WO2013176632A1 - Modular side device with an intramedullary nail for guiding a bone during its lengthening - Google Patents
Modular side device with an intramedullary nail for guiding a bone during its lengthening Download PDFInfo
- Publication number
- WO2013176632A1 WO2013176632A1 PCT/SI2013/000032 SI2013000032W WO2013176632A1 WO 2013176632 A1 WO2013176632 A1 WO 2013176632A1 SI 2013000032 W SI2013000032 W SI 2013000032W WO 2013176632 A1 WO2013176632 A1 WO 2013176632A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- bone
- screws
- lengthening
- boreholes
- intramedullary nail
- Prior art date
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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/66—Alignment, compression or distraction mechanisms
-
- 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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
-
- 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
- A61B17/60—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 for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6458—Devices extending alongside the bones to be positioned with pin-clamps fixed at ends of connecting element
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—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
Abstract
The improvement relates to a modular side device with an intramedullary nail for guiding a bone, especially a femur or a tibia, in a method for its lengthening, wherein the device is basically comprised of an external lengthening member (1) extending along the external side of a limb parallel to a bone (2) foreseen for lengthening, wherein each end of the member (1) is provided with a respective clamp (3), into which two respective rod-screws (4) with a counter nut are fastened transversely to the longitudinal axis of the clamp (3); and of an intramedullary nail (6) arranged in a canal (5) of the interrupted bone (2). The improvement of the device is formed in a way that a connecting member (7) is arranged on the bone (2) at the site foreseen for connecting with the proximal clamp (3), said member (7) further including two threaded boreholes (8) foreseen to receive two rod-screws (4) and also including through boreholes (9) arranged in a distance from the threaded boreholes (8) and intended to receive bone screws (10), wherein between the connecting member (7) and the joint-proximal section of the bone (2) an adjusting member (11) is arranged which guarantees that the connecting member (7) lies in parallel with the lengthening element or perpendicularly to the rod-screws (4) regardless of the irregular conical shape of the bone (2).
Description
MODULAR SIDE DEVICE WITH AN INTRAMEDULLARY NAIL FOR GUIDING A BONE
DURING ITS LENGTHENING
Object of Invention
[001] The object of the invention is improvement of a modular side device with an intramedullary nail for guiding a bone, especially the femur or the tibia in a method for its lengthening. The device comprises an external bone fixator, an internal bone fixator (intramedullary nail) and connecting members.
Technical Problem
[002] The technical problem solved by the present invention is how to improve the described device in the area of its connection with both parts of a cut bone during a treatment that takes several months in order for the screw link arranged between the device and each part of the cut bone to withstand the forces that occur during adhesion of a lengthened bone and in the limited area in both parts of the bone for screwing in screws, under the consideration of the presence of an internal bone fixator located in the bone canal of both parts of the cut bone and of the presence of the external shape of the bone at a joint, wherein such screw link should considerably reduce a possibility of penetration of bacteria from the skin through a hole in the skin, through which, during the entire period of lengthening, a part of the device is arranged via the external fixator into the bone, and what is even worse, even to the bone canal and along its entire length. An infection requires an immediate attendance, even surgical, which results in severe problems and even discontinuation of the method for bone lengthening. Reduced possibility of infection is therefore of utter importance in the method for bone lengthening in order to achieve successful results.
Prior Art
[003] The device to be improved is embedded as a side external and longitudinally continuously prolongable assembly that is connected with each respective end in transversal direction with each respective part of an interrupted bone, wherein both parts of the bone are axially guided by an intramedullary nail arranged coaxially in canals of both parts of the bone, which canals are filled with bone marrow. The femur is the bone that is the most frequently subject to lengthening. The improved device of the invention can be adapted for application on other bones by performing some dimensional adaptations of the improved device of the invention taking account of the morphology of the treated bone.
[004] In the continuation, the femur will be taken as an example of application of the described improved device of the invention, since the femur is the bone the most frequently subject to lengthening of this type. This bone has an irregular shape and its dimension varies from one patient to another especially in the area of transition to a thickened section of a knee joint, in the proximity of which a bone lengthening is the most frequently performed. Therefore there is a need for an improved connection in order to do away with the drawbacks of the current variant to completely remove or considerably reduce the above-described problems during the method for bone lengthening as described in the technical problem.
