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WO2005053553A1 - Dispositif de repositionnement de fractures - Google Patents

Dispositif de repositionnement de fractures Download PDF

Info

Publication number
WO2005053553A1
WO2005053553A1 PCT/CH2003/000800 CH0300800W WO2005053553A1 WO 2005053553 A1 WO2005053553 A1 WO 2005053553A1 CH 0300800 W CH0300800 W CH 0300800W WO 2005053553 A1 WO2005053553 A1 WO 2005053553A1
Authority
WO
WIPO (PCT)
Prior art keywords
lever
plate
bone
central axis
rear end
Prior art date
Application number
PCT/CH2003/000800
Other languages
German (de)
English (en)
Inventor
Patrizio Frigeri
Daniel Schmucki
Original Assignee
Synthes Ag Chur
Synthes (U.S.A)
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 Synthes Ag Chur, Synthes (U.S.A) filed Critical Synthes Ag Chur
Priority to PCT/CH2003/000800 priority Critical patent/WO2005053553A1/fr
Priority to AU2003281904A priority patent/AU2003281904A1/en
Publication of WO2005053553A1 publication Critical patent/WO2005053553A1/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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/8866—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices for gripping or pushing bones, e.g. approximators
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
    • A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/808—Instruments for holding or positioning bone plates, or for adjusting screw-to-plate locking mechanisms
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/0046—Surgical instruments, devices or methods with a releasable handle; with handle and operating part separable

