WO2008058403A1 - Dispositif de fixation de fragments d'articulation comportant du cartilage - Google Patents

Dispositif de fixation de fragments d'articulation comportant du cartilage Download PDF

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Publication number
WO2008058403A1
WO2008058403A1 PCT/CH2006/000639 CH2006000639W WO2008058403A1 WO 2008058403 A1 WO2008058403 A1 WO 2008058403A1 CH 2006000639 W CH2006000639 W CH 2006000639W WO 2008058403 A1 WO2008058403 A1 WO 2008058403A1
Authority
WO
WIPO (PCT)
Prior art keywords
rod
central axis
section
cross
helical
Prior art date
Application number
PCT/CH2006/000639
Other languages
English (en)
Inventor
Kaj Klaue
Original Assignee
Synthes Gmbh
Synthes (U.S.A)
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 Synthes Gmbh, Synthes (U.S.A) filed Critical Synthes Gmbh
Priority to PCT/CH2006/000639 priority Critical patent/WO2008058403A1/fr
Priority to TW096139639A priority patent/TW200824640A/zh
Publication of WO2008058403A1 publication Critical patent/WO2008058403A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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 or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue

Definitions

  • the invention relates to a device for osteochondrosynthesis according to the preamble of claim 1 and to a kit comprising an embodiment of the device and a drill bit according to claim 35.
  • Such devices can be applied for various medical indications, particularly for the fixation of articulation fragments, i.e. fragments having bone - as well as cartilage portions.
  • osteochondrosis in case of disturbances of growth at adolescents (so called osteochondrosis or osteochondritis).
  • CPM continuous passive kinetotherapy
  • the articulation fragments mostly are so small that often only a single pin may be positioned therein. A plurality of pins would also endanger the vitality of the bone portion. Furthermore, the articulation fragments are often positioned such that an
  • a tube shaped device for osteosynthesis, particularly to temporarily put a toe in splints is known from WO2004/089255, which is implanted by means of a guide rod.
  • the various disadvantages of this known device are:
  • the circular cross section of the tube allows the individual bones to rotate about the tube, i.e. there is no rotational securing of the implant;
  • the inserted guide rod can bend and pass on a false path; the tube can get jammed on the guide rod; the tubular implant and the guide rod are weakened through a small dimension of the rod and the central cannulation in the tube; the application from distal, i.e. starting from the ball of the toe results in a loss of the distal interphalangeal articulation).
  • the invention solves the posed objectives with a device for osteochondrosynthesis comprising the features of claim 1 , as well as with a kit including a device according to the invention and a drill bit comprising the features of claim 35.
  • the advantages achieved by the invention are essentially the following: a) the interfragmentary stability is significantly improved allowing a securing of the consolidation; b) the stability, particularly in rotation is held.
  • the central axis of the rod is linear.
  • the rod has an enveloping cylinder with a diameter of less than 7 mm, preferably less than 6 mm.
  • the rod has an enveloping cylinder with a diameter of more than 3 mm, preferably more than 4 mm.
  • the rod has an enveloping cone allowing an easier introduction.
  • the enveloping cone has a cone angle of maximum 5,5°.
  • the cross section remains constant over the entire length L of the rod.
  • the twisted rod has a peripheral surface which comprises at least two helical lines, preferably three helical lines.
  • the cross-section orthogonal to the central axis has a maximum dimension in the range of 1 to 3 mm, preferably in the range of 1 ,5 to 2,7 mm.
  • the pitch p of the helical line is less than 50 mm, preferably less than 40 mm.
  • the pitch p of the helical line is more than 20 mm, preferably more than 25 mm.
  • the pitch p is about 30 mm, i.e. one turn of the helically twisted rod corresponds to a length of about 30 mm.
  • the pitch p of the helical line is constant over its whole length.
  • the pitch p of the helical line is variable allowing the advantage of a slight axial compression if the pitch is high at the entering tip and low at the end of the implant (effect like in the Herbert screw (scaphoid bone).
