WO2001043652A1 - Compression bone nail - Google Patents

Compression bone nail Download PDF

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Publication number
WO2001043652A1
WO2001043652A1 PCT/EP2000/011595 EP0011595W WO0143652A1 WO 2001043652 A1 WO2001043652 A1 WO 2001043652A1 EP 0011595 W EP0011595 W EP 0011595W WO 0143652 A1 WO0143652 A1 WO 0143652A1
Authority
WO
WIPO (PCT)
Prior art keywords
characterized
bone nail
nail according
compression
compression bone
Prior art date
Application number
PCT/EP2000/011595
Other languages
German (de)
French (fr)
Inventor
Wolfram Mittelmeier
Original Assignee
Wolfram Mittelmeier
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
Priority to DE1999160507 priority Critical patent/DE19960507A1/en
Priority to DE19960507.6 priority
Application filed by Wolfram Mittelmeier filed Critical Wolfram Mittelmeier
Publication of WO2001043652A1 publication Critical patent/WO2001043652A1/en

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Classifications

    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7241Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7216Intramedullary pins, nails or other devices for bone lengthening or compression
    • A61B17/7225Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression

Abstract

The invention relates to a compression bone nail (1) for compressing bone fragments (17a, 17b) pertaining to a bone (17). The inventive compression bone nail comprises an elongated nail body (2) provided with longitudinal slots (4, 5) at one end for receiving interlocking-securing means (7, 8) for a bone fragment (17a). At least one sliding body (9) which can be inserted into the nail body (2) is provided with a guide bore (10) that receives a first interlocking-securing means (7). The sliding body (9) tapers in a direction towards the middle of the nail body (2) and contacts a second interlocking-securing means (8) by means of a contact surface (11). A tensing element engages with the end of the nail body (2) and forces the sliding body (9) with the contact surface (11) against the second interlocking-securing means (8).

Description

Compression bone pin

The invention relates to a compression bone nail for the compression of Knocnenfragmenten a bone.

A bone nail or an intramedullary nail used for the treatment of fractures, defective positions under and Langen, in particular in the long bones. To avoid a long-term Bettlagerigkeit or immobilization of bone fragments surgically reunited by osteosynthesis. For some time intramedullary nail to be used, the slit m a longitudinal direction of the bone nail and cloverleaf cross-section or V-shape formed nail use. Here, a Verklem ¬ mung is achieved in the marrow cavity of the bone by the transverse pipe Profll-elasticity.

With such Mark nailing however, a sufficient stability can be awarded only to the bone when it is relatively simple bone fracture in which the bone fracture pieces or bone fragments are braced against each other over the bone nail. In Trummerbruchen the bone may durcn force, such as the train the muscle sheath or through an external load to a co ¬ deformation-bone fracture pieces come to the bone nail. This has a partially significant Knochenverkurzung and taking out printing the bone pin end of the bone at the point of impact m the Korperweichteile result.

To use the intramedullary nail even with Trummerbruchen without risk of interaction diving, hence the so-called. De- was tentionsnagel developed. The locking of the intramedullary nail he ¬ follows with respect to the bone fragments by proximal and distal Bohrlocher with transverse and partly also scnrag extending bone screws or bolts. Through these nailing gross displacements of the bone fragments through the central splinting bone nail is avoided and ensures a high degree of Rotationsstabilitat.

However, AuCN to Detention nail does not provide sufficient stability, since the slotted bone nail has a low Verbmdungssteifigkeit and the fracture pieces are able to move to the Bohrflachen m result of lack of pressure compression under the influence of bending and twisting forces against each other. A major problem consists in, above all, that the durcn round cross bores of the Detention nail m can leading bolt the bone fracture stuccoes not together back, so that by the optional distance between the bone fragments, and by the mechanical agitation due to the insufficient stability of a serious fault can occur in bone healing. By applying a mechanical compression or compression osteosynthesis Knochenfragmenten- be created much more favorable cure conditions to cure Knochenbru- chen. In the mechanical compression fragment is increased by elastic tension and increasing the friction on the Knocnenbruchstelle the stability, at the same time larger disturbing the healing process relative movements of the bone fracture or bone fragments pieces is avoided.

