WO2010026307A2 - Unitary nail for bone synthesis - Google Patents

Unitary nail for bone synthesis Download PDF

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Publication number
WO2010026307A2
WO2010026307A2 PCT/FR2009/001050 FR2009001050W WO2010026307A2 WO 2010026307 A2 WO2010026307 A2 WO 2010026307A2 FR 2009001050 W FR2009001050 W FR 2009001050W WO 2010026307 A2 WO2010026307 A2 WO 2010026307A2
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WO
WIPO (PCT)
Prior art keywords
nail
head
pin
bone
ancillary
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Application number
PCT/FR2009/001050
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French (fr)
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WO2010026307A3 (en
Inventor
Pierre Le Guilloux
Original Assignee
Pierre Le Guilloux
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Publication date
Application filed by Pierre Le Guilloux filed Critical Pierre Le Guilloux
Publication of WO2010026307A2 publication Critical patent/WO2010026307A2/en
Publication of WO2010026307A3 publication Critical patent/WO2010026307A3/en

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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
    • A61B17/16—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
    • A61B17/1739—Guides or aligning means for drills, mills, pins or wires specially adapted for particular parts of the body
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B2017/00477—Coupling

Definitions

  • the technical field of the invention is that of instruments, devices or surgical methods, and more particularly to an object, on the one hand, an olecranon nail, on the other hand, an associated tooling and finally the associated method of use.
  • the problem of fracture osteosynthesis of the olecranon a prominent part of the ulna corresponding to the posterior region of the elbow, already knows several devices, in particular that of the placement of a specific implant.
  • EP1792578 which describes an implant device for the osteosynthesis of the elbow, characterized in that it comprises two fastening systems, one of which applies a distal pressure and of which the other allows a longitudinal pressure, or traction, using a washer provided with three pointed lugs.
  • this fastening system by traction consists of a rod provided with a screw thread at one end which can accommodate a screw which allows the establishment of a washer.
  • it comprises a clearance between said washer and the rod and screw assembly, which allows to marry the anatomy of the bone.
  • the washer is characterized in that it is circular and has pointed lugs for better fixation of the device to the bone.
  • the distal locking is, meanwhile, carried out using a screw disposed transversely to the rod which is screwed into a tapping of the rod provided for this purpose.
  • Such a device has the disadvantages, on the one hand, to impose a large diameter to the ol constitutionalien nail, which is 6mm, which may weaken the olecranon see breaking.
  • the compression screw may loosen during repetitive movements of the elbow. This method increases the difficulties of securing said compression screw to the nail already in place and lengthens the operating time.
  • the pressure exerted on the bone by the washer is not uniform.
  • the nail is integral, comprises a rod provided with a head at one of its ends and is characterized in that the lower face of the head forms a plane forming with the longitudinal axis (x) of the rod an angle between 10 and 80 degrees modulo ⁇ .
  • the other end of said nail is refined to facilitate its introduction.
  • the head of said nail is characterized in that it comprises two parallel faces, the lower face being of ovoid shape.
  • the head of said nail provides support on the base of the olecranon and its ovoid shape, wider in the anteroposterior than in the medio-lateral direction, allows better bone contact through the fibers of the triceps tendon.
  • the ovoid shape allows easier introduction into contact with the olecranon through the vertical tendinous fibers of the triceps muscle, these moving parts can hinder the introduction of the nail and come between the head of the nail and the nail. bone.
  • the head of said nail has pointed lugs allowing better grip on the bone and improves the stability of the olecranon fragment.
  • the nail may also be characterized in that it comprises a radial bore which will allow the introduction of a pin allowing a perfect fixation of the nail in the bone.
  • the nail can also be characterized in that it comprises a tapping at its head. Indeed, the establishment of the pin in the bore provided for this purpose requires the use of ancillary which will be locked to said nail with a screw before being removed.
  • this nail is characterized in that it may consist of a resorbable material.
  • the pin used here is characterized in that it is able to cooperate with said nail.
  • it is provided with a head at one of its ends, a thread of nominal diameter D 'attached to this head and a smooth portion of diameter D adapted to slide in the bore of said rod, Being greater than D.
  • the smooth portion is intended to penetrate into the radial bore of said olecranon nail while the threading will allow attachment of the pin directly into the bone.
  • an ancillary setting of said nail and said pin comprises an inverted L-shaped handle characterized in that it comprises at each of its ends:
