WO2005096972A1 - Dispositif pour repositionner et retenir de maniere intraoperable des fragments de fracture osseuse - Google Patents

Dispositif pour repositionner et retenir de maniere intraoperable des fragments de fracture osseuse Download PDF

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Publication number
WO2005096972A1
WO2005096972A1 PCT/EP2005/000928 EP2005000928W WO2005096972A1 WO 2005096972 A1 WO2005096972 A1 WO 2005096972A1 EP 2005000928 W EP2005000928 W EP 2005000928W WO 2005096972 A1 WO2005096972 A1 WO 2005096972A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
threaded section
wire
fastening element
thread
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.)
Ceased
Application number
PCT/EP2005/000928
Other languages
German (de)
English (en)
Inventor
Stefan Fabian
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.)
Koenigsee Implantate und Instrumente zur Osteosynthese GmbH
Original Assignee
Koenigsee Implantate und Instrumente zur Osteosynthese 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 Koenigsee Implantate und Instrumente zur Osteosynthese GmbH filed Critical Koenigsee Implantate und Instrumente zur Osteosynthese GmbH
Priority to EP05715229A priority Critical patent/EP1729662A1/fr
Publication of WO2005096972A1 publication Critical patent/WO2005096972A1/fr
Anticipated expiration legal-status Critical
Ceased 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
    • A61B17/56—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
    • A61B17/683—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin comprising bone transfixation elements, e.g. bolt with a distal cooperating element such as a nut
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/34—Trocars; Puncturing needles
    • A61B17/3472—Trocars; Puncturing needles for bones, e.g. intraosseus injections
    • 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
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/846—Nails or pins, i.e. anchors without movable parts, holding by friction only, with or without structured surface
    • A61B17/848—Kirschner wires, i.e. thin, long nails
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8665—Nuts
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts

Definitions

  • the invention relates to a device for intraoperable reduction and retention of broken bone fragments according to the preamble of claim 1.
  • a number of devices are known from the prior art, with which bone fracture fragments occurring in particular in the case of splinter fractures are to be fixed in their position and their mutual growth should be promoted by compression.
  • rod-shaped or wire-shaped connecting elements are used, which are guided through the fragments and anchored in a counter cortex.
  • German published patent application DE 197 51 505 AI describes a device for fixing and retaining bone fractures, in which a connecting element in the form of a wire, pin or screw nail is driven into the fragmented bone and anchored by means of a trocar tip and a cutting thread , Due to the tensioning action of a clamping disk arranged on the connecting element, a compressing and stabilizing action is exerted on the fragmented bone.
  • a connecting element in the form of a wire, pin or screw nail is driven into the fragmented bone and anchored by means of a trocar tip and a cutting thread , Due to the tensioning action of a clamping disk arranged on the connecting element, a compressing and stabilizing action is exerted on the fragmented bone.
  • the possible uses of such a device are only limited to cases in which the counter cortex receiving the cutting thread has sufficient strength and material strength.
  • Complicated fractures in which there is no sufficiently massive countercortical bone and the bone to be treated is split up into a large number of smaller fragments, do not offer the possibility of accepting an additional tensile force screw thread and thus a connecting element as described in the above-mentioned document.
  • the compression disc specified there makes it relatively difficult to regulate and set the compression pressure required for the fragmented bone.
  • Such a device is therefore only suitable as a permanent implant for a relatively limited use. rich in bone fractures, but not as an intraoperable and therefore only temporarily usable in a healing process.
  • the fixation of a bone plate that supports the healing process of the bone is not possible with such a device.
  • German patent DE 44 18 974 C2 There, a drill wire for stabilizing broken bone fragments and a drill attachment and tension screwdriver for anchoring the drill wire in the bone material are described.
  • the drilling wire is driven into the fragmented bone and anchored there instead of the aforementioned clamping disk using a threaded sleeve with an external thread that cuts into the bone material.
  • the threaded sleeve can also be stabilized with a clamping nut.
  • the additional insertion of the threaded sleeve requires an even larger proportion of sufficiently large and undamaged bone fragments and is therefore not suitable for more complicated fractures with a larger number of smaller fragments.
  • the structure of the device described and in particular the anchoring of the drill wire by means of the threaded sleeve mentioned can be regarded as a permanent implant, again using a bone plate is not possible.
  • an adequate fixation and compression also allows for smaller fragments of broken bones and can be used as an intraoperable and thus temporarily used tool in the bone.
  • the use of a bone plate should be possible as an option.
  • the required device should also allow a simple and precise setting and regulation of the necessary compression pressure on the bone fragments or the fracture joint.
  • a drill wire is used for the device according to the invention. This has a first threaded section immediately following a drill tip and a second threaded section spaced apart from the first threaded section. In connection with this, a fastening element is screwed onto the first and / or the second threaded section, which compresses the bone from the outside or forms a counter bearing.
  • the drilling wire does not necessarily have to be anchored in a weak cortex, but can be driven through it.
  • the first threaded section located immediately behind the drill tip protrudes from the opposite cortex and can receive a first fastening element which, in conjunction with a second fastening element arranged on the second threaded section, compresses the bone fragments pierced by the drilling wire.
  • the drilled bone structure of the counter cortex does not have to form an abutment for the exciting effect of the fastening element on the second threaded section.
  • the first threaded section can also be anchored directly in the opposite cortex.
  • the counter cortex forms the abutment for the compressing action of the fastening element on the second threaded section, with the rotational adjustment of the second threaded section cut screwed fastener the compression pressure applied to the bone can be regulated.
  • At least one spacer sleeve pushed onto the drill wire, bridging at least one thread-free section and transmitting the compression pressure of the fastening element arranged on the second threaded section to the bone can be provided.
  • This embodiment makes it possible to use a drilling wire of a fixed length for bones of different sizes.
  • this expedient design ensures that the surgeon has a sufficiently large range of movement and manipulation.
  • a first and / or a second bone plate pushed onto the tapped wire and fixed by the fastening element or the spacer sleeve and pressing the bone can be provided.
  • the arrangement of drilling wire, fastening element and spacer sleeve serves in addition to its compression effect for the application and precise fixing of the bone plate.
  • the fastening element and / or the spacer sleeve can advantageously have a threaded section which can be screwed to a complementary thread of the bone plate.
  • the fastening element or the spacer sleeve not only press-fit onto the surface of the bone plate, but are firmly anchored in the bone plate, this forming an additional pressure surface of the fastening element or the spacer sleeve firmly connected to the spacer sleeve or fastening element on the bone surface.
  • the counter thread or the threaded section can expediently be designed as parts of a conical thread. In this case, an optimized transmission of force between the spacer sleeve or fastening element and the bone plate and a positional stabilization of the overall arrangement are made possible.
