thereof relative to the distraction means 7. This second means may be an inner end portion 14 which is adapted to engage the surface 15 of the part of the proximal fragment 4 facing the ulna 1. The instrument 6 may further comprise an elongated fixing means 16 for preventing the distal fragment 5 from moving in radial rotation C and/or dorsal rotation D relative to the ulna 1. The fixing means 16 may also be used, at insertion thereof in the distal fragment 5, to reduce or set said fragment regarding the rotative dislocation in two planes. For insertion of the fixing means 16 into the distraction means 7, said latter means may comprise one or more passages 17, 18 through which the elongated fixing means 16 can be inserted. The passa- ges 17, 18 can extend diagonally through the screw head 10 and be directed in such a way that a fixing means 16 running through such a passage 17 or 18, extends with an angle between the longitudinal centre line CI of the distraction means 7 and the longitudinal centre line C2 of the fixing means 16 within an interval of 30-45°, preferably about 40° (as shown in fig. 4) .
The angle β (fig. 4 ) between the two passages 17, 18 may be 60-90°, i.e. twice the angle . Thereby, the rotation of the distraction means 7 can be limited to 180° for locating one of the passages 17 or 18 in desired position. The fixing means 16 may be an elongated wire 19 (or tin rod) , the first part 20 of which is located in one of the passages 17 or 18 and can be fixed therein to the distraction means 7 by means of a mounting means 21, e.g. a screw after a second part 22 of the wire has been inserted into the distal fragment 5.
An alternative to the instrument described above is illustrated in fig. 5 in which the reference numerals for the members having the same function have been maintained from the instrument according to figs. 3 and 4. The distraction means 7 of fig. 5 is also a screw 8 having an outer portion 9 , a first and a second part 11 and 13 and an inner end portion 14. The screw head 10 in the embodiment of figs. 3 and 4 is lacking at the embodiment of fig. 5, which means that the entire distraction means 7 can be located under the skin with less risk for infections .
At the embodiment of fig. 5 the inner end portion 14 also has a transverse recess 23 , whereby two points 24, 25 are defined which are adapted to engage the surface 15.
The instrument 6 of fig. 5 includes a fixing means 16 which is designed in another way than the wire 19 and which unlike the wire 19 is not attached to the distraction means 7 but directly to the ulna 1. Thus, the fixing means 16 according to the embodiment of fig. 5 consists of a screw 26 having an outer portion 27, a first part 28 for fixation of the fixing means 16 to the ulna 1 and a second part 29 which is adapted to project into the distal fragment 5 of the radius 2.
The outer portion 27 of the screw 26 is preferably designed for cooperation with a screw driving tool in order to screw in and unscrew the screw 26 from the ulna 1 with ease. The first part 28 of the screw 26 is provided with external threads 30, preferably of the self-tapping type, for fixing the screw 26 to the ulna 1. The second part 29 of the screw 26 however, has no threads and is 6 .
insertable into the distal fragment 5. The second part 29 may have an inner end portion 31 which preferably is similarly designed as the end portion 14 of the distraction means 7. Hereby, it is prevented that the distal fragment 5 can move relative to the screw 26. The inner end portion 31 may have a transverse recess 32, whereby two points 33, 34 are defined which can engage the distal fragment 5.
The screw 26 is located a short distance from the screw 8 and the angle α between the screws 8 and 26 can be as large as between the distraction means 7 and the wire 19 at the embodiment of figs. 3 and 4. The screw 26 is substantially longer than the screw 8 and the screws 8 , 26 may have the same diameter on the external threads 12, 30 and the same diameter on untapped parts. Furthermore, the outer portions 9, 27 may have the same shape. At the instrument 6 of figs . 3 and 4 as well as at the instrument 6 of fig. 5, the distractions 7 and the fixing means 16 may have longitudinal passages 35, 36 (indicated with dashed and dotted lines in fig. 5) for threading onto elongated guide means 37, 38 which have been applied in advance. These guide means 37, 38 are adapted to facilitate mounting of the screws 8, 26.
The instrument 6 is applied by the following proce- dure, whereby the instrument 6 of fig. 5 has been chosen as example:
1) the forearm is held in constant axial draw in the longitudinal direction, whereby the distal fragment 5, by pulling in ligaments in direction E, resumes its nor- mal position;
2) a bore hole Hi is prepared in the ulna 1 about 4-5 cm up from the wrist from the outer edge of the ulna 1 and in right angle or perpendicular to the longitudinal axis of the ulna 4; 3) the distraction means 7 is inserted with a good half of its length such that it runs through the cross- 7 .
-section of the ulna 1 into the space between the ulna 1 and the radius 2 , but without reaching the edge of the radius 2 facing the ulna 1;
4) the proximal fragment 4 of the radius 2 is lif- ted upwards with a special lifting hook (not shown) in dorsal direction F and the distraction means 7 is advanced or driven farther in such that it engages and gets a grip of the surface 15 of the proximal fragment 5 facing the ulna 1; 5) continued advancing of the distraction means 7 occurs, whereby the proximal fragment 4 is moved in radial direction G relative to the ulna 1, such that it reaches its normal position NS relative to the ulna 1 and is stabilized in this normal position NS by the distraction means;
6) the position of the distal fragment 5 of the radius 2 is fineadjusted from outside in direction H for location in its normal position NS relative to the proximal fragment 4; 7) while the draw in the longitudinal direction of the forearm is maintained, in inclined hole H2 is drilled
(at an angle α relative to the bore hole HI) through the ulna 1 closer to the wrist and a hole H3 is drilled or bored also through the surface of the distal fragment 5 facing the ulna 1;
8) the untapped second part 29 of the fixing means 16 is inserted into the inclined hole H2 in the ulna 1, while the first part 28 thereof is self-tapping therein, whereby said fixing means 16 is advanced until its end 31 reaches the inner side of the tip of the distal fragment 5 ;
9) both fragments 4 and 5 of the fracture of the radius are thereby fixed against the ulna 1 and the draw in the longitudinal direction of the forearm is removed. The invention is not limited to the two embodiments described above but may vary within the scope of the 8 .
subsequent claims. Thus, the distraction means 7 may be designed in other ways than as a screw 8, the distraction means 7 may further comprise a first part 11 with other means than external threads 12 for its fixation in the ulna 1, the inner end portion 14 may be designed in other ways for engagement with the surface 15 of the proximal fragment 4. If a fixing means 16 is used, said means may be designed in other ways than as a wire 19 or a screw 26 and if it is a screw, it may have other means than external threads 30 for its fixation to the ulna 1.
The screw 8 defining the distraction means 7 and the screw 26 defining the elongated fixing means 16 may have the same diameter on the external threads 12 and 30 respectively, and identical or substantially identical outer portions 9 and 27 respectively, for the screw driving tool. Furthermore, the screw 26 constituting the fixing means 16 may have a substantially greater length than the screw 8 providing the distraction means 7. It should also be mentioned that the inner portion 14 of the distraction means 7 , by engaging or interfere with the surface of the proximal fragment 4 of the radius 2 , prevents or at least obstructs rotation of the distraction means 7 counter clockwise relative to the ulna 1 so that undesired unscrewing of said distraction means 7 from the ulna 1 is prevented or at least obstructed. At the embodiment of figs. 3 and 4, the elongated fixing means 16 prevents, thanks to its cooperation with the distraction means 7, rotation of said distraction means 7 relative to the ulna 1.

