WO2003082161A1 - Appareil orthopedique pour fracture - Google Patents

Appareil orthopedique pour fracture Download PDF

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Publication number
WO2003082161A1
WO2003082161A1 PCT/GB2003/001397 GB0301397W WO03082161A1 WO 2003082161 A1 WO2003082161 A1 WO 2003082161A1 GB 0301397 W GB0301397 W GB 0301397W WO 03082161 A1 WO03082161 A1 WO 03082161A1
Authority
WO
WIPO (PCT)
Prior art keywords
brace
fracture
loading area
bone
loading
Prior art date
Application number
PCT/GB2003/001397
Other languages
English (en)
Inventor
Douglas Wardlaw
Original Assignee
Grampian University Hospitals Nhs Trust
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 Grampian University Hospitals Nhs Trust filed Critical Grampian University Hospitals Nhs Trust
Priority to AU2003224245A priority Critical patent/AU2003224245A1/en
Publication of WO2003082161A1 publication Critical patent/WO2003082161A1/fr

Links

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
    • A61B17/60—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
    • 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
    • A61B17/6491—Devices extending alongside the bones to be positioned allowing small-scale motion of bone ends
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. splints, casts or braces
    • A61F5/0102—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations
    • A61F5/0104—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation
    • A61F5/0118—Orthopaedic devices, e.g. splints, casts or braces specially adapted for correcting deformities of the limbs or for supporting them; Ortheses, e.g. with articulations without articulation for the arms, hands or fingers
    • 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
    • A61B17/66—Alignment, compression or distraction mechanisms

