WO2012010184A1 - Clou médullaire - Google Patents

Clou médullaire Download PDF

Info

Publication number
WO2012010184A1
WO2012010184A1 PCT/EP2010/004498 EP2010004498W WO2012010184A1 WO 2012010184 A1 WO2012010184 A1 WO 2012010184A1 EP 2010004498 W EP2010004498 W EP 2010004498W WO 2012010184 A1 WO2012010184 A1 WO 2012010184A1
Authority
WO
WIPO (PCT)
Prior art keywords
intramedullary nail
nail according
expandable
radially
intramedullary
Prior art date
Application number
PCT/EP2010/004498
Other languages
German (de)
English (en)
Inventor
Norman Zschech
Original Assignee
Norman Zschech
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 Norman Zschech filed Critical Norman Zschech
Priority to PCT/EP2010/004498 priority Critical patent/WO2012010184A1/fr
Publication of WO2012010184A1 publication Critical patent/WO2012010184A1/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
    • A61B17/68—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
    • A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
    • A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression
    • 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
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
    • A61B17/7275—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with expanding cylindrical parts
    • 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
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone

Definitions

  • the invention relates to intramedullary nails according to the preambles of the independent claims.
  • Intramedullary nails are known in the art and are used to make an internal splint, the so-called osteosynthesis, in fractures.
  • an intramedullary nail is inserted into the medullary cavity of the bone to fix the fractured bone on either side of the fracture.
  • the intramedullary nail is fixed to both parts of the bone, which leads to a splinting of the bone and ultimately to a healing of the fracture site.
  • the DE 699 25 169 T2 which forms the starting point of the present invention, describes internal locking options with radially expandable sections, which are caused by distortion of the intramedullary nail.
  • the clamping takes place here by a threaded rod, which passes through the entire intramedullary nail.
  • a major disadvantage of the known internal locking option is that after a treatment period of on average several months, the internally locked portion in the removal of the intramedullary nail is not unlocked, partially or only with great effort and the intramedullary nail is difficult to pull out of the bone.
  • the present invention has for its object to provide an intramedullary nail with at least one internal locking option, the removal of the intramedullary nail at the end of the treatment time should be possible in a simple manner.
  • the present invention relates to an intramedullary nail having a radially expandable portion which establishes a frictional connection in the medullary cavity of the bone.
  • the expanded portion is forcibly radially recoverable, so that a simple removal at the end of the treatment is made possible.
  • the radially expandable portion widens in a predetermined defined area.
  • the area is discussed in more detail below by axial bearings on the below, limited in its maximum length and characterized by a special geometric shape and / or by recesses. ⁇ This particular geometric shape and / or the recesses allow the material of which the intramedullary nail consists in the area to be expanded to expand radially.
  • the recesses are slot-like design in a preferred embodiment. These can be groove-like recesses introduced into the surface of the intramedullary nail as well as the material can be completely penetrating holes, holes, slots or other formations of this type.
  • the recesses may also form a latticed configuration of the portion to be expanded or wave or sawtooth formed.
  • the ends of the recesses have a voltage-reducing shape and / or recess, for example in the form of a round hole.
  • This round hole prevents spreading of the longitudinal slot by cracking, which can occur during installation and during several months of staying in the 'expanded state of stress.
  • the radial expansion is caused by a compression of the intramedullary nail in the section to be expanded. This compression can then be done by a collet, which is ximalen and distal end of the section to be expanded is fixed in the axial direction.
  • the intramedullary nail is formed in the section to be expanded and / or in its entirety by a plastically expandable material, so that no recesses or grooves are necessary and a maximum surface for frictional connection is formed.
  • the axial fixation of the clamping sleeve is preferably carried out on one side by a movable bearing, on the other side by a threaded engagement.
  • the thus formed storage makes it possible to put the intramedullary nail in the section to be stretched under tension and to force him to expand radially.
  • the storage is preferably performed in an axially acting tensile and compressive direction.
  • a reverse force of the clamping sleeve allows a compression in the axial direction opposite movement.
  • This movement inevitably leads to a reformation of the expanded section by axial extension of the intramedullary nail.
  • the clamping sleeve is mounted on both sides of the radially widening portion.
  • a fixation by means of a tool for operating the clamping sleeve in only one area of this section is possible and further the use of a second or more clamping sections in an intramedullary nail realized.
  • a fixation of an intramedullary nail with two expandable sections is possible.
  • each section is independently fixable with its own clamping tool.
  • the introduction and fixation of the intramedullary nail is preferably carried out only from one side, so that only a cut and an opening of the tubular bone are necessary.
  • the tension of the section to be widened by the tool should be done by means of rotary motion.
  • the intramedullary nail is inserted with a positioning wire over which the intramedullary nail is guided with its hollow interior.
  • FIG. 1 is a schematic representation of an intramedullary nail, according to a first embodiment, in a tubular bone in the installed state,
  • FIG. 2 is a schematic sectional view of the intramedullary nail of FIG. 1 with a radially expandable section in the unexpanded state, FIG.
  • Fig. 3 shows a section of the intramedullary nail of Fig. 2 with two-bearing
  • Fig. 4 shows a section of the intramedullary nail and the clamping sleeve in the expanded
