WO2013105906A1 - Système de fixation d'os et d'articulation - Google Patents

Système de fixation d'os et d'articulation Download PDF

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Publication number
WO2013105906A1
WO2013105906A1 PCT/TH2012/000001 TH2012000001W WO2013105906A1 WO 2013105906 A1 WO2013105906 A1 WO 2013105906A1 TH 2012000001 W TH2012000001 W TH 2012000001W WO 2013105906 A1 WO2013105906 A1 WO 2013105906A1
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WO
WIPO (PCT)
Prior art keywords
bone
joint fixing
locking
fixing system
joint
Prior art date
Application number
PCT/TH2012/000001
Other languages
English (en)
Inventor
Sunton Wongsiri
Original Assignee
Sunton Wongsiri
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 Sunton Wongsiri filed Critical Sunton Wongsiri
Priority to PCT/TH2012/000001 priority Critical patent/WO2013105906A1/fr
Publication of WO2013105906A1 publication Critical patent/WO2013105906A1/fr

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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8869—Tensioning devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—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
    • 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
    • A61B17/683—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
    • 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
    • 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
    • A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • 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
    • A61B17/8004—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with means for distracting or compressing the bone or bones
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—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
    • A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
    • A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
    • 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
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • 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
    • A61B17/56—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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/842—Flexible wires, bands or straps
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8665—Nuts
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8695—Washers
    • 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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8875—Screwdrivers, spanners or wrenches
    • 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
    • A61B2017/567—Joint mechanisms or joint supports in addition to the natural joints and outside the joint gaps