  • a stop positioned orthogonally to the handle whose face in contact with the nail is tapered by an angle of between 10 and 80 degrees modulo ⁇ and having a locking means consisting of a bore for the introduction of a locking screw.
  • This last bore will serve as a guide for the forest that will pierce the bone.
  • the ancillary thus described allows the very precise positioning of the pin in the bone and said olecranon nail via said locking means with the nail.
  • the method of laying the nail is characterized in that it comprises the following steps:
  • FIG. 1 shows a diagram of the nail and its pin optimized according to one embodiment of the invention
  • FIG. 2 shows a diagram of the nail and its pin according to this embodiment positioned on a ulna;
  • FIG. 3 shows a diagram of an ancillary device according to one embodiment of the invention
  • FIG. 1 shows a diagram of a nail and its pin optimized according to one embodiment of the invention.
  • Said nail 1 having a diameter of between 4.5 and 5 mm, is a monobloc made of titanium and has an elongated configuration along the axis (x). It consists of a body 2, a head 3 at one of its ends while the other end 4 is tapered to allow a better implementation of said nail 1.
  • the head 3 of said nail 1 has a face lower 5 and an upper face 6 both parallel.
  • the lower face 5 of the head has pointed lugs 7 and forms a plane forming with the longitudinal axis (x) of the rod an angle of 20 degrees.
  • a tapping 8 can accommodate a screw to allow the locking of the nail 1 on an ancillary for the installation of a pin 9 longitudinal locking of the nail 1 in a bone.
  • Said pin 9 is shown in the radial bore 10 of the nail
  • I provided for this purpose (along the axis (y)). It has a diameter of 2.5 mm on its unthreaded portion and a nominal diameter equal to 3.5 mm on its threaded portion 11 in contact with the head 12 of said pin, here of rounded configuration.
  • Figure 2 shows a diagram of the nail and its pin according to an embodiment positioned on a ulna.
  • the nail 1 is here represented in the ulna 13 along the longitudinal axis (x) of the bone 13.
  • the nail 1 allows the maintenance of the base of the olecranon 14 of the rest of the ulna 13 because inserted longitudinally (following the axis (x)) and perpendicular to the lesion 15.
  • the lugs 7 of said nail 1 are inked in the bone 13 to allow better fixation of the nail on the bone and the pin 9 is positioned in the bone, 13 while passing through the bore 10 of the nail 1. Its threaded portion
  • Figure 3 shows a diagram of the ancillary according to one embodiment of the invention.
  • the ancillary 16 comprises a handle 17 L with two ends, one 18 is adapted to lock said nail 1 and the other 19 is adapted to guide a drill and push the pin 9.
  • the end 18 consists of a stop 20 positioned orthogonally to the handle 17 whose end 21 is tapered by an angle equal to the angle of inclination of the head 3 of said nail 1 shown in Figure 1, that is to say 20 degrees.
  • the contact between the nail 1 and the abutment will form a plane connection.
  • the end 18 of said ancillary 16 has a bore 22 and the stop 20 has another bore 23, along the same axis of symmetry of said bore 22 and of smaller diameter, which are thus adapted to receive a screw 24 to lock the nail 1 on the ancillary 16 via the thread (8) of the nail (1).
  • the second end 19 of the handle 17 of the ancillary 16 has a bore 25, itself orthogonal to the handle 17. This bore 25 forms with a guide 26, a sliding pivot connection whose end 27 inside the tool comprises a window 28 allowing to see the head of the pin to inform the operator during the screwing step.
  • the guide 26 is also characterized in that it comprises an inner bore 29 along its entire length to allow to introduce a drill bit and thus also act as a guide for said forest diameter slightly greater than the non-threaded body of the pin .
  • the general shapes of the nail, the pin and the ancillary may be different and not respect the proportions indicated in the previous embodiments.
  • the nail can also be of variable length and terminates tapered as a breakable pin, allowing in this configuration to treat bifocal olecranon and diaphyseal ulna fractures.
  • the guide 26 may be able to push the pin 9. Indeed, it is constituted at this end of a window 28, orifice of a diameter optionally equal to or greater than the head of said pin 9 which allows to maintain it when it is introduced. Said guide 26 thus has two distinct roles here: a first to guide the drill and thus allow precise drilling of the bone before the introduction of the pin 9 and a second which is to push the pin 9 along the same axis without deflect and thus ensure the locking of the nail 1 in the bone.
  • the head of the pin may be of hexagonal shape and the guide 26 of the ancillary can thus include an end adapted to push the pin into the bone but also able to screw said pin via a bore hexagonal. The method of placing said pin will then include a step of introducing and screwing the pin using the ancillary before the separation of the latter with said nail.
  • a nail according to the invention may be made of titanium but also cobalt chromium or any other suitable material possibly resorbable.
  • several pins can lock the same nail, several radial bores to said nail will then be provided.

