WO2014076681A1 - Fixateur mandibuaire externe - Google Patents

Fixateur mandibuaire externe Download PDF

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Publication number
WO2014076681A1
WO2014076681A1 PCT/IB2013/060232 IB2013060232W WO2014076681A1 WO 2014076681 A1 WO2014076681 A1 WO 2014076681A1 IB 2013060232 W IB2013060232 W IB 2013060232W WO 2014076681 A1 WO2014076681 A1 WO 2014076681A1
Authority
WO
WIPO (PCT)
Prior art keywords
screws
self
units
threading
mandibular
Prior art date
Application number
PCT/IB2013/060232
Other languages
English (en)
Inventor
Piero CASCONE
Original Assignee
Universita' Degli Studi Di Roma "La Sapienza"
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 Universita' Degli Studi Di Roma "La Sapienza" filed Critical Universita' Degli Studi Di Roma "La Sapienza"
Publication of WO2014076681A1 publication Critical patent/WO2014076681A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—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
    • A61B17/6466—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod
    • 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
    • A61B17/8625—Shanks, i.e. parts contacting bone tissue
    • A61B17/8635—Tips of screws
    • 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

Definitions

  • the present invention relates to a device for maxillofacial surgery, in particular a device for the fixation of mandibular condyle fractures.
  • Mandibular condyle fractures are very common, as they represent at least 30% of all mandibular fractures. This is due to the fact that the condylar neck is the least resistant area in the entire mandible.
  • the treatment of this type of fracture is focused on fracture reduction and rigid fixation systems to allow for osteosynthesis healing. Such a treatment can be carried out by maxiHomandibular fixation or by internal fixation or with both of these techniques.
  • maxiHomandibular fixation or by internal fixation or with both of these techniques.
  • one of the favorite techniques concerns an open reduction surgery with internal fixation by means of titanium mini-plates. This technique allows the mandibular function to be restored in a relatively short time.
  • the internal fixation technique has the drawback that the position of the condyle cannot be changed once the surgery has finished and that the removal of the plates, sometimes necessary, needs further surgery in general anesthesia with the same risks as the previous one. If the condyle is fixed in an incorrect position using mini-plates and screws, morphological alterations may occur with the risk of dysfunctional problems and the onset of osteoarthritis. In these cases, the condyle position cannot be modified but with another surgery. The need to develop a surgical methodology for mandibular condyle fractures which reduces the above drawbacks is thus felt. Summary of the invention
  • the present invention thus aims to achieve the above-discussed objects by implementing a device for the fixation of bone fractures, particularly for mandibular condyle fractures which, according to claim 1 , comprises two pairs of screws, two support units for said pairs of screws to keep them reciprocally parallel and spaced apart, two connection units provided with articulation for said support units, two backing units for said connection units, a joining bar to which said backing units are hooked.
  • the device advantageously comprises self- threading and self-piercing screws.
  • Another object of the present invention relates to the method for treating mandibular condyle fractures comprising, in this order and according to claim 6, the following steps: preauricular incision with exposure of the condylar head, positioning and insertion of a screw with self-threading and self- piercing tip on the condylar head, correct repositioning of the condyle, insertion of a second screw with self-threading and self-piercing tip on the condylar head, positioning and insertion of another pair of screws with self-threading and self- piercing tip on the mandibular body, check of the correct realignment of the fracture, and consolidation of the system by means of a joining bar connected to the screws by means of clamps.
  • Fig. 1 shows a device according to the invention
  • Fig. 2 shows a screw with self-threading and self-piercing tip
  • Fig. 3 shows a special screwdriver for screws and clamps
  • Fig. 4 shows a support for a pair of screws.
  • the device object of the present invention comprises two pairs of screws 1 with self-threading and self-piercing tip, two support units (4) for said screws 1 connected by means of an articulation 5 and by means of a rod 6 which may be straight or S-shaped, or even directly 7 depending on the cases, to a joining bar 8.
  • Two backing units 9 are used to hook rod 6, or directly to hook the two support units (4) by means of clamps to the joining bar 8.
  • the two backing units (9) can slide and be fixed by means of clamps along the joining bar 8.
  • Fig. 2 describes a screw 1 with the detail of the self-threading and self-piercing tip 3.
  • Screwdriver 10 comprises a hollow polygonal head with which it is possible to both engage and tighten the clamping nut of the clamps which is hollow inside, having a polygonal inner surface that mates with the polygonal head of screwdriver 6, and tighten screws 1 in the bone, which screws 1 are provided with a dedicated end part 2 (fig. 2) which can be engaged by the hollow head of screwdriver 10.
  • the surgical access required for a correct positioning of the device is of the mini-invasive preauricular type.
  • Such an access point provides access to the condylar head.
  • the system then includes the positioning and screwing, using the dedicated screwdriver 10, of one of screws 1 of the pair on the condyle head. By this operation it is thus possible to correctly reposition the condylar fragment.
  • the second screw 1 of the pair parallel to the first one, is positioned and screwed onto the condyle head by means of screwdriver 0 and a special template for parallel drilling.
  • the two screws 1 of the pair are held in place by a support and connection unit shown in Fig. 4 and globally indicated with reference numeral 200.
  • Such a support and connection unit consists of a connection rod 6 connected by means of an articulation to support 4, which support holds the pair of screws 1 reciprocally parallel and at a predefined distance through dedicated housings 13. Screws 1 can slide along their longitudinal axis and can thus be fixed in the correct position and locked with clamp 13 by means of the clamping nut 14 and screwdriver 10. The end part 15 of the connection rod 6 is engaged by the backing unit 9 and then fixed to the joining bar 8 (fig. 1 ). Depending on the cases, rod 6 may be S-shaped or support 4 may be directly connected to the backing unit 9 by means of an articulation. The surgical procedure then continues with the positioning and implantation of the second pair of screws on the mandibular bone.
  • the above-described supports 200 for screws 1 are then attached to screws 1.
  • the system is consolidated by the joining bar 8 which connects to the support 200 of screws 1 by means of clamps.
  • the device used to connect screws 1 to the joining bar 8 is provided with articulation points so that the two pairs of screws 1 can orientate independently according to three orthogonal axes. Since this fixation system is totally external, with the exception of the implanted screws 1 , it allows the condyle position to be changed even after the surgery, which is not possible with an internal fixation system. Another advantage results from the special type of screws used which strongly reduces the surgery time.
  • the technical advantage of this system thus derives from the speed of execution of the surgical procedure and its flexibility which allows post-surgery adjustments of the condyle position.
  • applying such a method allows a considerable saving in terms of duration of surgery, hospitalization and rehabilitation sessions.
  • the learning curve for such a technique is considerably shorter than the above-described techniques, and moreover the risk of permanent damage to soft tissues, including facial nerve injury, is around 1%.

