WO2003030749A1 - Clou centro-medullaire a rainure et methode d'osteosynthese de segments diaphysaires - Google Patents

Clou centro-medullaire a rainure et methode d'osteosynthese de segments diaphysaires Download PDF

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Publication number
WO2003030749A1
WO2003030749A1 PCT/MX2001/000074 MX0100074W WO03030749A1 WO 2003030749 A1 WO2003030749 A1 WO 2003030749A1 MX 0100074 W MX0100074 W MX 0100074W WO 03030749 A1 WO03030749 A1 WO 03030749A1
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WO
WIPO (PCT)
Prior art keywords
nail
diaphyseal
medullary
osteosynthesis
grooved
Prior art date
Application number
PCT/MX2001/000074
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English (en)
Spanish (es)
Inventor
Jorge P. Flores Davila
Original Assignee
Flores Davila Jorge P
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 Flores Davila Jorge P filed Critical Flores Davila Jorge P
Priority to PCT/MX2001/000074 priority Critical patent/WO2003030749A1/fr
Publication of WO2003030749A1 publication Critical patent/WO2003030749A1/fr

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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
    • A61B17/72—Intramedullary pins, nails or other devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6441—Bilateral fixators, i.e. with both ends of pins or wires clamped
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
    • A61B17/921—Impactors or extractors, e.g. for removing intramedullary devices for intramedullary devices