  • the helical line is running over more than 360°, preferably over more than 540°.
  • the helical line is running over less than 900°, preferably less than 720°. Generally, a small pitch of the helical line renders the insertion of the rod in the bone more difficult.
  • noncircular cross section is formed polygonally, preferably triangularly.
  • a triangular cross section a quadrilateral or pentagonal cross section could also be used.
  • the corners of the polygonal cross section are rounded.
  • the polygonal cross section has concave sides.
  • the rod is provided with at least three longitudinal edges or longitudinal fins on its peripheral surface which run helical with regard to the central axis of the rod.
  • the advantage achieved is that the longitudinal edges or longitudinal fins of the rod cut into the cartilage or bone tissue.
  • the longitudinal edges or longitudinal fins are separated from each other through concave recesses running helical with regard to the central axis of the rod. This allows to achieve a better stability and avoids any other angles of the whole implant (solidity, resistance of the implant without angles). The only sharp angles would be the edges of the fins.
  • the concave recesses have a depth between 5% and 30% of the diameter of the enveloping cylinder.
  • the rod is provided with a front end determined for insertion in the bone, said front end being preferably configured bluntly.
  • a blunt, e.g. planar embodiment of the front end is particularly suitable in an application in case of osteochondritis.
  • the rod comprises a coaxial head portion which has a cross section enlarging towards the rear end of the rod.
  • the cross sectional area of the head portion orthogonal to the central axis progressively enlarges toward the rear end.
  • the head portion has a cylindrical enveloping surface coaxial to the central axis with a diameter equivalent to the maximum outer diameter of the rod.
  • the ratio between the length I of the head portion and the length L of the rod is between 1/20 and 1/3.
  • bioresorbable material is essentially brittle and crumbling.
  • the rod consists of a reinforced, preferably self- reinforced bioresorbable material.
  • the bioresorbable material can be a Poly-L-Lactide (PLLA) or a Caprolactone. These materials show the advantage that they resorb faster via the synovial fluid.
  • the rod consists of a Copolymer of lactic acid and glycolic acid, preferably in a ratio of 3 : 1 to 5 : 1.
  • the rod can consist of a Copolymer from Poly-L-Lactide (PLLA) and Poly (DL-lactide-Co-Glycolid Acid) PLGA, preferably in a ratio 3 : 1 to 5 : 1 and typically in the ratio 4 : 1. Also, the rod can consist of a Copolymer of PoIy-L, D-Lactide.
  • PLLA Poly-L-Lactide
  • DL-lactide-Co-Glycolid Acid DL-lactide-Co-Glycolid Acid
  • the rod is tubularly configured. This configuration allows the advantage that a guide wire can be used during insertion of the rod in the bone.
  • the inner diameter of the tubular rod is smaller than 1 ,6 mm, preferably smaller than 1 ,3 mm.
  • the wall thickness of the tubular rod can be greater than 0,1 mm, preferably greater than 0,15 mm but smaller than 0,5 mm, preferably smaller than 0,4 mm.
  • the length of the rod can be between 3 - 6 cm, preferably between 4 - 5 cm.
  • the rod tapers at least at one end, preferably converging to a pointed tip such that the rod can easier be implanted.
  • the rod has a smooth peripheral surface.
  • the rod has a peripheral surface comprising an axial saw-tooth or fish-scales like three-dimensional structure, thus allowing the advantages of an unidirectional insertion in the bone only and that the surface structure facilitates insertion of the rod and prevents pull-out.
  • noncircular cross section of the rod is centrally symmetric.
  • a kit with a device according to invention and with a drill bit whereby the drill bit has a diameter D being smaller than the maximum outer diameter of the rod and being preferably more than 30% smaller.
  • the device according to the invention is used for fixation of articulation fragments, particularly such having bone and cartilage portions.
  • Fig. 1 illustrates a perspective view of an embodiment of the device according to the invention
  • Fig. 2 illustrates a sectional view of the embodiment of fig. 1 along line Il - II;
  • Fig. 3 illustrates a sectional view of another embodiment of the device according to the invention.