Abstract

L'invention concerne un dispositif et un procédé de traitement de fractures du condyle mandibulaire. Le dispositif comprend un système de fixation externe comprenant des vis auto-taraudeuses et auto-perçantes. Ces vis sont implantées par une chirurgie à invasion minime sur le col et le corps mandibulaire à l'aide d'un tournevis dédié, et le système est ensuite consolidé à l'aide d'une barre de jonction externe qui se connecte à la vis par le biais de broches externes.
PCT/IB2013/060232 2012-11-19 2013-11-19 Fixateur mandibuaire externe WO2014076681A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
ITRM2012A000574 2012-11-19
IT000574A ITRM20120574A1 (it) 2012-11-19 2012-11-19 Fissatore esterno mandibolare

Publications (1)

Publication Number Publication Date
WO2014076681A1 true WO2014076681A1 (fr) 2014-05-22

Family

ID=47633347

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2013/060232 WO2014076681A1 (fr) 2012-11-19 2013-11-19 Fixateur mandibuaire externe

Country Status (2)

Country Link
IT (1) ITRM20120574A1 (fr)
WO (1) WO2014076681A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2655086C1 (ru) * 2017-07-17 2018-05-23 Федеральное государственное бюджетное образовательное учреждение высшего образования "Волгоградский государственный медицинский университет" Министерства здравоохранения Российской Федерации ФГБОУ ВО ВолгГМУ МЗ РФ Экзоскелет нижней челюсти
CN113855202A (zh) * 2021-09-18 2021-12-31 浙江省人民医院 一种头面部不规则骨骨折复位辅助器

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2698534A1 (fr) * 1992-11-27 1994-06-03 Hardy Jean Marie Fixateur externe modulaire pour ostéosynthèse des petits os, notamment de la main.
DE19503609A1 (de) * 1994-02-05 1995-08-10 Normed Medizin Technik Vertrie Vorrichtung für die Fixation von Knochensegmenten
WO2006102166A2 (fr) * 2005-03-18 2006-09-28 Ron Anthon Olsen Attelle reglable pour osteosynthese
WO2011121512A2 (fr) * 2010-03-27 2011-10-06 Rajiv Agarwal Systeme externe de stabilisation et de distraction de surfaces osseuses courbes

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2698534A1 (fr) * 1992-11-27 1994-06-03 Hardy Jean Marie Fixateur externe modulaire pour ostéosynthèse des petits os, notamment de la main.
DE19503609A1 (de) * 1994-02-05 1995-08-10 Normed Medizin Technik Vertrie Vorrichtung für die Fixation von Knochensegmenten
WO2006102166A2 (fr) * 2005-03-18 2006-09-28 Ron Anthon Olsen Attelle reglable pour osteosynthese
WO2011121512A2 (fr) * 2010-03-27 2011-10-06 Rajiv Agarwal Systeme externe de stabilisation et de distraction de surfaces osseuses courbes

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2655086C1 (ru) * 2017-07-17 2018-05-23 Федеральное государственное бюджетное образовательное учреждение высшего образования "Волгоградский государственный медицинский университет" Министерства здравоохранения Российской Федерации ФГБОУ ВО ВолгГМУ МЗ РФ Экзоскелет нижней челюсти
CN113855202A (zh) * 2021-09-18 2021-12-31 浙江省人民医院 一种头面部不规则骨骨折复位辅助器

Also Published As

Publication number Publication date
ITRM20120574A1 (it) 2014-05-20

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