  • Fig. 5 is a schematic representation of an intramedullary nail according to a second imple mentation form, wherein the fixation is effected by two radially expandable sections and
  • Fig. 6 shows a section of a long bone bone with clamped intramedullary nail according to FIG. 5 and in the breakage resulting pressure forces.
  • Fig. 1 shows a schematic representation of an intramedullary nail 1 in the medullary cavity of the tubular bone 2, which is fixed at one end by a radially expanded portion 3, at the other end by transverse holes with transverse pins 4.
  • the intramedullary nail 1, which is provided for internal locking, is shown in a sectional view of the tubular bone 2 in the inserted state in the medullary cavity.
  • the lower fixing in the drawing is a radial expansion in the sense of the present invention.
  • the section 3 of the intramedullary nail 1 was expanded radially, so that with the medullary cavity of the tubular bone 2, a frictional connection is made.
  • transverse bores are made with the aid of a positioning gauge 5.
  • transverse pins 4 are introduced and fixed, which are shown by way of example in various embodiments in FIG.
  • the expandable portion 3 has recesses 6, which favor a radial expansion of the section 3.
  • the radially expanded portion 3 shown in Fig. 1 below is forcibly radially recoverable.
  • the so recoverable area allows the surgeon to pull the intramedullary nail 1 easily after the end of treatment from the medullary cavity.
  • the positioning of the expanded portion 3 shown here at the lower end of the long bone 2 is chosen completely freely and can be made at any height of the intramedullary nail 1 and the tubular bone 2.
  • Fig. 2 shows an end of an intramedullary nail 1 with a radially expandable portion 3.
  • a threaded engagement 7 is completely internal, so that when inserting any breaking off Marksplitter the medullary cavity can not settle in the threads of the threaded engagement 7.
  • the threaded engagement 7 is formed so that in the axially compressed state, the threads is also completely covered.
  • one end 8 is chamfered.
  • the recesses 6 are shown in FIG.
  • the longitudinal slots 9 can be arranged in the axial direction at the same height 1 la, offset at a height 1 lb or in any desired manner on the intramedullary nail 1.
  • the expansion is caused by an axial compression of the section 3 to be widened.
  • the expandable section 3 is compressed by rotating a clamping sleeve 12 located in the intramedullary nail 1 via the threaded engagement 7 in the axial direction, so that a radial expansion of the area 10 results from the accumulation forces.
  • the ends of the longitudinal slots 9 are widened by holes 13. These holes prevent further expansion of the slots 9 by cracking. Cracking can occur if the material is under excessive tension at the end of a slot due to the radial expansion.
  • FIG. 3 shows a cross-section of the end of the intramedullary nail 1 from FIG. 2. Shown is the clamping sleeve 12, each with a bearing 7, 14 on either side of the region 10 to be flared.
  • the bearing takes place on one side by an axial bearing 14 or axial Fixation while simultaneously exhibiting a rotational degree of freedom, for example a snap ring, on the other side by the threaded engagement 7.
  • the change in length is preferably carried out so that the section 3 to be expanded is compressed in the axial direction.
  • the area 10 expands radially.
  • the area 10 widens over its entire length in order to create the largest possible contact surface for the frictional connection between intramedullary nail 1 and medullary cavity of the long bone 2.
  • the expansion can take place in many other possible expansion forms. These are determined, for example, by the shape of the recesses 6.
  • the recesses may be slit-like, wavy or grid-shaped.
  • Fig. 4 shows a cross section of the intramedullary nail 1, a cross section of the clamping sleeve 12 with engagement of a tool 15.
  • the tool 15 is preferably formed as a hexagon socket and engages in a part of the clamping sleeve 12, so that the forces applied to the rotation of the clamping sleeve 12 forces sufficiently transmitted by the tool engagement.
  • the tool 15 is made chamfered at its end to be inserted into the clamping sleeve 12. This beveling of the tool 15 allows a self-guiding introduction into the clamping sleeve 12.
  • Fig. 5 shows another possible embodiment.
  • an intramedullary nail 1 is shown according to one of the independent claims, which has a radially expandable portion 3 both at its proximal and at its distal end.
  • both the expandable portion 3 in the proximal and the expandable portion 3 in the distal region is fixed from the inside.
  • the expandable sections 3 are separately expandable.
  • a fixation of the first section 3 is made possible, followed by a bias of the second section 3, an adjustment of the break point for an optimum fit of the bone ends at the break point to each other and a fixation of the second section 3.
  • both fixations from one side are feasible. There is no need to set cross holes and there is no need to work from two sides. This arrangement is therefore feasible for the patient with significantly fewer skin incisions and thus less scarring, since the introduction of the intramedullary nail 1 with subsequent locking can be done from one side.
  • FIG. 6 shows the compressive forces 17 resulting from the negative change in length 16, which act at the break point through the fixation by means of radially expandable section 3. It is due to the negative change in length of the intramedullary nail 1 in the axial direction, caused by the radial expansion of the upper portion 3 with prior fixation of the lower portion 3.
  • the adjustment on a Side of the break made and fixed the intramedullary nail 1 on one side. Thereafter, the adjustment takes place on the opposite side, with also subsequent fixation.
  • Due to the axial compression of the intramedullary nail 1 is a negative change in length.
  • the Markangel 1 contracts in the axial direction between the two expanded sections together. At the fracture site, the two pieces of bone against each other by the axial contraction of the intramedullary nail 1 pressed. The resulting compressive force in the area of the fracture promotes a faster healing process of the fracture.
  • FIG. 6 relates to the embodiment according to FIG. 5. However, it can also be implemented with any other embodiment of an intramedullary nail 1 according to one of the independent claims.

