WO2023249575A1 - Femur antegrade extension nail structure fixed with external fixator - Google Patents

Femur antegrade extension nail structure fixed with external fixator Download PDF

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Publication number
WO2023249575A1
WO2023249575A1 PCT/TR2022/050637 TR2022050637W WO2023249575A1 WO 2023249575 A1 WO2023249575 A1 WO 2023249575A1 TR 2022050637 W TR2022050637 W TR 2022050637W WO 2023249575 A1 WO2023249575 A1 WO 2023249575A1
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WO
WIPO (PCT)
Prior art keywords
nail
bone
femur
antegrade
extension
Prior art date
Application number
PCT/TR2022/050637
Other languages
French (fr)
Inventor
Halil BULDU
Dogukan ILHAN
Original Assignee
Livelifetaller Tip Turizmi Ve Saglik Danismanligi Ticaret Limited Sirketi
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 Livelifetaller Tip Turizmi Ve Saglik Danismanligi Ticaret Limited Sirketi filed Critical Livelifetaller Tip Turizmi Ve Saglik Danismanligi Ticaret Limited Sirketi
Priority to PCT/TR2022/050637 priority Critical patent/WO2023249575A1/en
Publication of WO2023249575A1 publication Critical patent/WO2023249575A1/en

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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
    • A61B17/56—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
    • 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
    • A61B17/68—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
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form

Definitions

  • the invention relates to the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its purpose by using the external fixator for the first time and to developing an alternative method to length/bone extension methods by means of changing its form.
  • the invention relates to making the nail structure full and solid in femur antegrade extension nails, contributing to the stability by giving a flat form and eliminating the curve shape, and allowing the nail to slide in the intramedullary canal being exposed to less friction during elongation.
  • the subject of the invention is related to the attachment of the external fixator schanz pins to the bone through inside the nail by enlarging the holes on the body in order to pass the schanz pins through the slots on the nail in femur antegrade extension nails and making them suitable for the schanz pins.
  • the invention relates to providing ease of application by fixing the external fixator schanz pins from the inside of the nail to the bone, and preventing the negative effects such as bending, breaking, or twisting due to the long segment capture of the fixator schanz pins that capture the bone from end to end.
  • the first is the system that is only applied externally.
  • This method called the Ilizarov and monolateral fixator method, is a system in which the bone is fixed with thin wires and hoops. This device holds the bone from above and below, after the bone is cracked, the patient slowly extends the bone by turning the screws on the device. This is also called the external detection method.
  • the desired extension cannot be achieved due to bending and twisting as the patient will walk for months with pressure.
  • the second method is the combined method, which is a further stage. In this method, there is a fixation system outside the skin to fix the bone, and inside there is a nail or plate.
  • the combined system is more preferred.
  • the combined system for example, since an average of 1 mm extension can be done per day in a person who will have a total extension of 5 centimetres, they will walk around with the device for only 50 days, then will be operated again removing the outside system and leaving a plaque or nail inside.
  • the third method is extension with systems only through the bone. In this method, there is no visible system from the outside, there only is a nail that grows gradually inside the bone, that is, a motorized nail. However, it is more costly than other methods.
  • the invention aims the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its purpose by using the external fixator for the first time and to develop an alternative method to length/bone extension methods by means of changing its form.
  • the invention aims to contribute to the stability of the femur antegrade extension nails by making the nail structure full and solid, giving a flat form, and eliminating the curve shape.
  • the invention aims to fix the external fixator schanz pins from the inside of the nail to the bone by enlarging the holes of the femur antegrade nails and making them suitable for the schanz pins.
  • the aim of the invention is to provide ease of application by using external fixator schanz pins on the nail and to prevent problems such as bending, breaking or twisting due to the long segment capture of the fixator schanz pins that capture the bone from length to length.
  • the invention relates to making the nail structure full and solid in femur antegrade extension nails, contributing to the stability by giving a flat form and eliminating the curve shape, and allowing the nail to slide in the intramedullary canal being exposed to less friction during elongation.
  • the invention aims the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its normal purpose (fracture fixation, fracture union etc.), by using the external fixator for the first time and to develop an alternative method to length/bone extension methods by means of changing its form, flattening it and making it solid by stuffing it.
  • the invention allows to make the nail structure full and solid in femur antegrade extension nails (7), contribute to the stability by giving a flat form and eliminating the curve shape, and allows the nail to slide in the intramedullary canal being exposed to less friction during elongation.
  • the invention is to eliminate the angulation (curve) by making the solid flattened and stuffed nail (1) form straight and stuffing it by closing the 3 mm cannulated area and to contribute to the stability of the bone by making the inner cavity of said solid flattened and stuffed nail (1) whole and monolithic.
  • the nail head part (A) is narrowed compared to the diameter of the flattened and stuffed nail (1).
  • the distal dynamic locking hole (3) located at the tip of the nail is located just proximal to the distal static locking holes (2) located at the tip of the nail.
  • distal static locking holes (2) are formed on the solid flattened and stuffed nail (1) through which the transverse locking screw is fixed to the bone.
  • proximal dynamic hole (5) located on the left proximal of the holes (6) suitable for the schanz pins on the solid flattened and stuffed nail (1).
  • oblique locking hole (4) right next to the proximal dynamic hole (5), that is, proximal.
  • the oblique screw passing through the oblique locking hole (4) uses the proximal dynamic hole (5) as a way and is fixed to the bone by passing through the flattened and stuffed nail (1) in the lateral direction. In this way, both an oblique screw and a transverse locking screw are inserted into the bone. ( Figure - 7 and Figure - 8)
  • Schanz pins inserted into the bone from the external fixator in the femur antegrade extension nail (7), which is the subject of the invention, are fixed to the bone by passing through the flattened and stuffed nail (1).
  • the steps of using schanz pins, external fixator and femur antegrade extension nail (7) for the first time as a bone lengthening method are as follows;

