EP0957783A1 - Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques - Google Patents

Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques

Info

Publication number
EP0957783A1
EP0957783A1 EP96931968A EP96931968A EP0957783A1 EP 0957783 A1 EP0957783 A1 EP 0957783A1 EP 96931968 A EP96931968 A EP 96931968A EP 96931968 A EP96931968 A EP 96931968A EP 0957783 A1 EP0957783 A1 EP 0957783A1
Authority
EP
European Patent Office
Prior art keywords
probe
hole
nail
rod
metallic
Prior art date
Legal status (The legal status 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 status listed.)
Withdrawn
Application number
EP96931968A
Other languages
German (de)
English (en)
Inventor
Lucio Catamo
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Individual
Original Assignee
Individual
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 Individual filed Critical Individual
Publication of EP0957783A1 publication Critical patent/EP0957783A1/fr
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1725—Guides or aligning means for drills, mills, pins or wires for applying transverse screws or pins through intramedullary nails or pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/16—Instruments for performing osteoclasis; Drills or chisels for bones; Trepans
    • A61B17/17—Guides or aligning means for drills, mills, pins or wires
    • A61B17/1707—Guides or aligning means for drills, mills, pins or wires using electromagnetic effects, e.g. with magnet and external sensors
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B2017/00017—Electrical control of surgical instruments
    • A61B2017/00022—Sensing or detecting at the treatment site
    • A61B2017/00039—Electric or electromagnetic phenomena other than conductivity, e.g. capacity, inductivity, Hall effect

Definitions

  • TECHNICAL FIELD Many different techniques are employed in current o ⁇ hopaedic and traumatologic practice according to the bone segment involved and to special surgical indications.
  • intramedullary metallic means static, dynamic or mixed (Grosse empf, Kuntscher, A O . etc.). control segmental rotation and mantain the desired limb length.
  • the great advantage of intramedullary fixation is demonstrated by the simple technique, by the reducet extension of the skin incision for the nail insertion and by the prevention of fracture site opening. Nevertheless such procedure requires repeated x-ray controls, or image intensifier shots, with exposure of the patient and the O.R. personnel to ionizing radiations.
  • the recognition ofthe hole ofthe intramedullary nail and the subsequent aiming of a screw is possible by a simple and harmless device which uses an electromagnetic probe that localizes metallic means and reveals the holes with on-off mechanism 8
  • the probe is made by an inductive sensor of proximity which an internal high frequency oscillator that produces an elecromagnetic field in the immediate vicinity ofthe sensor.
  • the presence of a metallic object (actioner) in the action field of the sensor reduces the wideness of the oscillation since part of the electromagnetic energy is transferred from the sensor to the actioner on which dissipates for the
  • the probe consists of a head (site of the electromagnetic device) and a handle which is guided by the operator sliding along the limb where a nail is present.
  • the overall length is 15-20 cm.
  • the head has a circular configuration and delimits a central hole; while sliding along the limb indicates the presence of the metallic object; at the level ofthe nail hole the signal fades till a complete interruption once fl the probe hole overlaps the nail hole.
  • the skin point where the probe hole lies is the exact point where the incision may be made to drive correctly the interlocking screw.
  • an electromagnetic probe with a sensor (sensor of Hall) which reveals the electromagnetic field produced by a small magnet.
  • This small i ⁇ magnet is inse ⁇ ed in the hole of the nail inside a small pull-out screw (of metal or teflon).
  • the probe contains a stabilized feeder, an hall -effect sensor, a differential amplifier, a Schmitt trigger, a low power transistor with open collector. In resting condition the base of the final transistor is not polarized therefore that transitor does not conduct.
  • a magneto-resistive sensor made of special "bridge” resistances with a component sensitive to variations of the magnetic field which crosses them, in order to change the inner conductivity according to such 6 field. Having a bridge connection and feeding them with a continous tension on two opposite sides the bridge, one can obtain a variation ofthe differential tension on the other two sides proportional to the variation of the crossed magnetic field.
  • the magnet which stimulates probe is characterized by a tiny cylindrical magnet of few millimeters, able to produce a magnetic field axial to the intramedullary nail 47 hole. It is inserted in the heas of a screw or a rod (metallic, teflon, PVC or other material) which temporality plugs the nail hole.
  • a fourth possibility is represented by the electromagnetic signal produced by 2 l ⁇ microelectromagnets fixed to the rod which is introduced along the intramedullary nail: a high frequency signal, betwenn 20 Khz and 1 Mhz, is produced alternatively by the two microelectromagnets and is recorded by the probe on the skin.
  • the probe is made of 4 magneto-resistive sensor in crossed position for a more precise and straightforward research in the north, south, west and east directions A
  • the probe is contained in a small sterilisable cyiider with the shape of a pen, a few millimeters of diameter, and allows the longitudinal gliding along the limb which hosts the nail. It is introduced in a specific guide which, once the hole has been localized, allow the extracion ofthe probe and
  • the screw containing the small magnet that plugs the nail hole will then be extracted with a screwdriver, the whole rod containing the magnet will be directly pulled out or a metallic rod will be used to catch the magnet.
  • Electromagnetic probe for the recognition of metallic bodies and the discrimination of their holes durin special internal fixation techniques
  • Orthopaedics 3 Fig. 3.
  • Intramedullary metallic means in long bone fractures The coil emitts an electromagnetic field with the main magnetic axis corresponding to the hole axis. Blocking system ofthe rod aa ig 7 in long bone fractures the use of intramedullary metallic means.
  • the head has a circular configuration and delimits a central hole.
  • the 4 (8) magnetic sensor have their sensitive surfaces a plane at 90° to the tube axis.
  • the guide-tube allows the way through ofthe drill for the bone hole without losing the co ⁇ ect adjustment against the cortical bone, thanks to the special conformation ofthe head.
  • a current generator at 20 Khz sinusoidal frequency, with a rough 200 mA RMS intensity, is alternatively connected to 2 emitting coils in a mettalic or teflon rod (with preprinted circuit) in the medullary nail.
  • the coil emitts an electromagnetic field with the main magnetic axis co ⁇ esponding to the hole axis.
  • the detecting probe is formed by a teflon handle which supports an holed cylinder, containing 4 coils, each on a magnetic iron "semiolla", with the open side looking toward the head of the probe.
  • the metallic guide-tube is inserted in the cylinder hole with the faceted and pointed extremity for the adjustment against the cortical bone.
  • the 4 magnetic iron sensor have their sensitive surfaces on a plane at 90° to the tube axis, with at the final phase of the research coincides whith the one of the searched magnetic field.
  • the positions on the plane are simmetric and equidistant (crosswise).
  • the signals induced by the field itself are equidistant
  • Such signal are conditioned, filtered and amplified in tension and cu ⁇ ent by a superficially mounted circuit inserted into the probe handle.
  • the 4 amplified signal are transmitted by the connection cable to the instrumend containig the generator where they are received, refiltered and reamplified. Each signal is then revealed in
  • the signal in continuos cu ⁇ ent, with a tension equivalent to the wideness of the conesponding in alternating cu ⁇ ent, are measured by a microcomputer containig a digital analogic converter.
  • the guide-tube allows the way through ofthe drill for the bone hole without losing the co ⁇ ect adjustment against the cortical bone, thanks to the special conformation ofthe head.
  • a metallic sheath, removable from the guide-tube, allows the insertion ofthe scew (wose head has a wider diameter than the body) without removing the handle ofthe probe from its leaning point against the cortical bone (co ⁇ esponding