Definitions

  • the present invention relates to a device and method for the treatment of bone fractures of long bones and more particularly to a device and method for the treatment of intertrochanteric femoral bills.
  • Femoral fractures of the trochanteric region 2. Femoral fractures of the intracapsular area of the femoral neck, and 3. Diaphyseal femoral fractures.
  • femoral neck fractures As for femoral neck fractures, they are known to cause frequent aseptic necrosis or femoral head osteoarthritis. The treatment is often replacement by partial hip replacement. Diaphyseal fractures are primarily of traumatic etiology.
  • the methods applicable to intracapsular fractures are usually partial hip replacements.
  • FIG. 1 A and 1B illustrates a drilled and undrilled nail respectively.
  • pre-drilled or non-drilled nails consist in that (a) they cannot be used in multiple intertrochanteric fractures, and (b) they only provide good stability in the plane of the transverse fracture of the middle third.
  • FIG. 1C illustrates an osteosynthesis of a transverse fracture of the middle third using a nail of the prior art, the arrows indicate the movement that may exist in the fractured portions.
  • the holes that have been incorporated in the center-medullary drilled nails try to solve the problem of nail instability.
  • the holes of sayings Nails are designed to introduce proximal and distal screws and are intended to prevent the fractured bone from rotating on its own axis and moving in the axial direction.
  • the nails of the prior art are not able to approach the bones or provide or maintain controlled compression in the fractured portions where osteosynthesis is performed.
  • treatment methods consist of osteosynthesis with perforated plates of different designs such as flat plate 50 and angled plate 40 illustrated in FIG. 1D and 1 E.
  • an angled plate 40 (FIG. 1 E) is inserted into the femoral neck and the plate is applied to the femoral shaft. Said plates constitute a support when applying screws in the fractured portions.
  • the treatment of a trochanteric fracture using an angled plate of the prior art is illustrated in Figure 1F.
  • the angled plate method cannot be successfully applied to the case of multiple intertrochanteric fractures that are accompanied with multiple diaphyseal fractures of several femoral diaphyseal fragments or hip fractures plus diaphyseal fractures, because multiple fractures do not provide adequate support for perforated plates, difficulties that are nevertheless overcome with the method of the present invention.
  • Anatomical replacement 2. Avoid tissue injury
  • Another object of the invention is to provide an improved device and methods for the treatment of transverse fractures of the middle third.
  • This method will be applied in long bones with the possibility of access for the use of a grooved medullary center nail.
  • We will exemplify its application with the osteosynthesis of the femur, but as will be evident to a person skilled in the art, this can also be applied to other long bones.
  • FIG. 1A shows an undrilled nail of the prior art.
  • FIG. 1B shows a pre-drilled nail.
  • FIG. 1C illustrates an osteosynthesis of a transverse fracture of the middle third using nail 1 A of the prior art.
  • FIG. 1 D illustrates a front view of a straight monocortical compression plate and a side view thereof, of the prior art, which can be used in conjunction with the slotted nail of the present invention.
  • FIG. 1 It illustrates a front and side view of an angled plate of existing techniques, which can be used in conjunction with the slotted nail of the present invention.
  • FIG. 1 F illustrates an osteosynthesis of an intertrochanteric fracture using the angled plate of FIG. 1 E of the prior art.
  • FIG. 2 illustrates an epiphyse-diaphyseal grooved spinal center nail in accordance with the first embodiment of the present invention.
  • FIG. 3 illustrates a nail for diaphyseal-epiphyseal osteosynthesis, for use with angled plate according to a second embodiment of the present invention.
  • FIG. 4 illustrates a nail for diaphyseal osteosynthesis only. According to a third embodiment of the present invention.
  • FIG. 5 illustrates the GUIDE MECHANISM for the introduction of cortical screws into the grooved center-medullary nail in accordance with the present invention.
  • FIG. 6 illustrates an osteosynthesis of an intertrochanteric fracture with multiple femoral diaphyseal fragments using an angled plate.
  • FIG. 7 illustrates a diaphyseal osteosynthesis using a straight plate.
  • FIG. 8 illustrates a transverse diaphyseal osteosynthesis of the middle third using bi-cortical external compression means.
  • a device and method for performing surgery for the reduction of multiple trochanteric fractures with or without femoral diaphyseal multiple fragments is described.
  • the device comprises a slotted center-medullary nail 10 in accordance with any of the modalities described and whose application depends on the fracture and criteria of the physician.
  • the device for the treatment of fractures of the present invention is composed of the following elements: a) Slotted nail 11 diaphyseal of (FIG. 2), or b) Slotted nail 12 Femoral or diaphyseal-epiphyseal bread 2 pieces to add angled plate ( FIG. 3), or c) Slotted nail 13 diaphyseal medullary center only (FIG. 4).
  • the nail is also complemented with at least some of the following accessories: d) Proximal extension 18; e) Cortical and spongy screws 30; f) Angled plate 40; g) Straight plate 50; h) Controlled compression system 60; Y i) Center-medullary nail groove locator system 70.
  • the diaphyseal grooved medullary center nail 11 comprises a body 15 having a distal end 151 and a proximal end 152, said body 15 includes at least one groove 16, the groove 16 is intended to allow cortical screws 30 to pass through the diaphyseal grooved center-medullary nail 11.
  • the center-medullary nail 11 is composed of four slots, but as will be apparent to a person skilled in the art this number may vary.
  • the groove 16 of the medullary center nail may be free or contain a filler 161 of a soft material that does not oppose the passage of cortical screws 30. Alternatively, it may have a cover or cover 162 of a material that does not prevent the passage of screws. corticals 20. Both the filling 161 and the cover 162 are intended to prevent the growth of bone tissue inside the groove 16 which, over time, can prevent difficulty in its removal.
  • connection means 17 of the grooved center-medullary nail 11 with the impactor 71 are arranged, these are illustrated in FIG. 2 as threaded sections male 171 and female 172, placed in the grooved center-medullary nail 11 and impactor 71 respectively.
  • any mechanical type of connection can be used, for example, an insertion attachment means.
  • the impactor 71 is intended to provide an end to facilitate the introduction of the nail into the medullary canal, but also aims to serve as a guide for the introduction of the screws 30.
  • the latter objective is achieved with the locator system 70 of the groove of the center-medullary nail, described later.
  • the straight plate 50 by virtue of the holes it presents allows the possibility of placing screws 30 that cross the nail and allow osteosynthesis to be performed in the fractured segments.
  • the impactor 71 is intended to provide an end to facilitate the introduction of the nail into the medullary canal, but also aims to serve as a guide for the introduction of the screws 30. This latter objective is achieved with the locator system 70 of the center-medullary nail groove, which is described below. See FIG. 5.
