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WO1994028812A1 - Dispositif d'immobilisation d'une fracture osseuse - Google Patents

Dispositif d'immobilisation d'une fracture osseuse Download PDF

Info

Publication number
WO1994028812A1
WO1994028812A1 PCT/GB1994/001292 GB9401292W WO9428812A1 WO 1994028812 A1 WO1994028812 A1 WO 1994028812A1 GB 9401292 W GB9401292 W GB 9401292W WO 9428812 A1 WO9428812 A1 WO 9428812A1
Authority
WO
WIPO (PCT)
Prior art keywords
cable
bone
fracture fixation
bone fracture
fixation apparatus
Prior art date
Application number
PCT/GB1994/001292
Other languages
English (en)
Inventor
Kevin Hardinge
Original Assignee
Kevin Hardinge
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
Priority claimed from GB939312271A external-priority patent/GB9312271D0/en
Priority claimed from GB9403167A external-priority patent/GB9403167D0/en
Priority claimed from GB9410049A external-priority patent/GB9410049D0/en
Application filed by Kevin Hardinge filed Critical Kevin Hardinge
Priority to AU69343/94A priority Critical patent/AU6934394A/en
Publication of WO1994028812A1 publication Critical patent/WO1994028812A1/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
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
    • 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

Definitions

  • the present invention relates to bone fracture fixation apparatus and, in particular, to bone fracture fixation apparatus incorporating a cable as the fixation means.
  • fixator apparatus comprising; a bone fixating member, at least one cable guide
  • the present application combines the aforementioned priority applications.
  • Fractures occur when an external force acts on the bone and in healthy bones the bone consistency can usually withstand the forces applied to it by plates and screws both during corrective surgery and thereafter.
  • the bone may not be able to withstand the forces applied to it by the plates and screws, for example, a long bone, such as
  • bone fracture fixation apparatus comprising: a cable and a cable securing device, said
  • cable securing device having at least one guide means adapted to receive a portion of the said cable and deformably operable to capture the said cable therein.
  • the cable has two ends, one of which ends is thickened so that
  • the cable securing device comprises a crimpable member .
  • the crimpable member accommodates the said cable and may then be crimped to securedly
  • the said guide means is in the form of an aperture.
  • the apparatus may be used with a bone plate which is adapted to be secured to a bone by a cable using the said cable securing device.
  • the cable securing device may comprise a bone plate which has guide means deformably
  • bone fracture fixation apparatus comprising: a cable and a cable securing device, the said cable securing device incorporating a bone plate having at least one guide means extending at least partially over, through, under or around the said
  • bone plate for accommodating the said cable and means for fixing the cable with respect to the said bone plate.
  • the plate comprises a crimpable member.
  • the crimpable member may be incorporated as part of the bone plates but, preferably, comprises a separate member which accommodates the said cable and which may be crimped to securedly accommodate the cable therein.
  • the crimpable member has at least one guide means adapted to
  • the cable has two ends, one of which ends is thickened so that it will not pass through or be received in the said guide means.
  • the said guide means is in the form of an aperture.
  • the thickened end of the cable may not be received in the said separate crimpable member and, in this configuration, it r ⁇ ay or may not be received in the said guide means on the bone plate depending upon the construction thereof.
  • a bulky securing device has been located on the upper surface of the trochanter in order to produce the required fixation.
  • the bulkiness of the device causes irritation to overlying soft tissue and also the adjoining abductor
  • Such a device may also hinder muscle movement and through a combination of discomfort, muscle weakening and hindered muscle movement the patient frequently has a limp and suffers discomfort.
  • present invention provides a considerable improvement to currently available fixation systems and, allows fixation of the trochanter by means of a cable and securement of the cable by the securing device in a position removed from the
  • trochanter results in a greatly improved technique.
  • the securing device in such applications has at least two channels each adapted to receive at least one cable end and deformably operable
  • the channels are fully enclosed in the body of the holding device and form a hole passing therethrough for accommodating cable and, by crimping,
  • a method of bone fracture fixation comprising the following steps:
  • the cable is located to oppose the relevant bone surfaces and the un-thickened cable end is then threaded through the securing device channel or hole.
  • the bone surfaces are then compressed using a cable tensioner and upon obtaining the required compression the securing device is crimped at the appropriate point. The tension is maintained throughout this step so that after the next step, the cutting of the cable at the end of the un-thickened cable, the tension in the cable being released the cable retracts into the channel.
  • the said guide means comprises a hole passing through the cable securing device or a groove passing thereover.
  • the said cable guide means are spaced at intervals and along the said bone plate when found therein.
  • the said guide means comprise a hole
  • the said bone plate is an elongate member shaped in the longitudinal direction to be close fitting with the bone to which it is applied and shaped in the lateral direction to be sufficiently curved to accommodate lateral curvature of the bone.
