JPH04505405A - Bone marrow central nail fixation system for fixation of fractures - Google Patents

Abstract

(57) [Summary] This bulletin contains application data before electronic filing, so abstract data is not recorded.

Description

[Detailed description of the invention] Bone marrow central needle fixation system for fixing fractures Bone bone to fix fracture parts Many nail fixations/stem implants within the medullary canal are generally well known. In addition, research on many nail fixation systems that meet the following criteria: is being done.

- Nailing should be performed as close to the fracture as possible to prevent vascularization. The possibility of vascularization must be maximized.

- Nails must be able to support the fracture as quickly as possible. No.

The single nail (na mouth) is used to counter bending or to make it easier to insert into the medullary canal. It must have some degree of elasticity.

However, the use of such nail fixation systems is currently limited. However, they are not completely satisfactory, and there are various drawbacks in their manufacture. It has the following. In fact, when inserting a nail, it is necessary to match the nail diameter to the bone canal diameter. It takes a certain amount of time to measure the The use of machines is frequently required. Furthermore, intraosseous vascularization (vascularization) zation), the generation of callus, and techniques that cannot be ignored. It is accompanied by subsequent bleeding.

Additionally, different diameters are also available to accommodate the types of bones that arise from the patient's morphology. It is necessary to stock a large number of nails of various lengths. This is clearly a significant cost It has an impact on

Another drawback is that the bone wall in contact with the nail is subject to constant pressure.

Additionally, for some types of nails, the lower support surface may be quite sharp. Ru. Furthermore, there is a large muscle mass surrounding the bone, especially in the femur, so it is necessary to treat it immediately. This makes it difficult to reduce the fractured area. This fixes the nail. It is difficult to handle, and it is difficult to handle.

In the patent specification of DE 92308 5, several strips combined at both ends are Expandable nail fixation systems constructed of teal wire are known. The part near the nail The steel wires in this section have a swivel that prevents any possibility of movement. It is fixed by looking into it. Such a design better prevents bone fragments from rotating around each other. For this reason, this type of nail cannot be fixed mechanically.

The present invention aims to solve these drawbacks.

The first problem that the present invention aims to solve is to eliminate the need to ream bone canals. The second problem is to continue vascular regeneration by removing nail fixation. It is important to do it properly and properly.

Such problems are solved by nail fixation systems having multiple rods.

This/stem has rods that use a solid area at the lower end of the bone and form one set. Insert the bone from the top to the bottom through the opening formed near the top of the bone. It is inserted separately into the medullary canal. The coupling sleeve is installed in this opening. This coupling sleeve is formed to bundle each of the rods together. It is possible to roughly limit the translational movement of the rod. this /The stem is also reducible against elastic deformations.

Another object of the invention is the provision of an automatic lock/stem. To achieve this purpose Therefore, each rod has a straight section that cooperates with the sleeve and a small section that also cooperates with the medullary canal. It is preformed to be limited by at least one bend. Each of the first and second notes is made of a material that is deformed when inserted but returns to its original shape after insertion. will be accomplished.

This system will have both flexible and hard systems. Therefore, the lofts should be bundled and passed over the entire height of the sleeve, parallel to each other and slit. It has a hole that penetrates perpendicularly to the tube. Each loft is modified by the elasticity of the loft itself. In order to receive the load from the side of the fracture, the stress from each mouth is concentrated on the sleeve. It is obvious to do so.

To prevent the risk of rod migration to the top, a The parts are attached. i.e. to secure the rod against movement , which has a member that acts as a stopper for fixation.

The other problem that the present invention seeks to solve is that bone material loss occurs. It's about responding. In this regard, after fixing the stopper to the sleeve, the stopper has a free space. to form a reserve chamber in case the rod protrudes due to loss of bone material. It is something. In some cases, the plug also has a collar for fixation in the corresponding position of the bone. It may have -.

The pond problem to be solved by the present invention is to embed the loft precisely in the required position. This means that each rod can be guided (i.e., these The lateral condyle, medial condyle, and bore are shaped so that they form a true non-rotating tripod. posterior notch and femoral trochlea (troc) hlea). Each of the tasks involves inserting within the lower part of the bone. Short bending section and more emphasis to guide the rod according to the position to be inserted The problem is solved by an end that is a curved part. Similarly, the sleeve is angled It has positioning means for positioning.

Another important problem that the present invention seeks to solve is that all possible types of fractures and Our goal is to provide universal nails that are compatible with various types and shapes. to solve this problem, Each rod is the same length, no longer than the longest possible bone. The length is determined so that

The invention will be explained in more detail using the accompanying drawings.

Figure 1 shows a fracture fixed by the needle fixation/stem means of the present invention. .

FIG. 2 shows a preferred embodiment of each of the lofts in the system of the present invention. .

FIG. 3 is an enlarged plan view taken along line 3-3 in FIG.

FIG. 4 is an enlarged bottom view of a portion corresponding to FIG. 1.

Figure 5.6.7 shows different embodiments of the cobbling sleeve used in the invention. FIG.

