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WO2003053265A1 - Clou modulaire pour os - Google Patents

Clou modulaire pour os Download PDF

Info

Publication number
WO2003053265A1
WO2003053265A1 PCT/DE2002/004571 DE0204571W WO03053265A1 WO 2003053265 A1 WO2003053265 A1 WO 2003053265A1 DE 0204571 W DE0204571 W DE 0204571W WO 03053265 A1 WO03053265 A1 WO 03053265A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone nail
expansion sleeve
screw
modular
modular bone
Prior art date
Application number
PCT/DE2002/004571
Other languages
German (de)
English (en)
Inventor
Christos Garnavos
Emmanuell Anapliotis
Original Assignee
Merete Medical Gmbh
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 Merete Medical Gmbh filed Critical Merete Medical Gmbh
Publication of WO2003053265A1 publication Critical patent/WO2003053265A1/fr

Links

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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A61B17/7233—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone
    • A61B17/7258—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone

Definitions

  • the invention relates to a bone nail that can be inserted from several sides, preferably for the treatment of corresponding fractures in the upper arm, wherein the bone nail can be inserted into the upper arm bone either from the proximal or from the distal side and, in the case of insertion on the shoulder side, a spreading locking sleeve on the bone nail is set and opened by means of an expansion screw, in case of insertion from the elbow side of the bone nail is inserted and secured with a screw elbow.
  • EP 0496 954 discloses a bone nail for the treatment of upper arm fractures, the hollow bone nail being used at the proximal end of the upper arm bone, the nail having a plurality of axially parallel slots at the distal end, so that the distal end is widened by screwing in an expansion screw.
  • two transverse screws are inserted through the bone and through the nail in the proximal area.
  • This type of treatment for an upper arm fracture means that the patient is treated with a lot of effort, since the upper arm bone has to be opened from two sides and additional transverse screws have to be inserted, all of which have to be removed again.
  • the bone nail used must therefore be as long as the corresponding upper arm bone of the patient.
  • the healing process that follows after the removal of the inserted parts is lengthy and stressful since considerable areas of the medullary canal have been changed.
  • a fairly large stock of bone nails of different lengths is also necessary.
  • the object of the invention is therefore to propose a bone nail which, depending on the position of the fracture in the humerus, can be inserted either from the proximal or distal side of the humerus and can be fixed accordingly.
  • the appropriate insertion side on the humerus is determined, then the position and length of the bone nail is determined, in order to choose a length that is sufficient for the bone nail on both sides of the fracture in the medullary cavity fixed.
  • This is achieved in particular with a hollow bone nail for inserting a guide wire, inserting the bone nail from the selected side and screwing in an expansion sleeve, with external locking rings and internal thread, onto the bone nail and then spreading the expansion sleeve by screwing in an expansion screw.
  • the expansion sleeve is partially slotted several times, so that segments with internal and external threads are created, these segments expanding or spreading when the expansion screw is screwed in through the conically thickening head of the expansion screw and fixing the bone nail in the medulla.
  • the extension screw in the case of fractures in or on the humeral head, instead of the bone nail being fastened by the expansion sleeve, the extension screw can be used to screw an extension part onto the bone nail, which in turn can be used to secure the fracture by means of transverse screws.
  • Fig. 9 the expansion sleeve with self-locking cone.
  • FIGS. 1-4 show the modular bone nail 20 according to the invention lying one above the other in the order in which they belong together.
  • the expansion sleeve 10 is screwed into the bone nail 20, and the expansion screw 1 is screwed into this, as will be explained in more detail below.
  • the expanding screw 1 shows the expanding screw 1 with a conical head 2, threaded shaft 3, hexagon socket 4 and through hole 5.
  • the expanding sleeve 10 according to FIGS. 2 and 3 consists of a cylindrical body with external pointed rings 11 and a smooth round part 12. These rings 11 are preferably arranged here in parallel with uniform thread-like tips and depressions. However, other contours can also be used, for example as coarse threads or cutting rings with a design that starts at the roof.
  • the part provided with these rings 11 is provided with a number of slits 13, here eight slits which end in a bore 13A, so that eight segments 19 also result.
  • the expansion sleeve 10 initially has an internal thread 14 matching the threaded shaft 3, including an internal hexagon 15 and an internal thread 16 below.
  • the threaded pin 17 carries a thread suitable for the bone nail 20.
  • the expansion sleeve is provided with a bore 18 through which the guide wire passes can be performed.
  • a bone nail 20 is shown in FIG. 4. This begins at the upper end with a short cylindrical part 21, which merges into a shaft 23 with an almost square cross section, but with inwardly curved surfaces, as shown in FIG. 4A.
  • the bone nail 20 has an internal thread 24 at the top, matching the threaded pin 17 of the expansion sleeve 10.
  • the opposite lower end has an inclined part 26.
  • the entire bone nail 20 is hollow and has an inner bore 23.
  • Two cross bores 25 are also present in the lower region.
  • a slot 27 is provided at the top of the head of the bone nail 20, into which the corresponding lugs of a further attachment part 50 fit, as will be explained in more detail below.
  • This cross-section of the bone nail 20 brings about great stability, and on the other hand the square cross-sectional shape with inwardly curved surfaces ensures a high degree of security against rotation during the implantation period in the upper arm.
  • the bone nail must rest, it must not change its position under any circumstances.
  • the expansion screw 1 is screwed in until it is almost flush with the top of the expansion sleeve 10.
  • the segments 19 are moved outwards and the rings 11 dig into the corresponding areas of the cortex and / or the cancellous bone and fix the entire bone nail unit.
  • the distal elbow 30 is shown in FIGS. 5 and 6. This consists of a cylindrical straight part 31 and an inclined part 32 which ends in a vertical surface 33. At the bottom there is a threaded pin 34 which is made to match the internal thread 24 of the bone nail 20. A vertical bore 35 ends at the top in a central recess 36. The inclined part 32 is also provided with a through bore 37, this bore also having an internal thread 38 on the surface 33. If the distal elbow 30 is screwed onto a bone nail 20, this unit is used from the elbow side to support a fracture in the upper arm. An impact tool, not shown, engages in the recess 36. After the bone nail 20 has been driven in, a commercially available bone screw can be inserted through the bore 37 to fix the unit. The side with the large outer radius comes to rest in the hollow of the elbow called fossa olecrani.
  • an attachment part 50 can be screwed to the bone nail 20, which in turn by means of transverse screws Fixation of the fracture can be guaranteed.
  • the cylindrical extension part 50 has two lugs 51 at the bottom, which fit into the corresponding slot 27 of the bone nail 20.
  • a slot 54 At the top of the head part 50 there is a slot 54, furthermore a threaded section 52, the bore 53 of which is almost continuous and ends on a conical section 56.
  • Two bores 55 serve for later attachment of the bone nail 20 with the screwed-on attachment part 50 in the fracture area of the bone.
  • the corresponding fastening screw 60 can be seen from FIG. This has a threaded section 62 which fits into the thread 24 of the bone nail 20.
  • a cone head 61 is provided as a self-locking cone in connection with the cone section 56.
  • An internal hexagon 63 serves as Screw-in aid, but other forms of screw-in tools are also possible.
  • FIG. 9 shows the expansion sleeve 70 already described above, but here changes to the possibility of connection by means of the fastening screw 60.
  • the expansion sleeve 70 consists of a cylindrical body with external pointed rings 11 and a smooth round part 12. The one with these rings 11 The part provided is provided with a number of slots 13, here eight slots which end in a small bore 13A, so that eight segments 19 also result.
  • the expansion sleeve 10 initially carries an internal thread 14, which then merges into a through bore 53 with a self-locking cone 56.
  • the cylindrical extension part 12 has two lugs 51 at the bottom, which fit into the corresponding slot 27 of the bone nail 20.
  • this modular bone nail is that the bone nail itself is very simple to build and therefore inexpensive to manufacture, and due to the variable attachment of different end pieces, it is particularly suitable for different locations on the upper arm bone or other fracture sites.
  • All the parts described above are made of a stable implant material, preferably a titanium alloy.
  • a described bone nail 20 can also be used together with the expansion sleeve 10 and the expansion screw 1 from the distal side of an upper arm fracture.
  • this can also be provided at both ends with a cylindrical part with an internal thread, for example in the case of a multiple fracture or other complicated fractures. Then a tip (not shown in more detail) can be screwed onto the drive-in side of the bone nail for better sliding of the bone.