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)
  • Surgical Instruments (AREA)

Abstract

L'invention concerne un clou médullaire servant à fixer un os tubulaire cassé, comprenant un segment apte à s'élargir radialement. Selon l'invention, le segment apte à s'élargir radialement reprend inévitablement sa forme radiale initiale après l'élargissement.
PCT/EP2010/004498 2010-07-22 2010-07-22 Clou médullaire WO2012010184A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/004498 WO2012010184A1 (fr) 2010-07-22 2010-07-22 Clou médullaire

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/EP2010/004498 WO2012010184A1 (fr) 2010-07-22 2010-07-22 Clou médullaire

Publications (1)

Publication Number Publication Date
WO2012010184A1 true WO2012010184A1 (fr) 2012-01-26

Family

ID=43726099

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/EP2010/004498 WO2012010184A1 (fr) 2010-07-22 2010-07-22 Clou médullaire

Country Status (1)

Country Link
WO (1) WO2012010184A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN107260287A (zh) * 2017-07-27 2017-10-20 焦作市新港医疗设备有限公司 一种胫骨/肱骨髓内钉及使用该胫骨/肱骨髓内钉的胫骨组与肱骨组
WO2018049232A1 (fr) * 2016-09-08 2018-03-15 Meduloc, Llc Implant et méthode de fixation d'os longs
US10092339B2 (en) 2012-06-18 2018-10-09 Biedermann Technologies Gmbh & Co. Kg Bone anchor
CN108652725A (zh) * 2018-05-23 2018-10-16 江苏艾为康医疗器械科技有限公司 用于交锁髓内钉的弹性锁钉

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0970666A2 (fr) * 1998-07-01 2000-01-12 Johnson & Johnson Medical Limited Elément prothétique
WO2001034045A1 (fr) * 1999-11-11 2001-05-17 Synthes Ag Chur Clou intramedullaire a expansion radiale
WO2002058575A1 (fr) * 2001-01-27 2002-08-01 John Bruce Clayfield Davies Ameliorations apportees a des clous a os extensibles
EP1552797A2 (fr) * 1999-01-27 2005-07-13 Disc-O-Tech Medical Technologies, Ltd. Espaceur extensible intervertebral
WO2005094706A1 (fr) * 2004-03-31 2005-10-13 Orthofix S.R.L. Clou centromedullaire contenant des elements en materiau a memoire de forme
WO2009004603A2 (fr) * 2007-07-03 2009-01-08 Sota Orthopaedics Limited Appareil de cheville