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

Abstract

The invention relates to the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its purpose by using the external fixator for the first time and to developing an alternative method to length/bone extension methods by means of changing its form. The invention relates to the prevention of bending and twisting of the femoral antegrade extension nail (7) due to metal fatigue, by means of its solid, full and flat form, even if the patient presses on the nail for months. The subject of the invention is related to the attachment of the external fixator schanz pins to the bone through the nail by enlarging the holes on the body in order to pass the schanz pins through the slots on the nail (7) in the femur extension nails and making them suitable for the schanz pins. The invention relates to providing ease of application by fixing the external fixator schanz pins from the inside of the nail to the bone and preventing the negative effects such as bending, breaking, or twisting due to the long segment capture of the external fixator schanz pins that capture the bone from length to length.

Description

FEMUR ANTEGRADE EXTENSION NAIL STRUCTURE FIXED WITH EXTERNAL FIXATOR
Technical Field
The invention relates to the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its purpose by using the external fixator for the first time and to developing an alternative method to length/bone extension methods by means of changing its form.
The invention relates to making the nail structure full and solid in femur antegrade extension nails, contributing to the stability by giving a flat form and eliminating the curve shape, and allowing the nail to slide in the intramedullary canal being exposed to less friction during elongation.
The subject of the invention is related to the attachment of the external fixator schanz pins to the bone through inside the nail by enlarging the holes on the body in order to pass the schanz pins through the slots on the nail in femur antegrade extension nails and making them suitable for the schanz pins.
The invention relates to providing ease of application by fixing the external fixator schanz pins from the inside of the nail to the bone, and preventing the negative effects such as bending, breaking, or twisting due to the long segment capture of the fixator schanz pins that capture the bone from end to end.
Prior art
By means of the rapidly adapted technological developments in the field of orthopaedics, patients can return to their work and social lives in a short time after the treatments applied on the bone.
In the state of the art, locked or unlocked intramedullary nails, antegrade nails and many similar nail types are used in bone damage treatments. These nails used are produced from steel, titanium and similar materials and are fixed by using nails and pins by advancing into the bones with special techniques. These screws or pins are usually passed through the holes at the top and bottom ends of the nail and applied to the bone with screws. The nails used are produced hollow, that is, as holes, and have an angled structure. All of the femur nails used are curved and created for fracture fixation and treatment. They are curved in order to adapt to the human bone structure. In this way, a more comfortable application is obtained while fixing the fracture.
In the current technique, there are basically 3 systems for extension. The first is the system that is only applied externally. This method, called the Ilizarov and monolateral fixator method, is a system in which the bone is fixed with thin wires and hoops. This device holds the bone from above and below, after the bone is cracked, the patient slowly extends the bone by turning the screws on the device. This is also called the external detection method. However, in this method, the desired extension cannot be achieved due to bending and twisting as the patient will walk for months with pressure. The second method is the combined method, which is a further stage. In this method, there is a fixation system outside the skin to fix the bone, and inside there is a nail or plate. Since people who have cosmetic extension do not want to walk around with a device that is visible from the outside, the combined system is more preferred. In the combined system, for example, since an average of 1 mm extension can be done per day in a person who will have a total extension of 5 centimetres, they will walk around with the device for only 50 days, then will be operated again removing the outside system and leaving a plaque or nail inside. The third method is extension with systems only through the bone. In this method, there is no visible system from the outside, there only is a nail that grows gradually inside the bone, that is, a motorized nail. However, it is more costly than other methods.
