WO2022080752A1

WO2022080752A1 - Metal nail for treatment of fracture

Info

Publication number: WO2022080752A1
Application number: PCT/KR2021/013752
Authority: WO
Inventors: 이세엽
Original assignee: (주)한국원자력 엔지니어링
Priority date: 2020-10-13
Filing date: 2021-10-07
Publication date: 2022-04-21
Also published as: KR102225080B1

Abstract

The present invention provides a metal nail for treatment of a fracture, which allows, even after fixing upper and lower bones of a fracture site, fine adjustment of a gap in the fracture site to have an interval that enables union to be well achieved, and which allows, even when torsional deformation occurs in a fracture site, positioning back to and fixation in the original condition, and which, by enabling the adjustment of a gap in a fracture site and the convenient adjustment of a torsion angle at any time without reoperation, enables bone union to be well achieved and can prevent deformities or dysfunctions due to positional deformation when restoring bones. The metal nail for treatment of a fracture of the present invention comprises: a rod-shaped fixing body having a plurality of fixing holes; and interlocking screws for fixing the fixing body to bones through the fixing holes, wherein the fixing body is divided in the longitudinal direction to form an upper fixing body and a lower fixing body, which are fitted into and connected to each other, and a length-adjusting means and a torsion-adjusting means are provided between the upper fixing body and the lower fixing body, so as to finely adjust the lower fixing body relative to the upper fixing body in the longitudinal direction, and so as to rotate the lower fixing body around the longitudinal direction as a central axis line at a predetermined angle with respect to the upper fixing body.

Description

Metal tablets for fracture treatment

The present invention relates to a metal chisel for the treatment of fractures, and more particularly, to a metal chisel for the treatment of fractures that can finely control the distance between fractured parts and enable torsion correction of the upper and lower parts of the fracture to facilitate osseointegration.

Human bones are mostly made of calcium phosphate called hydroxyapatite, and when a large force is applied, it is easy to fracture.

Fractures are divided into open and closed fractures according to their appearance, comminuted fractures and segmental fractures depending on the fracture state. It has to be done so that the shape and function can be maintained as before, but it takes a considerable amount of time to coalesce, and there are many cases where the osseointegration does not work well.

In general, delayed union refers to a state in which bone union is delayed despite treatment for a period sufficient to allow fractures to coalesce, usually 3 to 6 months, and nonunion means at least 9 months after injury. Among non-union fractures, it means a case in which no signs of union are seen on radiographic examination for 3 months. It means that the back occurs, and it can lead to persistent pain, cosmetic problems, and functional impairment.

In general, cortical bone union is explained by two mechanisms. Primary osseointegration refers to a case in which a compressive force between osseous fragments is fixed using a rigid structure, and it refers to a mechanism in which osteoblasts form bone tissue and coalesce in the place where the osteoclast cutting cone has passed without callus formation.

Secondary osseointegration refers to a mechanism in which a callus is formed first and then undergoes remodeling process when it is fixed with a flexible instrument such as a cross-linked metal plate or intramedullary medulla, and when there is a minute movement between the osseous fragments, the callus is formed.

In the case of treatment for the purpose of secondary osseointegration, in order for the fusion to occur well, the callus is formed at the fracture site and it is necessary to fix the fracture site while healing is in progress. can

Surgical fixation of fractured bones includes a method using an external fixation device, a method in which a metal plate is placed on the bone surface and fixed with a metal screw, and a method in which a metal chisel is inserted into the bone and fixed with a metal screw.

Metal tablets are mainly suitable for fixing thick and long bones such as femurs and tibias, and as a conventional example, intramedullary metal tablets for fracture treatment disclosed in Korean Utility Model Registration No. 20-0309570 are known.

The metal tablet of the prior art is made of a hollow or rod-shaped body formed long in the longitudinal direction, a plurality of fixing holes perforated obliquely at a predetermined angle are formed in the upper portion of the body, and a plurality of fixing holes are formed in the lower portion in the horizontal direction. The fixing hole is formed, and the body of the metal tablet is inserted into the bone marrow, and the upper and lower portions of the fracture site are fixed with occlusal screws using a plurality of fixing holes.

However, since these conventional metal chisels simply fix the upper and lower bones of the fracture site, even after fixation, the gap at the fracture site may be too attached or widened due to the microscopic positional deformation of the bone, which may cause non-union. In addition, if torsional deformation occurs at the fracture site, the bone cannot be restored to its original state, which may result in deformity or dysfunction.

Also, if the bone position is changed due to a severe fracture, the bone is adjusted to its original position and fixed with a metal chisel. height, and if the deformation is severe, there is a problem that it needs to be fixed again through reoperation.