  • Fig. 4 illustrates a partial perspective view of a further embodiment of the device according to the invention.
  • Fig. 5 illustrates a lateral view orthogonal to one lateral surface of the embodiment of fig. 4;
  • Fig. 6 illustrates a sectional view of the embodiment of fig. 4 along line III - III.
  • the device for the fixation of a joint fragment illustrated in figs. 1 and 2 essentially consists of a helically twisted rod 1 with a linear central axis 2 and a noncircular (here triangular) cross section 3, which is made of a preferably self-strengthening PoIy-L 1 D- Lactide (SR-PLA 96/4).
  • Copolymers from Poly-L-Lactide (PLLA) and Poly-(DL-lactide- Co-Glycolide acid) (PGLA), preferably in a ratio 4:1 are suitable as well.
  • PGLA Poly-(DL-lactide- Co-Glycolide acid)
  • PGLA Poly-(DL-lactide- Co-Glycolide acid)
  • PGLA Poly-(DL-lactide- Co-Glycolide acid)
  • PGLA Poly-(DL-lactide- Co-Glycolide acid)
  • PGLA Poly-(DL-lactide- Co-Gly
  • the helically twisted rod 1 has an enveloping surface formed as an enveloping cylinder 30 coaxial to the central axis 2.
  • the length of the rod 1 is 3,75 cm.
  • the surface of the rod 1 is completely smooth.
  • the front end 23 of the rod 1 which is determined to enter in the toe is tapered such that it terminates rounded.
  • the noncircular cross section 3 is shaped triangularly so that the peripheral surface 10 of the rod 1 is provided with three longitudinal edges or longitudinal fins 6,7,8.
  • the longitudinal edges or longitudinal fins 6,7.8 extend helically around the central axis 2 of the rod 1 such forming helical lines at the peripheral surface of the rod 1.
  • the sides of the triangle are concavely shaped, such that the longitudinal edges or longitudinal fins 6,7,8 are mutually separated through concave recesses 9.
  • the recesses 9 extend helically around the linear central axis 2 of the rod 1.
  • the cross section 3 orthogonal to the central axis 2 has a maximum dimension 12 of between 1 to 3 mm, preferably between 1 ,5 to 2,7mm and a minimum dimension of between 1 ,0 - 2,5 mm, typically 1 ,6 mm.
  • the recesses 9 have a depth of between 0,1 to 0,5 mm.
  • the bore to be performed in the intramedullary channel of the respective bone has a bore diameter 18 which is advantageously smaller than the maximum dimension 12 of the cross section of the rod 1 such enabling the longitudinal fins 6,7,8 to cut into the wall of the bored intramedullary channel allowing a rotational securing of the rod 1.
  • FIG. 3 An alternative embodiment of the rod 1 is illustrated in fig. 3 which differs from the embodiment illustrated in figs. 1 and 2 only therein that the noncircular cross section 3 is shaped elliptically instead of triangularly.
  • the lines formed by the principal vertices of each subsequent cross section 3 form helical edges.
  • the embodiment illustrated in figs. 4 - 6 depicts a rod 1 including a helically twisted portion with a triangular constant cross section 3 and a head portion 25 coaxially arranged to the central axis 2 and terminally arranged at the rear end 24 of the rod 1.
  • the central axis 2 which is here formed by the line joining the gravity centres of the axial subsequent cross sections extends linearly in the embodiment shown here.
  • the cross section orthogonal to the central axis 2 of the head portion 25 enlarges towards the rear end 24.
  • the peripheral surface 10 of the rod 1 is provided with three plane lateral surfaces 26,27,28 and three longitudinal edges or longitudinal fins 6,7,8.
  • the triangular cross section 3 is equilateral and has a circumcircle with the maximum outer diameter 12 of the rod 1.
  • the head portion 25 is distinguished by an axial curvature of the plane lateral surfaces 26,27,28 adjacent the portion of the rod 1 with constant cross section such that the distance a between the central axis 2 and each one of the lateral surfaces 26,27,28 progressively increases toward the rear end 24 of the rod 1. Furthermore, the head portion 25 has a length I and an enveloping surface with the maximum outer diameter 12 and where the lateral surfaces 26,27,28 run into at the rear end 24 of the rod 1 so that the end face orthogonal to the central axis 2 is a circular area.
  • the non-circular profile of the fragment produces the necessary rotational stability.
  • the insertion of a second rod is not necessary. Anyhow, mostly there is no space for this and such a second rod would additionally endanger the vitality (vascularity).