A lock compression intramedullary nail, the (Interlockmg Compression Nail = ICN) is called ICN intramedullary nail, is based on a proximal compression mechanism through a comparison πegelungsbolzen and a distal double locking. In this compression nail better stabilization is achieved by axial Vorkom ¬ pression of the nail bone system along the bone nail axis. By a central axia ¬ le compression screw it is screwed into an internal thread at the pro- imum nail end of the bone nail for applying a force to the locking bolt and the locking bolt. The locking bolt is supported in ei ¬ nem long slot of the bone nail and thus beweglicn laterally. the locking bolt including associated with the locking pin bone fragment is moved distally by turning the compression screw. In this way, the introduction of additional compression forces or pressure forces is possible m the bone fracture. The compres- onsvernagelung offers significant advantages posted for the Materlaibeanspruchung beyond. While it is in the non-biased locking nailing through the intermittent, various functional force effects to unfavorable fatigue loads with suction. Zero-Come, which can lead, under certain circumstances to Ermudungsbruchen of screws and nails, are formed with a sufficient high mechanical preload by the compression screw, due to the functional load only modulating loads without zero through swing. The material is less heavily loaded. However, the ICN compression bone nail achieved also partially sufficient mechanical bone fragment compression. The mechanical bone fragment compression depends not only on the structure of the com- pression bone nail, but also significantly on the strength of the bone tissue in the bone locking bolt. In osteoporosis, which occurs at an advanced age, especially in women, the bone structure is thinned and weakened so that it m can the bones lead to plastic long deformation of bones Bohrlocher at ei ¬ ner higher pressure loading of the locking bolt, or even fissures or fractures can weakened bone occur. Moreover, it comes at a higher mechanical pressure exerted by the locking pin to the bone, in principle, also to faster cellular bone on bone stock, which also cause plastic long deformation of bone Bohrlocher in bone marrow nailing. The associated migration of the locking bolt in the bone m toward the bone fracture site or fracture leads to the fact that removing the locking bolt from the top of the compression screw, whereby it eventually comes to a loss of mechanical compression for the osteosynthesis. After the loss of the mechanical compression, the relatively unstable conditions of static bone locking ultimately are only given. A reduction of the mechanical compressive force to the bone Bohrlocher, m which are mounted the locking bolt, by a Oberflachenver- the locking bolt flat support in the borehole bone stock großerung be achieved at a predetermined desired compression force. Simply increasing the diameter of the Verπegelungsbolzens is not possible due to limited bone diameter m rule. The support surface is thus increased thereby, that reduces the on position ¬ pressure on the bone at the well bone bearings in that providing two or more locking bolts simultaneously instead of a locking bolt, thus achieving a distribution of the pressure forces.

The German utility model with the number Roll G 9401 916.9 describes a multifunctional scenes intramedullary nail in which a scenery or a Gleitkorper is provided which is m the bone nail m longitudinal direction steplessly lockable. The Gleitkorper case has through-holes for receiving bone-Vemegelungs fasteners. Fig. 1 shows the proximal end portion of such a bone nail. In the illustrated scenes bone nail, a proximal times arranged axial compression clamping screw does not act directly on the bone-Vemegelungs fastener or the locking screw but on the Gleitkorper, the two or menrere transversal or inclined obliquely extending bores for receiving two or more identifies itteln interlocking lungs Fixture. Since the locking fasteners or bone screws are in immediate succession, this bone nail is also referred to as a modular tandem compression nail or TCN bone nail (TCN: Tandem Compression Nail).

In EP 0865769 Al a modular intramedullary nail is also described. The intramedullary nail therein has a proxima- len portion, a middle portion and a distal portion, the proximal section of the intramedullary nail from ¬ a longitudinal slot and a transverse bore having arranged thereunder. The distal portion of the intramedullary nail containing at least one transverse bore. The proximal portion of the intramedullary nail further comprises a protracted over the length of the elongated slot cross bore for receiving a Gleitkorpers or insert. Here, the Gleitkorper is provided with two in relation to the longitudinal axis sloping Fuhrungsbohrungen for receiving locking screws, locking pins or blades.

That described in the German Utility Model Roll number G 9401 916.9 multifunctional scenes intramedullary nail, as well as the modular intramedullary nail shown in EP 0865769 Al ha ¬ ben edoch the disadvantage that the m employed the nail Gleitkorper high mechanical friction to the Nagelkorper respectively. The Gleitkorper in these known compression bone nails are relatively long and have a cylindrical shape. In consequence of a jamming of the cylindrical tilting Gleitkorper m the Nagelkorper it comes to high Reibungsver ¬ losses during the mechanical compression. In addition, it comes with functional loads at a much faster decrease of the applied compressive force because conditional spring force reserve path is shortened due to the small bending of the locking screws through the e- lastische bending of the locking screws.

A further disadvantage in the known compression bone nail is that at least two locking screws are performed by the Gleitkorper which are arranged behind one another rigidly in a tandem position. Therefore, both locking screws can only move uniformly according to the prior art, in these conventional compression bone nails and thus are not m adapt able individually to the elastic and plastic deformations of the bone Bohrlocher for mounting of the locking screws, whereby the force distribution in the bone unfavorably is.

It is therefore the object of the present invention to provide a compression bone nail which avoids the drawbacks mentioned above and causes compression of bone fragments of a bone with low friction losses at a favorable force distribution in the bone.

This object is erfmdungsgemaß by a compression bone nail solved by the features specified in patent claim 1.