The present invention is to solve the problems of the prior art as described above, and its purpose is to be able to fine-tune the gap between the fracture site to a good fusion interval even after fixing the upper and lower bones of the fracture site, and torsional deformation at the fracture site An object of the present invention is to provide a metal nail for fracture treatment that can be fixed by positioning it in its original state even when this occurs.

In addition, the present invention is a metal tablet for the treatment of fractures that can easily and frequently adjust the gap adjustment and torsion angle of the fracture site without reoperation, so that osseointegration is well achieved and deformities or functional disorders caused by positional deformation during bone restoration can be prevented. is to provide

In order to achieve the above object, the present invention is a metal tablet for fracture treatment comprising a rod-shaped fixture having a plurality of fixing holes formed therein, and an occlusal screw for fixing the fixture to a bone through the fixing holes, the high The stag is formed by separating the upper and lower fixtures in the longitudinal direction to fit each other and connect, and a length adjusting means is provided between the upper and lower fixtures to finely adjust the lower fixture to the upper fixture in the longitudinal direction. It is characterized by metal tablets for the treatment of fractures that are designed to be controlled.

In addition, in the present invention, the length adjusting means is installed between the upper fixed body and the lower fixed body, and the upper end is supported on the upper fixed body to rotate with the longitudinal direction as the central axis, and the lower end is on the lower fixed body. It consists of a central rotating body screw-fitted in the longitudinal direction, and a length adjusting rod for rotating the central rotating body, wherein the length adjusting rod is disposed at a position spaced apart from the central axis of the central rotating body and the end is located close to the central rotating body, The head is located at the upper end of the upper fixture, and the end positioned close to the central rotating body is equipped with a gear tooth, which is characterized by a metal chisel for fracture treatment that is designed to mesh with the gear teeth formed in the circumferential direction on the outer surface of the central rotating body.

In addition, in the present invention, the length adjusting means is made of a length adjustment rod and a screw hole arranged at a position spaced apart from the central axis of the upper and lower fixture, the screw hole is centered in the longitudinal direction of the lower fixture It is formed with an axis, and the length adjusting rod is characterized by a metal nail for fracture treatment in which a screw portion for screw-fitting with the screw hole is formed at the lower end and the head of the upper end is positioned at the upper end of the upper fixture.

In addition, in the present invention, the torsion control means installed between the upper and lower fixtures and rotating the lower fixture by a predetermined angle with respect to the upper fixture with the longitudinal direction of the upper and lower fixtures as the central axis. It is characterized by a metal tablet for the treatment of fractures further comprising a.

In addition, in the present invention, the torsion control means is made of a torsion control rod having a gear tooth formed in the circumferential direction with respect to the central axis of the lower fixture, and a gear tooth meshed with the gear tooth, the head of the torsion control rod Boo is characterized by a metal nail for fracture treatment that is positioned on the top of the upper fixture.

Also, in the present invention, a wire guide hole is formed in the longitudinal direction at the center of the upper fixture and the lower fixture, and the length adjustment rod and the torsion adjustment rod are installed at a position deviated from the wire guide hole, and the length adjustment rod and the torsion A metal tablet for fracture treatment, characterized in that the head of the control rod does not protrude from the upper surface of the upper fixture, and the head is exposed to the upper surface of the upper fixture and has an adjustment groove formed to facilitate rotation.

According to the present invention having the above characteristic configuration, as the metal nail fixture is formed vertically and finely adjusted in the longitudinal and torsional directions, the gap between the fracture site after fixing the fractured bone is spaced at an interval where osseointegration is well achieved. It can maintain, and also has the effect of preventing deformity or dysfunction after restoration by correcting the state of torsion of the bone.

In addition, the present invention provides a simple incision that exposes the upper end of the fixture without re-operation and fixing again even if the position of the bone fixed by the fixture is changed as the longitudinal and torsional direction adjustment work of the fixture is performed at the upper end of the fixture It can be easily adjusted with just one control, which has the effect of reducing the cost and time due to re-adjustment.

1 is a front view showing the state of use of a metal tablet according to the present invention.

Figure 2 is a side view showing the longitudinal direction and torsion direction adjustment state of the metal nail according to the present invention.

Figure 3 is an exploded perspective view of a metal tablet according to a first embodiment of the present invention.

Figure 4 is an enlarged cross-sectional view of the main part of the metal nail according to the first embodiment of the present invention.

Fig. 5 is a cross-sectional view of an essential part of Fig. 4;

6 is a cross-sectional view of a main part of a metal nail according to a second embodiment of the present invention.