Definitions

  • the invention relates to a device for repositioning bone fragments, according to the preamble of patent claim 1.
  • a device for aligning long bones is known from WO 02/096294 GREEN.
  • This known device comprises a lever with an arcuate segment which can be guided around a tubular bone and a tensioning element which is arranged to be displaceable parallel to the lever and can be pressed against the proximal surface of the tubular bone.
  • a disadvantage of this known device is that the arcuate segment of the device has to be guided around the long bones and therefore a detachment of the surrounding soft parts is necessary.
  • EP 0 468 192 FRIGG discloses an osteosynthesis plate which can be connected to an aiming arm and which can be inserted into the human body through a small incision and which enables the bone fracture to be reduced by manipulating the aiming arm fixed to the plate.
  • a disadvantage of this known device is that the bone screws are screwed into the bone perpendicular to the plane of the plate, so that when using monocortical bone screws, the device is reduced during a reduction, for example on the proximal femur, where large forces may have to be transferred to a bone fragment is not rigidly attached to the bone.
  • the invention seeks to remedy this.
  • the invention has for its object to provide a device which is releasably attachable to one side of the bone on the surface of the bone that can be reached by a small incision and ensures a firm, rigid hold of the device on the bone.
  • the invention solves the problem with a device for repositioning bone fragments, which has the features of claim 1.
  • the bone or the bone fragment only has to be freed from the soft tissue on a small part of its surface
  • the device is suitable for fractures on a wide variety of bones and bone areas, in particular also in the case of fractures in the pelvis,
  • a rigid connection between the bone or the bone fragment and the device can be established
  • the angle ⁇ between the bore axes and the central axis of the device can be between 1 ° and 20 °, preferably between 5 ° and 15 °.
  • the plate comprises at least three bores, which are not arranged on an axis, for receiving bone screws, so that repositioning forces transverse to the longitudinal axis of the plate can also be optimally transmitted from the plate to the bone.
  • the plate has a maximum dimension A while the lever has a length L.
  • the ratio between the length of the lever L and the maximum dimension A of the plate is preferably in a range of 2 ⁇ L / A ⁇ 10.
  • the plate can have a different shape depending on the type of fracture and the location of the fracture and is preferably anchored to the bone by means of at least two head locking screws.
  • the plate can be triangular, trapezoidal or S-shaped.
  • the holes for receiving the screw heads of the bone screws are placed, for example, in the corners or on the longitudinal axis.
  • the device comprises a handle that can be detachably connected to the lever, whereby the manipulation of the device can be facilitated.
  • the handle is preferably angled relative to the lever, but can also be arranged coaxially.
  • a T-handle which is located at the rear end of the lever, is also possible. To transfer large forces to reduce the The handle at the rear end of the lever is provided with bone fragments by means of a rotationally positive connection of these two parts with respect to the central axis.
  • the device comprises a target device, which can be attached to the rear end of the lever, for example when the handle is removed, and by means of which a drill bit, which is used for drilling the bone screws in the bone, can be aligned.
  • the aiming device preferably comprises a centering plate which can be attached to the rear end of the lever and has centering bores, in which centering sleeves with sleeve openings in particular can be inserted, which are suitable, for example, for receiving drill sleeves.
  • An anti-rotation device is preferably provided at the rear end of the lever for the defined positioning of the centering plate on the lever, so that the centering bores can be brought into a specific position relative to the plate.
  • the bores in the plate are designed such that they taper conically towards the underside.
  • Conical internal threads are preferably provided in these conical bores. This provides the advantage that the underside of the plate does not necessarily have to lie on the bone surface in order to achieve a rigid fixation of the plate to the bone.
  • the lever can be firmly connected to the plate, for example welded to it, or it can also be detachably, preferably fastened to the plate by means of a threaded connection.
  • the handle is preferably connected to the lever in a rotationally fixed manner with respect to the central axis, the means for the rotationally positive connection between the lever and handle preferably consisting in the fact that the lever at its rear end has a non-circular cross-sectional area that is orthogonal to the central axis, via which a sleeve attached to the handle is slidable with a complementary cross-sectional area of its central bore.
  • FIG. 1 shows a view of an embodiment of the device according to the invention fastened to a long bone
  • FIG. 2 shows an enlargement of the section marked by the circle A in FIG. 1;
  • FIG. 3 shows a section along the line II - II in Fig. 2.
  • FIG. 4 is a view of the embodiment of the device shown in FIG. 1 without a handle and with a target device;