Patent Citations (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0970666A2 (fr) * 1998-07-01 2000-01-12 Johnson & Johnson Medical Limited Elément prothétique
EP1552797A2 (fr) * 1999-01-27 2005-07-13 Disc-O-Tech Medical Technologies, Ltd. Espaceur extensible intervertebral
WO2001034045A1 (fr) * 1999-11-11 2001-05-17 Synthes Ag Chur Clou intramedullaire a expansion radiale
DE69925169T2 (de) 1999-11-11 2006-02-23 Synthes Ag Chur, Chur Radial aufweitbarer marknagel
WO2002058575A1 (fr) * 2001-01-27 2002-08-01 John Bruce Clayfield Davies Ameliorations apportees a des clous a os extensibles
WO2005094706A1 (fr) * 2004-03-31 2005-10-13 Orthofix S.R.L. Clou centromedullaire contenant des elements en materiau a memoire de forme
WO2009004603A2 (fr) * 2007-07-03 2009-01-08 Sota Orthopaedics Limited Appareil de cheville

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10092339B2 (en) 2012-06-18 2018-10-09 Biedermann Technologies Gmbh & Co. Kg Bone anchor
US11116556B2 (en) 2012-06-18 2021-09-14 Biedermann Technologies Gmbh & Co. Kg Bone anchor
WO2018049232A1 (fr) * 2016-09-08 2018-03-15 Meduloc, Llc Implant et méthode de fixation d'os longs
JP2019526377A (ja) * 2016-09-08 2019-09-19 メダロック， エルエルシー 長骨固定のためのインプラントおよび方法
US10813673B2 (en) 2016-09-08 2020-10-27 Meduloc, Llc Implant and method for long bone fixation
US11622796B2 (en) 2016-09-08 2023-04-11 Meduloc, Llc Implant and method for long bone fixation
CN107260287A (zh) * 2017-07-27 2017-10-20 焦作市新港医疗设备有限公司 一种胫骨/肱骨髓内钉及使用该胫骨/肱骨髓内钉的胫骨组与肱骨组
CN107260287B (zh) * 2017-07-27 2023-03-21 焦作市新港医疗设备有限公司 胫骨/肱骨髓内钉及使用该髓内钉的胫骨组与肱骨组
CN108652725A (zh) * 2018-05-23 2018-10-16 江苏艾为康医疗器械科技有限公司 用于交锁髓内钉的弹性锁钉

Similar Documents

Publication Publication Date Title
EP3117787B1 (fr) Vis pediculaire avec tulipe
EP3454767B1 (fr) Instrument à usage médical de fixation provisoire d'une vis de pédiculaire polyaxiale
DE102004027881B4 (de) Knochenschraube und Osteosynthesevorrichtung
EP1568329B1 (fr) Elément d'ancrage osseux
EP2570092B1 (fr) Clou médullaire
EP0844856B1 (fr) Implant intervertebral et instruments pour placer l'implant intervertebral
EP1663036B1 (fr) Dispositif de traitement de fractures femorales
EP1853182B1 (fr) Systeme de fixation orthopedique
EP0794736B1 (fr) Element de fixation osteosynthetique
EP1481654A1 (fr) Implant de fusion intervertébrale ainsi que l'instrument pour le placement et la distraction de cet implant
WO2014146797A1 (fr) Ensemble d'instruments et procédé pour introduire une cage dans un espace intervertébral entre deux corps vertébraux
EP1181894B1 (fr) Moyens d'ostéosynthèse
DE102012104207A1 (de) Montagewerkzeug
CH685734A5 (de) Mit Draht befestigbare Knochen-Platte zur inneren Festlegung eines Bruches.
EP1865861A1 (fr) Element de fixation
CH615821A5 (fr)
DE2260839C2 (de) Vorrichtung zur Behandlung von getrennten Röhrenknochen mittels Druckosteosynthese
WO2009010412A1 (fr) Élément de fixation
EP1827267B1 (fr) Dispositif de fixation orthopedique, et systeme de fixation orthopedique
WO2012010184A1 (fr) Clou médullaire
EP1491165A1 (fr) Prothèse vertébrale
EP3019102B1 (fr) Vis d'ostéosynthèse
DE202010009097U1 (de) Marknagel
WO2014111134A1 (fr) Kit d'implantation mtv
DE202022104343U1 (de) Vorrichtung zum Betätigen eines Marknagels, umfassend ein Gewindeelement zum Anschluss eines Marknagels

Legal Events

Date Code Title Description
121 Ep: the epo has been informed by wipo that ep was designated in this application

Ref document number: 10757022

Country of ref document: EP

Kind code of ref document: A1

NENP Non-entry into the national phase

Ref country code: DE

WWE Wipo information: entry into national phase

Ref document number: 2010757022

Country of ref document: EP

122 Ep: pct application non-entry in european phase

Ref document number: 10757022

Country of ref document: EP

Kind code of ref document: A1