Figures 8 and 9 show different embodiments of the end of the mouth.

FIG. 10 is a front view showing an embodiment of the sleeve pond.

FIG. 11 shows the sleeve shown in FIG. 1O in a state where the bone is nailed.

FIG. 12 is a front view taken from line 12-12 in FIG. 11.

Figures 13.14.15 and 16 show the main embedding surfaces of the nail-fixed 7 stem of the present invention. It shows.

The bone (0) shown in Figure 1 has a nail fixation system implanted in the fractured area. this /The stem is composed of a plurality of rods 1 and a coupling sleeve. Ru.

Each of the orifices (1) is a normal opening formed very close to the head of the bone (0). Through the mouth (01), it is inserted into the bone marrow of the bone (0) from end to end. is formed. For this, the rods are inserted separately into the opening (01), Precisely guided to form a clamp to cooperate with the solid part of the lower end of the bone Ru. An opening (Ol) provides a means of restricting translational movement, and each opening (Ol) In order to make it possible to bundle the The grease sleeve (2) is attached. As shown in Figure 2, each mouth and C are It is formed from a straight part (la) part and a bent part (1b), and the bent part has a large radius. It consists of a bent part (1bl) and an end part (1b2) that is bent more emphatically. Each mouth .

For example, the bent portions (lbl-1, b2) of the board form a tripod shape so as not to rotate. As shown, the lateral condyle, medial condyle, Bosteriano 1 (posterior note) h) and for precise implantation in the required area of the femoral trochlea. Enables introduction. In this case, the end (1b2) is spherical (Fig. 9) or It must be noted that it needs to be spatula-shaped (Figure 8). Straight section of each rod (1a) has the significance of cooperating with the shape of the sleeve (2). In addition, each loft , when inserted from the opening (01), it can be deformed by elastic force, and after insertion, the final It is made of a material that can return to its original state. Preferably a rod is a steel material capable of limited elastic deformation, work-hardened to an elastic force of 1440 MPa It is formed of type Z2 CND 17-13. A serious problem is that The total length (L) of each mouth is the same and longer than the longest possible bone. The length has been determined to be long.

By way of example, this length is on the order of approximately 60 cm. In the following description, rod A straight section of can protrude from the sleeve. In this case, the protrusion of the rod The exposed part is cut off at the terminal end of the sleeve (2). Therefore, according to the body You can obtain nails made by

Over the entire height of the sleeve (2), - pairs of through holes are formed, which are aligned with each other. This hole (2a) is parallel to the hole (2a), and is for passing the opening (1) through and for bundling.

The diameter of the hole (2a) is determined so that each opening can be freely slid (Fig. 1). and Figure 3). The holes are preferably evenly spaced around the circumference and are It is preferable to arrange it near the circumference of the tube (2). There are 4 of these holes (2a) Although it is preferable that it is, it is not limited to this. The sleeve (2) is Each opening and do is loaded with the fracture part by its own elastic force, so that The purpose is to provide a concentration of load on each rod. Therefore The mating sleeve (2) of the opening (1) is then act as a truly dynamic system that responds itself to changing situations. Ru.

Particular attention must be paid to the embodiments shown in FIGS. 1C, 11, and 12.

Here, the sleeve (2) is inserted into the opening (Ol) and then fixed to the bone. can be done. Under these circumstances, this assembly is completely stable. .

Regarding the nail fixation system, it is possible to eliminate movement along the length of the bone, reducing the risk of fractures. Any rotation of the parts can be prevented. For example, the sleeve (2) with a lateral protrusion for a screw-type fixing member (3) (see Figure 11). are doing. In this case, the insertion opening for holding the CI ID (01) with the sleeve The part is machined in such a way that it is possible to fix the protrusion for passage (see figure 12). For example, the sleeve (2) may be made of stainless steel 316 or china. Made of tanium TA aV ELI type metal. Similarly, its outer surface is Smooth or grooved. The sleeve (2) is fixed to the sleeve, e.g. It should be noted that there are features such as No 1chi (2C) that are located at an angle of There is. The length of the sleeve varies, e.g. from 40 to 100 mm. It is within the range.

As particularly shown in FIGS. 5, 6 and 7, the top of the sleeve is located on the outside of the sleeve. Any movement of the mouth in the direction of the top should be restricted under the given circumstances. or a member is provided to fix the rod to prevent movement. It is. For example, as shown in Figure 5, the plugging member is located at the center of the sleeve (2). It is constructed as a wonon ear (4) which is fixed with a screw at a portion. Figure 6 and in FIG. 7 the plug member is configured as a plug (5). This stopper (5) is It is screwed onto the top end of the sleeve (2). The stopper (5) is large. A cap member or cap member of the relevant part of the whole bone at the large metamorphosis (uochanter) is a protruding collar part (5) for fixing the screw inserted to form a sleeve. a) may be provided. When there is no bone content or there is no bone content Free space to provide a spare room for storing the protrusions of the , mouth and do (e) It is also planned to apply a plug member (4) or 5) on the sleeve in order to leave a has been done.