Fig. 7 is a cross-sectional view of an essential part of Fig. 6;

8 is a plan view of a metal crystal according to a second embodiment of the present invention.

Hereinafter, a preferred embodiment of the present invention will be described in detail based on the accompanying drawings. 1 and 2 is a state diagram showing an example of applying the metal chisel according to the present invention to a fractured femur. (11,12) is formed.

Therefore, after making a hole in the upper end of the femur and inserting the fixture 10 into the bone marrow, the fixture 10 through the upper and

lower fixing holes

11 and 12 of the fixture 10 with an occlusal screw 13. and to fix bones.

At this time, in the metal tablet of the present invention, the fixed body 10 is separated and formed into an upper fixed body 20 and a lower fixed body 30 in the longitudinal direction and connected to each other by fitting, the upper fixed body 20 and the lower fixed body A length adjustment means and a torsion adjustment means are provided between the 30 and the lower fixture 30 with respect to the upper fixture 20 in the longitudinal direction and the torsion direction (the direction of rotation with the longitudinal direction of the fixture as the central axis) to be fine-tuned.

That is, FIGS. 3 to 5 show a first embodiment of the present invention, and as shown, the rod-shaped fixture 10 is divided into approximately two equal parts, and the upper fixture 20 and the lower fixture ( 30), a fitting hole 21 is formed in the lower portion of the upper fixture 20 so that the upper portion of the lower fixture 30 is fitted in the longitudinal direction.

The length adjusting means includes a central rotating body 40 and a length adjusting rod 50 which are installed inside between the upper fixed body 20 and the lower fixed body 30 . The central rotating body 40 is supported so that the upper end rotates in the longitudinal direction on the upper fixed body 20 as the central axis, and the lower end has a threaded part 41 formed therein, and the lower fixed body 30 has a threaded part 31 formed in the longitudinal direction. ) and screwed together. At this time, as shown in FIG. 4 , the rotation support configuration of the central rotating body 40 and the upper fixed body 20 combines the C-shaped ring 42 to the central rotating body 40 and the C-shaped ring 4 to the upper fixed body 20 . ) can be configured by forming a ring groove into which is inserted.

The length adjustment rod 50 is for rotating the central rotating body 40, the end is located close to the central rotating body 40, the head part 51 is located at the upper end of the upper fixed body 20, the central rotating body A gear tooth 52 is provided at the end located close to the 40 so as to engage with the gear tooth 43 formed in the circumferential direction on the outer surface of the central rotating body 40 .

In addition, in the center of the upper fixture 20 and the lower fixture 30,

wire guide holes

20a and 30a are formed in the longitudinal direction, and the length adjustment rod 50 is deviated from the wire guide hole 20a. It is installed in the position, and the head 51 of the length adjustment rod 50 does not protrude from the upper surface of the upper fixed body 20 , and the head 51 is exposed to the upper surface of the upper fixed body 20 . It is preferable to form an adjustment groove (51a) for easy rotation.

Therefore, by rotating the head 51 of the length adjusting rod 50, the central rotating body 40 is the upper part by the gear teeth 52 of the length adjusting rod 50 and the gear teeth 43 of the central rotating body 40. It is rotated about the central axis with respect to the fixed body 20, whereby the lower fixed body 30 is screwed by the

screw parts

31 and 41 of the central rotating body 40 and the lower fixed body 30. It moves slightly in the longitudinal direction.

In addition, the torsion control means of the present invention is installed between the upper fixed body 20 and the lower fixed body 30, and the upper height with the longitudinal direction of the upper fixed body 20 and the lower fixed body 30 as the central axis. It is configured to rotate the lower fixed body 30 by a predetermined angle with respect to the static body 20, and the gear teeth 32 formed in the circumferential direction (torsional direction) about the central axis in the lower fixed body 30, and the gear teeth A torsion control rod (60) having a gear tooth (61) engaged with the (32) is provided.

At this time, the head 62 of the torsion control rod 60 is located at the upper end of the upper fixed body 20, and the lower fixed body 30 has an arc-shaped rectangular hole 33 in which the gear part 32 is formed. It is formed so that the lower fixed body 30 can be rotated at a predetermined angle with respect to the upper fixed body 20 .

In addition, the torsion control rod 60 is installed at a position deviated from the wire guide hole 20a of the upper fixture 20 , and the head 62 of the torsion control rod 60 is the upper fixture 20 . It is preferable not to protrude from the upper surface, and to form an adjustment groove 62a in the head 62 that is exposed to the upper surface of the upper fixture 20 to facilitate rotation.

In addition, as shown in Fig. 4, the head portion 51 of the length adjustment rod 50 and the head portion 52 of the torsion adjustment rod 60 are coupled to the upper fixture 20 by C-shaped

rings

53 and 63, respectively. This allows the length adjustment rod 50 and the torsion adjustment rod 60 to rotate in place.

In addition, in the center of the upper fixture 20 and the lower fixture 30,

wire guide holes

The operation of the present invention having such a configuration will be described. When the femur is fractured as in FIGS. 1 and 2, a hole is drilled in the upper end of the femur and the metal nail fixture 10 is inserted into the femur through the bone marrow, and the upper bone of the fracture site is the upper fixture 20. It is fixed with the upper fixture 20 with an occlusal screw 13 through a fixing hole 11 formed in the ) and fixed with the lower fixture 30.

As shown in FIGS. 4 and 5 in a state in which the upper and lower bones of the fracture site are fixed to the upper and

lower fixtures

20 and 30 as described above, the length adjusting rod 50 of the length adjusting means is rotated in the forward and reverse directions When this is done, the central rotating body 40 is rotated about the central axis in the longitudinal direction by the gear teeth 52 of the length adjustment rod 50 and the gear teeth 43 of the central rotating body 40, and the screw part of the central rotating body 40 Since (41) is screw-fitted to the screw part 31 of the lower fixture 30, the lower fixture 30 according to the rotation direction of the central rotation body 40 is fine in the longitudinal direction with respect to the upper fixture 20 is moved

Therefore, as shown in FIG. 1 , non-union or delayed union can be prevented by finely adjusting the gap (H) for the fracture site and maintaining it at an interval suitable for union.

In addition, the present invention rotates the torsion control rod 60 of the torsion control means in the forward and reverse directions as in FIGS. 4 and 5 , the gear teeth 61 of the torsion control rod 60 and the gear teeth of the lower fixture 30 . By (32), the lower fixed body 30 is rotated by a predetermined angle about the axial axis with respect to the upper fixed body (20).

Therefore, when the upper and lower bones are twisted for the fracture site as shown in FIG. 1, the torsion control rod 60 can be selectively rotated forward and backward to adjust it to its original position, thereby causing malformation or dysfunction due to malunion. can prevent

On the other hand, in the present invention, as the adjusting positions of the length adjusting means and the torsion adjusting means are located at the upper end of the upper fixture 20, after fixing the femur by the fixture 10, when the position of the fractured upper and lower bones is deformed Deformation can be adjusted with only a small incision to expose the head 51 of the length control rod 50 or the head 62 of the torsion control rod 60, so that the fixture 10 is fixed again through reoperation in the prior art It is significantly simpler and can reduce cost and effort compared to what needs to be done.

6 to 8 show a second embodiment of the present invention. In the first embodiment, only the configuration of the length adjusting means is changed, and the configuration of the torsion adjusting means is the same. Accordingly, the same reference numerals are assigned to the configuration of the torsion control means, and overlapping configuration and operation descriptions are omitted.

The length adjusting means in the second embodiment includes a screw hole 131 formed in the lower fixture 30 with the longitudinal direction as a central axis, and the screw hole 131 installed in the upper fixture 20 and provided at the lower end of the screw hole. A screw portion 151 for screw-fitting with the 131 is formed, and the head portion 152 of the upper end is made of a length adjustment rod 150 positioned at the upper end of the upper fixture 20 .

Therefore, by rotating the head 152 of the length adjusting rod 150, the lower fixture 30 by the screw 151 of the length adjusting rod 150 and the screw hole 131 of the lower fixture 130. ) is minutely moved in the longitudinal direction, which is the central axis direction, with respect to the upper fixture 20 .

At this time, as shown in FIGS. 6 and 8, the head 152 of the length adjustment rod 150 is coupled to the upper fixture 20 by a C-shaped ring 153 so that the length adjustment rod 150 rotates in place. The through hole 121 of the upper fixture 20 through which the length adjustment rod 150 penetrates in the longitudinal direction is a rectangle formed long in the circumferential direction with the central axis of the upper fixture 20 as the center. When the lower fixed body 30 rotates in the circumferential direction about the central axis with respect to the upper fixed body 20 by the rotation of the torsion control rod 60, which is a torsion control means, as in FIGS. 7 and 8 by forming enable rotation.

In addition, in the center of the upper fixture 20 and the lower fixture 30,

wire guide holes

20a and 30a are formed in the longitudinal direction, and the length adjustment rod 150 and the torsion adjustment rod 60 are the wires. It is installed at a position out of the guide hole 20a, and the

heads

152 and 62 of the length control rod 150 and the torsion control rod 60 do not protrude from the upper surface of the upper fixture 20, and the head It is preferable to form

adjustment grooves

152a and 62a that are exposed to the upper surface of the upper fixture 20 to facilitate rotation in the

portions

152 and 62 .