  • the plate has spaced longitudinally therein cable guide means extending in a lateral direction designed to accommodate bone encircling cable therethrough.
  • the cable guide means may- pass across a fenestration of the plate so that
  • a compression device can be introduced to crimp the cable guide means thus securing the cable in the plate and simultaneously securing the plate on the bone
  • spaced arcuate grooves are located along one
  • the grooves or holes are spaced in pairs and the arcuate indentations are adjacent each of the said pairs on one side thereof.
  • the arcs allow a close fitting crimp member to be accommodated therein which crimp member also accommodates the cable which passes through the adjacent groove or hole for crimping engagement of the said cable. If a cable is
  • the thickened end of the cable abuts on to the other longitudinal side of the cable plate and the cable is thereafter threaded through the hole or groove in the cable plate and accommodating adjacent crimp member to be passed around the adjacent bone and then back through the second hole or
  • the cable is achieved.
  • fenestrations may consist of two semi-ovoid shapes symmetrically aligned to each other and separated by a bridge extending laterally across the plate and containing at least one guide means therein, extending therethrough, so that a compression device introduced to the bridge by way of the
  • fenestrations may crush the said bridge, effectively fixing the cable in the cable guide means.
  • the fenestration is of a size that would not materially weaken the plate and
  • a plurality of paired fenestrations may be located at intervals along the longitudinal axis of the plate according to the number of cable guide means required for securing the plate to the bone.
  • the plates may be of a stainless steel or other suitable material and are
  • the crimps are also preferably, malleable to allow crimping of the cable.
  • Fig.1 shows an elevational view of a cable securing device and cable
  • Fig.2 is a front elevation of a bone plate with fenestrations
  • Fig.3 is a side elevation of a bone plate
  • Fig.4 is a sectional view of a bone plate
  • Fig.5(a) shows a widened end cable
  • Fig.5(b) shows a cross-section through a widened end cable and bone
  • Fig.6 shows a front elevation of a bone plate with arcuate side grooves
  • Fig.7 shows a bone plate crimp and cable during assembly
  • Fig.8(a) shows an enlarged plan view of a crimp
  • Fig.8(b) shows a cross-section through a crimp.
  • the cable securing device 2 comprises two elongate enclosed channels 4,6 adapted to receive cable 8 therethrough, said cable entering at points 10,12 and exiting at points 14,16 respectively.
  • a cable tensioner grips the cable and provides the necessary cable tension to give the required compression of the bone surfaces.
  • the securing device is crimped at points 10 and 12 and while tension is maintained the cable is then cut at points 14 and 16.
  • an elongate plate member 1 has at intervals along the
  • a plurality of paired semi-ovoid fenestrations 4 having a bridge 22 extending laterally therebetween along the axis of symmetry of the paired fenestrations, the said bridge containing a pair of cable guide means, (transverse port holes, not shown) extending laterally therethrough and further extending through the plate member.
  • the side of the plate member 18 is shown to have spaced along its length a plurality of pairs of portholes 24, said pairs spaced along its
  • a cross-section of the plate 18 is curved to accommodate the bone surface on the underside thereof and the upper surface is also curved closely mimicking the normal bone surface and thus providing more comfort when in contact with soft tissue.
  • a cable 28 having a widened end 30 is shown separately and in use respectively.
  • the widened end 30 of the cable abuts on to cable guide means 32 such that only the non-widened end 34 of the cable need be secured in the guide means or in a crimp (not shown) as appropriate.
  • an elongate bone plate 36 has at intervals along the length thereof a series of spaced pairs 38,40, 40,42, 44,46 and 48, 50 extending laterally from one longitudinal side of the bone plate to the other.
  • the said bone plate 36 having formed in one longitudinal side thereof, adjacent each
  • arcuate cut-outs 52 to 58 are designed to accommodate a close fitting crimp member such as that shown in
  • a bone plate 36 is shown with four arcuate cut outs along one longitudinal side thereof and resting against the length of bone 60 which bone is compressed by circumferential cable 62, which circumferential cable has widened end 64 abutting onto hole 38 on the non cut-out longitudinal side of the
  • said bone plate passes through the said hole and through an accommodating matching hole 68 in an adjacent crimp 66 accommodated and close fitting with cut
  • an enlarged plan view of the crimp 66 shows a segment form which is adapted to be close fitting with arcuate cut outs formed in the side of a bone plate such as 36.
  • Two spaced laterally extending channels 72 and 74 extend from the arcuate side of the crimp to the straight side thereof.
  • a cross-.sectional view of the crimp shows the shape of the channels 72 and 74 which are wider in the interior and toward the base of the crimp and thus allow crimping of the over hanging portion 76 and 78 when cable is accommodated therein.
  • the inside edges of the channel are serrated (not shown) to aid in gripping the cable when the crimp is compressed.
  • crimp and bone plate can be varied to suit requirements.
  • shape of the crimp can be varied depending upon the application and, in particular, depending upon which part of the bone surface it is to be fixed adjacent to. Such an embodiment could be utilised during trochanteric osteotomy where it is necessary to secure the cut trochanter back onto the top of the femur. By passing the cable across the trochanter a number of times depending upon requirements and securing the two ends of the cable using the crimp as described