Landscapes

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

Abstract

La nécessité d'utiliser, parfois à l'excès, l'intensificateur d'image pour localiser les trous de vis pour les procédures de fixation interne au moyen d'un clou de raccordement implique un accroissement du risque d'exposition aux radiations touchant le chirurgien orthopédique, le personnel de la salle d'opération et le patient. L'invention concerne l'utilisation d'une sonde magnétorésistante qui recherche un signal produit par 2 microélectroaimants fixés à la tige qui est introduite le long du clou intramédullaire: un signal haute fréquence produit en alternance par les deux microélectroaimants est enregistré par la sonde sur la peau. Cette sonde est faite de 4 capteurs magnéto-résistifs disposés sur des axes orthogonaux pour une recherche plus précise et immédiate des points sur l'axe des x et l'axe des y. Un écran à 4 flèches montre le sens qu'on devrait suivre pour obtenir un centrage correct sur les trous. Une quatrième possibilité est représentée par un petit aimant au néodyme qui peut être introduit sous forme de 'bouchon' dans le trou du clou ou fixé à une tige insérée dans le canal du clou. Cela permet une localisation rapide et précise du trou et réduit la durée d'exposition aux radiations de même que la durée de l'intervention chirurgicale dans son ensemble.
EP96931968A 1995-10-13 1996-09-24 Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques Withdrawn EP0957783A1 (fr)

Applications Claiming Priority (3)

Application Number Priority Date Filing Date Title
ITBO950144 ITBO950144U1 (it) 1995-10-13 1995-10-13 Sonda elettromagnetica di individuazione di mezzi metallici e di disciminazione dei relativi fori per la attuazione di particolari
ITBO950144U 1995-10-13
PCT/IT1996/000179 WO1997013467A1 (fr) 1995-10-13 1996-09-24 Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques

Publications (1)

Publication Number Publication Date
EP0957783A1 true EP0957783A1 (fr) 1999-11-24

Family

ID=11340473

Family Applications (1)

Application Number Title Priority Date Filing Date
EP96931968A Withdrawn EP0957783A1 (fr) 1995-10-13 1996-09-24 Sonde pour localiser des trous dans des dispositifs de fixation internes orthopediques

Country Status (4)

Country Link
EP (1) EP0957783A1 (fr)
AU (1) AU7078896A (fr)
IT (1) ITBO950144U1 (fr)
WO (1) WO1997013467A1 (fr)