Definitions

  • This invention relates to a brace for treatment of a fracture, in particular a brace for treatment of a fracture to a human limb, for example a fracture to the lower end of the radius.
  • the most common fracture treatment uses a plaster of Paris cast, which is applied at the time of fracture reduction.
  • the cast effectively immobilises the fractured area, but can thus result in the fractured area being very stiff after the fracture has healed and the cast removed. Also, this method of treatment is not always successful in maintaining the fracture position and may leave significant long-term deformity of the fractured area.
  • Fracture braces are known which attempt to overcome the disadvantages of casts.
  • a fracture brace is disclosed in GB 2193102 and EP 0255388.
  • the brace is rigid and comprises two main portions, conjoined together by two elasticated Velcro straps.
  • a first portion covers the dorso-radial surface of the forearm from the level of the radio-carpal joint and radial syloid for approximately two thirds of the forearm.
  • At either end of the brace there are two specified areas of high loading.
  • a second portion is applied to the antero-ulnar aspect of the forearm and has a similar raised area of a specified size.
  • This fracture brace allows earlier mobilisation of the fracture area than a cast but fails to maintain the fracture position adequately enough to allow a significant long term advantage.
  • a further alternative form of treatment is to use external fixators whereby pins are applied to the fracture.
  • the fracture is reduced and the external fixator is applied holding the fracture fragments in a distracted, reduced position.
  • This immobilises the wrist and leaves a very stiff wrist which again requires a long period of rehabilitation.
  • External fixation has also been applied to the less comminuted fractures where there is one fairly large distal fragment through which pins can be inserted and this is done along with pins in the radius proximal to the fracture.
  • the external fixator is then able to hold the fracture reduced and allow the wrist to move.
  • the external fixator in this position is cumbersome, resulting in patients having difficulty performing normal day to day activities, such as dressing. Pint tract infection may occur in some cases.
  • a brace for treatment of a fracture having at least one loading area adapted for placement of a first fixating means therethrough into a first bone portion on one side of a fracture, and placement of a second fixating means therethrough into a second bone portion on the other side of the fracture.
  • the brace comprises first and second load applicators, and optionally means for holding the first and second load applicators in relative position when fitted about a fracture.
  • the first load applicator can comprise the at least one loading area, and typically comprises a distal loading area and a proximal loading area, wherein the distal loading area is adapted for placement of the fixating means therethrough into the fracture.
  • first and second bone portions are respective fragments of bone, but the brace of the invention is not restricted to fractures that have comminuted bone fragments, and green stick or other fractures can usefully be treated by this brace.
  • the first bone portion is distal relative to the second proximal bone portion.
  • Embodiments of the present invention can thus provide enhanced fracture reduction and corrective alignment, and improved stability of fracture bones and/or mobility of joints.
  • use of the brace can provide a decreased incidence of deformity and/or morbidity as bones and joints are allowed free movement in a stabilised manner.
  • the invention also provides a method of treating a fracture, comprising the steps of applying a brace to the fracture, the brace having at least one loading area adapted for receiving bone fixating means therethrough; passing a first fixating means through the loading area of the brace into a first bone portion on one side of a fracture; and passing a second fixating means through the loading area of the brace into a second bone portion on the other side of the fracture.
  • first and second fixating means for example, through the distal loading area into a distal fragment of a fracture and a proximal bone fragment adjacent the fracture respectively, provides advantages over conventional fracture braces.
  • the use of said second fixating means gives the brace improved attachment to the undamaged bone adjacent the fracture, and helps prevent shortening of the fracture during healing.
  • the second fixating mans helps protect the fracture from undue external forces.
  • the distal loading area is preferably of such a size as to provide loading to the whole area of the distal fracture fragment, and to provide similar loading to e.g. an intact portion of bone adjacent to the fracture, i.e. the second portion. This loading on the intact portion of the bone adjacent the fracture acts as a stop to help prevent over-reduction of the fracture.
  • the second load applicator, and the distal and proximal loading areas of the first load applicator may be of conventional structure for use in a fracture brace, as is known in the art.
  • the first and second load applicators may be fixed in relation to each other, for example moulded as an integral piece, or may be fixed relative to one another by one or more rigid fixing members.
  • the load applicators will typically be made of preformed moulded plastics material.
  • the means for holding the first and second load applicators in relative position around a fracture may be any suitable means.
  • said means for holding may comprise an adjustable or resilient strap, for example an elasticated VelcroTM strap.
  • the fracture brace of the present invention preferably further comprises a resilient member which conjoins the distal and proximal loading areas.
  • the resilient member is preferably elastically deformable when fitted about a fracture. In this way, as swelling at the fracture location decreases, the resilient member can store energy when it is deformed, which energy is released as it returns to its initial shape. In this way pressure can be maintained substantially constant on the fracture area during treatment.
  • the resilient member should be flexible, so that it can deform when the brace is fitted around a fracture, returning to its original shape as the fracture swelling reduces.
  • the resilient member preferably consists substantially of a resilient material, conveniently plastics materials, for example polypropylene.
  • the resilient member preferably comprises one or more elongate members attached at each end to the distal and proximal loading areas respectively. The use of such a resilient member enables the loading to be maintained more uniformly as the fracture swelling is reduced.
  • proximal and distal loading areas of the first load applicator may be part of an integral structure, for example without such a resilient member, using straps to maintain loading.
  • the first and second fixating means used in the present invention may comprise, for example, metal pins or Kirschner wires (K-wires) to be inserted through the distal loading area into the distal fracture fragment and adjacent proximal bone fragment.
  • the first and/or second fixating means may be screwed or otherwise fixed to the bone to prevent movement of the fixating means either further into or out of the bone, and may be screwed or otherwise fixed to the distal loading area to prevent relative movement of the fixating means therewith.
  • the proximal loading area may be adapted for placement of fixating means therethrough into a proximal bone fragment .
  • the brace is typically adapted for use with a limb fracture .
  • Figure 1 shows first and second load applicators for use in a brace of the present invention
  • Figure 2 shows a brace of the present invention in position fitted around a fractured wrist from the dorso-radial side
  • Figure 3 shows the brace of Figure 2 from the antero-ulnar side
  • Figure 4 shows first and second fixating means inserted into a distal fracture fragment and proximal bone fragment respectively.
  • a brace 1 comprises a first load applicator 3 and second load applicator 2.
  • the second applicator 2 is an antero-ulnar portion
  • the first applicator 3 is a dorso-radial portion.
  • the means for holding the first 3 and second 2 load applicators in relative position when fitted about a fracture comprises an elasticated VelcroTM strap 4, to which the second load applicator 2 is attached.
  • the first applicator 3 has a proximal loading area 5, and a distal loading area 6.
  • the proximal 5 and distal 6 loading areas are conjoined by two resilient polypropylene struts 7.
  • the distal loading area 6 comprises a first 8 and second 10 set of holes therein, through which first and second fixating means, namely K- wires, (not shown in Figure 1) can pass.
  • the brace 1 in use the brace 1 is applied as shown.
  • the first load applicator 3 covers the dorso-radial surface of the forearm from the level of the radio-carpal joint and radial syloid proximally for approximately two thirds of the forearm.
  • the second load applicator 2 of the brace 1 is applied to the antero-ulnar aspect of the forearm, and is fixed in position around the fracture relative to the first load applicator 3 by strap 4.
  • a first set of distal K-wires 12 pass through the distal loading area 6 into the distal fracture fragment, and a second set of proximal K- wires 14 pass through the distal loading area 6 into the proximal bone fragment.
  • the positioning of the first 12 and second 14 sets of K-wires is shown in more detail in Figure 4.
  • the fracture is reduced, and the K-wires 12, 14 are inserted into the distal fracture fragment and proximal bone fragment as is conventional in the art, for example using a jig.
  • the jig spaces the wires 12, 14 and directs them such that they enter the bone appropriately.
  • the distal loading area 6 has first 8 and second 10 sets of holes therein corresponding to the spacing of the wires 12, 14 in the jig, and is fitted over the wires 12, 14.
  • the wires 12, 14 are then fixed to the distal loading area 6 by conventional means, for example a crimping mechanism, to ensure that no migration of the wires 12, 14 occurs.
  • the first 3 and second 2 load applicators are then positioned, and the strap 4 tightened and tensioned.
  • the resilient struts of polypropylene 7 will tend to straighten out. Energy is thus stored in the deformed polypropylene struts 7 which act as a spring.