  • the fastening element is advantageously designed as a knurled nut or a wing nut.
  • the shape of the nut ensures a particularly well-defined contact and contact surface between the fastening element and the spacer sleeve or Bone plate.
  • the wing shape enables the surgeon to operate the fastening and tensioning element in a particularly simple manner.
  • the drill wire expediently has, at its end opposite the trocar tip, an attachment which is suitable for receiving a drive device.
  • the drill wire can thus be mechanically driven into the bone material.
  • 1 shows an exemplary embodiment of a drilling wire
  • FIG. 2 shows an exemplary embodiment of a fastening element in the form of a wing nut
  • FIG. 4 shows a first exemplary arrangement of the device in a fragmented bone
  • Fig. 5 shows a second exemplary arrangement of the device in a fragmented bone with a fastener as an abutment
  • Fig. 6 shows a third exemplary arrangement of the device in a fragmented bone with a fastening element as an abutment and a spacer sleeve with a conical threaded section.
  • the drill wire expediently consists of metallic drawn bar steel, pure titanium, titanium alloys or stainless steel known from the prior art, such as surgical instrument steel or implant steel.
  • the diameter of the drill wire is less than 5 millimeters and is expediently in the range of 1 to 3 mm.
  • the end designed as a drilling tip can be, for example, a triple-surface trocar tip or another comparable trocar device.
  • the length of the drill wire and in particular the lengths of the sections 30, 40 and 50 are in principle arbitrary.
  • the first threaded section 30 is expediently designed as a metric thread with a length of more than 10 mm.
  • the length of the thread-free section 40 can be varied in a range from approximately 70 mm to 170 mm, smaller or larger lengths being possible.
  • the second threaded section 50 consists of a further preferably 20 to 40 mm long metric thread.
  • the end section 110 consists of a cylindrical rod or attachment, the diameter of which corresponds to or is smaller than the core diameter of the second threaded section 50. It is designed in particular for clamping in a corresponding device of a drilling machine.
  • the total length of the drilling wire should expediently not exceed 300 mm. This is preferably in the range from 100 to 250 mm.
  • FIG. 2 shows an exemplary fastening element in the form of a wing nut 60 in a sectional illustration and a view from the left.
  • the wing nut consists of a body 61 containing a support surface 65 and a wing section 62 serving to actuate and tighten the wing nut.
  • the support surface 65 of the body 61 can expediently be designed for direct contact with the bone surface.
  • the wing nut has an internal thread 63 at least in sections.
  • the wing nut contains an unthreaded through bore 64 which is enlarged compared to the internal thread 63 and is essentially guided through the wing section 62.
  • 3 shows exemplary embodiments of a spacer sleeve 70.
  • This consists of a rod-shaped sleeve body 71 of any shape and the contact surfaces of the end heads 72 forming the spacer sleeve.
  • the end heads 72 are advantageously designed to be suitable for direct contact with the bone surface.
  • the spacer sleeve 70 can thus rest on the bone with one of the end heads 72 even without a bone plate.
  • the sleeve body 71 has a central inner bore 73 which extends through the end heads 72 and whose diameter is larger than the largest outer diameter of the sections of the drill wire 10, so that the spacer sleeve 70 can be displaced over the entire length of the drill wire.
  • an end head of the spacer sleeve 70 is replaced by a threaded section 100, which can in particular be designed as a conical thread.
  • FIG. 4 shows a first exemplary use of the device according to the invention.
  • the drilling wire 10 is screwed into a fragmented bone 150 using the drilling tip 20 and the first threaded section 30 and anchored in the counter cortex 151.
  • a bone plate 80 is then slid through a screw hole over the drill wire 10 toward the fragmented bone 150.
  • the thread-free section 40 of the drilling wire 10 is bridged by the subsequently pushed on spacer sleeve 70.
  • spacer sleeve 70 instead of the single long spacer shown in FIG. 4, several shorter spacers can also be used.
  • a fastening element for example the wing nut 60 described in FIG.
  • FIG. 5 shows a further example of use of the device according to the invention.
  • the drill tip 20 is guided through the counter cortex 151 in connection with the first threaded section 30 and pierces it, so that the first threaded section 30 is exposed on the opposite side of the fragmented bone 150.
  • a wing nut 60 is screwed onto the first threaded section 30 and, in connection with the counter cortex, serves as an abutment for the tensioning and compressing effect of the arrangement of spacer sleeve 70, bone plate 80 and the second wing nut screwed onto the second threaded section 50, as explained in connection with FIG. 4 60 forms.
  • FIG. 6 shows a further example of the arrangement according to the invention based on the exemplary form of use shown in FIG. 5.
  • the bone plate 80 has a conical internal thread 90 which engages with the conical threaded section 100 of the spacer sleeve 70 shown in FIG. 3.
  • this configuration exerts the wing nut 60 arranged on the second threaded section 50
  • Compressive force is introduced evenly over the flanks of the conical thread into the bone plate without friction losses and a stabilizing function results.
  • the device examples explained in the figures can also be used exclusively for precise positioning and fixing of the bone plate 80, without compressing the bone.
  • the direction of the drill wire to be inserted is specified by an angle-stable drill bush screwed into the plate.
  • the arrangement of the drilling wire, spacer sleeve and wing nut is removed in a sequence of steps which is the reverse of its assembly, as soon as the bone plate introduced via the device has been permanently screwed to the bone structure or otherwise attached to it.
  • the suitable for the passage of the drilling wire or for the drill bush The hole used in the bone plate can now be used to fill with another screw, taking advantage of the cavity worked into the bone structure by the drill wire. In this case, additional trauma is avoided.