Solution to the Technical Problem
[005] The described technical problem is solved by an improved device of the invention, the improvement being in the area of its screw link with each respective part of the bone that is lengthened. The link of the invention is characterized in that for each part of the interrupted bone an intermediate adjusting connecting member is foreseen. At one end said member is screwed into the bone under the consideration of morphological properties of the bone of
a respective patient, and at a distance from this screw connection screwed with screws, preferably two screws that run transversally to the longitudinal axis of the bone and are fastened at the other end to a clamp fixed to one end of the axially prolongable external assembly. As the lengthening is the most frequently performed in the proximity of the knee joint, the adjusting connecting member is designed to be adapted to the morphology of the section of the bone by introduction of an adjusting member, on which it abuts, namely in a way that after the intermediate connecting member is arranged, the boreholes lie in it and are intended for a connection with a clamp of the external prolongable assembly of the device, mutually in parallel. Further, the intermediate connecting member is provided with indents and/or boreholes for receiving bone screws, wherein the indents and/or boreholes allow each individual bone screw to be directed to the centre of the bone defined by its external surface and the surface of its canal, in which the intramedullary nail is arranged during the method for bone lengthening. At the other link on the other part of the bone a screw on the connecting member is foreseen in accordance with the operative method additionally to the above-indicated screws. The screw on the connecting member runs transversally through the entire bone and through the borehole in the intramedullary nail arranged in the bone canal. The intramedullary nail is thus axially fixed as foreseen by the operative method.
[006] Therewith a mechanically strong screw link is achieved, which is urgently needed during the method for bone lengthening.
[007] The invention will now be explained in more detail in the continuation by way of an embodiment and the enclosed drawings representing in
Fig. 1 longitudinal cross-section of an interrupted bone intended for lengthening with a modular side device with an intramedullary nail and the
improvement of the invention;
Fig. 2 cross-section of a bone with the described device along the line II - II of Fig. 1
Fig. 3 elevation of the adjusting member; Fig. 4 front view of the adjusting member; Fig. 5 side view of the adjusting member;
Fig. 6 cross-section of a bone with the described device along the line VI - VI of Fig. 1;
Fig. 7 elevation of the connecting member; Fig. 8 front view of the connecting member; Fig. 9 side view of the connecting member. Remaining tissues at the bone are not shown in figures.
[008] A modular side device with an intramedullary nail for guiding a bone, especially the femur or the tibia, in the method for its lengthening, including the device's improvement, is basically comprised of an external lengthening member 1 extending along the external side of a limb parallel to a bone 2 cut at a site 2a where it is intended for lengthening. Each end of the
member 1 is provided with a respective clamp 3, into which two respective rod- screws 4 with a counter nut are fastened. In a canal 5 of the interrupted bone 2 there is arranged an intramedullary nail 6 that guides both parts of the bone 2 in a way to be extendable in axial direction.
[009] The improvement of the device of the invention is a connecting member 7 arranged on the bone 2 in the joint proximal section, wherein the member 7 includes two threaded boreholes 8 foreseen to receive two rod-screws 4 with a counter nut that are simultaneously fastened to a respective adjacent clamp 3. The connecting member 7 further includes through boreholes 9 arranged in a distance from the threaded boreholes 8 and intended to receive bone screws 10. Between each connecting member 7 and the surface of the bone 2 an adjusting member 11 is arranged, said adjusting member 11 making sure that the connecting member 7 lies parallel to the lengthening member 1 or perpendicularly to the rod-screws 4 regardless of the irregular conical shape of the bone 2.
[0010] Due to various shapes of bones 2 in individual patients it is foreseen that the adjusting members 11 are of various shapes in order to adjust to individual groups of bone 2 shapes. The adjusting members 11 in the first embodiment have the shape of a wedge with different wedge angles to meet the requirement described in the previous paragraph. Boreholes 12 are of the shape and at those sites to correspond to boreholes 9 and the necessary orientation of bone screws 10. Instead of these boreholes or only of some boreholes 12 indents 13 may be formed that even increase possibilities of various positions of the bone screws 10 as required by the needs of each operation.
