WO2013045713A1 - Partial carpal arthrodesis device - Google Patents

Partial carpal arthrodesis device Download PDF

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Publication number
WO2013045713A1
WO2013045713A1 PCT/ES2011/070668 ES2011070668W WO2013045713A1 WO 2013045713 A1 WO2013045713 A1 WO 2013045713A1 ES 2011070668 W ES2011070668 W ES 2011070668W WO 2013045713 A1 WO2013045713 A1 WO 2013045713A1
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Prior art keywords
section
sections
arthrodesis
partial
carpal
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PCT/ES2011/070668
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Spanish (es)
French (fr)
Inventor
Pedro HERNÁNDEZ CORTES
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Servicio Andaluz De Salud
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Priority to PCT/ES2011/070668 priority Critical patent/WO2013045713A1/en
Publication of WO2013045713A1 publication Critical patent/WO2013045713A1/en

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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
    • 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
    • A61B17/1728—Guides or aligning means for drills, mills, pins or wires for holes for bone plates or plate screws

Definitions

  • the present invention relates to the field of medical implantology, more specifically in those implants intended for immobilization of joints.
  • the object of the invention consists of a device that allows immobilization of the bone structure by anchoring said device to the bones that make up said structure.
  • the arthrodesis operation consists of a surgical intervention in which two bone pieces are fused, eliminating a joint.
  • This intervention is very common in the spine by fixing two or more vertebrae with each other, generating the initial fixation by means of more or less complex metal implants, which prey on the pedicles, plates or apophysis of the vertebrae, while the final fusion takes place biological process that results from the debridement of the joint segments to be sacrificed and contribution of graft or bone substitute.
  • Arthrodesis has been and is a very important therapeutic weapon in the treatment of advanced degenerative joint disease, since arthroplasty is not applicable to all joints or at least, it does not offer the best clinical-functional results for certain lesions and topographies These types of techniques were performed on the wrist as an alternative to joint resection or amputation in tuberculous conditions.
  • Other early indications of arthrodesis were the correction of polio deformities, spastic deformities, as Steindler described in 1918, and sequelae of Volkmann's ischemic contracture.
  • total wrist arthrodesis is a well-established surgical procedure that provides a reproducible reduction of pain in patients with multiple inflammatory, degenerative or post-traumatic conditions, although sacrificing all mobility.
  • Palmer and cois in 1985 described the degree of mobility necessary to perform most activities of daily living, the so-called functional mobility, which is 5 or flexion, 30 ° extension, 10 ° radial inclination and 15 ° of ulnar inclination.
  • the doll has 2 main joint lines: the joint radiocarpal (between the bones of the forearm and the first row of carpal bones) and the midcarpal (joint line between the two rows of the carpus).
  • the lesion or affects the radiocarpal and midcarpal joints total wrist arthrodesis is the only technique with which the disappearance of pain will be achieved.
  • the "partial" or focal arthrodesis (only of the affected area), has the advantage, at least theoretical of alleviating pain, preserving part of the mobility (that provided by the unaffected joint segments) and therefore improving the overall function of The wrist-hand unit.
  • radio-scapho-semilunar arthrodesis One type of partial wrist arthrodesis is radio-scapho-semilunar arthrodesis, which would be indicated in cases where there is joint degeneration limited to the radiocarpal joint, as occurs in the sequelae of fractures of the distal extremity of the radius, early stages of posttraumatic carpal osteoarthritis (SLAC doll) and in rheumatoid arthritis patients with wrist involvement.