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

Abstract

The invention pertains to the field of surgical instruments, devices, and methods, and more particularly relates to a nail (1) and a pin (9) positioned using an ancillary according to an associated method. According to one characteristic, the unitary nail for bone synthesis (1) includes a rod (2) with a head (3) at one end thereof, and is characterised in that the lower surface (4) of the head (3) defines a plane that forms, together with the longitudinal axis (x) of the rod (2), an angle of between 10 and 18 degrees modulo π.

Description

Clou monobloc d'ostéosynthèse One-piece nail for osteosynthesis
Le domaine technique de l'invention est celui des instruments, dispositifs ou procédés chirurgicaux, et a plus particulièrement pour objet, d'une part, un clou olécranien, d'autre part, un outillage associé et enfin le procédé d'utilisation associé. La problématique de l'ostéosynthèse de fractures de l'olécrane, partie saillante du cubitus correspondant à la région postérieure du coude, connaît déjà plusieurs dispositifs, notamment celui de la mise en place d'un implant spécifique. A ce titre, on connaît la demande de brevet d'invention EP1792578 qui décrit un dispositif d'implant pour l'ostéosynthèse du coude, caractérisé en ce qu'il comprend deux systèmes de fixation dont l'un applique une pression distale et dont l'autre admet une pression longitudinale, ou traction, à l'aide d'une rondelle munie de trois ergots pointus. Plus particulièrement, ce système de fixation par traction est constitué d'une tige munie d'un pas de vis à une extrémité pouvant accueillir une vis qui permet la mise en place d'une rondelle. De plus, il comporte un jeu entre ladite rondelle et l'ensemble tige et vis, ce qui permet d'épouser l'anatomie de l'os. Enfin la rondelle est caractérisée en ce qu'elle est circulaire et possède des ergots pointus pour une meilleure fixation du dispositif à l'os. Le verrouillage distal est, quant à lui, effectué à l'aide d'une vis disposée transversalement à la tige venant se visser dans un taraudage de la tige prévu à cet effet. Un tel dispositif a notamment les inconvénients, d'une part, d'imposer un diamètre important au clou olécranien, qui est de 6mm, ce qui risque de fragiliser l'olécrane voir de le casser. D'autre part, la vis de compression peut se desserrer lors des mouvements répétitifs du coude. Cette méthode augmente les difficultés de solidarisation de ladite vis de compression au clou déjà en place et allonge le délai opératoire. En outre, la pression exercée sur l'os par la rondelle n'est pas uniforme.The technical field of the invention is that of instruments, devices or surgical methods, and more particularly to an object, on the one hand, an olecranon nail, on the other hand, an associated tooling and finally the associated method of use. The problem of fracture osteosynthesis of the olecranon, a prominent part of the ulna corresponding to the posterior region of the elbow, already knows several devices, in particular that of the placement of a specific implant. As such, it is known the patent application EP1792578 which describes an implant device for the osteosynthesis of the elbow, characterized in that it comprises two fastening systems, one of which applies a distal pressure and of which the other allows a longitudinal pressure, or traction, using a washer provided with three pointed lugs. More particularly, this fastening system by traction consists of a rod provided with a screw thread at one end which can accommodate a screw which allows the establishment of a washer. In addition, it comprises a clearance between said washer and the rod and screw assembly, which allows to marry the anatomy of the bone. Finally the washer is characterized in that it is circular and has pointed lugs for better fixation of the device to the bone. The distal locking is, meanwhile, carried out using a screw disposed transversely to the rod which is screwed into a tapping of the rod provided for this purpose. Such a device has the disadvantages, on the one hand, to impose a large diameter to the olécranien nail, which is 6mm, which may weaken the olecranon see breaking. On the other hand, the compression screw may loosen during repetitive movements of the elbow. This method increases the difficulties of securing said compression screw to the nail already in place and lengthens the operating time. In addition, the pressure exerted on the bone by the washer is not uniform.