Landscapes

  • 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)
  • Prostheses (AREA)

Abstract

La présente invention concerne un dispositif pour ostéochondrosynthèse ayant la forme d'une tige (1) avec un axe central (2) et une longueur L et qui consiste principalement en un matériau biorésorbable, moyennant quoi A) la tige (1) est dotée d'une coupe transversale non circulaire (3) perpendiculaire à l'axe central (2) au moins dans une partie S de la longueur L; et B) la tige (1) est tordue le long de son axe central (2).
PCT/CH2006/000639 2006-11-14 2006-11-14 Dispositif de fixation de fragments d'articulation comportant du cartilage WO2008058403A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/CH2006/000639 WO2008058403A1 (fr) 2006-11-14 2006-11-14 Dispositif de fixation de fragments d'articulation comportant du cartilage
TW096139639A TW200824640A (en) 2006-11-14 2007-10-23 Device for osteochondrosynthesis

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2006/000639 WO2008058403A1 (fr) 2006-11-14 2006-11-14 Dispositif de fixation de fragments d'articulation comportant du cartilage

Publications (1)

Publication Number Publication Date
WO2008058403A1 true WO2008058403A1 (fr) 2008-05-22

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ID=38229566

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2006/000639 WO2008058403A1 (fr) 2006-11-14 2006-11-14 Dispositif de fixation de fragments d'articulation comportant du cartilage

Country Status (2)

Country Link
TW (1) TW200824640A (fr)
WO (1) WO2008058403A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011054124A1 (fr) * 2009-11-09 2011-05-12 Spinewelding Ag Dispositif médical, appareil, et méthode chirurgicale

Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1337074A1 (ru) * 1985-06-21 1987-09-15 В.В.Коптюх Устройство дл остеосинтеза
WO1995001810A1 (fr) * 1993-07-07 1995-01-19 Smith & Nephew Plc Prothese implantable, trousse et dispositif de fabrication
EP0714643A1 (fr) * 1994-12-02 1996-06-05 JOHNSON & JOHNSON PROFESSIONAL Inc. Dispositif de fixation des os
WO1998051241A1 (fr) * 1997-05-16 1998-11-19 Norian Corporation Broches implantables
WO2001080754A1 (fr) * 2000-04-20 2001-11-01 Synthes Ag Chur Dispositif pour fixer des implants sur un os ou dans un os
US20020123751A1 (en) * 2001-03-02 2002-09-05 Fallin T. Wade Two-part orthopedic fastener
US20060247387A1 (en) * 2005-04-29 2006-11-02 Board Of Trustees Of Michigan State University Hyperbranched polymer modified biopolymers, their biobased materials and process for the preparation thereof

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
SU1337074A1 (ru) * 1985-06-21 1987-09-15 В.В.Коптюх Устройство дл остеосинтеза
WO1995001810A1 (fr) * 1993-07-07 1995-01-19 Smith & Nephew Plc Prothese implantable, trousse et dispositif de fabrication
EP0714643A1 (fr) * 1994-12-02 1996-06-05 JOHNSON & JOHNSON PROFESSIONAL Inc. Dispositif de fixation des os
WO1998051241A1 (fr) * 1997-05-16 1998-11-19 Norian Corporation Broches implantables
WO2001080754A1 (fr) * 2000-04-20 2001-11-01 Synthes Ag Chur Dispositif pour fixer des implants sur un os ou dans un os
US20020123751A1 (en) * 2001-03-02 2002-09-05 Fallin T. Wade Two-part orthopedic fastener
US20060247387A1 (en) * 2005-04-29 2006-11-02 Board Of Trustees Of Michigan State University Hyperbranched polymer modified biopolymers, their biobased materials and process for the preparation thereof

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
DATABASE WPI Week 198815, Derwent World Patents Index; AN 1988-104222, XP002442738 *

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO2011054124A1 (fr) * 2009-11-09 2011-05-12 Spinewelding Ag Dispositif médical, appareil, et méthode chirurgicale
CN102695466A (zh) * 2009-11-09 2012-09-26 斯伯威丁股份公司 医疗器械、医疗装置和外科手术方法
EP2898843A3 (fr) * 2009-11-09 2015-09-30 Spinewelding AG Dispositif médical, appareil et méthode chirurgicale
US9155563B2 (en) 2009-11-09 2015-10-13 Spinewelding Ag Medical device, apparatus, and surgical method
AU2010314743B2 (en) * 2009-11-09 2016-03-17 Spinewelding Ag Medical device, apparatus, and surgical method
CN105962993A (zh) * 2009-11-09 2016-09-28 斯伯威丁股份公司 医疗器械、医疗装置和外科手术方法
US9566099B2 (en) 2009-11-09 2017-02-14 Spinewelding Ag Medical device, apparatus, and surgical method
US10342587B2 (en) 2009-11-09 2019-07-09 Spinewelding Ag Medical device, apparatus, and surgical method

Also Published As

Publication number Publication date
TW200824640A (en) 2008-06-16

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