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
  • A61B17/72—Intramedullary pins, nails or other devices
  • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
• • 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
  • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
  • A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression

Definitions

• the invention relates to an intramedullary device for fixation, compression and traction of the femur in the treatment of various kinds of fractures, and is used in the field of orthopaedics and traumatology.
• interlocking nails In order to avoid this negative moment of the intramedullary osteosynthesis, the so-called interlocking nails have recently been invented and applied, said nails having holes in their top and bottom ends. Screws are inserted through the proximal and the distal fragments and respectively through the holes of the medullary nails. Thus the fragments get blocked and the above-mentioned dislocations are avoided. This is what the inventors call static fixation. If no transverse screw is inserted through one of the fragments, it gets free and axially pressed to the fixed fragment, this being
• the so-called external fixators are also used in practice.
• a great number of Kirschner wires or pins are inserted through the skin into the fragments, the outer ends of said pins being affixed to a system of metal planes, rods and screws placed outside the human body. This system moves the wires or pins, and the fragments together with them, to one or another direction.
• the external fixators are used for the treatment of some kinds of fresh fractures, delayed union and non-union of fractures, lengthening or shortening of limbs, and some other orthopaedic cases. They are useful also in the treatment of infected fractures.
• fixators In some types of fixators:
• the device consists of two metal tubes with different diameters, situated coaxially one inside the other and having a profile similar to that of a Kuntscher nail.
• a screw situated therein, whose length may vary depending on the case.
• the top end of the screw passes through a bearing welded to the outer tube, a stopper being situated under and above the bearing.
• transverse holes are drilled transverse holes at an equal distance (1 -2 cm) from each other.
• Under the distal hole there is a longitudinal slot on each of the two sides of the outer tube, the length of which can vary.
• the slider also has holes of the same size as those on the outer tube, but in its distal part. Above the holes, there are longitudinal slots cut bilaterally on the slider and having a size corresponding to the slots on the outer tube. Thus the holes on the outer tube are disposed exactly opposite the slots on the slider, and the holes on the slider are disposed the same way opposite the slots on the outer tube.
• the top end of the outer tube is cylindrical and has outside threads at a length of approximately 1 cm.
• Fig. 1. represents a scheme of the principles of operation of an intramedullary device for fixation, compression and traction of the femur.
• an intramedullary device for fixatioh, compression and traction of the femur consists of two metal tubes (4, 5) with different diameters, coaxially disposed one inside the other. Both tubes have a profile similar to that of a Kuntscher nail.
• the inner tube or slider (5) has in its top end threads with a feeding screw ( 1 ) disposed therein.
• the top end of the screw ( 1 ) passes through a bearing (2) welded to the outer tube, and under and above the bearing there is disposed a stopper (3).
• a stopper (3) Located under the bottom end of the screw ( 1 ) there are transverse holes drilled on the opposite sides of the outer tube (4) at an equal distance ( 1 -2 cm) from each other.
• the slider (5) Under the distal hole there is a longitudinal bilateral slot cut on the outer tube (4), whose length may vary.
• the slider (5) also has holes of the same size as those on the outer tube, but in its distal part. Above them, there are bilateral longitudinal slots on the slider having a size corresponding to the slots on the outer tube. Thus the holes on the outer tube are disposed exactly opposite the slots on the slider, while the holes on the slider are disposed the same way opposite the slots on the outer tube.
• the top end of the outer tube is cylindrical and has outside threads at a length of 1 cm.
• the construction of the present device allows a telescoping movement of the inner tube towards the outer one.
• the system comprising the two tubes and the feeding screw is introduced into the medullar canal of the two fragments by means of a tubular driver, which is screwed on the top end of the outer tube.
• a target device through the proximal and the distal fragments there are inserted one or two (depending on the case) transverse screws having a diameter of 5 mm (6) and passing through the two opposite walls of the bone (7) and through the respective holes and slots on the metal tubes as well. So installed, the system can serve as a static fixator like the interlocking nails.
• the surgeon turns the longitudinal screw to one or another direction by means of a screw driver placed through the tubular driver. Due to the constantly acting forces of compression or traction in the system, the latter is rather stable, so that the surgeon does not have to try to insert it tightly into the femur canal in every case.
• the proper length of the device applied is to be complied with the fracture site level.
• the top end of the tubular driver is left to stick a little bit out of the skin. It is covered by a sterile dressing and is opened only when accomplishing the daily lengthening, which is usually from 1 to 1 ,5 mm. The driver is unscrewed and removed after the lengthening has been accomplished, and the wound is sutured.
• the . intramedullary device for fixation, compression and traction of the femur possesses the possibilities both of the interlocking nails for static fixation and those of the external fixators for dynamic compression and traction, avoiding at the same time the above-mentioned disadvantages of those methods. That is why it takes priority over the interlocking nails or external fixators in all cases, except for cases of infected fractures or infected non-union fractures.
• Zickel.R.E. An intramedullary fixation device for proximal part of the femur: nine years experience. J. Bone Joint. Surg. 58-A.866.1976

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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)

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Cited By (5)

Citations (2)

• 1998
  • 1998-11-11 BG BG102912A patent/BG63619B1/bg unknown
• 1999
  • 1999-11-11 WO PCT/BG1999/000025 patent/WO2000027298A1/en active Application Filing

Patent Citations (2)

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