L'un des buts de l'invention est de résoudre ces inconvénients en proposant un implant permettant une fixation permanente de ce dernier sans pour autant fragiliser le fragment proximal à l'aide d'un outil facilitant la mise en place et limitant ainsi le délai opératoire. La solution apportée est un clou ainsi qu'une goupille mise en place à l'aide d'un ancillaire selon un procédé associé. Selon une caractéristique, le clou est monobloc, comporte une tige munie d'une tête à l'une de ses extrémités et est caractérisée en ce que la face inférieure de la tête forme un plan faisant avec l'axe longitudinal (x) de la tige un angle compris entre 10 et 80 degrés modulo π. L'autre extrémité dudit clou est affinée pour faciliter son introduction. De plus, la tête dudit clou est caractérisée en ce qu'elle comporte deux faces parallèles, la face inférieure étant de forme ovoïdale. Ainsi, la tête dudit clou permet un appui sur la base de l'olécrâne et sa forme ovoïdale, plus large dans le sens antéro-postérieur que dans le sens médio-latéral, permet un meilleur contact osseux au travers des fibres du tendon tricipital. En effet, la forme ovoïdale permet une introduction plus facile au contact de l'olécrâne à travers les fibres tendineuses verticales du muscle triceps, ces parties moHes pouvant gêner l'introduction du clou et venir s'interposer entre la tête dudit clou et l'os. Selon une autre caractéristique, la tête dudit clou comporte des ergots pointus permettant une meilleure accroche sur l'os et améliore la stabilité du fragment olécranien. Le clou peut aussi être caractérisé en ce qu'il comporte un alésage radial qui va permettre l'introduction d'une goupille permettant une parfaite fixation du clou dans l'os. Enfin, le clou peut également être caractérisé en ce qu'il comporte un taraudage au niveau de sa tête. En effet, la mise en place de la goupille dans l'alésage prévu à cet effet nécessite l'utilisation d'un ancillaire qui sera verrouillé audit clou à l'aide d'une vis avant d'être retiré. Enfin ce clou est caractérisé en ce qu'il peut être constitué d'un matériau résorbable.One of the aims of the invention is to solve these drawbacks by proposing an implant permitting permanent fixation of the latter without weakening the proximal fragment by means of a tool facilitating the setting up and thus limiting the delay. procedure. The solution provided is a nail and a pin set up using an ancillary according to an associated method. According to one characteristic, the nail is integral, comprises a rod provided with a head at one of its ends and is characterized in that the lower face of the head forms a plane forming with the longitudinal axis (x) of the rod an angle between 10 and 80 degrees modulo π. The other end of said nail is refined to facilitate its introduction. In addition, the head of said nail is characterized in that it comprises two parallel faces, the lower face being of ovoid shape. Thus, the head of said nail provides support on the base of the olecranon and its ovoid shape, wider in the anteroposterior than in the medio-lateral direction, allows better bone contact through the fibers of the triceps tendon. Indeed, the ovoid shape allows easier introduction into contact with the olecranon through the vertical tendinous fibers of the triceps muscle, these moving parts can hinder the introduction of the nail and come between the head of the nail and the nail. bone. According to another characteristic, the head of said nail has pointed lugs allowing better grip on the bone and improves the stability of the olecranon fragment. The nail may also be characterized in that it comprises a radial bore which will allow the introduction of a pin allowing a perfect fixation of the nail in the bone. Finally, the nail can also be characterized in that it comprises a tapping at its head. Indeed, the establishment of the pin in the bore provided for this purpose requires the use of ancillary which will be locked to said nail with a screw before being removed. Finally this nail is characterized in that it may consist of a resorbable material.
La goupille utilisée ici est caractérisée en ce qu'elle est apte à coopérer avec ledit clou. Ainsi, elle est munie d'une tête à l'une de ses extrémités, d'un filetage de diamètre nominal D' joint à cette tête et d'une partie lisse de diamètre D apte à glisser dans l'alésage de ladite tige, D'étant supérieur à D. Ainsi la partie lisse est destinée à pénétrer dans l'alésage radial dudit clou olécranien tandis que le filetage permettra une fixation de la goupille directement dans l'os.The pin used here is characterized in that it is able to cooperate with said nail. Thus, it is provided with a head at one of its ends, a thread of nominal diameter D 'attached to this head and a smooth portion of diameter D adapted to slide in the bore of said rod, Being greater than D. Thus the smooth portion is intended to penetrate into the radial bore of said olecranon nail while the threading will allow attachment of the pin directly into the bone.
Enfin, un ancillaire de mise en place dudit clou et de ladite goupille comporte un manche en forme de L inversé caractérisé en ce qu'il comporte à chacune de ses extrémités:Finally, an ancillary setting of said nail and said pin comprises an inverted L-shaped handle characterized in that it comprises at each of its ends:
- d'une part, une butée positionnée orthogonalement au manche dont la face en contact avec le clou est biseautée d'un angle compris entre 10 et 80 degrés modulo π et comportant un moyen de verrouillage composé d'un alésage pour l'introduction d'une vis de verrouillage. Ainsi, dans cette configuration, la tête de clou viendra en contact plan avec la butée dudit ancillaire et sera fixée par ladite vis de verrouillage;- On the one hand, a stop positioned orthogonally to the handle whose face in contact with the nail is tapered by an angle of between 10 and 80 degrees modulo π and having a locking means consisting of a bore for the introduction of a locking screw. Thus, in this configuration, the nail head will come into plane contact with the abutment of said ancillary and will be fixed by said locking screw;
- d'autre part, un alésage orthogonal au manche, support d'un système guide en liaison pivot glissant avec lui et dont l'extrémité comporte une fenêtre permettant la visualisation du vissage de la goupille dans l'os et comportant un alésage centré en son axe de symétrie étendu sur toute sa longueur. Ce dernier alésage servira ainsi de guide pour le foret qui viendra percer l'os. L'ancillaire ainsi décrit permet la mise en place très précise de la goupille dans l'os et ledit clou olécranien via ledit moyen de verrouillage avec le clou. Pour cela, le procédé de pose du clou est caractérisé en ce qu'il comporte les étapes suivantes:- On the other hand, a bore orthogonal to the handle, support of a guide system in pivot connection sliding with it and whose end includes a window allowing visualization of the screwing of the pin in the bone and having a bore centered in its axis of symmetry extended over its entire length. This last bore will serve as a guide for the forest that will pierce the bone. The ancillary thus described allows the very precise positioning of the pin in the bone and said olecranon nail via said locking means with the nail. For this, the method of laying the nail is characterized in that it comprises the following steps:
- Solidarisation du clou à un ancillaire tel que décrit précédemment par l'intermédiaire d'une vis de verrouillage;- Solidarization of the nail to an ancillary as described previously by means of a locking screw;
- Perçage dans l'os d'un alésage de diamètre supérieur à celui du diamètre du clou;- Drilling in the bone of a bore of diameter greater than that of the diameter of the nail;
Introduction manuelle du clou;Manual introduction of the nail;
- Perçage dans l'os d'un alésage de diamètre compris entre D et D' par l'intermédiaire d'un foret guidé par ledit ancillaire;- Drilling in the bone of a bore diameter between D and D 'through a drill guided by said ancillary;
Vissage de la goupille guidée par l'ancillaire; Désolidarisation de l'ancillaire et du clou.Screwing the pin guided by the ancillary; Disassociation of the ancillary and the nail.
D'autres avantages et caractéristiques apparaîtront dans la description d'un mode de réalisation de l'invention au regard des figures annexées parmi lesquelles:Other advantages and features will become apparent in the description of an embodiment of the invention with reference to the appended figures among which:
- la figure 1 montre un schéma du clou et de sa goupille optimisés selon un mode de réalisation de l'invention ; - la figure 2 montre un schéma du clou et de sa goupille selon ce mode de réalisation positionnés sur un cubitus;- Figure 1 shows a diagram of the nail and its pin optimized according to one embodiment of the invention; - Figure 2 shows a diagram of the nail and its pin according to this embodiment positioned on a ulna;
- la figure 3 montre un schéma d'un ancillaire selon un mode de réalisation de l'invention,FIG. 3 shows a diagram of an ancillary device according to one embodiment of the invention,
La figure 1 montre un schéma d'un clou et de sa goupille optimisés selon un mode de réalisation de l'invention. Ledit clou 1 , de diamètre compris entre 4,5 et 5mm est monobloc en titane et de configuration longiligne suivant l'axe (x). Il est constitué d'un corps 2, d'une tête 3 à l'une de ses extrémités tandis que l'autre extrémité 4 est effilée pour permettre une meilleure mise en place dudit clou 1. La tête 3 dudit clou 1 comporte une face inférieure 5 et une face supérieure 6 toutes deux parallèles. De plus, la face inférieure 5 de la tête comporte des ergots pointus 7 et forme un plan faisant avec l'axe longitudinal (x) de la tige un angle de 20 degrés. Un taraudage 8 permet d'accueillir une vis pour permettre le verrouillage du clou 1 sur un ancillaire permettant la pose d'une goupille 9 de verrouillage longitudinale du clou 1 dans un os. Ladite goupille 9 est représentée dans