Definitions

  • the invention relates to a specialized instrument used during a surgical procedure of bone and joint in order to assist the motion of joints and to increase the stability of a bone fixation system.
  • hinge external fixator in the surgery of fracture
  • the fracture line of the coronoid is perpendicular to the joint line which means that the shearing and distraction forces will make the fracture displaced easily, even where an initial complete stable fixation exists.
  • the screw fixation alone is not stable enough to allow the elbow motion.
  • the plate fixation may be the alternative to provide a stronger joint for loading, in the case of comminuted and unstable fractures, the simple plate fixation is not strong enough for stable movement because of shearing and distraction forces.
  • the bone and joint fixing system for early joint motion and stabilization is invented in order to improve the stability of bone fixation that aims to solve the above-stated problems.
  • This invention consists of an internal joint fixator which increases the stable movement; a tension-plate system which provides resistance to the shearing and distraction forces that cause the noted hardware failures; a dual locking system which creates higher stability from two plates; and an internal joint fixator template which provide the guidance for the direction of fixation.
  • This invention relates to the bone and joint fixing system for early joint motion and stabilization which is used to improve the stable joint movement and stability of bone fixation.
  • the system according to this invention is applicable to the surgical procedure of fracture, dislocation, subluxation or the related injuries thereof.
  • FIG. la illustrates the components of the bone and joint fixing system, showing the anatomic like motion-system, the tension-plate system, the dual locking system and the tension adjustment system.
  • FIG. lb illustrates a sectional view of the locking system of adjustable means, which shows the securing of the adjustable mean.
  • FIG. lc illustrates a sectional view of the locking system of adjustable means, which shows the securing of the adjustable mean.
  • FIG. 2a illustrates the three components of the circular hinge system, showing the rotating means, the variable attaching element and the extended element.
  • FIG. 2b illustrates the non-circular hinge system, showing the non-circular hinge and the non-circular rotational rings; the curve adjuster and the external rotation adjuster.
  • FIG. 2c illustrate sectional views of the rotating means comprises of the rotating ring and the motion control screw.
  • FIG. 2d illustrate sectional views of the embedded elongation systems.
  • FIG. 3a illustrates the ligament washer to use for fixation the ligament to bone.
  • FIG. 3b illustrate views of the limited motion rings.
  • FIG. 3c illustrate views of the limited motion caps.
  • FIG. 4a illustrates the triangular shape of the extended element.
  • FIG. 4b illustrates the standard plate shape of the extended element.
  • FIG. 4c illustrates the adjustable mean shape of the extended element.
  • FIG. 4d illustrates the flexible mean shape of the extended element.
  • FIG. 4e illustrates the extended element bender for adjusting the shape of the adjustable mean shape of the extended element.
  • FIG. 4f illustrate sectional views of the plate attachment screws.
  • FIG. 5a illustrate the joint subluxation and the joint reduction by using the internal joint fixator.
  • FIG. 5b illustrate the different uses of the rotating means; the embedded elongating screw and the threadless embedded elongating screw.
  • FIG. 5c illustrate the use of the rotating means; the extended angle element.
  • FIG. 5d illustrate the different sizes of the triangular shape of the extended element.
  • FIG. 5e illustrates the use of the triangular shape of the extended element.
  • FIG. 5f illustrates the use of the adjustable mean shape of the extended element.
  • FIG. 5g illustrates the use of the standard plate shape of the extended element.
  • FIG. 5h illustrates the use of the flexible shape of the extended element.
  • FIG. 6a illustrates views of the tension-plate system and the tension adjustment system.
  • FIG. 6b illustrate views of the wire locking screw system.
  • FIG. 6c illustrates views of the quick locking system.
  • FIG. 6d illustrates views of the twisted wire system.
  • FIG. 7 a illustrate the different types of tension wires.
  • FIG. 7b illustrates the use of the tension adjustment system to lock the wire by the wire catcher.
  • FIG. 7c illustrates the use of the tension adjustment system to increase tension by grip the tension element.
  • FIG. 7d illustrates using of the tension adjustment system to secure the wire with the wire locking screw system by squeeze the quick screwing trigger.
  • FIG. 7e illustrates using of the tension-plate system in a knee joint.
  • FIG. 8a illustrates using of the dual locking on the double plates system.
  • FIG. 8b illustrates using of the proximal locking part and the distal locking part.
  • FIG. 8c illustrates using of dual locking on the double plates system in an elbow joint.
  • FIG. 8d illustrates using of dual locking on the double plates system in a knee joint.
  • FIG. 9a illustrates a view of the proximal guide template.
  • FIG. 9b illustrates views of the proximal guide template and the distal guide template.
  • FIG. 9c illustrates views of the screw placement template.
  • FIG. 9d illustrates a view of the screw template of the reduction guide.
  • FIG. 9e illustrates a view of the sizing template.
  • the major movements involve ligaments and bone which have articulation shaped like a circle that allows the movement in a circular motion with the center of rotation in the humeral bone.
  • a fracture or dislocation around the elbow may affect the loss of this normal circular motion and potentially cause traumatic arthritis.
  • This invention is uniquely designed in order to provide the assistance to any joint to function close to or similar to the normal anatomical motion.
  • the invention shows the assisted system of the motions for instance the motion of elbow and knee without any limitation of use.
  • the bone and joint fixing system comprises of the internal joint fixator (10), the dual locking system (30), and the tension-plate system (20) that has the tension adjustment system (50) for assisting of setting tension.
  • the internal joint fixator (10) provides the motions which are similar to normal human anatomical movement. For instance, in the case of the elbow, the hinge motion of the system is designed to allow the motion at the center of elbow motion.
  • the said internal joint fixator (10) consists of the rotating means (100), the variable attaching element (120) and the extended element (130).
  • the tension-plate system (20) creates normal tension by the tension wire (21) attached to the holes of two plates i.e. a proximal bone plate (341) and a distal bone plate (342), which holds the fractured fragments and can resist to the distraction force.
  • the dual locking system (30) comprises of the dual locking screws (31) used for securing the two plates i.e. a proximal bone plate (341) and a distal bone plate (342), which are held together in one unit from two fixations.