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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

Dispositif d'immobilisation d'une fracture osseuse comprenant: un câble et un dispositif de fixation du câble possédant au moins un moyen de guidage conçu pour recevoir une partie dudit câble et se déformant, afin de maintenir ledit câble. Dans un deuxième aspect de l'invention, on incorpore une plaque osseuse dans le dispositif de fixation du câble. Un câble possède généralement une deuxième extrémité conçue pour venir en butée sur ledit moyen de guidage, de telle manière que seule l'extrémité mince dudit câble nécessite d'être fixée. La fixation est généralement effectuée au moyen d'un sertissage, par l'intermédiaire de la déformation du moyen de guidage du câble. L'invention s'utilise avantageusement, entre autres, dans l'immobilisation de fractures et dans la fixation du trochanter pendant le remplacement d'une hanche artificielle.
PCT/GB1994/001292 1993-06-15 1994-06-15 Dispositif d'immobilisation d'une fracture osseuse WO1994028812A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU69343/94A AU6934394A (en) 1993-06-15 1994-06-15 Bone fracture fixation apparatus

Applications Claiming Priority (6)

Application Number Priority Date Filing Date Title
GB939312271A GB9312271D0 (en) 1993-06-15 1993-06-15 Improved bone plate fixation
GB9312271.1 1993-06-15
GB9403167A GB9403167D0 (en) 1994-02-18 1994-02-18 Surgical cable
GB9403167.1 1994-02-18
GB9410049A GB9410049D0 (en) 1993-06-15 1994-05-19 Fracture fixation apparatus
GB9410049.2 1994-05-19

Publications (1)

Publication Number Publication Date
WO1994028812A1 true WO1994028812A1 (fr) 1994-12-22

Family

ID=27266722

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GB1994/001292 WO1994028812A1 (fr) 1993-06-15 1994-06-15 Dispositif d'immobilisation d'une fracture osseuse

Country Status (2)

Country Link
AU (1) AU6934394A (fr)
WO (1) WO1994028812A1 (fr)

Cited By (15)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GR1003502B (el) * 1999-04-26 2001-01-03 Πλακα συγκρατησης καταγματων μειζονος τροχαντηρος
US6387099B1 (en) 2000-03-24 2002-05-14 Synthes (Usa) Surgical cable crimp
US8142434B2 (en) 2007-10-17 2012-03-27 Stryker Trauma Gmbh Cam-locking of cable for fracture plate
US8425617B2 (en) 2002-12-20 2013-04-23 Smith & Nephew, Inc. Knee prostheses with convex slope on portion of tibial articular surface
US8968318B2 (en) 2007-02-28 2015-03-03 DePuy Synthes Products, LLC Grooved crimp with a set screw
US8984720B2 (en) 2011-12-28 2015-03-24 Pioneer Surgical Technology, Inc. Tensioning instrument and method
US9265543B2 (en) 2011-12-27 2016-02-23 Pioneer Surgical Technology, Inc. Bone plate system and method
US9333021B2 (en) 2012-11-21 2016-05-10 Pioneer Surgical Technology, Inc. Tensioning instrument
US9730799B2 (en) 2006-06-30 2017-08-15 Smith & Nephew, Inc. Anatomical motion hinged prosthesis
US10314635B2 (en) 2014-05-28 2019-06-11 A&E Advanced Closure Systems, Llc Tensioning instruments
US10463410B2 (en) 2016-01-22 2019-11-05 A&E Advanced Closure Systems, Llc Bone plate having a connector and a connector for a surgical loop
US10485600B2 (en) 2016-07-29 2019-11-26 A&E Advanced Closure Systems, Llc Surgical cable tensioner
US10765465B2 (en) 2012-11-21 2020-09-08 A&E Advanced Closure Systems, Llc Tensioning instrument
US10820935B2 (en) 2017-02-03 2020-11-03 Stryker European Holdings I, Llc Tensioning cable locking device
US10881437B2 (en) 2013-12-05 2021-01-05 A&E Advanced Closure Systems, Llc Bone plate system and method