l'alésage radial 10 du clouFigure 1 shows a diagram of a nail and its pin optimized according to one embodiment of the invention. Said nail 1, having a diameter of between 4.5 and 5 mm, is a monobloc made of titanium and has an elongated configuration along the axis (x). It consists of a body 2, a head 3 at one of its ends while the other end 4 is tapered to allow a better implementation of said nail 1. The head 3 of said nail 1 has a face lower 5 and an upper face 6 both parallel. In addition, the lower face 5 of the head has pointed lugs 7 and forms a plane forming with the longitudinal axis (x) of the rod an angle of 20 degrees. A tapping 8 can accommodate a screw to allow the locking of the nail 1 on an ancillary for the installation of a pin 9 longitudinal locking of the nail 1 in a bone. Said pin 9 is shown in the radial bore 10 of the nail
I prévu à cet effet (suivant l'axe (y)). Elle est de diamètre égal à 2,5mm sur sa partie non filetée et de diamètre nominal égal à 3,5mm sur sa partie filetée 11 en contact avec la tête 12 de ladite goupille, ici de configuration arrondie.I provided for this purpose (along the axis (y)). It has a diameter of 2.5 mm on its unthreaded portion and a nominal diameter equal to 3.5 mm on its threaded portion 11 in contact with the head 12 of said pin, here of rounded configuration.
La figure 2 montre un schéma du clou et de sa goupille selon un mode de réalisation positionnés sur un cubitus. Le clou 1 est ici représenté dans le cubitus 13 suivant l'axe longitudinal (x) de l'os 13. Ainsi le clou 1 permet le maintien de la base de l'olécrane 14 du reste du cubitus 13 car .inséré longitudinalement (suivant l'axe (x)) et perpendiculairement à la lésion 15. Les ergots 7 dudit clou 1 sont encrés dans l'os 13 pour permettre une meilleure fixation du clou sur l'os et la goupille 9 est positionnée dans l'os ,13 tout en traversant l'alésage 10 du clou 1. Sa partie filetéeFigure 2 shows a diagram of the nail and its pin according to an embodiment positioned on a ulna. The nail 1 is here represented in the ulna 13 along the longitudinal axis (x) of the bone 13. Thus the nail 1 allows the maintenance of the base of the olecranon 14 of the rest of the ulna 13 because inserted longitudinally (following the axis (x)) and perpendicular to the lesion 15. The lugs 7 of said nail 1 are inked in the bone 13 to allow better fixation of the nail on the bone and the pin 9 is positioned in the bone, 13 while passing through the bore 10 of the nail 1. Its threaded portion
I I permet une fixation directe dans l'os 13. Dans cette configuration, le clou 1 est verrouillé et il ne risque pas de créer un jeu entre ledit clou 1 et l'os 13 lors de mouvements répétitifs. Les risques de désolidarisation sont donc évités.It allows a direct fixation in the bone 13. In this configuration, the nail 1 is locked and it does not risk creating a game between said nail 1 and the bone 13 during repetitive movements. The risks of uncoupling are therefore avoided.
La figure 3 montre un schéma de l'ancillaire selon un mode de réalisation de l'invention. Ainsi, l'ancillaire 16 comporte un manche 17 en L muni de deux extrémités dont l'une 18 est apte à verrouiller ledit clou 1 et l'autre 19 est apte à guider un foret et à pousser la goupille 9. Ainsi, l'extrémité 18 est constituée d'une butée 20 positionnée orthogonalement au manche 17 dont l'extrémité 21 est biseautée d'un angle égal à l'angle d'inclinaison de la tête 3 dudit clou 1 représenté figure 1 c'est-à-dire 20 degrés. Ainsi le contact entre le clou 1 et la butée formera une liaison plan. De plus, l'extrémité 18 dudit ancillaire 16 comporte un alésage 22 et la butée 20 comporte un autre alésage 23, suivant le même axe de symétrie dudit alésage 22 et de diamètre inférieur, qui sont ainsi aptes à recevoir une vis 24 permettant de verrouiller le clou 1 sur l'ancillaire 16 via le taraudage (8) du clou (1). La seconde extrémité 19 du manche 17 de l'ancillaire 16 comporte un alésage 25, lui-même orthogonal au manche 17. Cet alésage 25 forme avec un guide 26, une liaison pivot glissant dont une extrémité 27 intérieure à l'outil comporte une fenêtre 28 permettant de voir passer la tête de la goupille pour renseigner l'opérateur pendant l'étape de vissage. Le guide 26 est également caractérisé en ce qu'il comporte un alésage intérieur 29 sur toute sa longueur pour permettre d'y introduire un foret et ainsi avoir également le rôle de guide pour cedit forêt de diamètre légèrement supérieur au corps non fileté de la goupille. De nombreuses modifications peuvent être apportées au mode de réalisation décrit précédemment sans sortir du cadre de l'invention.Figure 3 shows a diagram of the ancillary according to one embodiment of the invention. Thus, the ancillary 16 comprises a handle 17 L with two ends, one 18 is adapted to lock said nail 1 and the other 19 is adapted