The invention provides a compression bone pin for compression of bone fragments of a bone with

an elongated Nagelkorper having at least one end elongated slots for receiving locking means for fixing bone fragments, at least one m can be used the Nagelkorper Gleitkorper having a Fuhrungsbohrung for receiving a first interlocking lungs fixing agent, wherein the Gleitkorper m toward the tapers center of Nagelkorpers back and touches a second locking fastening means having a contact surface, and with

engages the end of the Nagelkorpers a tensioning element which m and prints the Gleitkorper with the contact surface against the second locking fastening means.

In a preferred fuhrungsform of the inventive compression bone nail, the elongate Nagelkorper formed tapers at one end.

This offers the particular advantage that the compression can be inserted bone bone nail m m easily.

In a further preferred embodiment, the elongated Nagelkorper at a first end of elongated slots for receiving locking fastening itteln and at a second end cross-bores for receiving locking fasteners.

Preferably, the elongate Nagelkorper is hohlformig over its entire length and forms a tube with a nail Nagelkor- perwandung.

Preferably, the pers received by the Fuhrungsbogen Gleitkor- the first locked fastening means and the second fixing means are guided by opposing the Na gelkorperwandung provided elongate slots. In an alternative form fuhrungs from the second locking fixing means provided by a pair of opposed m Nagelkorperwandung the transverse bores is guided.

The Gleitkorper is preferably lockable.

In a particular embodiment of the inventive compression bone nail the vorgese ¬ hene in the body Fuhrungsbohrung m proceeds to a the longitudinal axis of Gleitkor- pers inclined angle. The Fuhrungsbohrungen preferably have an inclination angle between 120 ° -150 ° posted for the longitudinal axis for retrograde locking a bone fracture.

In a further embodiment, the Fuhrungsbohrungen have an inclination angle between 125 ° and 150 ° posted for the longitudinal axis of an oblique locking of the bone fracture.

In a further preferred embodiment the cross section of Nagelkorpers and can be inserted therein Gleitkor- is ovalformig pers.

Preferably, the Nagelkorper is formed partially hollow and has an internal bore for inserting the Gleitkorpers.

The Gleitkorper is advantageously a FUH rungsemπchtung the internal bore applications. The advantage here is that the Gleitkorper the internal bore of Nagelkorpers can be introduced m easily equal in the correct position. Here, the Funrungsemπchtung formed in a first embodiment by an m-Nagelkorper the inner wall of the groove, in the em is einfuhrbar to the Gleitkorper projection provided formed.

In an alternative from the fuhrungs Fuhrungsem- direction is formed by a groove formed in the Gleitkorper form, the m em engages the inner wall Nagelkorper projection provided.

The Gleitkorper preferably has an m of the longitudinal axis extending bore.

The elongated Nagelkorper is slightly curved in a preferred embodiment and has a radial radius of curvature of about 1.5 m. Thus, the inventions dungsgemaße compression bone nail is particularly suitable for thigh bone fracture.

In a further preferred embodiment the elongated Nagelkorper proceeds at one end with a specific bend angle bent to the longitudinal axis. The bend angle preferably amounts to approximately 25 °. dungsgemaße compression bone nail especially bemknochenbruche for tibia - This causes the erf is.

The tensioning element is preferably a clamping screw which engages in em internal thread which is provided at the end of the Nagelkorpers, wherein the clamping screw prints the Gleitkorper against the second locking fastener during the screwing.

Preferably the clamping screw has a screw head with an internal or on Außenmehrkantfor. In an alternative form Ausfuhrungs the clamping element is formed by a bayonet.

The locking fixing means are preferably Schrau ¬ ben.

In an alternative embodiment, the locking pin fastening means consist of.

In a particularly preferred embodiment of the inventions dungsgemaßen compression of the bone nail Gleitkorper is elongate and tapers over almost its entire length, it is possible that the Gleitkorper drove by a tilting movement m the inner bore of Nagelkorpers.

The compression bone nail is preferably made of stainless steel or another metal, for example titanium.

Alternatively, the compression bone pin can be made of titanium.

In a further embodiment there is a compression bone pin made from fiber reinforced plastic.

In a preferred development of the inventive compression bone nail is provided between the clamping element and the Gleitkorper em suspension component. This offers the particular advantage that the Federkraftweg is increased and the spring force reserve is maintained for a longer period between the clamping element and the Gleitkorper. In a particularly preferred embodiment, the suspension component consists of a spiral spring. The coil spring preferably has a spring excursion of at least 3 mm.

The spring force reserve at maximum bias voltage preferably amounts to at least 600 Newton.

In an alternative form Ausfuhrungs the suspension device is formed by a plate spring.

In a further embodiment, the suspension component consists of two nested double springs.

In a preferred embodiment the contact surface of Gleitkorper is rounded to the second locking fastening means.