  • the straight plate allows permanent compression to be applied to the fractured bone segments so that they narrow together and the osteosynthesis is more effective, in order to achieve direct or permanent consolidation. cousin without the presence of exotic callus. Even better results are obtained with the use of the controlled compression apparatus 60.
  • Slotted center-medullary nail 12 for diaphyseal-epiphyseal osteosynthesis of multiple intertrochanteric fractures with several femoral diaphyseal fragments or hip fractures plus diaphyseal fractures illustrated in FIG. 3, is similar to the diaphyseal grooved medullary center nail 11 of FIG. 2 but further comprises an extension 18, which is attachable with the center-medullary nail 12 by coupling means 17 '.
  • said coupling means 17 ' consist of the male threaded section 171 of the center-medullary nail 12 and the female threaded section 182 of the extension 18.
  • the male threaded section 181 of the extension can be coupled with the female threaded section 172 of the impactor 71 at the junction 17 ".
  • the coupling of the grooved center-medullary nail 12 and the extension 18 are intended to provide the nail with the necessary dimension to be able to penetrate the femoral distal diaphyseal segment, and allow removal of the extension 18 from the proximal femoral segment, so that it can be placed the angled plate in the free proximal trochanteric segment and in the femoral neck.
  • FIG. 6 illustrates the placement of the center-medullary nail of FIG. 2 and an angled plate 40 for osteosynthesis of an intertrochanteric fracture with multiple femoral diaphyseal fragments.
  • the extension 18 is removed to allow the application of the angled plate, accompanied by fastening with cortical and spongy screws 30 to fix the multiple fragments to their original position.
  • the rimmed extension 18 is then re-coupled, over the nail 12, and the nail is removed in accordance with the traditional methods, aided for better handling , mounting this segment on impactor 71.
  • the epiphyseal diaphyseal grooved center-medullary nail 12 is intended to:
  • Nail grooved spinal center for diaphyseal fractures 13 (FIG. 4), is prepared for the use of fractures of the shaft only, this reduction system can be applied with or without accompanying plate.
  • angled plate 40 has the characteristic of exhibiting a bend that defines an angle ⁇ of approximately 130 °.
  • the angled plate 40 is intended to provide reduction to the fragments resulting in the trochanteric fracture.
  • the angled plate 40 will have the help of the slotted femoral nail of the invention, to carry out the support function for the screws that perform the reduction of the diaphyseal fragments.
  • the angled plate 40 must be anchored in the fractured bone. Said anchorage is achieved by inserting one end into the femoral neck of the bone. Obviously, the above is only possible if the neck of the bone is substantially free of obstacles so that it can be inserted, which is why the extension 18 of the nail 12 illustrated in FIG. 3.
  • the nail 12 is grooved in nothing hinders the insertion of the angled plate and the screws, and because the extension 18 is removed from the trochanteric region of the bone, it also does not hamper the insertion of the angled plate 40
  • Monocortical external compression means comprise straight 50 and angled plates 40.
  • the straight plate 50 comprises a plate body 51, which has perforations 52 in which cortical and spongy screws 30 are introduced to hold the fractured segments.
  • the grooved medullary center nail of the present invention can be used in conjunction with the straight monocortical compression plate of Figure 1D, for the reduction of femoral fractures, although it is also possible to dispense with the plate and only hold the fragments only by means of the nail .
  • the plates 50 have as a basic function, to more solidly immobilize the union between the fractured parts, to allow the regeneration of the bone cells, Such regeneration or consolidation will allow the fractured parties to recover their consolidation.
  • the screws 30 are inserted into the oval holes 52 of the plate 50, and into the fractured cortical segments.
  • the screws are introduced with a certain inclination, so that when these screws are tightened, a compression force is generated between the fractured segments. It is estimated that the value of the compression force generated by the plate 50 is in a range of between 600 and 1 000 N (Newton).
  • Bicortical controlled compression means 60 can be applied to apply a pressure between the fractured segments. These controlled compression devices are widely described in the PCT / MX01 / 00050 international patent application cited as reference.
  • FIG. 8 illustrates the application of a transverse bone compression apparatus in combination with the slotted nail 10.
  • the controlled compression apparatus 60 comprises a grooved plate 61 at least two trans-bone nails 62 and a compression mechanism 63. Cortex screws 30 are inserted into holes 611 of plate 61 and screwed into the cortex of the first fractured segment. While screws 30 are also introduced into slot 612 and screwed into the second fractured segment.
  • two transosseous nails 62 are introduced, the position of these nails to perform interfragmentary compression depends on the doctor's vision according to the existing fractures.
  • the compression mechanism 63 shown in FIG. 8 as a pair of threaded sections and nuts, the transosseous nails 62 are brought closer together and thereby the fractured segments are also narrowed, that is to say a compression force is applied to the fractured segments.
  • the value of the generated pressure does not exceed 25 kN, so as not to exceed the modulus of elasticity and thereby avoid damage to the vitality of the fractured bone.
  • the applied force can cause an allowable deformation of up to 0.43 mm in patients of 20 years or less and of up to 0.21 mm in patients of 70 years.
  • Permissible deformation is an approximately linear function of age.
  • System 70 is illustrated in FIG. 5, said system consists of:
  • the edge 721 of the guide flag 72 is placed in the slit 711 of the compactor 71.
  • the second edge 722 is placed in the groove 731 of the guide rule 73 and inserted therein.
  • the grooved ruler 73 comprises at least one groove 732 which is coincident with the groove 16 of the grooved center-medullary nail 10. In this way, the surgeon can identify the position of the groove of the nail and introduce the osteosynthesis screws 30 through the grooves 16, which is preferably in the lateral part. Finally, IF THE IMPACTOR THAT WAS ADJUSTED UNTIL REACHING THE BUMPER, it will be possible to pass the spongy screws 30 on the hip and the cortex on the diaphysis, which will coincide with the groove of the grooved medullary center nail.
  • the access route of the grooved inside-medullary nail is lateral, using the same known technique already for the perforated or unperforated medullary center nail of the prior art.
  • This spinal center nail has a groove in the diaphyseal area only.
  • same method of application only cortical screws or the center medullary nail system plus or without controlled compression plate can be placed.
  • the plates and the nail should exert pressure only in the area surrounding the holes for the passage of screws, so as not to cause strong compression to the bone tissue that is between the plate and the medullary center nail, so it is essential to place plates with minimum screw pressure, which is achieved after adjusting these by loosening the same half turn.
  • the spinal center nail groove locator system can be used.

