Classifications

• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • 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 or setting implements
  • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
  • A61B17/64—Devices extending alongside the bones to be positioned
  • A61B17/6425—Devices extending alongside the bones to be positioned specially adapted to be fitted across a bone joint
• • A—HUMAN NECESSITIES
  • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
  • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
  • A61B17/00—Surgical instruments, devices or methods
  • 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 or setting implements
  • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
  • A61B17/66—Alignment, compression or distraction mechanisms

Definitions

• the present invention applies to the field of articulated devices used for the treatment of fractures in the wrist region.
• the treatment can be bloodless (reduction and constriction in a brachio-metacarpal or antibrachio-metacarpal plaster device for 5-6 weeks) or surgical, which is nowadays resorted to more often than in the past, of osteosynthesis with external fixation systems in radius distal metaepiphyseal fractures or with plate and pins.
• Stabilizers are characterized in that they allow a group of proximal pins to be connected to a group of distal pins, these pins can be directly applied onto a rod or into a clamp. These stabilization devices require a correct fracture reduction before tightening clamps.
• Articulated devices can be of the type allowing compression and distraction in the fracture site to be performed after being suitably attached to the limbs by means of groups of proximal and distal pins or of the type allowing, besides enabling a compression/ distraction to be performed, also the joint to be moved after attaching the device to the limbs.
• the above-mentioned articulator devices of the last type quite generally comprise a proximal attachment system for the pins, a distal attachment system for the pins and an articulator joint, which is connected to the respective proximal and distal systems by means of suitable connection devices.
• Some articulator devices belonging to this last category are known, intended to allow the hand to move with respect to the wrist during the recovery step.
• the technical problem underlying the present invention is therefore to provide an articulated device for the wrist allowing the patient wearing it to move the hand in a natural way with respect to the wrist without compromising the recovery, within a simple, extremely compact and easy- to-use structural solution.
• the articulated device for the wrist according to the present invention allows the wrist to be kept in a fixed position with respect to bones when that use is required.
• the articulated device for the wrist allows both a compression-extension movement and an abduction-adduction movement or selectively only one thereof to be performed.
• Figure 1 is a perspective view of the articulated device for the wrist according to the present invention
• Figure 2 is a view from above of the device of figure 1 ;
• Figure 3 is a sectional view taken along the line III-III of figure 2;
• Figure 4 shows the arrangement in space of the device with respect to the wrist region
• Figure 5 is an exploded view of the device of figure 1;
• Figures 6 and 7 show different views of an insert for limiting the rotation of the arched element.
• the articulated device 1 for the wrist comprising, more generally: a proximal connector 2 for housing a proximal attachment system for pins that are inserted in a proximal bone of the fracture, a distal connector 3 for housing a distal attachment system for pins that are inserted in a distal bone of the fracture; an articulator joint 4 to provide a controlled movement between the proximal connector 2 and the distal connector 3.
• the proximal connector 2 and the distal connector 3 actualize in a proximal rod and in a distal rod respectively that the clamps supporting the pins can be attached to, the latter ones, in case of fracture in the wrist region, such as for example distal radius fractures, are attached to the radius and to metacarpal bones respectively.
• the articulator joint 4 comprises an arched element 5 that is rotatably mounted on a support element 6 in order to enable rotation around an axis of rotation X located in correspondence with the instant center of rotation of the wrist (as it can be seen in figure 4).
• the arched element 5 is connected, at an end thereof, to the distal rod 3 by means of a peg 31 that is inserted into a corresponding seat that is present in the arched element 5.
• Suitable blocking means for blocking the rotation of the arched element 5 and rotation-limiting means for limiting the rotation of the arched element 5 for a pre-established portion of a circumferential arc are both directly mounted on the support element 6. These blocking means and limiting means will be better described hereafter.
• the support element 6 is mounted by means of a simple cardan joint 40 on the proximal connector 2, this simple cardan joint 40 has a first axis of rotation Z that is perpendicular to the axis of rotation X of the arched element 5 and a second axis of rotation Y that is perpendicular to the first axis of rotation Z, this latter axis Z is movable with respect to the axis of rotation of the arched element X along a circumferential arc whose center is located on the first axis of rotation Z.
• the articulated device 1 can act as an external fixator having the various elements composing it blocked together.
• the arched element 5 has a hole 5b passed through by a pin 52 which it is hinged on.
• the pin 52 has a hole in its center to allow a Kirchner wire to pass through, that hole has a central axis coinciding with the axis of rotation X.
• the center of rotation of the arched element 5 coincides with the center of rotation of the wrist, in order to obtain a perfect centering of the articulated device 1.
• the blocking means of the rotation of the arched element 5 comprise a locking grub screw 51 that can be operated in rotation from the outside, whose end is intended to abut against an edge of the arched element 5.
• the limiting means comprise on the contrary an axially displaceable insert 53.