  • the device object of the invention offers a series of advantages over known devices, since it allows performing partial wrist arthrodesis operations such as radio-scapho-semilunar arthrodesis.
  • the device object of the invention has a symmetric or asymmetric "Y" configuration and would be made of titanium, whose biological compatibility is demonstrated and allows magnetic resonance scanning after the intervention surgical
  • the second section coincides in its longitudinal axis with the first section and therefore appears as a continuation of said first section, while a third section starts from the junction point between said second section and the first section, although in this case the longitudinal axis of said third section defines a non-zero angle with respect to that of the first two sections, which is coincident between both first and second sections.
  • This setting looks like a lowercase "and”.
  • the second section is not a continuation of the first section and forms an angle with respect to the first section and the third section, which as in the previous configuration also defines a non-zero angle with the first section. This setting looks like a capital "Y".
  • the joints between the device and the bones of the joint are given by screws of 2.4 mm, in number of two, for each of the carpal bones in two different angles.
  • the anchor offered by the second oblique screw supports efforts in two senses, axial and tangential, providing greater mechanical resistance to the device, thus strengthening the immobilization of the joint.
  • the device has small guides (screw hole path) of the drill so that the screws are directed to predetermined points of the bones to be fixed and that have been checked with radiographic templates of normal and pathological carps.
  • the perpendicular screws to the scaphoid and semilunar would be placed and then the radius screws, which when introduced by oval holes (designed for this purpose in the main vertical branch of the plate) allow self-compression of the bones to be arthrodesed (improvement the bone union rate), to finally block this position with the oblique direction screws in scaphoid and semilunar.
  • osteoporotic bone screws fragment, not very dense
  • these are also threaded to the plate, which has been shown with other devices that significantly increases the stability of the system.
  • the device object of the invention also has a series of accessory holes to temporarily fix with needles and to be able to assess by radioscopy the proper placement thereof.
  • the implant has holes in its sections to house a centering device that allows the device to be placed and aligned with the bones to be joined and facilitates intraoperative manipulation. DESCRIPTION OF THE DRAWINGS
  • Figure 1. It shows an overhead view of the device object of the invention with the fork of the smaller sections configured in the form of "Y".
  • Figure 2. Shows an overhead view of the device object of the invention with one of the smaller sections coinciding with the greater section; showing a setting in "and".
  • Figure 3a Shows the device of the invention configured in "Y” on an x-ray of the wrist.
  • Figure 3b. Shows the device of the invention configured in "y” on a wrist x-ray.
  • Figure 4.- Shows the device of the invention configured in "y” with the center mounted.
  • the device (1) To perform a partial wrist arthrodesis, the device (1) is positioned on bones to be immobilized: radius, scaphoid and semilunar; For this purpose, a centering device (8) is used.
  • the device (1) has a series of accessory holes (5) in the main branch and in each of the sections (2,3,4) of the device (1) so that, by manipulating said centering (8) , the device (1) can be positioned and fixed, in holes intended to house said centering device (8), temporarily with Kirschner needles to assess a correct alignment by radioscopy.
  • the screws are 2.4 mm for the carpus and 3.5 mm for the radius, which are fixed perpendicularly to the bone passing through perpendicular through holes (7) while other screws, which form the anchoring pair, are fixed obliquely to the bone through oblique through holes (6) and always after fixing to the radius;
  • Each anchor pair is defined in each of the sections (2,3,4).