Regardless of the embodiment, the plug member can accept a withdrawn sleeve. You should pay attention to this point.

13, 14, 15 and 16, the application of the nail fixation system of the present invention The technology used will be explained.

A bone incision is made at the large trochanter.

At this level, the hole (01) for inserting the rod and the storage chamber for the sleeve (2) are formed. (Figure 13).

Reduction pins of a known and preferred type align the two bone fragments resulting from the fracture. It is inserted into the hole (Ol) to reduce the fracture. under the given circumstances This allows the reduction pin to be passed through the fractured area more easily and at the lower part of the canal. To adjust and manipulate the bottle, apply it to the reduction pin itself within the apex of the medullary canal. It should be noted that a fixed reduction lever is used. In addition, for those skilled in the art Descriptions of well-known techniques will be omitted here.

Thereafter, each of the mouth and 1-do is separately inserted into the opening (01) as described above. (See Figure 14). That is, for example, to form a tripod shape so that it does not rotate. , lateral condyle, medial condyle, posterior notch and It is placed in the femoral trochlea. Public for rod operation A bright magnifying glass is used according to the known method.

The sleeve (2) is inserted and placed within the opening (01) (see Figure 15).

The protrusion of the rod (1) is cut by a known and preferred means such as cutting pliers. disconnected.

A plug member (4) or (5) is attached to the sleeve (2).

If necessary, the sleeve can be removed, for example by screw means inserted into the protrusion (2C). Fixed.

Suture the skin.

The effects of the present invention are clear from the above description. Below, I will list the most important points. .

The sleeve can be used in combination to create a resilient and fixed nail fixation system. Therefore, each rondo moves separately and receives a concentrated weight. Lower automatic fixation, i.e. rotation Provide a tripod-like shape that does not rotate. Intraosseous vascularization on) continues. Perform a nail fixation system appropriate to the size of the bone. In other words, considering Adapt the rod to the available bone length. counteracts loss of bone substance and improves apical direction A preliminary chamber is provided between the plug member and the top end of the sleeve to allow movement of the rod. It has the ability to form.

summary The present invention relates to a bone marrow central nail fixation system equipped with multiple orifices. A feature of the invention is that the rod is resilient to elastic deformation and that formed near the top of the bone to form one set using solid regions at the ends. It is inserted separately into the medullary canal of the bone from top to bottom through an orifice. A force-2 pulling sleeve is attached to the opening of the rod to bundle each of said rods. at a point where it is possible to bend and further restrict the translational movement of said loft. be.

international search report international search report FR9000941 SA　43568

Claims (12)

[Claims] 1. In a central bone marrow nail fixation system comprising a plurality of rods (1), said rods the top of the bone so that the heads form one set using the solid area of the lower end of the bone. into the medullary canal of the bone from the nuchal part to the bottom part through the opening (01) formed in the vicinity. inserted separately, A coupling sleeve (2) is attached to the opening, and a coupling sleeve (2) is attached to the rod (1). ) are formed to bundle each of the rods, and further limit the translational movement of the rods. is possible, A nail fixation system characterized by being reducible even against elastic deformation. 2. The rod (1) has at least one bent part (1b) in contact with the medullary canal and a straight part. The nail fixing according to claim 1, characterized in that it has a straight part (1a) in contact with the rib. system. 3. The rod (1) is deformable during insertion and returns to its initial state after insertion. 3. The nail fixation system according to claim 2, characterized in that it is made of a material that is compatible with the nail system. 4. Passing and bundling the rod (1) over the entire height of the sleeve (2) Claim 1 characterized in that it has a set of vertically passing parallel holes (28) for Nail fixation system as described. 5. The neck of the sleeve (2) acts as a plug to fix the translational movement of the rod (1). Nail according to claim 4, characterized in that the working plug elements (4), (5) are fixed. Fixed system. 6. The plug member (5) has a collar (5a) for fixation to the corresponding part of the bone. 6. The nail fixation system of claim 5, further comprising: 7. Said plug member (5) fixed on the sleeve (2) prevents damage caused by loss of bone material. In order to provide or leave a preliminary chamber to enable the rod (1) to protrude. Nail fixation system according to claim 5 or 6, characterized in that it has a space (e). . 8. The holes (2a) of the sleeve are arranged evenly inside the circumference. 5. The nail fixation system of claim 4. 9. The sleeve (2) has positioning means (2c) for determining its angle. The nail fixation system according to claim 1, characterized in that: 10. a member (2b) for fixing the sleeve (2) to a corresponding part of the bone; 2. The nail fixation system of claim 1, further comprising: 11. The curved portion (1b) is for guiding the rod to the position to be placed in the bottom of the bone. Nail fixation system according to claim 2, characterized in that it has a short end with a small curvature. . 12. Each of the rods (1) is of equal length and has a length greater than the longest bone possible. 2. The nail fixation system of claim 1, wherein: