WO2015087200A1 - Système et procédé pour aligner des clous centromédullaires - Google Patents

Système et procédé pour aligner des clous centromédullaires Download PDF

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Publication number
WO2015087200A1
WO2015087200A1 PCT/IB2014/066506 IB2014066506W WO2015087200A1 WO 2015087200 A1 WO2015087200 A1 WO 2015087200A1 IB 2014066506 W IB2014066506 W IB 2014066506W WO 2015087200 A1 WO2015087200 A1 WO 2015087200A1
Authority
WO
WIPO (PCT)
Prior art keywords
nail
distal holes
intramedullary
distal
coils
Prior art date
Application number
PCT/IB2014/066506
Other languages
English (en)
Inventor
Pietro Arcidiacono
Original Assignee
Pietro Arcidiacono
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 Pietro Arcidiacono filed Critical Pietro Arcidiacono
Publication of WO2015087200A1 publication Critical patent/WO2015087200A1/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
    • A61B17/16—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
    • A61B17/1707—Guides or aligning means for drills, mills, pins or wires using electromagnetic effects, e.g. with magnet and external sensors
    • 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
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins

Definitions

  • the present invention relates to a system for aligning intramedullary nails.
  • the present invention relates also to a method for aligning intramedullary nails.
  • intramedullary nails are used, in particular in the case of breakage of the long bones, to stabilize in the correct position the separate stumps of a fractured bone.
  • An intramedullary nail normally comprises an elongated internally hollow body with a predetermined rigidity, the shape of which depends on the type of bone to which the nail is intended.
  • the elongated body is also provided with proximal and distal holes for the fixing.
  • FIG. 1 shows an intramedullary nail 1 inserted in a bone 2 by means of two screws 3 inserted in distal holes 4.
  • the intramedullary nails are substantially rigid, they must be somehow elastic and, in almost all cases, they deform more or less significantly during implantation.
  • the nails can flex in the anterior-posterior and medium-lateral direction and, in addition, the nails can be subjected to torsion (internal rotation or external rotation) .
  • torsion internal rotation or external rotation
  • the known nails guiding systems comprise a bar, an adapter to connect the bar to a proximal portion of the nail, so that the bar has a predetermined direction, and a mask hinged at the distal end of the nail, so as to rotate in a plane.
  • the mask is provided with guide holes which reproduce the configuration of the distal holes.
  • the guidance systems known are arranged to be calibrated before the installation of the nail. In other words, the bar is initially connected to the nail by means of the adapter, and then, the position of the mask is adjusted by sliding the bar with respect to the adapter and rotating the mask itself with respect to the bar, so that the guide holes match the distal holes of the nail. The bar is then separated from the nail and reconnected to it after implantation .
  • Purpose of the present invention is to provide a system and a method for aligning intramedullary nails which allow the use of screws not necessarily made of metallic material but made of polymeric material absorbable by the body and to overcome the limits of alignment inaccuracy and dangerousness of the operating conditions which still affect the systems and methods of alignment of intramedullary nails previously described with reference to the known technique.
  • a system for aligning intramedullary nails is provided, as defined in claim 1.
  • a method for aligning intramedullary nails is provided, as defined in claim 6.
  • FIG. 1 shows an image of an intramedullary nail inserted in a bone, according to the prior art
  • FIG. 2 shows a schematic view of system for aligning intramedullary nails, according to the invention
  • FIG. 3 shows a schematic view of a drill of the system for aligning intramedullary nails, according to the invention
  • FIG. 4 shows a schematic view of a longitudinal section of the intramedullary nail inserted through the system for aligning intramedullary nails, according to the invention .
  • the system 10 comprises an intramedullary nail 11 suitably modified, and comprises two distal holes 14, having axes of symmetry Y'Y' and Y' 'Y' ', able to accomodate screws 13 to be inserted and to be aligned respectively to the axis Y'Y' and Y' 'Y' ' .
  • the intramedullary nail 11 comprises, in its internal thickness
  • the nail 11 is provided along its extension of two longitudinal slots 17 that run from the point where the two coils 16 are positioned up to a distal end of the nail 11.
  • Two pairs of electrical wires 18 and 19 respectively flow along the slots 17.
  • Each of these pairs of electrical wires 18 and 19 connects each of the two coils 16 to two external meters, namely to instruments external to the nail 11, able to measure the voltage induced on the two coils 16.
  • the two pairs of wires 18 and 19 protrude from the nail 11 so as to arrive on the contacts 20 and 21 of a board 22 which acts as a support base.
  • the system 10 also comprises an apparatus 23 configured for processing the electrical signals coming from the coils 16, trough the board 22, so as to insert screws 13 in the distal holes 14 of the intramedullary nail 11 in a aligned way.
  • the apparatus 23 comprises a powered drill used for the insertion of the screws 13 in the intramedullary nail 11.
  • Figure 3 shows the drill 24 comprised in the apparatus 23, equipped with a support 25 for a solenoid 27.
  • the drill tip 26 is attached to the spindle of the drill 24, not shown in the figure.
  • the drill 24 is used from time to time to insert first one and then the other screw 13 to be inserted in a distal hole 14.
  • the system 10 is based on the electromagnetic interaction between the coils 16 and the solenoid 27 wound on the support 25 of the drill 24, in order to align each screw 13 to the axes Y' and Y' ' .
  • the solenoid 27 sends a variable magnetic field directed toward the coils 16.
  • the coils 16 comprised in the intramedullary nail 11 receive the variable magnetic field and, for electromagnetic induction of the law Lenz, generate a potential difference having an intensity proportional to the variation of the magnetic flux that invests them.
  • the two receiving coils 16 are aligned to the axes Y'Y' and Y' 'Y' ', being in the holes 14 of the nail 11 in which the fixing screw 13 must be inserted.
  • the condition of alignment between the holes 14 of the nail 11 and the solenoid 27 is obtained when the electromagnetic induction is maximal, this condition being signaled to the operator so that to be sure of the optimal condition for the insertion of fixing screws 13 in the nail 11.
  • the system 10 for alignment of intramedullary nails is used after the predetermination of the best initial condition from which to start for searching the alignment, that is the condition in which the holes 14 of a nail 11 are when the nail has been inserted without undergoing deformation .
  • the Applicant use the knowledge of the deformation of the intramedullary nail after its insertion.
  • Such deformations are formed by anterior-posterior and medium-lateral bending and by internal or external twists. Therefore, as described above, executing movements that follow the bending anterior- posterior and medium-lateral bending and the internal or external twists, it's possible to provide an automatic positioning sysetm which find the alignment in a simple and safe way.
  • the apparatus 23 is movable so as to be able to translate along the three reference axes XYZ and to rotate with respect to them.
  • the maximum potential difference in reception can be obtained when the transmission solenoid and the receiving coils are aligned with each other, or when the reference axis Y coincides with the axis of symmetry Y'Y' or Y' 'Y' ' .
  • the system 10 may also comprise, within the apparatus 23, a signaling device of the achieved alignment, not shown in the figure.
  • the apparatus 23 since the apparatus 23 receives the measures of the induced electromotive force, can incorporate a calculation unit that stores all the values of the induced voltage and find the value correspondent to the occurrence of the condition of maximum induction .
  • the system 10 comprises a robotized control device which finds the alignment through a series of displacements and rotations indicating at the end the point and the direction where to insert the screw 13 to fix the intramedullary nail 11.
  • the present application also relates to a method for aligning intramedullary nails.
  • the method comprises the steps of:
  • the errors relative to the initial positioning of the instrumentation used for retrieving the point and the direction of insertion of the fixing screw in the intramedullary nail become irrelevant because they can be compensated.
  • frequencies of used electromagnetic fields are extremely lower than those of x-rays and make the exposure of operators and patients harmless during the operation of the equipment .

Abstract

L'invention concerne un système (10) pour aligner des clous centromédullaires, comprenant : • - un clou centromédullaire (11) comprenant deux trous distaux (14) ayant des axes de symétrie Y'Y' et Y''Y'' et pouvant répartir des vis (13) à aligner respectivement sur l'axe Y'Y' et Y''Y'', et deux fentes longitudinales (17) s'étendant des trous distaux (14) à une extrémité distale du clou (11) ; • - des bobines (16) placées dans l'épaisseur interne (15) du clou centromédullaire (11) en correspondance des deux trous distaux (14), et coaxiales aux trous distaux (14) ; et • - deux paires de fils électriques (18, 19) reliés aux bobines (16), chaque paire de fils électriques (18, 19) s'étendant le long d'une des fentes (17) de façon à sortir de l'extrémité distale du clou centromédullaire (11).
PCT/IB2014/066506 2013-12-09 2014-12-02 Système et procédé pour aligner des clous centromédullaires WO2015087200A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
IT000022A ITCZ20130022A1 (it) 2013-12-09 2013-12-09 Sistema e metodo di allineamento di chiodi endomidollari
ITCZ2013A000022 2013-12-09

Publications (1)

Publication Number Publication Date
WO2015087200A1 true WO2015087200A1 (fr) 2015-06-18

Family

ID=49958539

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/IB2014/066506 WO2015087200A1 (fr) 2013-12-09 2014-12-02 Système et procédé pour aligner des clous centromédullaires

Country Status (2)

Country Link
IT (1) ITCZ20130022A1 (fr)
WO (1) WO2015087200A1 (fr)

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0523905A2 (fr) * 1991-07-09 1993-01-20 Stryker Corporation Alignement axial d'un guide de perçage
WO1997013467A1 (fr) * 1995-10-13 1997-04-17 Lucio Catamo Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0523905A2 (fr) * 1991-07-09 1993-01-20 Stryker Corporation Alignement axial d'un guide de perçage
WO1997013467A1 (fr) * 1995-10-13 1997-04-17 Lucio Catamo Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques

Also Published As

Publication number Publication date
ITCZ20130022A1 (it) 2015-06-10

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