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

Abstract

A description is given of a device and a method for radioscaphoid/semilunate joint immobilization using arthrodesis which is afforded by a three-part plate, each of said parts being placed on each of the bones to be joined by means of screws.

Description

DISPOSITIVO DE ARTRODESIS PARCIAL DEL CARPO  CARPO PARTIAL ARTHRODESIS DEVICE
D E S C R I P C I Ó N D E S C R I P C I Ó N
OBJETO DE LA INVENCIÓN OBJECT OF THE INVENTION
La presente invención se refiere al campo de la implantología médica, más concretamente en aquellos implantes destinados a la inmovilización de articulaciones. The present invention relates to the field of medical implantology, more specifically in those implants intended for immobilization of joints.
El objeto de la invención consiste en un dispositivo que permite la inmovilización de la estructura ósea mediante el anclaje de dicho dispositivo a los huesos que componen dicha estructura. The object of the invention consists of a device that allows immobilization of the bone structure by anchoring said device to the bones that make up said structure.
ANTECEDENTES DE LA INVENCIÓN BACKGROUND OF THE INVENTION
La operación de artrodesis consiste en una intervención quirúrgica en la cual se fusionan de dos piezas óseas, eliminando una articulación. Esta intervención es muy común en el ráquis fijando dos o más vértebras entre sí generando la fijación inicial por medio de implantes metálicos más o menos complejos, que hacen presa en los pedículos, láminas o apófisis de las vertebras, mientras tiene lugar la fusión definitiva, proceso biológico que resulta del desbridamiento de los segmentos articulares a sacrificar y aporte de injerto o sustituto óseo . The arthrodesis operation consists of a surgical intervention in which two bone pieces are fused, eliminating a joint. This intervention is very common in the spine by fixing two or more vertebrae with each other, generating the initial fixation by means of more or less complex metal implants, which prey on the pedicles, plates or apophysis of the vertebrae, while the final fusion takes place biological process that results from the debridement of the joint segments to be sacrificed and contribution of graft or bone substitute.
La artrodesis ha sido y es un arma terapéutica muy importante en el tratamiento de enfermedad articular degenerativa avanzada, ya que la artroplastía no es aplicable a todas las articulaciones o al menos, no ofrece los mejores resultados clínico-funcionales para determinadas lesiones y topografías. Este tipo de técnicas se realizaron en la muñeca como alternativa a la resección articular o la amputación en afecciones tuberculosas. Otras indicaciones tempranas de la artrodesis fueron la corrección de las deformidades en la poliomielitis, las deformidades espásticas, como describiera Steindler en 1918, y secuelas de la contractura isquémica de Volkmann. Arthrodesis has been and is a very important therapeutic weapon in the treatment of advanced degenerative joint disease, since arthroplasty is not applicable to all joints or at least, it does not offer the best clinical-functional results for certain lesions and topographies These types of techniques were performed on the wrist as an alternative to joint resection or amputation in tuberculous conditions. Other early indications of arthrodesis were the correction of polio deformities, spastic deformities, as Steindler described in 1918, and sequelae of Volkmann's ischemic contracture.
En 1965, Clayton y otros, describieron el uso de clavos de Steinman largos, para la fusión de la muñeca reumática. En 1971 , Mannerfelt y Malmstem modificaron el procedimiento usando clavos de Rush, insertados a través del 3o metacarpiano hasta la diáfisis del radio, en combinación con una grapa de Wiberg, para garantizar la estabilidad rotacional, procedimiento que se hizo muy popular y que dio lugar a múltiples variantes (Stanley 1986) aplicables a artrodesis de muñeca cerradas y a cielo abierto. La fusión de muñeca con placas y tornillos fue introducida por el grupo AO en literatura germana en 1969 y se tradujo al inglés en 1970. Larson en 1974 describió una serie de 23 pacientes con fusión de muñeca con placa a compresión utilizando el método AO. En la actualidad, la artrodesis total de muñeca es un procedimiento quirúrgico bien establecido que proporciona una reducción reproducible del dolor en pacientes con múltiples afecciones inflamatorias, degenerativas o postraumáticas, si bien sacrificando toda la movilidad. Palmer y cois en 1985, describieron el grado de movilidad necesario para realizar la mayoría de las actividades de la vida diaria, la denominada movilidad funcional, que es de 5o de flexión, 30° de extensión, 10° de inclinación radial y 15° de inclinación cubital. La muñeca tiene 2 líneas articulares principales: la articulación radiocarpiana (entre los huesos del antebrazo y la