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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)

Abstract

L'invention concerne un dispositif chirurgical permettant de réduire des fractures multiples intertrochantériennes et diaphysaires fémorales, des fractures de la hanche et/ou des fractures diaphysaires. Ledit dispositif comprend un clou centro-medullaire a rainure appliqué avec ou sans plaque angulaire ou avec ou sans plaque diaphysaire. Le clou centro-médullaire à rainure diaphysaire comporte un corps (15) comprenant au moins une rainure (16), ce qui permet donc de placer des vis (30) de fixation. De plus, le dispositif comprend : (a) un élément d'extension (18), pouvant s'accoupler au clou (10), et ayant pour objet de procurer au clou la dimension nécessaire pour pouvoir pénétrer dans le canal médullaire de l'os fracturé, puis être retiré du clou (10) lorsque celui-ci a été introduit suffisamment dans la cavité médullaire, afin de permettre l'ancrage de la plaque angulaire et de s'accoupler à nouveau au clou (10), afin de l'extraire de la cavité médullaire ; et (b) une plaque angulaire permettant de supporter les portions épiphysaires et diaphysaires fracturées.
PCT/MX2001/000074 2001-10-12 2001-10-12 Clou centro-medullaire a rainure et methode d'osteosynthese de segments diaphysaires WO2003030749A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/MX2001/000074 WO2003030749A1 (fr) 2001-10-12 2001-10-12 Clou centro-medullaire a rainure et methode d'osteosynthese de segments diaphysaires

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/MX2001/000074 WO2003030749A1 (fr) 2001-10-12 2001-10-12 Clou centro-medullaire a rainure et methode d'osteosynthese de segments diaphysaires