Defects in the known state of the art, high cost, affecting the comfort of the patient, not being able to provide the desired extension, bending, twisting and similar problems in the nails and screws used over time necessitated an R.&D study in this field.
The Aim of the Invention
The invention aims the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its purpose by using the external fixator for the first time and to develop an alternative method to length/bone extension methods by means of changing its form. The invention aims to contribute to the stability of the femur antegrade extension nails by making the nail structure full and solid, giving a flat form, and eliminating the curve shape. The invention aims to fix the external fixator schanz pins from the inside of the nail to the bone by enlarging the holes of the femur antegrade nails and making them suitable for the schanz pins.
The aim of the invention is to provide ease of application by using external fixator schanz pins on the nail and to prevent problems such as bending, breaking or twisting due to the long segment capture of the fixator schanz pins that capture the bone from length to length.
The invention relates to making the nail structure full and solid in femur antegrade extension nails, contributing to the stability by giving a flat form and eliminating the curve shape, and allowing the nail to slide in the intramedullary canal being exposed to less friction during elongation.
Detailed Description of the Invention
Figures related to the structure of the schanz pin inserted into the bone from the external fixator in full solid femur antegrade nails with flat structure are given below.
Figure - 1 Side View of Femur Antegrade Extension Nail
Figure - 2 Side Detail View of Femur Antegrade Extension Nail Tip and Holes Suitable for Schanz Pins
Figure - 3 Upper Perspective Detail Sectional View of Holes Suitable for Schanz Pins of Femur Antegrade Extension Nail
Figure - 4 Upper Perspective Detail Section View of Femur Antegrade Extension Nail Tip
Figure - 5 Upper Perspective General View of Solid Flattened And Stuffed Nail Femur Antegrade Extension Nail of which is Flattened Monol ithical ly
Figure - 6 General Detailed and Sectional View of Femur Antegrade Extension Nail Figure - 7 Side General Detail View of Femur Antegrade Extension Nail
Figure - 8 Detailed and Sectional View of Femur Antegrade Extension Nail
Figure - 9 Upper Perspective General View of Femur Antegrade Extension Nail Tip Part
Figure - 10 Upper Perspective Detail and Section View of Femur Antegrade Extension Nail Tip
Figure - 11 Upper Perspective View of Femur Antegrade Extension Nail Tip Body Schanz Pin, Oblique Locking, Distal Static Locking Holes
Figure - 12 Detailed and Sectional Upper Perspective View of Femur Antegrade Extension Nail Tip Body Schanz Pin, Oblique Locking, Static Locking Holes
Reference numbers:
1. Solid Flattened And Stuffed Nail
2. Distal Static Locking Hole
3. Distal Dynamic Locking Hole
4. Oblique Locking Hole
5. Proximal Dynamic Hole
6. Hole Suitable for Schanz Pins
7. Femur Antegrade Extension Nail
A. Nail Head
The invention aims the use of femur antegrade nail, which is a fracture fixation nail, for extension, different from its normal purpose (fracture fixation, fracture union etc.), by using the external fixator for the first time and to develop an alternative method to length/bone extension methods by means of changing its form, flattening it and making it solid by stuffing it.