primera hilera de huesos del carpo) y la mediocarpiana (línea articular entre las dos hileras del carpo). Cuando la lesión o afecta a las articulaciones radiocarpiana y mediocarpiana, la artrodesis total de muñeca es la única técnica con la que se conseguirá la desaparición del dolor. In 1965, Clayton and others, described the use of long Steinman nails, for the fusion of the rheumatic wrist. In 1971, Mannerfelt and Malmstem modified the procedure using Rush nails, inserted through the 3rd or metacarpal to the radius diaphysis, in combination with a Wiberg staple, to ensure rotational stability, a procedure that became very popular and gave place to multiple variants (Stanley 1986) applicable to closed wrist arthrodesis and open sky. Doll fusion with plates and screws was introduced by the AO group in German literature in 1969 and translated into English in 1970. Larson in 1974 described a series of 23 patients with wrist fusion with compression plate using the AO method. Currently, total wrist arthrodesis is a well-established surgical procedure that provides a reproducible reduction of pain in patients with multiple inflammatory, degenerative or post-traumatic conditions, although sacrificing all mobility. Palmer and cois in 1985, described the degree of mobility necessary to perform most activities of daily living, the so-called functional mobility, which is 5 or flexion, 30 ° extension, 10 ° radial inclination and 15 ° of ulnar inclination. The doll has 2 main joint lines: the joint radiocarpal (between the bones of the forearm and the first row of carpal bones) and the midcarpal (joint line between the two rows of the carpus). When the lesion or affects the radiocarpal and midcarpal joints, total wrist arthrodesis is the only technique with which the disappearance of pain will be achieved.
Sin embargo, cuando la afección degenerativa afecta sólo a una parte de la muñeca. La artrodesis "parcial" o focal (sólo de la zona afectada), presenta la ventaja, al menos teórica de paliar el dolor, preservando parte de la movilidad (aquella que proporcionan los segmentos articulares no afectados) y por tanto mejorando la función global de la unidad muñeca-mano. However, when the degenerative condition affects only part of the wrist. The "partial" or focal arthrodesis (only of the affected area), has the advantage, at least theoretical of alleviating pain, preserving part of the mobility (that provided by the unaffected joint segments) and therefore improving the overall function of The wrist-hand unit.
Un tipo de artrodesis parcial de muñeca es la artrodesis radio- escafo-semilunar, que estaría indicada en los casos donde existe una degeneración articular limitada a la articulación radiocarpiana, como ocurre en las secuelas de las fracturas de la extremidad distal del radio, primeras fases de la artrosis postraumática del carpo (muñeca SLAC) y en pacientes de artritis reumatoide con afectación de las muñecas. One type of partial wrist arthrodesis is radio-scapho-semilunar arthrodesis, which would be indicated in cases where there is joint degeneration limited to the radiocarpal joint, as occurs in the sequelae of fractures of the distal extremity of the radius, early stages of posttraumatic carpal osteoarthritis (SLAC doll) and in rheumatoid arthritis patients with wrist involvement.
Este tipo de intervención no se prodiga mucho, pues entre otras complicaciones hay una considerable tasa de pseudoartrosis (no unión de la artrodesis). A ello contribuye la ausencia de un dispositivo de fijación primaria adecuado a la anatomía y patología de la región. Es habitual utilizar para tal fin, materiales no específicos de los que derivan otros problemas, porque proporcionan sólo un punto de fijación por hueso carpiano . This type of intervention does not spread much, since among other complications there is a considerable rate of pseudoarthrosis (non-union of arthrodesis). The absence of a primary fixation device appropriate to the anatomy and pathology of the region contributes to this. It is customary to use non-specific materials from which other problems derive, because they provide only one point of fixation for carpal bone.
DESCRIPCIÓN DE LA INVENCIÓN El dispositivo objeto de la invención ofrece una serie de ventajas sobre los dispositivos conocidos, ya que permite realizar operaciones de artrodesis parcial de muñeca tipo artrodesis radio-escafo-semilunar. Para la realización de la inmovilización de radio, escafoides y semilunar, el dispositivo objeto de la invención tiene una configuración en "Y" simétrica o asimétrica y estaría fabricado en titanio, cuya compatibilidad biológica está demostrada y permite realizar exploración por resonancia magnética tras la intervención quirúrgica. DESCRIPTION OF THE INVENTION The device object of the invention offers a series of advantages over known devices, since it allows performing partial wrist arthrodesis operations such as radio-scapho-semilunar arthrodesis. For the realization of the immobilization of radio, scaphoid and semilunar, the device object of the invention has a symmetric or asymmetric "Y" configuration and would be made of titanium, whose biological compatibility is demonstrated and allows magnetic resonance scanning after the intervention surgical
En una configuración del dispositivo uno de los tramos, el segundo tramo, es coincidente en su eje longitudinal con el primer tramo y por tanto aparece como una continuación de dicho primer tramo, mientras que un tercer tramo parte del punto de unión entre el citado segundo tramo y el primer tramo, aunque en este caso el eje longitudinal de dicho tercer tramo define un ángulo no nulo con respecto del de los dos primeros tramos, que es coincidente entre ambos primer y segundo tramo. Esta configuración tiene una apariencia de una "y" minúscula. En otra configuración del dispositivo, el segundo tramo no es una continuación del primer tramo y forma un ángulo con respecto del primer tramo y del tercer tramo, que al igual que en la configuración anterior también define un ángulo no nulo con el primer tramo. Esta configuración tiene una apariencia de una "Y" mayúscula. In a configuration of the device one of the sections, the second section, coincides in its longitudinal axis with the first section and therefore appears as a continuation of said first section, while a third section starts from the junction point between said second section and the first section, although in this case the longitudinal axis of said third section defines a non-zero angle with respect to that of the first two sections, which is coincident between both first and second sections. This setting looks like a lowercase "and". In another configuration of the device, the second section is not a continuation of the first section and forms an angle with respect to the first section and the third section, which as in the previous configuration also defines a non-zero angle with the first section. This setting looks like a capital "Y".
Las uniones entre el dispositivo y los huesos de la articulación vienen dadas por tornillos de 2,4 mm, en número de dos, para cada uno de los huesos del carpo en dos ángulos diferentes. The joints between the device and the bones of the joint are given by screws of 2.4 mm, in number of two, for each of the carpal bones in two different angles.
El anclaje que ofrece el segundo tornillo oblicuo soporta esfuerzos en dos sentidos, axial y tangencial, aportando mayor resistencia mecánica al dispositivo, reforzando así la inmovilización de la articulación. The anchor offered by the second oblique screw supports efforts in two senses, axial and tangential, providing greater mechanical resistance to the device, thus strengthening the immobilization of the joint.
El dispositivo presenta unas pequeñas guías (trayecto del orificio del tornillo) de taladro para que se dirijan los tornillos a puntos predeterminados de los huesos a fijar y que se han comprobado con plantillas radiográficas de carpos normales y patológicos. The device has small guides (screw hole path) of the drill so that the screws are directed to predetermined points of the bones to be fixed and that have been checked with radiographic templates of normal and pathological carps.
En primer lugar se colocarían los tornillos perpendiculares al escafoides y semilunar y seguidamente, los tornillos del radio, que al introducirse por orificios ovalados (diseñados a tal fin en la rama vertical principal de la placa) permiten realizar autocompresión de los huesos a artrodesar (mejora la tasa de unión ósea), para finalmente bloquear esta posición con los tornillos de dirección oblicua en escafoides y semilunar. First, the perpendicular screws to the scaphoid and semilunar would be placed and then the radius screws, which when introduced by oval holes (designed for this purpose in the main vertical branch of the plate) allow self-compression of the bones to be arthrodesed (improvement the bone union rate), to finally block this position with the oblique direction screws in scaphoid and semilunar.
Para evitar la posible movilización secundaria de los tornillos en hueso osteoporótico (frágil, poco denso), éstos también van roscados a la placa, lo que se ha demostrado con otros dispositivos que aumenta notablemente la estabilidad del sistema. To avoid the possible secondary mobilization of the osteoporotic bone screws (fragile, not very dense), these are also threaded to the plate, which has been shown with other devices that significantly increases the stability of the system.