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Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP2108322A1 (fr) * 2008-04-09 2009-10-14 José Costa Martins Plaque de contention/compression trochantérique
WO2013075730A1 (fr) * 2011-11-25 2013-05-30 Stryker Trauma Gmbh Système d'implant pour une fixation osseuse
US8668695B2 (en) 2008-10-15 2014-03-11 Zimmer Gmbh Intramedullary nail
US9597129B2 (en) 2007-05-25 2017-03-21 Zimmer Gmbh Reinforced intramedullary nail

Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1989006948A1 (fr) * 1988-02-04 1989-08-10 Pfizer Hospital Products, Inc. Appareil de reduction de fracture
US5112333A (en) * 1990-02-07 1992-05-12 Fixel Irving E Intramedullary nail
EP0491138A1 (fr) * 1990-12-17 1992-06-24 Synthes AG, Chur Dispositif de fixation d'os cassés
WO1994027508A2 (fr) * 1993-06-01 1994-12-08 Endocare Ag Instrument auxiliaire pour osteosynthese permettant de traiter des fractures subtrochanteriennes et pertrochanteriennes, ainsi que des fractures du col du femur
WO1998018397A1 (fr) * 1996-10-28 1998-05-07 Smith & Nephew, Inc. Clou centro-medullaire tubulaire et modulaire
ES2119848T3 (es) * 1992-12-04 1998-10-16 Synthes Ag Clavo intramedular modular.
EP1053718A1 (fr) * 1999-05-12 2000-11-22 Sulzer Orthopedics Ltd. Clou de verrouillage pour le traitement des fractures de la tige fémorale
ES2155892T3 (es) * 1994-07-15 2001-06-01 Smith & Nephew Inc Clavo intramedular modular encanulado.
WO2001043652A1 (fr) * 1999-12-15 2001-06-21 Wolfram Mittelmeier Clou a os de compression

Patent Citations (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1989006948A1 (fr) * 1988-02-04 1989-08-10 Pfizer Hospital Products, Inc. Appareil de reduction de fracture
US5112333A (en) * 1990-02-07 1992-05-12 Fixel Irving E Intramedullary nail
EP0491138A1 (fr) * 1990-12-17 1992-06-24 Synthes AG, Chur Dispositif de fixation d'os cassés
ES2119848T3 (es) * 1992-12-04 1998-10-16 Synthes Ag Clavo intramedular modular.
WO1994027508A2 (fr) * 1993-06-01 1994-12-08 Endocare Ag Instrument auxiliaire pour osteosynthese permettant de traiter des fractures subtrochanteriennes et pertrochanteriennes, ainsi que des fractures du col du femur
ES2155892T3 (es) * 1994-07-15 2001-06-01 Smith & Nephew Inc Clavo intramedular modular encanulado.
WO1998018397A1 (fr) * 1996-10-28 1998-05-07 Smith & Nephew, Inc. Clou centro-medullaire tubulaire et modulaire
EP1053718A1 (fr) * 1999-05-12 2000-11-22 Sulzer Orthopedics Ltd. Clou de verrouillage pour le traitement des fractures de la tige fémorale
WO2001043652A1 (fr) * 1999-12-15 2001-06-21 Wolfram Mittelmeier Clou a os de compression

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9597129B2 (en) 2007-05-25 2017-03-21 Zimmer Gmbh Reinforced intramedullary nail
EP2108322A1 (fr) * 2008-04-09 2009-10-14 José Costa Martins Plaque de contention/compression trochantérique
US8668695B2 (en) 2008-10-15 2014-03-11 Zimmer Gmbh Intramedullary nail
US9474557B2 (en) 2008-10-15 2016-10-25 Zimmer Gmbh Intramedullary nail
WO2013075730A1 (fr) * 2011-11-25 2013-05-30 Stryker Trauma Gmbh Système d'implant pour une fixation osseuse
US20140378973A1 (en) * 2011-11-25 2014-12-25 Stryker Trauma Gmbh Implant system for bone fixation
US9463054B2 (en) 2011-11-25 2016-10-11 Stryker European Holdings I, Llc Implant system for bone fixation

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