Claims

9. Claims :
1. Instrument for repositioning and fixation of fractures on the radius of the forearm with the ulna thereof as support, c h a r a c t e r i z e d i n that at least one elongated distraction means (7) includes a first part (11) which is adapted for fixing said distraction means (7) to the ulna (1) and a second part (13) which is adapted to move and stabilize the proximal fragment (4) of the radius (2) relative to the ulna (1) , that the second part (13) of the distraction means (7) is displaceable through a hole (Hi) therefor provided in the ulna (1) until said second part (13) cooperates with the proximal fragment (4) of the radius (2) for moving said proximal fragment (4) from its dislocation
(FS) to its normal position (NS) relative to the ulna (1) , that the first part (11) of the distraction means (7) has first means (12) for fixing said distraction means (7) relative to the ulna (1) such that said dist- raction means (7) remains in a set position relative thereto when said distraction means (7) stabilizes the proximal fragment (4) of the radius (2) in its normal position (NS) relative to the ulna (1) , and that the second part (13) of the distraction means (7) has second means (14) for fixing the proximal fragment (4) of the radius (2) relative to said distraction means (7) and prevent movement of said proximal fragment (4) of the radius (2) relative thereto.
2. Instrument according to claim 1, c h a r a c - t e r i z e d i n that the first means of the distraction means (7) on the first part (11) consists of external threads (12) through which said first part (11) is screwed onto the ulna (1) .
3. Instrument according to claim 2, c h a r a c - t e r i z e d i n that the external threads (12) of
10.
the first part (11) are of such self-tapping type that they cut threads in the ulna (1) .
4. Instrument according to any of claim 2 or 3 , c h a r a c t e r i z e d i n that the distraction means (7) is a screw (8) with an outer portion (9) which is designed or adapted for cooperation with a screw driving tool in order to screw or drive in the screw (8) into the ulna (1) or unscrew said screw (8) therefrom.
5. Instrument according to any of claims 1 - 4, c h a r a c t e r i z e d i n that the second means of the second part (13) consists of an inner end portion (14) which engages or interferes with the surface (15) of the proximal fragment (4) of the radius (2) and prevents lateral displacement of said proximal fragment (4) and/or rotation thereof relative to the distraction means (7) and thereby, relative to the ulna (1) .
6. Instrument according to claim 2 and/or 3 and/or 4 and/or 5, c h a r a c t e r i z e d i n that the second part (13) of the distraction means (7) engages or interferes with the surface (15) of the proximal fragment (4) of the radius (2) , which prevents or at least obstructs rotation of the distraction means (7) relative to the ulna (1) such that undesired unscrewing of the external threads (12) from the ulna (1) is prevented or at least obstructed.
7. Instrument according to claim 6, c h a r a c t e r i z e d i n that said second part (13) has at least an inner, relative to the distraction means (7) radially directed end portion (14) for preventing or at least obstructing rotation of said distraction means (7) .
8. Instrument according to any preceding claim, c h a r a c t e r i z e d i n that the instrument (6) comprises at least one elongated fixing means (16) having a first part (20 or 28) which is fixed relative to the ulna (1) and a second part (22 or 29) which projects into the distal fragment (5) of the radius (2) for preventing rotation thereof in radial direction (C)
11.
and/or dorsal direction (D) .
9. Instrument according to claim 8, c h a r a c ¬ t e r i z e d i n that the elongated fixing means (16) , at insertion of the second part (22) thereof into the distal fragment (5) of the radius (2), presses said dis¬ tal fragment (5) outwards in a radial-distal direction (E and H) relative to the proximal fragment (4) of the radius (2 ) .
10. Instrument according to claim 8 or 9, c h a - r a c t e r i z e d i n that the angle (α) between longitudinal centre lines (CI and C2) for the distraction means (7) and elongated fixing means (16) is within an interval of 30-45°, preferably about 40°.