In an alternative embodiment, the contact surface of the Gleitkorpers is chamfered.

This also the second locking device can be inserted obliquely the bone.

The Nagelkorper is preferably coated with a bioactive osteotak- schematically effective or antunfektziosen layer.

This osteotaktisch effective layer is preferably composed of hydroxyapatite or Tπcalciumphosphat.

In a further preferred embodiment is located between the Gleitkorper and the inner wall of Nagelkorpers em lubricant to further reduce the friction encountered. In further preferred embodiments of the erfm- dungsgemaßen compression bone nail will be described for explaining features essential to the invention with reference to the attached figures.

Show it:

1 shows the proximal end portion of a compression bone nail with a zylmderforangen Gleitkorper the prior art;

2 shows an embodiment of the compression bone nail for the compression of bone fragments of a bone in accordance with the invention;

Figure 3 is a sectional view through a fractured bone, where the m erfmdungsgemaße compression bone nail is used;

4 shows a further From fuhrungsform of the inventive compression bone nail which is particularly suitable for the tibia or humerus bone;

Figures 5a, b, c show various possible applications of the ER fmdungsgemaßen compression bone nail;

Figures 6a, b show further possible applications of the erfmdungs- gemaßen compression bone nail by varying the orientation of the locking fastener.

Figure 2 shows a first embodiment of the inventive compression bone nail for the compression of bone fragments, which is particularly suitable for a femur bone. The compression bone nail 1 has an elongated Nagelkorper 2, which is hollow and a thin Nagelkorperwandung 3 has. At a proximal end of the Nagelkorpers 2 has this elongated slots 4, 5 for receiving the transverse locking fastening means 7, 8. In the Nagelkorper 2 em Gleitkorper 9 is inserted at the proximal end having a Fuhrungsbohrung 10 for receiving the upper locking fastener. 7 The Gleitkorper 9 is elongate and tapers toward the center m of the Nagelkorpers 2. The Gleitkorper 9 has a contact surface 11 with which it contacts the lower locking fastening means. 8 In addition, the Gleitkorper shown in Figure 2 has a 9 m longitudinally extending bore.

At the proximal upper end of the m 2 illustrated compression bone nail 1 em clamping element is also 12 provided in the form of a clamping screw which m engages the proximal end of Nagelkorpers 2 and the Gleitkorper 9 with its contact surface 11 via e suspension component 13 against the locking component 7 prints. To this end, the clamping screw 12 is screwed m em provided on the proximal end of the internal thread 2 Nagelkorpers fourteenth

In order to better introduce the Nagelkorpers 2 m bone, the Nagelkorper 3 tapers at the lower distal end, as can be seen from FIG. 2 At the distal end of m figure has 2 illustrated compression bone nail 1 cross holes 15, 16 for receiving additional locking fasteners 19, 20th

The captured by the Fuhrungsbohrung 10 of the Gleitkorpers 9 locked fastening means 7 and the locking fixing means 8 are guided by the Nagelkorperwan ¬ formed in the dung 3 opposite elongated slots 4; 5. The second locking fastening means 8 can in this case be guided alternatively provided by two opposite m Nagelkorperwandung the transverse bores, which do not allow movement of the locking fastener 8 in the longitudinal direction of Nagelkorpers.

The compression bone nail 1 consists of a biokompatib- le material, for example stainless steel or a titanium alloy or a fiber reinforced plastic. The suspension device 13 serves to increase the spring force path and to the longer maintenance of the spring force reserve between the tensioning element 12 and the proximal end of Gleitkorpers 9. The suspension device 13 is in the position shown in Figure 2 embodiment of a spiral spring, whose spring travel is preferably at least 3 mm and their Fe - derkraftreserve amounts to at least 600 N maximum preload. The spring is thereby compressed completely only at a bias m height of the maximum achievable elastic compression forces, so that the spring on bone resorption at the support of the locking fastener can still continue to act with a large and chronologically slowly decreasing compression force. In alternative embodiments the suspension element 13 may AuCN from a plate spring or consist of a plastic suspension component. In a further alternative embodiment of the suspension device 13 consists of a nested double spring.

The m Figure 2 shown Gleitkorper 9, due to the fact that he SiCN tapers toward the center of Nagelkorpers hm 2, a low friction with the Nagelkorperwandung 3. In this case, the SiCN tapers Gleitkorper 9 preferably almost over its entire length, so that it can lead by a tilting movement within the Nagelkorpers 2 relative to the axis of Nagelkorpers. This results in a Kippverklemmung between the Gleitkorper 9 and the Nagelkorper 2 is avoided. To further avoid Verklemmungsreibung the Gleitkorper 9 is formed in a preferred embodiment, proximal cross-section slightly ovalformig, wherein the distal end of the Gleitkorpers 9 so tapers that the Gleitkorper 9 only in a relatively short section near the transverse bend 10 frictional contact with the Nagelwandung 3 has. By the m FIG inventive shaped compression bone nail 1 shown 2 can be achieved high initial compression forces, since no significant frictional losses occur. At functional loads on the bone, the deformations of the exposed bore hole edge in the bone in the area of ​​the locking fastening means 7, 8 are substantially reduced and favorable spread by the inventive shaped compression bone nail. 1 The long Federkraftweg and the high spring force reserve, the clamping force and thus the compression force for osteo whereby the healing process is called synthesis decreased much more slowly.