to guide a drill and push the pin 9. Thus, the end 18 consists of a stop 20 positioned orthogonally to the handle 17 whose end 21 is tapered by an angle equal to the angle of inclination of the head 3 of said nail 1 shown in Figure 1, that is to say 20 degrees. Thus the contact between the nail 1 and the abutment will form a plane connection. In addition, the end 18 of said ancillary 16 has a bore 22 and the stop 20 has another bore 23, along the same axis of symmetry of said bore 22 and of smaller diameter, which are thus adapted to receive a screw 24 to lock the nail 1 on the ancillary 16 via the thread (8) of the nail (1). The second end 19 of the handle 17 of the ancillary 16 has a bore 25, itself orthogonal to the handle 17. This bore 25 forms with a guide 26, a sliding pivot connection whose end 27 inside the tool comprises a window 28 allowing to see the head of the pin to inform the operator during the screwing step. The guide 26 is also characterized in that it comprises an inner bore 29 along its entire length to allow to introduce a drill bit and thus also act as a guide for said forest diameter slightly greater than the non-threaded body of the pin . Many modifications can be made to the embodiment described above without departing from the scope of the invention.
Ainsi, les formes générales du clou, de la goupille et de l'ancillaire peuvent être différentes et ne pas respecter les proportions indiquées aux modes de réalisation précédents. Le clou peut aussi être de longueur variable et se terminé effilé comme une broche sécable, ce qui permet dans cette configuration de traiter des fractures bifocales olécraniennes et diaphysaires du cubitus.Thus, the general shapes of the nail, the pin and the ancillary may be different and not respect the proportions indicated in the previous embodiments. The nail can also be of variable length and terminates tapered as a breakable pin, allowing in this configuration to treat bifocal olecranon and diaphyseal ulna fractures.
Par ailleurs, le guide 26 peut être apte à pousser la goupille 9. En effet, elle est constituée à cette extrémité d'une fenêtre 28, orifice d'un diamètre éventuellement égale ou supérieur à la tête de ladite goupille 9 ce qui permet de la maintenir lors de son introduction. Ledit guide 26 a donc ici deux rôles distincts: un premier pour guider le foret et ainsi permettre un perçage précis de l'os avant la mise en place de la goupille 9 et un deuxième qui est de pousser la goupille 9 selon ce même axe sans dévier et ainsi assurer le verrouillage du clou 1 dans l'os. De plus, dans cette dernière configuration, la tête de la goupille peut être de forme hexagonale et le guide 26 de l'ancillaire peut ainsi comporter une extrémité apte à pousser la goupille dans l'os mais aussi apte à visser ladite goupille via un alésage hexagonal. Le procédé de mise en place de ladite goupille comportera alors une étape d'introduction et de vissage de la goupille à l'aide de l'ancillaire avant la désolidarisation de ce dernier avec ledit clou.Furthermore, the guide 26 may be able to push the pin 9. Indeed, it is constituted at this end of a window 28, orifice of a diameter optionally equal to or greater than the head of said pin 9 which allows to maintain it when it is introduced. Said guide 26 thus has two distinct roles here: a first to guide the drill and thus allow precise drilling of the bone before the introduction of the pin 9 and a second which is to push the pin 9 along the same axis without deflect and thus ensure the locking of the nail 1 in the bone. In addition, in this latter configuration, the head of the pin may be of hexagonal shape and the guide 26 of the ancillary can thus include an end adapted to push the pin into the bone but also able to screw said pin via a bore hexagonal. The method of placing said pin will then include a step of introducing and screwing the pin using the ancillary before the separation of the latter with said nail.
De plus, un clou selon l'invention peut être en titane mais aussi en chrome cobalt ou encore en tout autre matériau adéquat éventuellement résorbable. En outre, plusieurs goupilles peuvent verrouiller un même clou, plusieurs alésages radiaux audit clou seront alors prévus. Enfin, on peut insérer une goupille suivant un axe non radial avec le clou l'angle défini entre les axes (x) et (y) peut ainsi varier suivant la configuration de l'os et de la lésion. In addition, a nail according to the invention may be made of titanium but also cobalt chromium or any other suitable material possibly resorbable. In addition, several pins can lock the same nail, several radial bores to said nail will then be provided. Finally, it is possible to insert a pin along a non-radial axis with the nail the angle defined between the axes (x) and (y) can thus vary according to the configuration of the bone and the lesion.