Landscapes

  • 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

L'invention concerne un clou (20) pour os, pouvant être introduit par plusieurs côtés, destiné de préférence au traitement de fractures du bras. Ce clou peut être introduit dans l'humérus soit par le côté proximal soit par le côté distal. Dans le cas d'une introduction par le côté épaule, une douille de blocage expansible (10) est placée sur le clou (20) et ouverte au moyen d'une vis d'écartement (1), ou dans le cas d'une fracture de la tête de l'humérus, on peut placer un élément saillant, et dans le cas d'une introduction par le côté coude, le clou est introduit et bloqué au moyen d'une partie coudée à vis (30).
PCT/DE2002/004571 2001-12-20 2002-12-06 Clou modulaire pour os WO2003053265A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE10164464.7 2001-12-20
DE2001164464 DE10164464A1 (de) 2001-12-20 2001-12-20 Modularer Knochennagel

Publications (1)

Publication Number Publication Date
WO2003053265A1 true WO2003053265A1 (fr) 2003-07-03

Family

ID=7711134

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/DE2002/004571 WO2003053265A1 (fr) 2001-12-20 2002-12-06 Clou modulaire pour os

Country Status (2)

Country Link
DE (1) DE10164464A1 (fr)
WO (1) WO2003053265A1 (fr)

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8790343B2 (en) 2008-10-11 2014-07-29 Epix Orthopaedics, Inc. Intramedullary rod with pivotable and fixed fasteners and method for using same
US8906023B2 (en) 2007-06-22 2014-12-09 Epix Orthopaedics, Inc. Intramedullary rod for pivoting a fastener
US9861418B2 (en) 2012-02-08 2018-01-09 Epix Orthopaedics, Inc. Implant insertion device with continuously adjustable targeting assembly
US10123828B2 (en) 2013-03-15 2018-11-13 Epix Orthopaedics, Inc. Implantable device with pivotable fastener and self-adjusting set screw

Families Citing this family (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE102011109209A1 (de) * 2011-08-02 2013-02-07 Wittenstein Ag Schnittstelle für einen Marknagel

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0226701B1 (fr) * 1985-12-06 1990-06-13 Howmedica GmbH Broche de verrouillage destinée au traitement des fractures de l'humérus
US5122141A (en) * 1990-08-30 1992-06-16 Zimmer, Inc. Modular intramedullary nail
EP0496954A1 (fr) 1991-01-30 1992-08-05 Howmedica GmbH Clou centro-médullaire destiné au traitement du bras
US5855579A (en) * 1994-07-15 1999-01-05 Smith & Nephew, Inc. Cannulated modular intramedullary nail

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0226701B1 (fr) * 1985-12-06 1990-06-13 Howmedica GmbH Broche de verrouillage destinée au traitement des fractures de l'humérus
US5122141A (en) * 1990-08-30 1992-06-16 Zimmer, Inc. Modular intramedullary nail
EP0496954A1 (fr) 1991-01-30 1992-08-05 Howmedica GmbH Clou centro-médullaire destiné au traitement du bras
US5855579A (en) * 1994-07-15 1999-01-05 Smith & Nephew, Inc. Cannulated modular intramedullary nail

Cited By (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US8906023B2 (en) 2007-06-22 2014-12-09 Epix Orthopaedics, Inc. Intramedullary rod for pivoting a fastener
US9861403B2 (en) 2007-06-22 2018-01-09 Epix Orthopaedics, Inc. Method for pivoting a fastener
US10687871B2 (en) 2007-06-22 2020-06-23 Epix Orthopaedics, Inc. Intramedullary rod for pivoting a fastener
US8790343B2 (en) 2008-10-11 2014-07-29 Epix Orthopaedics, Inc. Intramedullary rod with pivotable and fixed fasteners and method for using same
US9861418B2 (en) 2012-02-08 2018-01-09 Epix Orthopaedics, Inc. Implant insertion device with continuously adjustable targeting assembly
US10123828B2 (en) 2013-03-15 2018-11-13 Epix Orthopaedics, Inc. Implantable device with pivotable fastener and self-adjusting set screw

Also Published As

Publication number Publication date
DE10164464A1 (de) 2003-07-03

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