Families Citing this family (23)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE20015775U1 (de) 2000-09-12 2002-01-31 stryker Trauma GmbH, 24232 Schönkirchen Knochennagel
US6746404B2 (en) 2000-12-18 2004-06-08 Biosense, Inc. Method for anchoring a medical device between tissue
US6783499B2 (en) 2000-12-18 2004-08-31 Biosense, Inc. Anchoring mechanism for implantable telemetric medical sensor
EP1358852B1 (fr) * 2002-05-03 2005-12-14 Luciano Trinchese Appareil pour ostéosynthèse de fragments osseux par clou endomédullaire
US7060075B2 (en) 2002-07-18 2006-06-13 Biosense, Inc. Distal targeting of locking screws in intramedullary nails
JP4759266B2 (ja) * 2002-10-03 2011-08-31 ヴァージニア テック インテレクチュアル プロパティーズ，インコーポレイテッド 磁気標的装置
CA2500845C (fr) 2002-10-03 2012-07-31 Virginia Tech Intellectual Properties, Inc. Dispositif de ciblage magnetique
DE20314742U1 (de) * 2003-09-24 2003-12-04 Stryker Trauma Gmbh Zielgerät für einen Verriegelungsnagel sowie Verriegelungsnagel
ITTO20040292A1 (it) 2004-05-06 2004-08-06 Ezio Visentin Organo di collegamento atto ad essere introdotto all'interno di una struttura ossea di un corpo umano o animale e sistema per il rilevamento di almeno un punto di riferimento prestabilito nell'organo di collegamento stesso.
DE202005009809U1 (de) 2005-03-31 2005-08-25 Stryker Trauma Gmbh Datenübertragungssystem in Verbindung mit einem Implantat
FR2896399B1 (fr) * 2006-01-24 2008-03-14 Andre Joly Dispositif de detection magnetique pour la mesure en percutane des positions des trous de passage des vis de verrouillage d'une plaque orthopedique.
FR2896400A1 (fr) * 2006-01-24 2007-07-27 Andre Joly Dispositif de detection magnetique pour la mesure de la position et de l'orientation des trous de fixation distale d'un appareillage chirurgical orthopedique centromedullaire canule verrouillable.
US7785330B2 (en) * 2006-09-11 2010-08-31 Depuy Products, Inc. Method and apparatus for distal targeting of locking screws in intramedullary nails
US9220514B2 (en) 2008-02-28 2015-12-29 Smith & Nephew, Inc. System and method for identifying a landmark
CN104799904B (zh) * 2008-02-28 2017-10-27 史密夫和内修有限公司 用于识别标记的系统和方法
US8945147B2 (en) 2009-04-27 2015-02-03 Smith & Nephew, Inc. System and method for identifying a landmark
US9031637B2 (en) 2009-04-27 2015-05-12 Smith & Nephew, Inc. Targeting an orthopaedic implant landmark
RU2012157125A (ru) 2010-06-03 2014-07-20 Смит Энд Нефью, Инк. Ортопедический имплантат
US8890511B2 (en) 2011-01-25 2014-11-18 Smith & Nephew, Inc. Targeting operation sites
US9526441B2 (en) 2011-05-06 2016-12-27 Smith & Nephew, Inc. Targeting landmarks of orthopaedic devices
CA2839060A1 (fr) 2011-06-16 2012-12-20 Smith & Nephew, Inc. Alignement chirurgical a l'aide de references
ITCZ20130022A1 (it) * 2013-12-09 2015-06-10 Pietro Arcidiacono Sistema e metodo di allineamento di chiodi endomidollari
US11457934B2 (en) 2018-07-24 2022-10-04 DePuy Synthes Products, Inc. Intramedullary nail with wire or magnet for targeting of a bone-anchor locking hole

Family Cites Families (6)

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LU84209A1 (fr) * 1982-06-17 1984-03-07 Cen Centre Energie Nucleaire Installation pour determiner la position d'un corps metallique dans un milieu peu conducteur de l'electricite
CA2073266A1 (fr) * 1991-07-09 1993-01-10 Stryker Corporation Systeme de ciblage distal
RU2046377C1 (ru) * 1992-06-01 1995-10-20 Юрий Яковлевич Реутов Металлоискатель
EP0589592A3 (fr) * 1992-09-22 1994-10-19 Orthofix Srl Moyens de centrage pour orifices de clous intramédullaires.
IT1265088B1 (it) * 1993-05-20 1996-10-30 Maurizio Luigi Valsecchi Dispositivo magnetico per la individuazione della posizione e direzione dell'asse di forature ossee nelle tecniche di inchiodamento
US5411503A (en) * 1993-06-18 1995-05-02 Hollstien; Steven B. Instrumentation for distal targeting of locking screws in intramedullary nails

Non-Patent Citations (1)

* Cited by examiner, † Cited by third party
Title
See references of WO9713467A1 *

Also Published As

Publication number Publication date
WO1997013467A1 (fr) 1997-04-17
ITBO950144U1 (it) 1997-04-14
ITBO950144V0 (it) 1995-10-13
AU7078896A (en) 1997-04-30

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