The first embodiment of the figure m erfmdungs- gemaßen compression bone nail 1 shown there 2 has an elongated Nagelkorper 2 with a Nagelwandung. 3 The Nagelkorper 2 is slightly curved in this embodiment and has a radial radius of curvature of about 1.5 m. In this way, the figure is m 2 compression bone nail shown particularly for human femur bone.

The locking fixing means 7, 8 are either locking screws or bolts.

As a tensioning element 12 also em bayonet closure can alternatively to the illustrated m FIG proximal clamping screw 2 12 are used. The Nagelkorper 2 is durchgangig hohlformig in the example shown in Figure 2 erfmdungs- gemaßen example. In alternative embodiments, however, the Nagelkorper 3 has an inner bore for the insertion of Gleitkorpers 9 only at the proximal end.

The Gleitkorper 9 is preferably usable over a Fuhrungsemrichtung in the Nagelkorper 2 or the inner bore. The Fuhrungsemrichtung is formed for example by an outer fold of the Nagelwandung m 3 and by a projection provided on the Gleitkorper 9 Fuhrungsdorn or projection. The outer fold forms a recess nutformige m Nail inner wall. Alternatively, the Fuhrungsemrichtung can also be formed by the m Gleitkorper 9 provided nutformige recess, m which engages a nail provided on the inner wall or inner fold em continuously running elongated projection.

The Fuhrungsemrichtung allows you to use the Gleitkorper m easily once the correct position m the Nagelkorper second In addition, the Fuhrungsemrich ¬ tung prevents relative rotational movement of the Gleitkorpers 9 within the Nagelkorpers 2. This misalignments of the locking fastening means 8 can be prevented.

The contact surface 11 of the Gleitkorpers 9 is slightly rounded in a preferred embodiment, whereby the tilting movement of the Gleitkorpers 9 is facilitated within the Nagelkorpers 2, and thus jamming is prevented.

In certain applications, the contact surface 11 of the Gleitkorpers 9 ausgeoildet obliquely to the longitudinal axis of the Gleitkorpers. 9 This makes it possible the locking fastener insert 8 obliquely m the bone.

The Nagelkorper 2 is coated, in preferred embodiments a bioactive osteotaktisch active layer, such as hydroxyapatite or Tπcalciumphosphat.

To the friction between the Gleitkorper 9 and the inner wall or inner bore of the nail Nagelkorpers 2 to decrease further, a lubricant between the Gleitkorper 9 and the inner wall can be additionally provided.

When m 2 is illustrated embodiment 1, the compression bone pin, the clamping screw 12 and the suspension device 13, as well as the Gleitstem 9 only at the proximal the upper end of the bone nail 1 on. However, this compression mechanism can also be at the distal end of the o- be provided both at the proximal end and the distal end of the compression bone nail. 1

Figure 3 shows how the m 2 illustrated first embodiment of the inventive compression bone nail 1 is used for the healing of a thigh bone fracture. As can be seen cross-section shown in Figure 3 from the figure, the broken femur to 17 em upper bone fragment 17a and em lower bone fragment 17b. The bone 17 is separated at a bone fracture site 18th therethrough in the longitudinal direction durcn both bone fragments proceeds the Nagelkorper 2. The Nagelkorper 2 is locked at the distal end on the locking fastener 19, 20 with the lower bone fragments 17b. The locking fasteners 19, 20 pass through the illustrated in Figure 2 cross bores 15, 16. The upper bone fragment 17a is on the locking fastening means 7 which is guided by the Gleitkorper 9, and by the locking fastening means 8 with the compression bone-pin 1 is connected. By tightening the tightening screw 12 is a compression force is applied to the first locking fixing means 7 via the Gleitkorper 9 ¬. At the same time Gleitkorper 9 printed on the Ver ¬ riege lungs fasteners 8, so that both locking fastening means 7 8 exert a compressive force on the upper bone fragment 17a. thus acts on the bone fracture site 18 from both sides of a compressive force, which increases the stability and significantly prompts the healing process.