  • the said dual locking system (30) provides the stronger fixation system and the resistance to the loading force.
  • the tension adjustment system (50) is a device designed to create tension force and to secure locking. In FIG.
  • variable attaching element (120) secure to the bottom plate (122) by plate attachment screws.
  • the variable attaching element (120) can be connected to the one end of the said extended element (130) by fusing in one unit.
  • the extended element (130) can be connected to the variable attaching element (120) with the locking means of connecting system (1305).
  • the locking means of connecting system (1305) comprises of the one end of the said extended element (130), an opening portion (186) for insertion of the one end of the said extended element (130) and the locking system of opening plate (184) for holding and securing.
  • the said locking means of connecting system (1305) consists of the opening portion (186) for inserting the extended element of adjustable mean (1303), the opening slot (181), the two opening plates (185) for increasing room of the opening portion (186), and the locking system of opening plate (184).
  • the said locking means of connecting system (1305) further comprises of the rough surface of extended element (182) and the rough surface of tube (183) for holding strength.
  • Human joints have difference motion patterns, for example, a circular motion of an elbow joint as shown in FIG. 2a and a non-circular motion of a knee joint, as shown in FIG. 2b.
  • circular motion the movement of elbow in a natural anatomical fashion is assisted by the internal joint fixator (10) that allows the center of the elbow joint to move in the same spot as the hinge joint at the rotating means (100) as shown in FIG. 2a.
  • non-circular motion the non- circular hinge system (106) is used to allow the motion in the joint as shown in FIG. 2b.
  • the non- circular hinge system (106) comprises of the non-circular hinge (1061) and the non-circular rotational rings (1064); the curve adjuster (1062) and the external rotation adjuster (1063) in order to allow non-concentric motion, to create translation movement and to create the external rotation movement, respectively.
  • the said rotating means (100) has variety motion features.
  • the said rotating means (100) comprises of the rotating ring (101) and the motion control screw (102) as shown in FIG. 2c.
  • the said rotating ring (101) has at least two layers rotate on each other as shown in FIG. 2c.
  • the embedded elongation system (107) of the rotating means (100) can be embedded in a bone, as shown in FIG. 2d.
  • the embedded elongation system (107) may use the embedded elongating screw (1072) in order to allow the motion at the neck of the screw or may use the threadless embedded elongating screw (1070) combined with the long locking tube (1071) or the short locking tube (1073) to allow the said motion.
  • a ligament washer (141) can be use to hold ligament (145) to bone for further ligament healing process as shown in FIG. 3a and the motion of the hinge can be adjusted based on the desired degree of motion by using the limited motion rings (103) or the limited motion cap (109) as shown in FIG. 3b and FIG. 3c.
  • the limited motion rings (103) provides the wide range of degrees which can be selected, such as the 120 degrees of motion (1031), the 90 degrees of motion (1032) and the 30 degrees of motion (1033).
  • the limited motion cap (109) also provides the wide range of degrees which can be selected, such as the 120 degrees of motion (1099), the 90 degrees of motion (1098) and the 30 degrees of motion (1097).
  • the illustrations show the different shapes of the extended element (130).
  • the extended elements of triangular shape (1301) comprises of two side extended elements that create greater stability of fixation during motion.
  • the extended element of standard plate (1302) consists of one extended element which is compatible to the standard plate.
  • the extended element of adjustable mean (1303) can be adjusted in various directions and shapes by using the extended element bender (1304).
  • the said extended element of adjustable means (1303) can be secured by the locking means of connecting system (1305).
  • the extended element of flexible mean (1306) has flexibility and adaptation which similar to the feature of the collateral ligament structures of the joint.
  • the extended element of flexible mean (1306) composes of a tension member (1308) for holding tension like the ligament and a tension securing screw for securing the said tension member (1308) to plates or bone.
  • variable attaching element (120) is a system which secures the internal joint fixator (10) to a bone, with various kinds of a plate attachment screw (13) as shown in FIG. 4b.
  • the plate-plate screw (131) is used to secure between a top attachment plate (121) and a bottom plate (122).
  • the plate-screw screw (132) is used to secure the top attachment plate (121) and the screw of the bottom plate (139).
  • the plate-bone screw (133) is used to secure the top attachment plate (121) to the bone (70).
  • the reduction can be retained with the minimal equipments of the internal joint fixator (10) as shown in FIG. 5a.
  • the internal joint fixator (10) is used to reduce subluxation by securing the rotating means (100) to the center of rotation of the joint (701) for motion and to secure the variable attaching element (120) to the bone (70) for fixation.
  • the rotating means (100) is moveably connected to the extended element (130) with the threadless embedded elongating screw (1070) or the embedded elongating screw (1072).
  • the rotating means (100) is non-moveably connected to the extended element (130) with the extended angle element (1075).
  • the internal joint fixator (10) can be selected in many embedded types of the rotating means (100), as shown in FIGs. 5b and 5c.
  • the rotating means (100) is an embedded elongating screw (1072) for motion at neck of the said embedded elongating screw (1072) or the threadless embedded elongating screw (1070) with the long locking tube (1071) or the short locking tube (1073) for motion at body of the said threadless embedded elongating screw 1070.
  • the extended angle element (1075) is the rotating mean (100) that is fused to the extended element (130) for improve the strength of connection.
  • the sizes and shapes of the said internal joint fixator (10) can be selected for a proper use as shown in FIG. 5d and FIGs. 5e, 5f, 5g and 5h, respectively.
  • the tension-plate system (20) is a system used to create an anti-distraction force to reduce the fracture gap and the fracture displacement.
  • the anti-distraction force is created by the tension wire (21) which is fixed between two plates i.e. a proximal bone plate (341) and a distal bone plate (342). Then, the anti-distraction force is set tension by the tension adjustment system (50) as show in FIG. 6a.
  • the tension wire (21) can be fixed by the wire plate locking screw system (23) as show in FIG. 6a and FIG. 6b, a quick locking system (28) as show in FIG. 6c and a twisted wire system (29) as show in FIG. 6d.