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2231352A1 (fr) * 1973-05-28 1974-12-27 Protek Ag
FR2614781A1 (fr) * 1987-05-05 1988-11-10 Galline Yves Dispositif d'attachement et outils pour sa mise en place, notamment pour attacher le grand trochanter au femur
DE3803435C1 (en) * 1988-02-05 1989-09-21 Ethicon Gmbh & Co Kg, 2000 Norderstedt, De Implanted splint for rib fractures
WO1993003681A1 (fr) * 1991-08-27 1993-03-04 Howmedica Inc. Piece d'insertion de positionnement de cable de cerclage

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2231352A1 (fr) * 1973-05-28 1974-12-27 Protek Ag
FR2614781A1 (fr) * 1987-05-05 1988-11-10 Galline Yves Dispositif d'attachement et outils pour sa mise en place, notamment pour attacher le grand trochanter au femur
DE3803435C1 (en) * 1988-02-05 1989-09-21 Ethicon Gmbh & Co Kg, 2000 Norderstedt, De Implanted splint for rib fractures
WO1993003681A1 (fr) * 1991-08-27 1993-03-04 Howmedica Inc. Piece d'insertion de positionnement de cable de cerclage

Cited By (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
GR1003502B (el) * 1999-04-26 2001-01-03 Πλακα συγκρατησης καταγματων μειζονος τροχαντηρος
US6387099B1 (en) 2000-03-24 2002-05-14 Synthes (Usa) Surgical cable crimp
US8425617B2 (en) 2002-12-20 2013-04-23 Smith & Nephew, Inc. Knee prostheses with convex slope on portion of tibial articular surface
US10149768B2 (en) 2002-12-20 2018-12-11 Smith & Nephew, Inc. High performance knee prostheses
US11369477B2 (en) 2002-12-20 2022-06-28 Smith & Nephew, Inc. High performance knee prostheses
US9320605B2 (en) 2002-12-20 2016-04-26 Smith & Nephew, Inc. High performance knee prostheses
US9402729B2 (en) 2002-12-20 2016-08-02 Smith & Nephew, Inc. High performance knee prostheses
US9707087B2 (en) 2002-12-20 2017-07-18 Smith & Nephew, Inc. High performance knee prosthesis
US10779949B2 (en) 2006-06-30 2020-09-22 Smith & Nephew, Inc. Anatomical motion hinged prosthesis
US9730799B2 (en) 2006-06-30 2017-08-15 Smith & Nephew, Inc. Anatomical motion hinged prosthesis
US8968318B2 (en) 2007-02-28 2015-03-03 DePuy Synthes Products, LLC Grooved crimp with a set screw
US9510882B2 (en) 2007-02-28 2016-12-06 DePuy Synthes Products, Inc. Grooved crimp with a set screw
US10512497B2 (en) 2007-02-28 2019-12-24 DePuy Synthes Products, Inc. Grooved crimp with a set screw
US8142434B2 (en) 2007-10-17 2012-03-27 Stryker Trauma Gmbh Cam-locking of cable for fracture plate
US9265543B2 (en) 2011-12-27 2016-02-23 Pioneer Surgical Technology, Inc. Bone plate system and method
US8984720B2 (en) 2011-12-28 2015-03-24 Pioneer Surgical Technology, Inc. Tensioning instrument and method
US10426532B2 (en) 2012-11-21 2019-10-01 A&E Advanced Closure Systems, Llc Bone plate system and method
US9561064B2 (en) 2012-11-21 2017-02-07 Pioneer Surgical Technology, Inc. Bone plate system and method
US10765465B2 (en) 2012-11-21 2020-09-08 A&E Advanced Closure Systems, Llc Tensioning instrument
US9333021B2 (en) 2012-11-21 2016-05-10 Pioneer Surgical Technology, Inc. Tensioning instrument
US10881437B2 (en) 2013-12-05 2021-01-05 A&E Advanced Closure Systems, Llc Bone plate system and method
US10314635B2 (en) 2014-05-28 2019-06-11 A&E Advanced Closure Systems, Llc Tensioning instruments
US11298172B2 (en) 2014-05-28 2022-04-12 A&E Advanced Closure Systems, Llc Tensioning instruments
US10463410B2 (en) 2016-01-22 2019-11-05 A&E Advanced Closure Systems, Llc Bone plate having a connector and a connector for a surgical loop
US11413077B2 (en) 2016-01-22 2022-08-16 A&E Advanced Closure Systems, Llc Bone plate having a connector and a connector for a surgical loop
US10485600B2 (en) 2016-07-29 2019-11-26 A&E Advanced Closure Systems, Llc Surgical cable tensioner
US10820935B2 (en) 2017-02-03 2020-11-03 Stryker European Holdings I, Llc Tensioning cable locking device

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Publication number Publication date
AU6934394A (en) 1995-01-03

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