This second embodiment can exhibit the same effects as those of the first embodiment described above.

The embodiments described so far have merely described preferred embodiments of the present invention, and the scope of the present invention is not limited to the described embodiments, and those skilled in the art within the spirit and claims of the present invention It should be understood that various changes, modifications or substitutions will be possible, and such embodiments fall within the scope of the present invention.

(Explanation of symbols)

10: fixing body 11, 12: fixing hole

13: occlusal screw 20: upper fixture

30:

lower fixture

32,43,52,61: gear teeth

40: central rotating body 50, 150: length adjustment rod

51, 62, 152: head 60: torsion control rod

131: screw hole 151: screw part

Claims

In the metal tablet for fracture treatment comprising a rod-shaped fixture having a plurality of fixing holes formed therein, and an occlusal screw for fixing the fixture to a bone through the fixing holes,

The fixing body is separated into the upper and lower fixtures in the longitudinal direction to be connected to each other by fitting, and a length adjusting means is provided between the upper and lower fixtures to separate the lower fixture with respect to the upper fixture in the longitudinal direction. to be fine-tuned with

The length adjustment means,

Installed inside between the upper and lower fixtures, the upper end is supported by the upper fixture so as to rotate with the longitudinal direction as the central axis, and the lower end includes a central rotating body screwed to the lower fixture in the longitudinal direction, and the central rotation It consists of a length adjusting rod for rotating the whole,

The length adjustment rod is disposed at a position spaced apart from the central axis of the central rotating body, the end is located close to the central rotating body, the head is located at the upper end of the upper fixed body, and the end located close to the central rotating body is provided with gear teeth, the central rotating body A metal tablet for the treatment of fractures, characterized in that the teeth are meshed with the gear teeth formed in the circumferential direction on the entire outer surface.
In the metal tablet for fracture treatment comprising a rod-shaped fixture having a plurality of fixing holes formed therein, and an occlusal screw for fixing the fixture to a bone through the fixing holes,

The fixing body is separated into the upper and lower fixtures in the longitudinal direction to be connected to each other by fitting, and a length adjusting means is provided between the upper and lower fixtures to separate the lower fixture with respect to the upper fixture in the longitudinal direction. to be fine-tuned with

The length adjustment means,

It consists of a length adjustment rod and a screw hole disposed at a position spaced apart from the central axis of the upper and lower fixtures,

The screw hole is formed with the longitudinal direction of the lower fixture as the central axis,

The length adjustment rod is a metal tablet for fracture treatment, characterized in that the screw portion is formed at the lower end for screw-fitting the screw hole and the head of the upper end is positioned at the upper end of the upper fixture.
According to claim 1 or 2, wherein the wire guide hole is formed in the longitudinal direction at the center of the upper and lower fixture, the length adjustment rod is installed at a position deviated from the wire guide hole, the length of the adjustment rod The head is prevented from protruding from the upper surface of the upper fixture, and the head is exposed to the upper surface of the upper fixture, and a groove for adjustment to facilitate rotation is formed.
According to claim 1 or 2, installed between the upper fixture and the lower fixture, the lower fixture is rotated by a predetermined angle with respect to the upper fixture with the longitudinal direction of the upper fixture and the lower fixture as the central axis. A metal tablet for the treatment of fractures, characterized in that it further comprises a torsion control means.
In the metal tablet for fracture treatment comprising a rod-shaped fixture having a plurality of fixing holes formed therein, and an occlusal screw for fixing the fixture to a bone through the fixing holes,

The fixing body is formed by separating the upper and lower fixtures in the longitudinal direction and connected by fitting with each other,

A torsion control means for rotating the lower fixture by a predetermined angle with respect to the upper fixture with the longitudinal direction of the upper fixture and the lower fixture as a central axis between the upper fixture and the lower fixture is provided;

The torsion control means,

It consists of a gear teeth formed in the circumferential direction about the central axis on the lower fixture, and a torsion control rod having gear teeth meshed with the gear teeth, and the head of the torsion control rod is positioned at the upper end of the upper fixture. A metal tablet for the treatment of fractures characterized by.
According to claim 5, wherein a wire guide hole is formed in the longitudinal direction at the center of the upper and lower fixtures, the torsion control rod is installed at a position deviated from the wire guide hole, the head of the torsion control rod is an upper height A metal tablet for the treatment of fractures, characterized in that the head is exposed to the upper surface of the upper fixture so as not to protrude from the upper surface of the body, and an adjustment groove is formed to facilitate rotation.