  • the wire plate locking screw system (23) comprises of the wire-locking portion (1351) for wire holding, the locking head with outer thread (1352) for plate holding, the driver part (1353) for screw driver insertion and the inner tube of screw ( 1354) for insertion the tension wire (21) inside.
  • the quick locking system (28) comprises of the quick locking means (281) for wire holding, the quick locking head with outer thread (282) for plate holding, the quick driver part (283) for screw driver insertion, the quick inner tread of locking hole (285) for screw holding and the quick locking hole (284) for insertion the tension wire inside.
  • the tension wire (21) can be selected from difference shape of wires, the regular headless wire (214), the rotatable head threadless wire (21 1), the locking head wire (216) and the anti-rotated head wire (217).
  • the steps of using the tension adjustment system (50) comprises of the insertion of the tension wire inside as shown in FIG. 6a, locking the tension wire by the wire catcher (59) as shown in FIG. 7b, squeezing the tension element (58) for increasing the tension as shown in FIG. 7c, and squeezing the quick fastener (56) for securing the tension wire with the wire plate locking screw system (23) as shown in FIG. 7d or the quick locking system (28) as shown in FIG. 7d.
  • the tension- plate system (20) can be used in any part of bone fixation with the principle of using tension-plate system (20) such as in elbow as shown in FIG. 6a and in knee as shown in FIG.7e.
  • the dual locking system (30) is a system used to create stability between two plates i.e. a proximal bone plate (341) and a distal bone plate (342), by locking both ends of the screw as shown in FIG. 8a.
  • the dual locking system (30) can receive the loading force that occurs on the broken bone. Then, loading force is transfered to two plates i.e. a proximal bone plate (341) and a distal bone plate (342), and bone (70) for increasing the broken bone stability.
  • the distal locking system (312) can be secured by using the locking nut (3121) to hold the screw into the plate locking hole.
  • the end of the dual locking screw (31) is secured to the bottom reverse locking hole (314), which has an internal thread at the bottom which matches the outer thread of the dual locking screw (31) as shown in FIG. 8b.
  • the dual locking system (30) can be used in any bones and joints such as the knee, elbow or wrist in order to increase the stability of fixation, as shown in FIGs. 8c and 8d.
  • the drill jig (33) is an additional tool to guide the direction of screw insertion.
  • the center guiding system (40) is a tool to guide the direction of center motion and screw placement.
  • the center guiding system (40) comprises of the proximal guide means (440) to guide the center of rotation of the joint (701) as shown in FIG. 9a, the distal guide means (443) to guide the center at the distal part as shown in FIG. 9b and the screw guide template (441) to guide the screw landmark as shown in FIG. 9c.
  • the proximal guide means (440) contains the articular surface grasper (4401), the center entry portion (4402), the system connector (4404) and the proximal plate guide element (4403), as shown in FIG. 9a.
  • the articular surface grasper (4401) can be use to match and hold the condyle.
  • the articular surface grasper (4401) are made flexible for matching then the center entry portion (4402) will locate the center of rotation of the joint (701).
  • the system connector (4404) is an attachable part to connect the distal guide means (443) to the proximal guide means (440).
  • the center entry portion (4402) is used to find the center of rotation of the joint (701) and allows insert pin.
  • the proximal plate guide element (4403) is the extended element of the proximal guide means (440) that are used to guide the direction of plate placement and to guide the drilling direction with the guiding screw hole 447.
  • FIG. 9a the proximal plate guide element (4403) is the extended element of the proximal guide means (440) that are used to guide the direction of plate placement and to guide the drilling direction with the guiding screw hole 447.
  • the distal guide means (443) is the distal guide which attaches to the proximal guide means (440) via the attachment slot (4433).
  • the distal guide means (443) is composed of the distal condylar matcher (4435), the body of the distal guide (4434), the attachment slot (4433), the aimer handle (4432) and the distal aimer (4431).
  • the distal condylar matcher (4435) has a shape like a circle ring that matches to the shape of distal circle condyle.
  • the body of distal guide (4434) is the body that connects the distal condylar matcher (4435) to the distal aimer (4431) that guides the distal center point. In FIG.
  • the screw guide template (441) is comprises of the adjustable condyle shape (4415) for matching the condyle space and the distal plate guide element (4416) with the guiding screw hole (447) for guiding the screw placement.
  • the adjustable condyle shape (4415) can be adjusted to various sizes by turning the adjustable ring (4414).
  • the reduction system (48) is comprises of the reduction template (481) for reduction the joint and the sizing template (485) for matching the size of the extended element (130).
  • the center guide element (4812) is inserted in the hole of center rotation of the joint (701) then the reduction template (481) is placed on the bone.
  • Temporary pins are inserted in the adjustment pining hole (481 1) and then the guiding screw holes (447) are used to guide the drilling direction.
  • the sizing template (485) is placed in the same position by using screws fixed in the guiding screw hole (447).
  • the sizing marker (4851) will show the proper size of the internal fixator (10).
  • surgeons may select any means of the said bone and joint fixing system 1 including the use of at least internal joint fixator (10), or the tension plate system (20) or the dual locking system (30), or the combination thereof, for holding broken bone pieces or preventing joints displacement.
  • Example 1 Use of the internal joint fixator (10) for preventing joint displacement.
  • the said internal joint fixator (10) can be use in the case of fracture with dislocation, dislocation alone or subluxation.
  • the steps of using the said internal joint fixator (10) comprises of:
  • Example 2 Use of the tension-plate system (20) for holding broken bone pieces.
  • the said tension-plate system (20) can be used in the case of fractures or the fractures with dislocation which may need the said internal joint fixator (10) in addition.
  • the steps of using the said tension-plate system (20) comprises of:
  • Example 3 Use of the dual locking system (30) for holding broken bone pieces.
  • the said dual locking system (30) can be used in the case of fractures or the fractures with dislocation. It can be use together with the internal joint fixator (10).
  • the steps of using the said dual locking system (30) comprises of:
  • proximal locking system (32) to secure the dual locking screw (3 1) attach to the proximal bone plate (341);