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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

L'invention concerne un dispositif pour repositionner et retenir de manière intraopérable des fragments de fracture osseuse. Ce dispositif comprend un fil de perçage qui est introduit dans les fragments de fracture osseuse et qui comprime ces derniers. Cette invention est caractérisée en ce que le fil de perçage comprend une première section filetée qui suit directement une pointe de perçage, ainsi qu'une deuxième section filetée qui est espacée de ladite première section filetée et qui est reliée avec un élément de fixation lequel est vissé sur la première et/ou la deuxième section filetée et qui comprime l'os de l'extérieur.
PCT/EP2005/000928 2004-03-19 2005-01-31 Dispositif pour repositionner et retenir de maniere intraoperable des fragments de fracture osseuse Ceased WO2005096972A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
EP05715229A EP1729662A1 (fr) 2004-03-19 2005-01-31 Dispositif pour repositionner et retenir de maniere intraoperable des fragments de fracture osseuse

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
DE102004014036.7 2004-03-19
DE200410014036 DE102004014036B4 (de) 2004-03-19 2004-03-19 Vorrichtung zum intraoperablen Fixieren von Knochenfragmenten

Publications (1)

Publication Number Publication Date
WO2005096972A1 true WO2005096972A1 (fr) 2005-10-20

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ID=34961104

Family Applications (1)

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PCT/EP2005/000928 Ceased WO2005096972A1 (fr) 2004-03-19 2005-01-31 Dispositif pour repositionner et retenir de maniere intraoperable des fragments de fracture osseuse

Country Status (3)

Country Link
EP (1) EP1729662A1 (fr)
DE (1) DE102004014036B4 (fr)
WO (1) WO2005096972A1 (fr)

Families Citing this family (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE202008000914U1 (de) 2008-01-22 2008-03-20 Stryker Trauma Gmbh Kirschnerdraht-Klammer
US8425554B2 (en) 2008-12-16 2013-04-23 Arthrex, Inc. Suture passing K-wire

Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE908906C (de) * 1950-06-02 1954-04-12 Dr Med H C Ernst Pohl Federnde Knochenschraube, besonders fuer Schraeg- und Laengsbrueche
FR1161507A (fr) * 1956-10-03 1958-09-01 Sarl Drapier Compresseur externe à pression continue pour réduction des fractures osseuses
US4185624A (en) * 1976-05-31 1980-01-29 Giulio Gentile Device for externally exerting a holding action on bone tissues
DE4418974A1 (de) * 1993-06-23 1995-01-05 Forster Franz Ing Gmbh Kompressionsgewindebohrdraht
US6238417B1 (en) * 1998-04-30 2001-05-29 J. Dean Cole Method for fixing at least two bone segments
US6302887B1 (en) * 1998-07-20 2001-10-16 Joseph John Spranza Hardware for high strength fastening of bone

Family Cites Families (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4456005A (en) * 1982-09-30 1984-06-26 Lichty Terry K External compression bone fixation device
DE4119720A1 (de) * 1990-06-15 1991-12-19 Thomas Dr Med Schewior Draht oder nagel mit haltemittel, vorzugsweise fuer einen fixateur
US6464713B2 (en) * 1990-06-28 2002-10-15 Peter M. Bonutti Body tissue fastening
DE19751505A1 (de) * 1997-11-21 1999-05-27 Friedrich Schiller Uni Jena Bu Vorrichtung zur Fixlerung und Retention von Knochenfrakturen

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE908906C (de) * 1950-06-02 1954-04-12 Dr Med H C Ernst Pohl Federnde Knochenschraube, besonders fuer Schraeg- und Laengsbrueche
FR1161507A (fr) * 1956-10-03 1958-09-01 Sarl Drapier Compresseur externe à pression continue pour réduction des fractures osseuses
US4185624A (en) * 1976-05-31 1980-01-29 Giulio Gentile Device for externally exerting a holding action on bone tissues
DE4418974A1 (de) * 1993-06-23 1995-01-05 Forster Franz Ing Gmbh Kompressionsgewindebohrdraht
US6238417B1 (en) * 1998-04-30 2001-05-29 J. Dean Cole Method for fixing at least two bone segments
US6302887B1 (en) * 1998-07-20 2001-10-16 Joseph John Spranza Hardware for high strength fastening of bone

Also Published As

Publication number Publication date
DE102004014036B4 (de) 2010-11-04
DE102004014036A1 (de) 2005-10-13
EP1729662A1 (fr) 2006-12-13

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