• the insert 53 is provided with a threaded channel 53b which the blocking grub screw 51 screws into.
• the blocking grub screw 51 is provided on the head with a shaped impression, preferably hexagon-like, for engaging with a screwing tool.
• the insert 53 has a cylindrical shape, whose threaded channel 53b which the blocking grub screw 51 passes through extends transversely, moreover it has an eccentric body 53a at an end thereof that is intended to abut against a ribbed profile 5a that is present on a perimeter portion of the arched element 5.
• the insert 53 is axially movable along an axis K between a position wherein the eccentric body 53a is inserted into the rib 5a of the arched element 5 therefore limiting the angular travel of the arched element to about 45°.
• the insert 53 is operated in order to move the eccentric body 53a away till going out of the rib 5a, the arched element 5 is free to rotate along a circumferential arc of about 60°-80°.
• the operation along the axis K of the insert 53 can occur also tangentially moving the grub screw 51 inserted into the insert 53.
• a friction ring 54 is located within an annular rib 53c that is present in correspondence with the eccentric body 53a.
• the simple cardan joint 40 comprises a connecting element 41 formed by a pair of annular elements 41a, 41b having the respective central axis corresponding to the first and second axis of rotation Z, Y. These annular elements 41a, 41b are joined together by a central connection element 41c in order to form a single piece.
• a first blocking screw 42 to block the rotation around the first axis of rotation Z and a second blocking screw 43 to block the rotation around the second axis of rotation Y are provided.
• Both the first and the second blocking screws 42,43 are provided on the head with a shaped impression, preferably hexagon-like, for engaging with a screwing tool.
• the proximal rod 2 is connected to the simple cardan joint 40 by means of a distraction/ compression device 20.
• This distraction /compression device 20 comprises a distraction/ compression body 21 having a threaded hole which a distraction/ compression pin 22 operated by a ring nut 23 screws into.
• a blocking screw 24 of the distraction/ compression pin 22 screws into a transversal threaded hole 22a of the distraction/ compression pin 22 passing through a slot 21b that is present on the distraction/ compression body 21.
• the proximal rod 2 is attached to an end of the distraction/ compression pin 22.
• connection between the arched element 5 supporting the distal rod 3 and the distraction/ compression device 20 supporting the proximal rod 2 is thus performed by means of the simple cardan joint 40.
• annular element 41a of the simple cardan joint 40 is connected to the support element 6 by means of the first blocking screw 42 acting as a pin of rotation around the axis Z.
• the annular element 41a is interposed between a pair of rings 6a that are present on the support element 6.
• annular element 41b of the simple cardan joint 40 is connected to the distraction/compression body 21 by means of the second blocking screw 43 acting as a pin of rotation around the axis Y.
• the annular element 41b is interposed between a pair of rings 21a that are present on the distraction/ compression body 21.
• the support element 6 has a fork- like shape having two opposing arms which the arched element 5 rotates in.
• the arc subtended between this common line and the line developing along the longitudinal extension of the fork arms is equal to about 45°. Due to this particular arrangement, the overall dimensions of the articulated device 1 are extremely reduced.
• the pin 52 passes through two opposing holes that are present at one end of the arms of the support element 6, while the insert 53 passes through two opposing holes that are present at the other end of the arms of the support element 6. These last two holes have the central axis that is perpendicular to the central axis of the pair of rings 6a which the first blocking screw 42 passes through and parallel to the axis X of the pin 52.
• the arched element 5 is made of a radio-transparent material, such as for example peek reinforced with carbon fibers;
• the pin 52 is made of steel and the support element 6 of aluminum alloy, but with a thickness not preventing x-ray transparency in order to see the fracture site.
• the support element 6, in correspondence with the end which the pin 52 passes through has a circular element 6b whose center is in line with the axis of rotation X.
• the pin 52 that is channeled to allow the Kirchner wire to pass through, and the circular element 6b have the same central axis, corresponding to the axis of rotation X of the arched element 5.
• the operator is helped in centering due to the fact that he observes the circular element 6b (sub- transparent) and the pin 52 (completely opaque) centered on the same axis.
• the circular element 6b has a higher radius than that of the pin 52, therefore, when they are in line, a small circle represented by the pin 52 within the greater circle represented by the circular element 6b can be observed in scopy.
• the device according to the present invention allows the requirements and drawbacks mentioned in the introduction of the present description with reference to the prior art to be met and overcome.

Landscapes

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

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Cited By (1)

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Citations (5)

Family Cites Families (6)

• 2013
  • 2013-03-18 IT IT000409A patent/ITMI20130409A1/it unknown
• 2014
  • 2014-03-11 JP JP2016503566A patent/JP6389869B2/ja active Active
  • 2014-03-11 US US14/778,069 patent/US9974568B2/en active Active
  • 2014-03-11 CN CN201480016454.6A patent/CN105050515B/zh not_active Expired - Fee Related
  • 2014-03-11 BR BR112015023864-5A patent/BR112015023864B1/pt not_active IP Right Cessation
  • 2014-03-11 EP EP14717994.9A patent/EP2976028B1/en active Active
  • 2014-03-11 WO PCT/EP2014/000645 patent/WO2014146766A1/en not_active Ceased
  • 2014-03-11 ES ES14717994.9T patent/ES2622957T3/es active Active
  • 2014-03-17 AR ARP140101263A patent/AR095636A1/es unknown
• 2015
  • 2015-09-10 IL IL241474A patent/IL241474B/en active IP Right Grant

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