[0011] The adjusting member 11 is provided with an axially extending elongate indent 14 open at the side surface. The elongate indent 14 is foreseen to receive a chamfered section 15 of rod-screws 4, wherewith a mutual proper
position of the connecting member 7 and the adjusting member 11 in longitudinal direction is guaranteed. To achieve better fitting of the adjusting member 11 to the bone 2, the adjusting member 11 is formed on a surface that is foreseen to abut on the bone 2 and is provided with a longitudinal notch 16 that may be also intermittent. By tightening the rod-screws 4 through the respective threaded borehole 8 both connecting members can be precisely set in parallel.
[0012] The intramedullary nail 6 is fixed on the joint-proximal section of the bone by screws 17, of which at least one reaches through the adjacent connecting member 7 and the adjusting member 11 as well as transversally through the entire bone 2 and through a hole 18 in the intramedullary nail 6.
[0013] According to the second embodiment, the adjusting member 11 can be formed as a tubular member acting as a washer under a respective bone screw 10, wherein tubular elements of various lengths are available to meet a need of the shape of the bone in the area of screw tightening.
[0014] The improvement of the invention of the same device is also reflected in the construction of connection of the external lengthening element 1 with the other end of the bone 2. As the bone 2 is frequently of a cylindrical shape in this area, said connection consists of a clamp 3 connected with the lengthening element 1, further of two rod-screws 4 with a counter nut and arranged with one of their ends within the clamps 3 and with their other ends screwed into the connecting member 7 in respective threaded boreholes 8. The connecting member 7 is fixed on the bone 2 by means of two bone screws 10 extending transversely only to the bones and do not enter either the canal 5 or go out of the bone 2.
[0015] A novel medical applicability of the connecting member 7 and the adjusting member 11 can be explained on the basis of the description of their
construction. The threaded boreholes 8 provided in the connecting member 7 are arranged at a distance from the through boreholes 9, which considerably extends a path to potential bacteria to penetrate from the hole in the skin at the rod-screws 4 to the connecting member 7 and further down to the bone screws 10, along their surface to the bone 2 and through the latter to the canal 5. Another advantage of the improvement of the invention lies in the fact that the adjusting member 11 provides a considerably better screw connection between the bone 2 and the intermediate modular side device for bone lengthening. To its advantage, the ratio between advantages and drawbacks of this device with respect to other devices that serve the same purpose but have different constructions is considerably increased. Introduction of the adjusting member 11, regardless of the shape of the bone 2 section, on which it is arranged, guarantees such position of the connecting member 7 that it runs in parallel with the second connecting member 7; it is guaranteed that all rod-screws 4 run in parallel, which excludes the occurrence of forces that could distort the position of both parts of the bone 2 until they are adhered.
[0016] The description of the embodiment of the invention indicates a precise number of the rod-screws 4 and bone screws 10 in order to match the number of these screws in the existing device which is improved with the described invention. Clearly enough, a change in the number of said screws does not change the content of the invention in any way whatsoever. It is also clear that all the screws are the so-called medical screws intended to be tightened into a metal or bone and are made of a suitable material. The connecting and adjusting element are also both made of a suitable medically acceptable material.
[0017] It is understood that a person skilled in the art can design other variants of individual elements based on having been acquainted with the above description of the invention without circumventing the essence of the invention described in the appended claims.