The invention allows to make the nail structure full and solid in femur antegrade extension nails (7), contribute to the stability by giving a flat form and eliminating the curve shape, and allows the nail to slide in the intramedullary canal being exposed to less friction during elongation. The invention is to eliminate the angulation (curve) by making the solid flattened and stuffed nail (1) form straight and stuffing it by closing the 3 mm cannulated area and to contribute to the stability of the bone by making the inner cavity of said solid flattened and stuffed nail (1) whole and monolithic. (Figure 1) In addition, the nail head (A) (Figure - 2, Figure - 4 and Figure - 6) of the femur antegrade extension nail (7) was solid flattened and narrowed and shortened in proportion to the diameter of the stuffed nail (1) to obtain a new form. However, the holes (6) suitable for the schanz pins, whose cross-section detail is given in Figure 12, on the surface of the flattened and stuffed nail (1) of the femur antegrade extension nail (7) are specially enlarged so that the schanz pins can enter. (Figure - 3) In this way, it has been reached to a size that schanz pins can enter. (Schanz pins are at least 6mm, and the invention is not limited to a single size.) One of the important features of the invention is that the nail head part (A) is narrowed compared to the diameter of the flattened and stuffed nail (1). The distal dynamic locking hole (3) located at the tip of the nail is located just proximal to the distal static locking holes (2) located at the tip of the nail.
One more locking hole was drilled specifically for the solid flattened and stuffed nail (1), and distal static locking holes (2) were added. Thus, distal static locking holes (2) are formed on the solid flattened and stuffed nail (1) through which the transverse locking screw is fixed to the bone. There is a proximal dynamic hole (5) located on the left proximal of the holes (6) suitable for the schanz pins on the solid flattened and stuffed nail (1). There is an oblique locking hole (4) right next to the proximal dynamic hole (5), that is, proximal. The oblique screw passing through the oblique locking hole (4) uses the proximal dynamic hole (5) as a way and is fixed to the bone by passing through the flattened and stuffed nail (1) in the lateral direction. In this way, both an oblique screw and a transverse locking screw are inserted into the bone. (Figure - 7 and Figure - 8)
Schanz pins inserted into the bone from the external fixator in the femur antegrade extension nail (7), which is the subject of the invention, are fixed to the bone by passing through the flattened and stuffed nail (1).
In the previous technique, only oblique screws could be used in femur antegrade nails. However, schanz pins were not used. By means of the use of schanz pins in the subject of the invention, and addition of extra distal static locking holes (2), the use of transverse locking screws provides ease of application during the process. However, this is the for the first time that a fracture nail was used as a femur antegrade extension nail (7). In addition, due to the long segment capture of the external fixator schanz pins that capture the bone throughout, bending, breaking or twisting problems are prevented during or after the procedure. (Figure 9, Figure - 10 and Figure - 11)
The steps of using schanz pins, external fixator and femur antegrade extension nail (7) for the first time as a bone lengthening method are as follows;
- extending the femur antegrade extension nail (7) from the femur priformis fossa to the intramedullary area,
- passing schanz pins through the slots on the external fixator,
- passing said schanz pins through holes (6) suitable for schanz pins located distal of the distal static locking holes (2) on the solid flattened and stuffed nail (1), and fixing them to the bone in such a way that one end will be in said external fixator slots and the other end will pass through the holes on said solid flattened and stuffed nail (1) in the bone,
- passing said schanz pins through the slots on said external fixator,
- passing said schanz pins through holes (6) suitable for schanz pins located proximal to the distal static locking holes (2) on said solid flattened and stuffed nail (1), and fixing them to the bone in such a way that one end will be in said external fixator slots and the other end will pass through the holes on said solid flattened and stuffed nail (1) in the bone,
- threading the oblique screw horizontally-angled by passing through the oblique locking hole (4) and going through the proximal dynamic hole (5) on said solid flattened and stuffed nail (1),
- fixing the oblique locking screw to the bone,
- passing a transverse locking screw through the distal static locking holes (2) on said solid flattened and stuffed nail (1), - fixing said transverse locking screw to the bone,
- fixing said external fixator by remaining distal to the bone, and
- fixing said femur antegrade extension nail (7) into the bone, and to the bone with said external fixator to extend the bone.