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Abstract

La présente invention concerne un système de fixation d'un os et d'une articulation, ledit système comprenant : un dispositif de fixation d'articulation interne comprenant au moins un moyen de rotation fixé à un élément allongé et un élément de fixation variable, ledit élément allongé fournissant un raccord entre ledit moyen de rotation et ledit élément de fixation variable. Ledit système de fixation d'os et d'articulation peut en outre comprendre un système plaque de tension. Ledit système de fixation d'os et d'articulation peut en outre comprendre un système de verrouillage double.
PCT/TH2012/000001 2012-01-13 2012-01-13 Système de fixation d'os et d'articulation WO2013105906A1 (fr)

Priority Applications (1)

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PCT/TH2012/000001 WO2013105906A1 (fr) 2012-01-13 2012-01-13 Système de fixation d'os et d'articulation

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Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
CN106725811A (zh) * 2017-02-28 2017-05-31 谢志进 树状组配式骨科内固定钉板系统
WO2018160612A1 (fr) * 2017-02-28 2018-09-07 Skeletal Dynamics Llc Dispositif de stabilisation d'articulation interne, système et procédé d'utilisation

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US6540708B1 (en) * 2000-02-18 2003-04-01 Sheldon Manspeizer Polycentric joint for internal and external knee brace
US20080275558A1 (en) * 2007-05-01 2008-11-06 Exploramed Nc4, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US20080275555A1 (en) * 2007-05-01 2008-11-06 Exploramed Nc4, Inc. Extra-Articular Implantable Mechanical Energy Absorbing Systems
US20110093080A1 (en) * 2009-10-20 2011-04-21 Slone Clinton N Extra-articular implantable mechanical energy absorbing assemblies having two deflecting members and methods
US20110093079A1 (en) * 2009-10-20 2011-04-21 Slone Clinton N Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US20110245928A1 (en) * 2010-04-06 2011-10-06 Moximed, Inc. Femoral and Tibial Bases

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* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US6540708B1 (en) * 2000-02-18 2003-04-01 Sheldon Manspeizer Polycentric joint for internal and external knee brace
US20080275558A1 (en) * 2007-05-01 2008-11-06 Exploramed Nc4, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US20080275555A1 (en) * 2007-05-01 2008-11-06 Exploramed Nc4, Inc. Extra-Articular Implantable Mechanical Energy Absorbing Systems
US20110093080A1 (en) * 2009-10-20 2011-04-21 Slone Clinton N Extra-articular implantable mechanical energy absorbing assemblies having two deflecting members and methods
US20110093079A1 (en) * 2009-10-20 2011-04-21 Slone Clinton N Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US20110245928A1 (en) * 2010-04-06 2011-10-06 Moximed, Inc. Femoral and Tibial Bases

Cited By (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US10327817B2 (en) 2008-08-01 2019-06-25 Skeletal Dynamics Llc Internal joint stabilizer device, system and method of use
CN106725811A (zh) * 2017-02-28 2017-05-31 谢志进 树状组配式骨科内固定钉板系统
WO2018160612A1 (fr) * 2017-02-28 2018-09-07 Skeletal Dynamics Llc Dispositif de stabilisation d'articulation interne, système et procédé d'utilisation

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