Landscapes

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

Abstract

L'invention concerne un appareil orthopédique pour le traitement d'une fracture, de type fracture d'un membre d'un être humain. Des modes de réalisation généraux comprennent un premier et un second applicateur de charge et un moyen permettant de maintenir ledit premier et ledit second applicateur de charge en position relative lorsque ceux-ci sont placés autour d'un membre fracturé.
PCT/GB2003/001397 2002-03-28 2003-03-28 Appareil orthopedique pour fracture WO2003082161A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU2003224245A AU2003224245A1 (en) 2002-03-28 2003-03-28 Fracture brace

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GB0207399.7 2002-03-28
GB0207399A GB0207399D0 (en) 2002-03-28 2002-03-28 Fracture brace

Publications (1)

Publication Number Publication Date
WO2003082161A1 true WO2003082161A1 (fr) 2003-10-09

Family

ID=9933954

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB2003/001397 WO2003082161A1 (fr) 2002-03-28 2003-03-28 Appareil orthopedique pour fracture

Country Status (3)

Country Link
AU (1) AU2003224245A1 (fr)
GB (1) GB0207399D0 (fr)
WO (1) WO2003082161A1 (fr)

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005122974A1 (fr) * 2004-06-18 2005-12-29 Oped Ag Orthese de poignet
CN106108993A (zh) * 2016-06-22 2016-11-16 类新 骨折固定装置
CN107744446A (zh) * 2017-12-04 2018-03-02 陈彩飞 一种用于治疗股骨头坏死的髋关节保护支撑架

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0255388A1 (fr) 1986-07-31 1988-02-03 Douglas Wardlaw Bandage de soutien pour une fracture
US4947835A (en) * 1989-04-05 1990-08-14 Dynasplint Systems, Inc. Adjustable splint assembly
EP0401755A2 (fr) * 1989-06-09 1990-12-12 ROLTRA-MORSE S.p.A. Prothèse pour la réduction et le maintien des fractures osseuses dans les membres
US5312322A (en) * 1992-11-02 1994-05-17 The United States Of America As Represented By The Secretary Of The Navy Three point extension splint to treat flexion contractures about limb synovial hinge joints
WO2001043671A1 (fr) * 1999-12-17 2001-06-21 Grampian University Hospitals Attelle pour fracture
US20020004659A1 (en) * 2000-04-28 2002-01-10 Fixano External fixator for immobilizing bone fragments, particularly in the area of the wrist

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0255388A1 (fr) 1986-07-31 1988-02-03 Douglas Wardlaw Bandage de soutien pour une fracture
GB2193102A (en) 1986-07-31 1988-02-03 Douglas Wardlaw Fracture brace
US4947835A (en) * 1989-04-05 1990-08-14 Dynasplint Systems, Inc. Adjustable splint assembly
EP0401755A2 (fr) * 1989-06-09 1990-12-12 ROLTRA-MORSE S.p.A. Prothèse pour la réduction et le maintien des fractures osseuses dans les membres
US5312322A (en) * 1992-11-02 1994-05-17 The United States Of America As Represented By The Secretary Of The Navy Three point extension splint to treat flexion contractures about limb synovial hinge joints
WO2001043671A1 (fr) * 1999-12-17 2001-06-21 Grampian University Hospitals Attelle pour fracture
US20020004659A1 (en) * 2000-04-28 2002-01-10 Fixano External fixator for immobilizing bone fragments, particularly in the area of the wrist

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2005122974A1 (fr) * 2004-06-18 2005-12-29 Oped Ag Orthese de poignet
US7993294B2 (en) 2004-06-18 2011-08-09 Oped Ag Wrist orthosis
CN106108993A (zh) * 2016-06-22 2016-11-16 类新 骨折固定装置
CN107744446A (zh) * 2017-12-04 2018-03-02 陈彩飞 一种用于治疗股骨头坏死的髋关节保护支撑架

Also Published As

Publication number Publication date
AU2003224245A1 (en) 2003-10-13
GB0207399D0 (en) 2002-05-08

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