El dispositivo objeto de la invención dispone asimismo de una serie de orificios accesorios para fijar temporalmente con agujas y poder valorar mediante radioscopia la adecuada colocación del mismo. Finalmente para facilitar el uso del implante, éste dispone en sus tramos de unos orificios destinados a albergar un centrador que permite colocar y alinear el dispositivo con los huesos a unir y facilita la manipulación intraoperatoria. DESCRIPCIÓN DE LOS DIBUJOS The device object of the invention also has a series of accessory holes to temporarily fix with needles and to be able to assess by radioscopy the proper placement thereof. Finally, to facilitate the use of the implant, it has holes in its sections to house a centering device that allows the device to be placed and aligned with the bones to be joined and facilitates intraoperative manipulation. DESCRIPTION OF THE DRAWINGS
Para complementar la descripción que se está realizando y con objeto de ayudar a una mejor comprensión de las características de la invención, de acuerdo con un ejemplo preferente de realización práctica de la misma, se acompaña como parte integrante de dicha descripción, un juego de dibujos en donde con carácter ilustrativo y no limitativo, se ha representado lo siguiente: Figura 1.- Muestra una vista cenital del dispositivo objeto de la invención con la bifurcación de los tramos menores configurada en forma de "Y". To complement the description that is being made and in order to help a better understanding of the characteristics of the invention, according to a preferred example of practical implementation thereof, a set of drawings is attached as an integral part of said description. where, for illustrative and non-limiting purposes, the following has been represented: Figure 1.- It shows an overhead view of the device object of the invention with the fork of the smaller sections configured in the form of "Y".
Figura 2.- Muestra una vista cenital del dispositivo objeto de la invención con uno de los tramos menores coincidente con el tramo mayor; mostrando un configuración en "y". Figure 2.- Shows an overhead view of the device object of the invention with one of the smaller sections coinciding with the greater section; showing a setting in "and".
Figura 3a.- Muestra el dispositivo de la invención configurado en "Y" sobre una radiografía de la muñeca. Figura 3b.- Muestra el dispositivo de la invención configurado en "y" sobre una radiografía de la muñeca. Figure 3a.- Shows the device of the invention configured in "Y" on an x-ray of the wrist. Figure 3b.- Shows the device of the invention configured in "y" on a wrist x-ray.
Figura 4.- Muestra el dispositivo de la invención configurado en "y" con el centrador montado. Figure 4.- Shows the device of the invention configured in "y" with the center mounted.
REALIZACIÓN PREFERENTE DE LA INVENCIÓN PREFERRED EMBODIMENT OF THE INVENTION
A la vista de las figuras se describe a continuación un modo de realización preferente del dispositivo (1 ) objeto de esta invención. Para realizar una artrodesis parcial de muñeca, se posiciona el dispositivo (1 ) sobre unos huesos a inmovilizar: radio, escafoides y semilunar; para ello se hace uso de un centrador (8). El dispositivo (1 ) presenta una serie de orificios accesorios (5) en la rama principal y en cada uno de los tramos (2,3,4) del dispositivo (1 ) de forma que, mediante la manipulación de dicho centrador (8), se puede posicionar y fijar el dispositivo (1 ), en unos orificios destinados a albergar dicho centrador (8), temporalmente con agujas de Kirschner para valorar una correcta alineación mediante radioscopia. In view of the figures, a preferred embodiment of the device (1) object of this invention is described below. To perform a partial wrist arthrodesis, the device (1) is positioned on bones to be immobilized: radius, scaphoid and semilunar; For this purpose, a centering device (8) is used. The device (1) has a series of accessory holes (5) in the main branch and in each of the sections (2,3,4) of the device (1) so that, by manipulating said centering (8) , the device (1) can be positioned and fixed, in holes intended to house said centering device (8), temporarily with Kirschner needles to assess a correct alignment by radioscopy.
Para realizar la inmovilización se hace necesario anclar el dispositivo (1 ) a cada uno de los huesos mediante tornillos, los tornillos son de 2,4 mm para el carpo y de 3,5 mm para el radio, que se fijan perpendicularmente al hueso pasando a través de unos taladros pasantes perpendiculares (7) mientras que otros tornillos, que forman el par de anclaje, se fijan oblicuamente al hueso pasando por unos taladros pasantes oblicuos (6) y siempre después de realizar la fijación al radio; cada par de anclaje se define en cada uno de los tramos (2,3,4). To make the immobilization it is necessary to anchor the device (1) to each of the bones using screws, the screws are 2.4 mm for the carpus and 3.5 mm for the radius, which are fixed perpendicularly to the bone passing through perpendicular through holes (7) while other screws, which form the anchoring pair, are fixed obliquely to the bone through oblique through holes (6) and always after fixing to the radius; Each anchor pair is defined in each of the sections (2,3,4).