11. Instrument according to any of claims 8 - 10, c h a r a c t e r i z e d i n that the distraction means (7) is provided with at least one through-passage (17 and/or 18) for the first part (20) of the elongated fixing means (16) , that said through-passage (17 and/or 18) is inclined relative to a longitudinal centre line (CI) for the distraction means (7) , that the first part (20) of the elongated fixing means (16) extends through said passage (17 or 18) and is fixed to the distraction means (7) and that a substantial portion of the second part (22) of the elongated fixing means (16) projects into the distal fragment (5) of the radius (2) .
12. Instrument according to claim 11, c h a r a c t e r i z e d i n that said passages (17, 18) are displaced 60-90° relative to each other.
13. Instrument according to claim 11 or 12 , c h a - r a c t e r i z e d i n that the first part (20) of the elongated fixing means (16) is fixed to a screw-head like outer portion (10) of the distraction means (7) by means of at least one mounting means (21) .
14. Instrument according to any of claims 8 - 13, c h a r a c t e r i z e d i n that the elongated fixing means (16) is an unthreaded wire (19) .
12.
15. Instrument according to any of claims 8 - 14, c h a r a c t e r i z e d i n that the elongated fixing means (16) thanks to its cooperation with the distraction means (7) , prevents rotation of said dist- raction means (7) relative to the ulna (1) .
16. Instrument according to claims 8 - 10, c h a r a c t e r i z e d i n that the second part (22) of the elongated fixing means (16) can be moved through a hole (H2) provided in the ulna (1) and inserted into a hole (H3) provided in the distal fragment (5) of the radius (2) and that the first part (28) of the elongated fixing means (16) has first means (30) for fixing said elongated fixing means (16) to the ulna (1) such that said fixing means (16) remains in a set position rela- tive to said ulna (1) .
17. Instrument according to claim 16, c h a r a c t e r i z e d i n that said first means on the first part (28) of the elongated fixing means (16) consists of external threads (30) through which said first part (28) is screwed onto the ulna (1) .
18. Instrument according to claim 17, c h a r a c t e r i z e d i n that the external threads (30) are of such self-tapping type that they cut threads in the ulna (1) .
19. Instrument according to claim 17 or 18, c h a r a c t e r i z e d i n that the elongated fixing means (16) is a screw (26) with an outer portion (27) which is designed or adapted for cooperation with a screw driving tool for driving in or advancing the screw (26) into the ulna (1) or unscrewing said screw (26) therefrom.
20. Instrument according to claim 4 and 19, c h a r a c t e r i z e d i n that the screw (8) defining the distraction means (7) and the screw (26) defining the elongated fixing means (16) have the same diameter on the external threads (12 and 30 respectively) and identical or substantially identical outer portions (9
13.
and 27 respectively) for the screw driving tool and that the screw (26) constituting the fixing means (16) has a substantially greater length than the screw (8) providing the distraction means (7) and an unthreaded second part (29) of substantial length.
21. Instrument according to any of claims 1 - 7, c h a r a c t e r i z e d i n that the distraction means (7) has a longitudinal passage (35) for threading said distraction means (7) onto an elongated guide means (37) which is mounted beforehand and adapted to guide the distraction means (7) when said distraction means (7) is applied.
22. Instrument according to any of claims 8 - 19, c h a r a c t e r i z e d i n that the elongated fixing means (16) is provided with a longitudinal passage (36) for threading said fixing means (16) onto an elongated guide means (38) which is mounted beforehand and adapted to guide the elongated fixing means (16) when said fixing means (16) is applied.
PCT/SE1999/000393 1998-03-16 1999-03-15 Instrument for repositioning and fixation of wrist fractures WO1999047061A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU29680/99A AU2968099A (en) 1998-03-16 1999-03-15 Instrument for repositioning and fixation of wrist fractures