  • FIG. 5 shows a section through an embodiment of the plate.
  • Fig. 6 is a plan view of the embodiment of the plate shown in Fig. 5;
  • Fig. 7 shows a section through the embodiment of the plate shown in Figs. 5 and 6.
  • the fixation means 30 of which comprises a plate 4 and a plurality of bone screws 3 for fixing the plate 4 to a bone 2 or a bone fragment.
  • the device 1 comprises a lever 7, which is fixedly connected to the plate 4 at its front end 11 and projects from the upper side 6 of the plate 4, and a handle 9 arranged at the rear end 10 of the lever 7 Bone 2 suitable concave underside 5 and opposite a convex top 6.
  • the plate 4 is fixed on the bone 2 by a plurality of bone screws 3, which on the one hand have a screw shaft 17 which can be screwed into the bone 2 and on the other hand comprise a screw head 18 which tapers conically against the screw shaft 17 and has a conical external thread 19.
  • the holes 13 in the plate 4 are complementary to the screw heads 18, are designed to taper conically towards the underside 5 and have an internal thread 14 (FIG. 5) which can be screwed to the screw heads 18, so that the screw heads 18 rigidly connect to the plate 4 can be screwed, even if the underside 5 of the plate 4 does not rest or only partially rests on the surface of the bone 2.
  • the bore axes 20 of the bores 13 in the plate 4 can be skewed or intersecting and cut the underside 5 here at an angle which deviates from 90 °.
  • the lever 7 is arranged relative to the plate 4 so that its central axis 8 intersects the top 6 and the bottom 5 orthogonally.
  • a handle 9 which is at an angle to the central axis 8 is detachably attached.
  • the plate 4 is preferably provided in the center with an elongated hole 16 extending from the upper side 6 to the lower side 5, so that the front end 11 of the lever 7, which is complementary to the elongated hole 16, can be pressed into the elongated hole 7.
  • the front end 11 of the lever 7 in the embodiment shown here is welded to the top 4 on the plate 4.
  • the lever 7 has a length L which corresponds approximately to 3-4 times the maximum dimension A of the plate 4 (FIG. 6).
  • the means 24 for the rotationally positive connection of the lever 7 to the handle 9 comprise a pin 42 arranged coaxially at the rear end 10, a non-circular cross-sectional area 23 orthogonal to the central axis 8, and one with the handle 9 connected, axially slidable over the pin 42 sleeve 25.
  • the non-circular cross-section 23 is formed here as a triangle with circular arcs 21 which are concentric with the central axis 8 and round off the corners of the cross-sectional area 23.
  • the bushing 25 has a coaxially continuous cavity 26, the cross-sectional area of which is considered orthogonal to the central axis 8 is complementary to the non-circular cross-sectional area 23 at the rear end 10 of the lever 7.
  • the bushing 25 is fixed at the rear end 10 of the lever 7 with a screw 22 which is coaxial with the central axis 8 and which can be screwed into a coaxial bore 27 provided with an internal thread at the rear end 10 of the lever 7.
  • the screw head 28 is when tightening the screw 22 on the outside End face of the sleeve 25 is pressed so that the sleeve 25 is clamped axially between the screw head 28 and the collar 31 arranged on the lever 7 at a distance s which is smaller than the axial length of the sleeve 25.
  • the embodiment shown in FIG. 4 differs from the embodiment shown in FIGS. 1 to 3 only in that the handle 9 is removed from the rear end 10 of the lever 7 and in its place a target device 37 at the rear end 10 of the lever 7 is arranged.
  • the target device 37 comprises a centering plate 29 which is pushed over the pin 42 at the rear end 10 of the lever 7.
  • the centering plate 29 lies axially on the collar 31 and is secured against rotation about the central axis 8 by an anti-rotation device 41.
  • the anti-rotation device 41 is realized by a pin 32 which is received in a bore 33 penetrating the centering plate 29 and the collar 31 parallel to the central axis 8.
  • the centering plate 29 is aligned in such a way that the central axes 35 of the centering sleeves 36 fastened to the centering plate 29 coincide with the bore axes 20 of the bores 13 in the plate 4 mounted on the front end 11 of the lever 7.
  • drill sleeves 34 with central bores 40 are provided, which are pushed into the sleeve openings 39 of the centering sleeves 36.
  • FIG. 5 to 7 show an embodiment of the plate 4 with a longitudinal axis 12 which, viewed in cross-sectional areas orthogonal to the longitudinal axis 12, has a curved underside 5 having a radius R.
  • This underside 5 is intended to rest on the surface of a bone 2 (FIG. 1).
  • the upper side 6 of the plate 4 opposite the underside 5 is beveled, when viewed in cross-sectional areas orthogonal to the longitudinal axis 12, so that the thickness of the plate 4 is approximately constant.
  • the plate 4 is triangular in shape orthogonal to the longitudinal axis 12 and has rounded corners 15.
  • An elongated hole 16 penetrates the plate 4 from the bottom 5 to the top 6, so that a complementary shaft segment at the front end 11 of the lever 7 is welded non-rotatably to the plate 4.
  • the plate 4 has a bore 13 which extends from the top 6 to the bottom 5 and tapers conically towards the bottom 5 and comprises a conical internal thread 14. So that's it Plate 4 can be rigidly attached to bone 2 by means of bone screws 3 (FIG. 1), which have a screw head 18 which has a conical thread.