Figure 4 shows a further embodiment of the inventive compression bone nail which is particularly suited for egg ¬ NEN tibia or humerus. In this embodiment, the elongate Nagelkorper 2 proceeds knickformig at the proximal end and has a specific buckling wmkel m depending on the healing bone to on. The bend angle preferably amounts to about 25 degrees. In this so-called Herzog-buckling, the compression intramedullary nail 1 is suitable as Figure 4 shown particularly chen for Schienbemkno-. As can be seen from Figure 4 on, the contact surface 11 of the Gleitkorpers 9 is obliquely formed in this embodiment, so that an advantageous power transmission of the tensioning element 12 is ensured via the Gleitkorper 9 to the second locking component. 8

Figure 5 shows various possible applications of the inventions dungsgemaßen compression bone nail. 1

By the inventive shaped compression bone nail 1 a double primary compression two locking fastener can be achieved, as can be seen from Figure 5a.

Alternatively, however, can also be a simple compression can be achieved by means of a proximal Verπegelungs device (as can be seen from Figure 5b), or by em below the Gleitkorpers 9 located locking device, as shown in Figure 5c. 1

Figures 6a, 6b show other possible applications of the inventive compression bone nail 1 by varying the Gleitkorpers 9 used.

When m 6a shown embodiment 9, the Gleitkorper to a running inclined to the longitudinal axis of the Gleitkorper Fuhrungsbohrung which has a certain angle of inclination. The angle of inclination may be between 120 ° and 150 ° for retrograde locking of the fracture or between 125 ° and 150 ° are for an anti-lock grade of the fracture.

When m Figure 6b shown embodiment both the Fuhrungsbohrung within the Gleitkorpers 9 and the contact surface 11 of the Gleitkorpers is obliquely formed so that both locking fastening means 7, 8 are inserted into the bone with a certain inclination angle to the longitudinal axis of the compression bone nail ,

The axial compression by the inventive shaped compression bone pin 1 causes a stabilizing effect while increasing the stiffness and significant reduction of the relative movement between the bone fragments.

Since the two locking fastening means 7, 8 are not rigidly disposed within the Gleitkorpers 9, but a relative movement between the two locking fastening means 7, 8 m transverse direction to the longitudinal axis of the compression bone nail 1 is possible, there is a more favorable mechanical load distribution m the bone.

A drop in the tension force in plastic deformation of the bone is in a particularly preferred embodiment of the compression bone nail by the increased spring energy reserve counteracted due to the spring element. 13

, 17a of the distal bone fragments over the locking fastening means 7 8 force mechanically lemgeleitet in the inventions dungsgemaßen compression bone nail. The compression bone nail 1 then forwards continues this mechanical force on the proximal end located at the proximal locking fastening means 19, 20 m, the proximal bone fragment 17b as a central force transducer. By Kompressionsschrau- be 12 em pressure on the bone fracture site 18 to the demand of the healing process is further exerted.

The Gleitkorper 9 is formed uniaxial, that is, has only a Fuhrungsbohrung for receiving a locking fastener 7 on.

Preferably intended primarily transversely aligned Ausfrasungen at the proximal end of the nail, allowing the correct insertion of a Zielmstruments for the nail holes.

The provided at the proximal end of the compression bone nail 1 female thread 14 for insertion of the clamping screw 12 can also serve for inserting a struments stumpage or a Ausschlagsm-. The internal thread 14 is preferably em metric nut thread for screwing the axial clamping screws, the clamping screws are preferably multi-head bolts with a hexagonal or an outer hexagon shape.

The diameter of the erf dungsgemaßen compression bone nail 1 amounts to about 9-14 mm. The m the spiral spring element Nagelkorper 2 used preferably has an outer diameter of about 7.8 mm and consists of a CoCr alloy.

The length of the Gleitkorpers 9 preferably amounts to less than 30 mm. This small length of the Gleitkorpers is possible because the Gleitkorper 9 has only one Fuhrungsbohrung 10 for receiving a locking fastener. 7 By shortening the Gleitkorpers 9 and the spring member 13 and the clamping screws can be provided for the proximal end of modular chamber 12 are inserted without the modular chamber having to lengthen.

The length of the erf dungsgemaßen compression bone nail 1 is adjustable in a preferred embodiment.

Claims

claims
1. Compression bone nail for the compression of bone fragments (17a, 17b) of a bone (17) comprising:
(a) an elongated Nagelkorper 2), the at least one end elongated slots (4, 5) for receiving locking fastening means (7, 8) (for em bone fragment 17a);
b) at least one m (the Nagelkorper 2) emsetzbaren sliding ¬ body (9) having a Fuhrungsbohrung (10) for receiving a first locking fastener (7), wherein the Gleitkorper (9) m toward the center of the Nagelkorpers (2) tapers hm and with a contact surface (11) em second locking fastening means (8) contacts,
c) engaging a tensioning element (12) m the end of the Nagelkorpers (2) and prints the Gleitkorper (9) with the Berührungsflä ¬ surface (11) against the second locking fixing means (8).
2. Compression bone nail according to claim 1, characterized characterized ¬ marked in that the elongate Nagelkorper (2) itself tapers at one end.
3. Compression bone nail according to claim 1, characterized characterized labeled in ¬ that the elongate Nagelkorper (2) at a first end of the elongated slots (4, 5) for receiving further Ver ¬ riege lungs-fastening means (7, 8) and at a second transverse bores (15, 16) for receiving further locking fastening means (19, 20).
4. Compression bone nail according to any one of the preceding claims, characterized in that the elongate Nagelkorper (2) is hohlformig over its entire length and forms em nail tube with a Nagelkorperwandung (3).
5. Compression bone nail according to any one of the preceding claims, characterized in that the through Fuhrungsbohrung (10) of the Gleitkorpers (9) recorded first locking fastening means (7) and the second Verrie ¬ gelungs-fastening means (8) through opposite elongated slots 4 be guided 5, the m of Nagelkorperwandung (3) are provided.
6. Compression bone nail according to any one of the preceding claims, characterized in that the second interlocking securing means (8) is guided by two opposing transverse bores, the m of Nagelkorperwandung
(3) are provided.
7. Compression bone nail according to any one of the preceding claims, characterized in that the Gleitkorper (9) is lockable.
8. Compression bone nail according to any one of the preceding claims, characterized in that the Fuhrungsbohrung
(10) proceeds to a the longitudinal axis of Gleitkorpers (9) geneig ¬ th angle by the Gleitkorper (9).
9. Compression bone nail according to claim 8, characterized characterized ¬ marked in that the inclined angle between 120 ° and 150 °.
10. Compression bone nail according to claim 8, characterized in that the inclined angle between 125 ° and 150 °.
11. Compression bone nail according to any one of the preceding claims, characterized in that the cross section of the nail body (2) and can be inserted therein Gleitkorpers (9) is ovalformig.
12. Compression bone nail according to any one of the preceding claims, characterized in that the nail body (2) is at least partially hohlformig and having an inner hole for inserting the Gleitkorpers (9).
13. Compression bone nail according to any one of the preceding claims, characterized in that the Gleitkorper (9) u- via suitable guide means into the inner bore
14. Compression bone nail according to claim 13, characterized in that the guide device formed from an m-Nagelkorper the inner wall of the groove, into which a to the Gleitkorper (9) protrusion is provided einfuhrbar.
15. Compression bone nail according to claim 13, characterized in that the guide device is formed by a in the Gleitkorper (9) provided groove, into which a provided to the inner wall Nagelkorper projection.
16. Compression bone nail according to any one of the preceding claims, characterized in that the Gleitkorper (9) has a longitudinally extending bore.
17. Compression bone nail according to any one of the preceding claims, characterized in that the elongate Nagelkorper (2) is curved and has a radial radius of curvature of about 1.5 m.
18. Compression bone nail according to any one of the preceding claims, characterized in that the elongate Nagelkorper (2) proceeds at one end with a specific Knickwmkel to the longitudinal axis.
19. Compression bone nail according to claim 18, characterized in that the Knickwmkel amounts to approximately 25 °.
20. Compression bone nail according to any one of the preceding claims, characterized in that the clamping element (12) is a clamping screw which m em at the end of Nagelkorpers (2) provided inside thread (14) engages and when screwing the Gleitkorper (9) against the second locking fixing means (8) prints.
21. Compression bone nail according to any one of the preceding claims 1-19, characterized in that the clamping element (12) is em bayonet closure.
22. Compression bone nail according to any one of the preceding claims, characterized in that the locking fastening means (7, 8, 19, 20) are screws.
23. Compression bone nail according to any one of the preceding claims 1-21, characterized in that the locking fastening means (7, 8, 19, 20) are bolts.
24. Compression bone nail according to any one of the preceding claims, characterized in that the Gleitkorper (9) is elongate and tapers almost over its entire length, it is possible that the Gleitkorper drove through a tilting movement m the inner bore of Nagelkorpers (2).
25. Compression bone nail according to any one of the preceding claims, characterized in that the compression bone nail consists of a stainless steel alloy.
26. Compression bone nail according to any one of the preceding claims 1-24 characterized in that the compression is bone nail of a titanium alloy.
27. Compression bone nail according to any one of the preceding claims 1-24 characterized in that the compression is bone pin made from fiber reinforced plastic.
28. Compression bone nail according to any one of the preceding claims, characterized in that between the clamping element (12) and the Gleitkorper (9) e suspension device
(13) is provided.
29. Compression bone nail according to claim 28, characterized denotes ¬ ge that the suspension device (13) is a spiral spring.
30. Compression bone nail according to claim 29, characterized in that the spiral spring has a spring excursion of at least 3 mm.
31. Compression bone nail according to claim 28, characterized in that the suspension device (13) is a plate spring.
32. Compression bone nail according to claim 28, characterized in that the suspension device (13) is formed by a nested double spring.
33. Compression bone nail according to claim 28, characterized in that the spring force reserve amounts at maximum bias voltage 600 N.
34. Compression bone nail according to any one of the preceding claims, characterized in that the contact surface (11) of Gleitkorpers (9) is rounded.
35. Compression bone nail according to any one of the preceding claims 1-33, characterized in that the contact surface (11) of Gleitkorpers (9) is chamfered.
36. Compression bone nail according to any one of the preceding An ¬ claims, characterized in that the Nagelkorper (3) is coated with a bioactive osteotaktisch active layer.
37. Compression bone nail according to claim 36, characterized denotes ¬ ge that the osteotaktisch effective layer of hydroxyapatite or Tπcalciumphosphat exists.
38. Compression bone nail according to any one of the preceding claims, characterized in that em lubricant between the Gleitkorper (9) and the inner bore of Nagelkorpers (2) is provided.
39. Compression bone nail according to any one of the preceding claims, characterized in that the length of the Nagelkorpers (2) is mechanically adjustable.
40. Compression bone nail according to any one of the preceding claims, characterized in that the diameter of Nagelkorpers (2) amounts to about 1 cm.
PCT/EP2000/011595 1999-12-15 2000-11-21 Compression bone nail WO2001043652A1 (en)