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
SE9800844A SE510973C2 (en) 1998-03-16 1998-03-16 Instruments for repositioning and fixation of wrist fractures
SE9800844-4 1998-03-16

Publications (1)

Publication Number Publication Date
WO1999047061A1 true WO1999047061A1 (en) 1999-09-23

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ID=20410546

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/SE1999/000393 WO1999047061A1 (en) 1998-03-16 1999-03-15 Instrument for repositioning and fixation of wrist fractures

Country Status (3)

Country Link
AU (1) AU2968099A (en)
SE (1) SE510973C2 (en)
WO (1) WO1999047061A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2010065855A1 (en) * 2008-12-05 2010-06-10 Synthes Usa, Llc Anchor-in-anchor system for use in bone fixation
US8882838B2 (en) 2008-06-05 2014-11-11 DePuy Synthes Products, LLC Articulating disc implant
US9060808B2 (en) 2008-12-05 2015-06-23 DePuy Synthes Products, Inc. Anchor-in-anchor system for use in bone fixation
US9084646B2 (en) 2008-03-26 2015-07-21 DePuy Synthes Products, Inc. Universal anchor for attaching objects to bone tissue
US9168148B2 (en) 2008-06-05 2015-10-27 DePuy Synthes Products, Inc. Articulating disc implant

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2489870A (en) * 1946-03-02 1949-11-29 Dzus William Bone fastening device
EP0298400A1 (en) * 1987-07-08 1989-01-11 Wasserstein, Isidor, Prof. Dr. med. Apparatus for fixing bone fragments

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US2489870A (en) * 1946-03-02 1949-11-29 Dzus William Bone fastening device
EP0298400A1 (en) * 1987-07-08 1989-01-11 Wasserstein, Isidor, Prof. Dr. med. Apparatus for fixing bone fragments

Cited By (12)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9084646B2 (en) 2008-03-26 2015-07-21 DePuy Synthes Products, Inc. Universal anchor for attaching objects to bone tissue
US10045804B2 (en) 2008-03-26 2018-08-14 Depuy Synthes, Inc. Universal anchor for attaching objects to bone tissue
US8882838B2 (en) 2008-06-05 2014-11-11 DePuy Synthes Products, LLC Articulating disc implant
US9168148B2 (en) 2008-06-05 2015-10-27 DePuy Synthes Products, Inc. Articulating disc implant
US10154910B2 (en) 2008-06-05 2018-12-18 DePuy Synthes Products, Inc. Articulating disc implant
WO2010065855A1 (en) * 2008-12-05 2010-06-10 Synthes Usa, Llc Anchor-in-anchor system for use in bone fixation
US8591513B2 (en) 2008-12-05 2013-11-26 DePuy Synthes Products, LLC Anchor-in-anchor system for use in bone fixation
US9060808B2 (en) 2008-12-05 2015-06-23 DePuy Synthes Products, Inc. Anchor-in-anchor system for use in bone fixation
US9204911B2 (en) 2008-12-05 2015-12-08 DePuy Synthes Products, Inc. Anchor-in-anchor system for use in bone fixation
EP2954862A1 (en) * 2008-12-05 2015-12-16 Synthes GmbH Anchor-in-anchor system for use in bone fixation
US9480507B2 (en) 2008-12-05 2016-11-01 DePuy Synthes Products, Inc. Anchor-in-anchor system for use in bone fixation
US9636154B2 (en) 2008-12-05 2017-05-02 DePuy Synthes Products, Inc. Anchor-in-anchor system for use in bone fixation

Also Published As

Publication number Publication date
SE9800844L (en) 1999-07-19
AU2968099A (en) 1999-10-11
SE510973C2 (en) 1999-07-19
SE9800844D0 (en) 1998-03-16

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