Landscapes

  • Health & Medical Sciences (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (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 dispositif (1) de repositionnement de fractures osseuses comportant (A) un levier (7) présentant un axe central (8), pourvu d'une extrémité avant (11) coupant l'axe central (8) et d'une extrémité arrière (10) coupant l'axe central (8), et (B) des éléments de fixation (30) disposés sur l'extrémité avant (11) du levier (7), servant à la fixation du dispositif (1) à un os (2) ou un fragment osseux; (C) les éléments de fixation (30) comportent une plaque (4) présentant un côté inférieur (5) axialement terminal, perpendiculaire à l'axe central (8), conçu pour l'appui contre la surface d'un os (2), et un côté supérieur opposé (6), et (D) des vis à os (3) présentant respectivement une tige de vis (17) pouvant être vissée dans l'os (2) et une tête de vis (18); (E) la plaque (4) est traversée par au moins deux perçages (13) présentant respectivement un axe de perçage (20) du côté supérieur (6) vers le côté inférieur (5); et (F) au moins un perçage (13) est disposé de telle manière que l'axe de perçage (20) et l'axe central (8) forment un angle alpha > 0 DEG .
PCT/CH2003/000800 2003-12-03 2003-12-03 Dispositif de repositionnement de fractures WO2005053553A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/CH2003/000800 WO2005053553A1 (fr) 2003-12-03 2003-12-03 Dispositif de repositionnement de fractures
AU2003281904A AU2003281904A1 (en) 2003-12-03 2003-12-03 Fracture repositioning device

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/CH2003/000800 WO2005053553A1 (fr) 2003-12-03 2003-12-03 Dispositif de repositionnement de fractures

Publications (1)

Publication Number Publication Date
WO2005053553A1 true WO2005053553A1 (fr) 2005-06-16

Family

ID=34638004

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/CH2003/000800 WO2005053553A1 (fr) 2003-12-03 2003-12-03 Dispositif de repositionnement de fractures

Country Status (2)

Country Link
AU (1) AU2003281904A1 (fr)
WO (1) WO2005053553A1 (fr)

Cited By (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1922003A4 (fr) * 2005-09-08 2011-03-02 Securos Inc Plaque de fixation
US11123117B1 (en) 2011-11-01 2021-09-21 Nuvasive, Inc. Surgical fixation system and related methods

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0468192A2 (fr) 1990-07-23 1992-01-29 Synthes AG, Chur Plaque d'ostéosynthèse
US6235034B1 (en) * 1997-10-24 2001-05-22 Robert S. Bray Bone plate and bone screw guide mechanism
DE20110946U1 (de) * 2001-07-02 2001-09-06 Aesculap AG & Co. KG, 78532 Tuttlingen Knochenplatte
US6364880B1 (en) * 1994-03-28 2002-04-02 Gary Karlin Michelson Spinal implant with bone screws
US6379364B1 (en) * 2000-04-28 2002-04-30 Synthes (Usa) Dual drill guide for a locking bone plate
WO2002096294A2 (fr) 2001-05-29 2002-12-05 Synthes (U.S.A.) Levier d'alignement pour os

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0468192A2 (fr) 1990-07-23 1992-01-29 Synthes AG, Chur Plaque d'ostéosynthèse
US6364880B1 (en) * 1994-03-28 2002-04-02 Gary Karlin Michelson Spinal implant with bone screws
US6235034B1 (en) * 1997-10-24 2001-05-22 Robert S. Bray Bone plate and bone screw guide mechanism
US6379364B1 (en) * 2000-04-28 2002-04-30 Synthes (Usa) Dual drill guide for a locking bone plate
WO2002096294A2 (fr) 2001-05-29 2002-12-05 Synthes (U.S.A.) Levier d'alignement pour os
DE20110946U1 (de) * 2001-07-02 2001-09-06 Aesculap AG & Co. KG, 78532 Tuttlingen Knochenplatte

Cited By (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP1922003A4 (fr) * 2005-09-08 2011-03-02 Securos Inc Plaque de fixation
US8177818B2 (en) 2005-09-08 2012-05-15 Securos, Inc. Fixation plate
US8715324B2 (en) 2005-09-08 2014-05-06 Securos, Inc. Fixation plate
US11123117B1 (en) 2011-11-01 2021-09-21 Nuvasive, Inc. Surgical fixation system and related methods

Also Published As

Publication number Publication date
AU2003281904A1 (en) 2005-06-24

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