Claims

Revendications claims
1. Clou monobloc d'ostéosynthèse comportant une tige (2) munie d'une tête (3) à l'une de ses extrémités et d'un alésage radial (10), caractérisé en ce que la face inférieure (5) de la tête forme un plan faisant avec l'axe longitudinal (x) de la tige (2) un angle compris entre 10 et 80 degrés modulo π.1. A one-piece osteosynthesis nail comprising a rod (2) provided with a head (3) at one of its ends and a radial bore (10), characterized in that the lower face (5) of the head forms a plane forming with the longitudinal axis (x) of the rod (2) an angle between 10 and 80 degrees modulo π.
2. Clou selon la revendication précédente, caractérisé en ce que sa tête (3) comporte deux faces parallèles (5) et (6).2. Nail according to the preceding claim, characterized in that its head (3) has two parallel faces (5) and (6).
3. Clou selon l'une quelconque des revendications 1 à 2, caractérisé en ce que la face inférieure (5) de la tête (3) du clou est de forme ovoïdale.3. Nail according to any one of claims 1 to 2, characterized in that the underside (5) of the head (3) of the nail is ovoid.
4. Clou selon l'une quelconque des revendications 1 à 3, caractérisé en ce que la face inférieure (5) de sa tête (3) comporte des ergots pointus (7). 4. Nail according to any one of claims 1 to 3, characterized in that the underside (5) of its head (3) has pointed lugs (7).
5. Clou selon l'une quelconque des revendications 1 à 4, caractérisé en ce qu'il comporte un taraudage (8) suivant l'axe longitudinal (x) traversant sa tête (3).5. Nail according to any one of claims 1 to 4, characterized in that it comprises a thread (8) along the longitudinal axis (x) passing through its head (3).
6. Clou selon l'une quelconque des revendications 1 à 5, caractérisé en ce qu'il est constitué d'un matériau résorbable.6. Nail according to any one of claims 1 to 5, characterized in that it consists of a resorbable material.
7. Dispositif d'ostéosynthèse comportant d'une part un clou monobloc selon l'une quelconque des revendications 1 à 6 et, d'autre part, une goupille apte à coopérer avec le clou. 7. Osteosynthesis device comprising firstly a one-piece nail according to any one of claims 1 to 6 and, secondly, a pin adapted to cooperate with the nail.
PCT/FR2009/001050 2008-09-04 2009-09-01 Unitary nail for bone synthesis WO2010026307A2 (en)

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Application Number Priority Date Filing Date Title
FR0804844 2008-09-04
FR0804844A FR2935257B1 (en) 2008-09-04 2008-09-04 OCLANIAN NAIL, ASSOCIATED ANCILLARY AND METHOD OF IMPLEMENTING THE SAME

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WO2010026307A3 WO2010026307A3 (en) 2010-05-14

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Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2385378A1 (en) * 1978-03-31 1978-10-27 Atlantis Finance Sa Osteosynthesis bone fracture joining device - uses dowels through bone at fracture, to support spindle down centre
US20030055428A1 (en) * 2001-09-12 2003-03-20 Swanson Todd V. Method and apparatus for treating supracondylar fractures of the femur
US20030097131A1 (en) * 2001-11-16 2003-05-22 Schon Lew C. Modular, blade-rod, intramedullary fixation device
FR2861576A1 (en) * 2003-10-31 2005-05-06 Jean Michel Cognet Osteosynthesis system for fractured upper end of ulna comprises lengthwise pin with holes for fixing screws at both ends

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2385378A1 (en) * 1978-03-31 1978-10-27 Atlantis Finance Sa Osteosynthesis bone fracture joining device - uses dowels through bone at fracture, to support spindle down centre
US20030055428A1 (en) * 2001-09-12 2003-03-20 Swanson Todd V. Method and apparatus for treating supracondylar fractures of the femur
US20030097131A1 (en) * 2001-11-16 2003-05-22 Schon Lew C. Modular, blade-rod, intramedullary fixation device
FR2861576A1 (en) * 2003-10-31 2005-05-06 Jean Michel Cognet Osteosynthesis system for fractured upper end of ulna comprises lengthwise pin with holes for fixing screws at both ends

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WO2010026307A3 (en) 2010-05-14
FR2935257B1 (en) 2011-12-16

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