Claims
1. Improvement of a modular side device with an intramedullary nail for guiding a bone, especially the femur or the tibia, in a method for its lengthening, wherein the device is basically comprised of an external lengthening member (1) extending along the external side of a limb parallel to an interrupted bone (2) cut at a site (2a) where it is intended for lengthening, wherein each end of the lengthening member (1) is provided with a respective clamp (3), into which two respective rod-screws (4) with a counter nut are fastened tranversally; and of an intramedullary nail (6) arranged in a canal (5) of the interrupted bone and fixed with screws (17) axially to extend radially through the interrupted bone (2) and simultaneously through a borehole (18) in the intramedullary nail (6) characterized in that a connecting member (7) is arranged on the bone (2) at the site (2a) foreseen for connecting with the proximal clamp (3), said member (7) further including two threaded boreholes (8) foreseen to receive two rod-screws (4) with a counter nut and also including through boreholes (9) arranged in a distance from the threaded boreholes (8) and intended to receive bone screws (10), wherein between each connecting member (7) and the joint-proximal section of the bone (2) an adjusting member (11) is arranged that is of an elongate wedge shape with a longitudinal notch (16) on the surface that abuts on the bone (2) and comprises boreholes (12) that are of the shape and at those sites to correspond to boreholes (9) in the connecting member (7) and to the necessary orientation of bone screws (10).
2. Improvement according to claim 1 characterized in that indents (13) may be provided in the adjusting member (11) instead of all or only some boreholes (12).
3. Improvement according to claims 1 and 2 characterized in that a longitudinally extending elongate indent (14) is provided in the adjusting member (11) to receive a chamfered section (15) of the screws (4).
4. Improvement according to claim 1 characterized in that the adjusting member (11) is formed as a member in the form of a washer under a respective bone screw (10).
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| SI201200159A SI24067A (en) | 2012-05-23 | 2012-05-23 | Improved modular side device with an intramedular pin for guiding a bone during its lengthening |
| SIP-201200159 | 2012-05-23 |
Publications (1)
| Publication Number | Publication Date |
|---|---|
| WO2013176632A1 true WO2013176632A1 (en) | 2013-11-28 |
Family
ID=48916163
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| PCT/SI2013/000032 WO2013176632A1 (en) | 2012-05-23 | 2013-05-23 | Modular side device with an intramedullary nail for guiding a bone during its lengthening |
Country Status (2)
| Country | Link |
|---|---|
| SI (1) | SI24067A (en) |
| WO (1) | WO2013176632A1 (en) |
Cited By (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| CN106618698A (en) * | 2016-10-27 | 2017-05-10 | 北京工业大学 | Seven-degree-of-freedom tibia single-side external fixator |
| WO2017203097A1 (en) * | 2016-05-27 | 2017-11-30 | Synoste Oy | An intra-corporal telescopic osteodistraction device, an extra-corporal force producing device, a method for bone lengthening and a bone lengthening arrangement |
| WO2020032891A3 (en) * | 2018-07-09 | 2020-07-02 | Tobb Ekonomi Ve Teknoloji Universitesi | An external fixator having an alignment device |
Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0639352A1 (en) * | 1993-08-20 | 1995-02-22 | Alumedica Aluminium-Bearbeitung Medizintechnik GmbH | Bone treating device |
| WO1997015176A2 (en) * | 1995-10-21 | 1997-05-01 | Dietmar Pennig | Intramedullary cavity nail for femur elongation |
| US5643258A (en) * | 1994-08-10 | 1997-07-01 | Howmedica Gmbh | Device for stabilizing long bones |
-
2012
- 2012-05-23 SI SI201200159A patent/SI24067A/en not_active IP Right Cessation
-
2013
- 2013-05-23 WO PCT/SI2013/000032 patent/WO2013176632A1/en active Application Filing