Claims

R E I V I N D I C A C I O N E S R E I V I N D I C A T I O N E S
Dispositivo de artrodesis parcial del carpo caracterizado porque comprende un cuerpo de formas redondeadas que está constituido por un primer tramo (2) que dispone de una bifurcación de la que parten un segundo tramo (3) y un tercer tramo (4), que forma un ángulo con dicho primer tramo (2), donde dicho cuerpo dispone de: Partial carpal arthrodesis device characterized in that it comprises a body with rounded shapes that is made up of a first section (2) that has a bifurcation from which a second section (3) and a third section (4) start, which forms a angle with said first section (2), where said body has:
- al menos un taladro pasante oblicuo (6) que se encuentra definido en al menos uno de los tramos (2,3,4), y - at least one oblique through hole (6) that is defined in at least one of the sections (2,3,4), and
- al menos un taladro pasante perpendicular (7) que se encuentra definido en al menos uno de los tramos (2,3,4). - at least one perpendicular through hole (7) that is defined in at least one of the sections (2,3,4).
Dispositivo (1 ) según reivindicación 1 caracterizado porque el segundo tramo (3) es colineal con el primer tramo Device (1) according to claim 1 characterized in that the second section (3) is collinear with the first section
(2) y el tercer tramo (4) es acodado. (2) and the third section (4) is elbowed.
3. Dispositivo (1 ) según reivindicación 1 caracterizado porque el segundo tramo (3) se encuentra dispuesto formando un ángulo con respecto del primer tramo (2). 3. Device (1) according to claim 1 characterized in that the second section (3) is arranged at an angle with respect to the first section (2).
4. Dispositivo (1 ) según reivindicación 3 caracterizado porque el segundo tramo (3) y el tercer tramo (4) están dispuestos de modo que el cuerpo es simétrico. 4. Device (1) according to claim 3 characterized in that the second section (3) and the third section (4) are arranged so that the body is symmetrical.
Dispositivo (1 ) según una cualquiera de las reivindicaciones anteriores caracterizado porque adicionalmente comprende unos orificios accesorios (5) que se encuentran ubicados en al menos uno de los tramos (2,3,4) adaptados para permitir la fijación temporal del dispositivo mediante agujas. Dispositivo (1 ) según una cualquiera de las reivindicaciones anteriores caracterizado porque adicionalmente comprende un centrador (8) destinado a manipular y posicionar el dispositivo (1 ). Device (1) according to any one of the preceding claims characterized in that it additionally comprises accessory holes (5) that are located in at least one of the sections (2,3,4) adapted to allow temporary fixation of the device using needles. Device (1) according to any one of the previous claims characterized in that it additionally comprises a centering device (8) intended to manipulate and position the device (1).
Dispositivo (1 ) según una cualquiera de las reivindicaciones anteriores caracterizado porque adicionalmente comprende en sus tramos (2,3,4) de unos orificios destinados a albergar el centrador (8). Device (1) according to any one of the previous claims, characterized in that it additionally comprises in its sections (2,3,4) holes intended to house the centering device (8).
Dispositivo (1 ) según reivindicación 7 caracterizado porque los tornillos se "roscan" o bloquean a la placa para evitar la movilización en hueso osteoporótico. Device (1) according to claim 7 characterized in that the screws are "threaded" or locked to the plate to prevent mobilization in osteoporotic bone.
Dispositivo (1 ) según reivindicación una cualquiera de las reivindicaciones anteriores caracterizado porque al menos uno de los taladros (6,7) del primer tramo (2) destinado al radio son ovalados para permitir la autocompresión del sistema. Device (1) according to any one of the preceding claims, characterized in that at least one of the holes (6,7) of the first section (2) intended for the radius are oval to allow self-compression of the system.
PCT/ES2011/070668 2011-09-26 2011-09-26 Partial carpal arthrodesis device WO2013045713A1 (en)

Priority Applications (1)

Application Number Priority Date Filing Date Title
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Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/ES2011/070668 WO2013045713A1 (en) 2011-09-26 2011-09-26 Partial carpal arthrodesis device

Publications (1)

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WO2013045713A1 true WO2013045713A1 (en) 2013-04-04

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US10925651B2 (en) 2018-12-21 2021-02-23 DePuy Synthes Products, Inc. Implant having locking holes with collection cavity for shavings

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