Claims

1. Femur antegrade extension nail (7) developed as an alternative to bone/length extension methods, characterized by comprising,
- a solid flattened and stuffed nail (1), whose strength is increased by making its inner cannula is stuffed and solid, which is given a flat form to be used for bone lengthening, and which provides support for bone stability by means of its form,
- at least one hole (6) suitable for schanz pins drilled to fit the schanz pins of at least 6 mm on said solid flattened and stuffed nail (1),
- the distal static locking hole (2), located on the right proximal of said holes (6) suitable for said schanz pins, where the transverse locking screw is fixed to the bone by travelling on said solid flattened and stuffed nail (1) and provides increasing bone stability.
2. Femur antegrade extension nail (7) according to Claim 1, characterized in that, it has a structure that becomes thinner and shorter towards the two distal ends.
3. Femur antegrade extension nail (7) according to Claim 1, wherein, said distal static locking holes (2) on said solid flattened and stuffed nail (1) are also found in nail head part (A) of said solid flattened and stuffed nail (1).
4. The femur antegrade lengthening nail (7) as an alternative method to length/bone lengthening operations, characterized by comprising the process steps of:
- extending said femur antegrade extension nail (7) from the femur priformis fossa to the intramedullary area,
- passing schanz pins through the slots on the external fixator,
- passing said schanz pins through the holes (6) suitable for the schanz pins located distal of the distal static locking holes (2) on said femur antegrade extension nail (7) body (1), and fixing them to the bone so that one end will be in said external fixator sockets and the other end will pass through the holes on the solid flattened and stuffed nail (1) in the bone,
- passing said schanz pins through the slots on said external fixator,
- passing said schanz pins through holes (6) suitable for schanz pins located proximal to the distal static locking holes (2) on said solid flattened and stuffed nail (7) body (1), and fixing them to the bone in such a way that one end will be in said external fixator slots and the other end will pass through the holes on said solid flattened and stuffed nail (1) in the bone,
- threading the oblique screw horizontally-angled by passing through the oblique locking hole (4) and going through the proximal dynamic hole (5) on said solid flattened and stuffed nail (1),
- fixing said oblique locking screw to the bone,
- passing a transverse locking screw through said distal static locking holes (2) on said solid flattened and stuffed nail (1),
- fixing said transverse locking screw to the bone,
- fixing said external fixator by remaining distal to the bone, and
- fixing said femur antegrade extension nail (7) into the bone, and to the bone with said external fixator to extend the bone.
PCT/TR2022/050637 2022-06-23 2022-06-23 Femur antegrade extension nail structure fixed with external fixator WO2023249575A1 (en)

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PCT/TR2022/050637 WO2023249575A1 (en) 2022-06-23 2022-06-23 Femur antegrade extension nail structure fixed with external fixator

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Application Number Priority Date Filing Date Title
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Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TW201511731A (en) * 2013-09-18 2015-04-01 Hung-Fa Chou Device and method of using intramedullary nail to extend bone length
CN206964671U (en) * 2016-12-13 2018-02-06 常州奥斯迈医疗器械有限公司 Carried for bone, the marrow combination of inner and outside device of Limb lengthening
US20190133650A1 (en) * 2016-05-27 2019-05-09 Synoste Oy An intra-corporal telescopic osteodistraction device, an extra-corporal force producing device, a method for bone lengthening and a bone lengthening arrangement

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
TW201511731A (en) * 2013-09-18 2015-04-01 Hung-Fa Chou Device and method of using intramedullary nail to extend bone length
US20190133650A1 (en) * 2016-05-27 2019-05-09 Synoste Oy An intra-corporal telescopic osteodistraction device, an extra-corporal force producing device, a method for bone lengthening and a bone lengthening arrangement
CN206964671U (en) * 2016-12-13 2018-02-06 常州奥斯迈医疗器械有限公司 Carried for bone, the marrow combination of inner and outside device of Limb lengthening

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