Priority Applications (2)

Application Number Priority Date Filing Date Title
DE1999160507 DE19960507A1 (en) 1999-12-15 1999-12-15 Compression bone pin
DE19960507.6 1999-12-15

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
AU18589/01A AU1858901A (en) 1999-12-15 2000-11-21 Compression bone nail

Publications (1)

Publication Number Publication Date
WO2001043652A1 true WO2001043652A1 (en) 2001-06-21

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ID=7932769

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Country Status (3)

Country Link
AU (1) AU1858901A (en)
DE (1) DE19960507A1 (en)
WO (1) WO2001043652A1 (en)

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WO2003030749A1 (en) * 2001-10-12 2003-04-17 Flores Davila Jorge P Grooved centro-medullary nail and a method for the osteosynthesis of diaphyseal segments
US7141073B2 (en) 1993-11-01 2006-11-28 Biomet, Inc. Compliant fixation of external prosthesis
EP2116206A1 (en) * 2008-05-09 2009-11-11 Ebi, Llc Intramedullary implant with locking and compression devices
US8303590B2 (en) 2007-01-26 2012-11-06 Ebi, Llc Lockable intramedullary fixation device
US8915970B2 (en) 2013-02-08 2014-12-23 Biomet Manufacturing, Llc Transdermal prosthesis
US20150057663A1 (en) * 2010-11-24 2015-02-26 Kyle Kinmon Intramedullary Nail, System, and Method With Dynamic Compression
US8968415B2 (en) 2012-02-07 2015-03-03 Biomet Manufacturing, Llc Implant fixation device
EP2926750A1 (en) * 2014-03-31 2015-10-07 Zimmer GmbH Intramedullary nail assembly
US9295504B2 (en) 2009-03-31 2016-03-29 Biomet C.V. Intramedullary nail with locking key
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US9320551B2 (en) 2007-01-26 2016-04-26 Biomet Manufacturing, Llc Lockable intramedullary fixation device
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EP1570797A1 (en) * 2004-03-05 2005-09-07 Helmut Kurcz Implant, in particular intramedullary nail
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US7141073B2 (en) 1993-11-01 2006-11-28 Biomet, Inc. Compliant fixation of external prosthesis
WO2003030749A1 (en) * 2001-10-12 2003-04-17 Flores Davila Jorge P Grooved centro-medullary nail and a method for the osteosynthesis of diaphyseal segments
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US8303590B2 (en) 2007-01-26 2012-11-06 Ebi, Llc Lockable intramedullary fixation device
US9320551B2 (en) 2007-01-26 2016-04-26 Biomet Manufacturing, Llc Lockable intramedullary fixation device
US9308031B2 (en) 2007-01-26 2016-04-12 Biomet Manufacturing, Llc Lockable intramedullary fixation device
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US20150057663A1 (en) * 2010-11-24 2015-02-26 Kyle Kinmon Intramedullary Nail, System, and Method With Dynamic Compression
US8968415B2 (en) 2012-02-07 2015-03-03 Biomet Manufacturing, Llc Implant fixation device
US8915970B2 (en) 2013-02-08 2014-12-23 Biomet Manufacturing, Llc Transdermal prosthesis
EP2926750A1 (en) * 2014-03-31 2015-10-07 Zimmer GmbH Intramedullary nail assembly
US9775655B2 (en) 2014-03-31 2017-10-03 Zimmer Gmbh Intramedullary nail assembly
WO2017178354A1 (en) * 2016-04-14 2017-10-19 Orthoxel Dac An intramedullary nail system

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AU1858901A (en) 2001-06-25

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