Patent Citations (3)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| EP0639352A1 (en) * | 1993-08-20 | 1995-02-22 | Alumedica Aluminium-Bearbeitung Medizintechnik GmbH | Bone treating device |
| US5643258A (en) * | 1994-08-10 | 1997-07-01 | Howmedica Gmbh | Device for stabilizing long bones |
| WO1997015176A2 (en) * | 1995-10-21 | 1997-05-01 | Dietmar Pennig | Intramedullary cavity nail for femur elongation |
Non-Patent Citations (1)
| Title |
|---|
| PALEY D ET AL: "FEMORAL LENGTHENING OVER AN INTRAMEDULLARY NAIL", JOURNAL OF BONE AND JOINT SURGERY. AMERICAN VOLUME, JOURNAL OF BONE AND JOINT SURGERY, US, vol. 79-A, no. 10, 1 October 1997 (1997-10-01), pages 1464 - 1480, XP000722086, ISSN: 0021-9355 * |
Cited By (5)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| WO2017203097A1 (en) * | 2016-05-27 | 2017-11-30 | Synoste Oy | An intra-corporal telescopic osteodistraction device, an extra-corporal force producing device, a method for bone lengthening and a bone lengthening arrangement |
| US11160588B2 (en) | 2016-05-27 | 2021-11-02 | Bala Sundararajan | System for stabilizing or lengthening bone |
| CN106618698A (en) * | 2016-10-27 | 2017-05-10 | 北京工业大学 | Seven-degree-of-freedom tibia single-side external fixator |
| WO2020032891A3 (en) * | 2018-07-09 | 2020-07-02 | Tobb Ekonomi Ve Teknoloji Universitesi | An external fixator having an alignment device |
| EP3820389A4 (en) * | 2018-07-09 | 2022-03-23 | Tobb Ekonomi Ve Teknoloji Universitesi | An external fixator having an alignment device |
Also Published As
| Publication number | Publication date |
|---|---|
| SI24067A (en) | 2013-11-29 |
Similar Documents
| Publication | Publication Date | Title |
|---|---|---|
| EP2340777B1 (en) | Osteosynthesis plate for fractures near joints or osteotomies | |
| CA2641874C (en) | Method and apparatus for bone fracture fixation | |
| AT507086B1 (en) | IMPLANT, IN PARTICULAR BRAND NAIL FOR THE TREATMENT OF A PROXIMAL HUMERUS FRACTURE | |
| EP2062543B1 (en) | Tibial target device for the double channel technique | |
| EP2802294B1 (en) | Intramedular locking bone screw for fixation of the big-toe joint | |
| EP2053980B1 (en) | Trochanter retention plate | |
| US20030040747A1 (en) | Interlocking intramedullary nail | |
| CA2559500A1 (en) | Resetting tool | |
| CA2557358C (en) | Intramedullary nail | |
| DE602004006774T2 (en) | FIXATOR FOR THE REPAIR OF TUBE BONE FRACTURES | |
| WO2013176632A1 (en) | Modular side device with an intramedullary nail for guiding a bone during its lengthening | |
| AT509852A4 (en) | FLEXIBLE HUMERUS NAIL | |
| EP3016604B1 (en) | Curved tibiotalar fusion nail | |
| DE102007005479A1 (en) | Palate seam extension system, has coupling unit provided between fixing part for attaching to palatal and bar to be connected with extension part, where coupling unit is adjusted and locked with respect to position of end | |
| Dell et al. | Osteosynthesis of diaphyseal fractures of the radius and ulna using an internal fixator (PC-Fix). A prospective study | |
| US11471294B2 (en) | Transcortal bone joint fusion system | |
| US11116555B2 (en) | Wing-shaped angle steel plate and a bone shaft fixation system | |
| EP3530223A1 (en) | Two-way fixing steel plate and bone fixing system | |
| RU2778673C2 (en) | Guider for rods for osteosynthesis of fractures of human short tubular bones | |
| EP2194896B1 (en) | Device for the osteosynthesis of fractures and luxations of the neck of the humerus | |
| WO2022255970A1 (en) | Femur periprosthetic fracture fixation plate | |
| US9763708B2 (en) | Intramedullary fixation device | |
| US10568671B2 (en) | Implantable compensating sleeve for an endoprosthesis | |
| JP2022544614A (en) | Plates for temporary bridging of fracture fragments | |
| RU118545U1 (en) | DEVICE FOR OSTEOSYNTHESIS IN PREPARATORY FRACTURES |
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: 13745204 Country of ref document: EP Kind code of ref document: A1 |
|
| NENP | Non-entry into the national phase |
Ref country code: DE |
|
| 122 | Ep: pct application non-entry in european phase |
Ref document number: 13745204 Country of ref document: EP Kind code of ref document: A1 |