WO2014182189A1 - Système de fixation osseuse - Google Patents

Système de fixation osseuse Download PDF

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Publication number
WO2014182189A1
WO2014182189A1 PCT/RU2013/000381 RU2013000381W WO2014182189A1 WO 2014182189 A1 WO2014182189 A1 WO 2014182189A1 RU 2013000381 W RU2013000381 W RU 2013000381W WO 2014182189 A1 WO2014182189 A1 WO 2014182189A1
Authority
WO
WIPO (PCT)
Prior art keywords
plate
bone
washers
prismatic
holes
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/RU2013/000381
Other languages
English (en)
Russian (ru)
Inventor
Михаил Ефимович КУПИТМАН
Игорь Александрович АТМАНСКИЙ
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
Priority to PCT/RU2013/000381 priority Critical patent/WO2014182189A1/fr
Priority to RU2015111297/14A priority patent/RU2605497C2/ru
Publication of WO2014182189A1 publication Critical patent/WO2014182189A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • A61B17/8023—Variable length plates adjustable in both directions
    • 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
    • A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage

Definitions

  • the invention relates to medicine, in particular to medical equipment, namely to surgical devices for the treatment of the musculoskeletal system of a person located along the bone and intended for osteosynthesis of bone fragments, namely, it is used in traumatology for the treatment of various injuries of bones and joints.
  • a device for osteosynthesis and fixation of the bone having a bone plate (12) including an edge, a protrusion, an edge, a threaded protrusion, a threaded rod, a threaded edge or a threaded hole (16), as well as a bone screw provided with a head.
  • the leveling sleeve (4) has a single-thread external thread and is screwed into the edge, protrusion, edge, threaded protrusion, threaded rod, threaded edge or threaded hole.
  • the leveling sleeve is screwed in with an internal thread.
  • the threaded hole includes a multi-thread internal thread (18) (DE 102010042930 (A1) - 2012-04-26).
  • Known adjustable bone plate which is made longitudinally curved, including a description of the use as the first plate having an end defined by at least two spaced teeth, and an end having means for attaching the plate to the body structure, i.e., to the bone ; and a second plate, a second plate having an end defined by at least two straight holes for introducing the teeth, and an end having means for attaching the plate to the body structure, i.e., to the bone; and a locking assembly for blocking the teeth in the holes and fixing the plate along the entire length (EP1807011 (A1) - 2007-07-18).
  • this bone plate has a longitudinal axis, a bone plate, includes upper surface, lower surface, first opening for introducing the head of the first bone anchor.
  • the first hole is configured and adapted to fix the shaft of the first bone anchor along the first axis.
  • the second hole is located at a distance from the first hole along the longitudinal axis.
  • the second hole serves to introduce the head of the second bone anchor, it is configured and adapted to fix the rod of the second bone anchor along the second axis.
  • the first hole and the second hole are configured so that the first axis and the second axis define one plane and intersect at a point below the bottom surface.
  • the rods of the first and second bone anchors can touch each other or almost touch at the point of intersection, so that the first and second bone anchors form a ligament (EP1633260 (A2) - 2006-03-15).
  • a known bone plate (1) which has an upper side (2), a lower side (3) facing the bone, a first end (11), a second end (12) and several holes (4) located between both ends (11, 12 ) and connecting the upper side (2) with the lower side (3), these holes serve to insert bone screws.
  • Two of the aforementioned holes of the plate (4) are created by combining two partially overlapping drilled holes (5, 6) of different types.
  • the first (5) of the two holes is round and cylindrical, having an internal thread (7) and a cylindrical axis (9).
  • the second drilled hole (6) has a conical axis (10) and tapers from the upper side (2) to the lower side (3) in the form of a truncated cone.
  • the named second drilled hole (6) has an internal thread (8).
  • the cylindrical axis (9) is located at a distance A from the conical axis (10), which is not equal to zero (EP1677693 (A1) - 2006-07-12).
  • Known bone plate (1) for osteosynthesis which has an upper surface (2), a lower surface (3) on the side of the bone and several holes (5) connecting the above upper and lower surfaces (2; 3), these holes are located along the longitudinal axis (4) plates and have central axes (6) for insertion of bone screws (10).
  • a department (8) is created in the form of a hollow cone, which extends beyond the bottom surface (3) and which is concentric with respect to the central axis (6).
  • the bone plate provides angular and axial stability, even ate the plate is relatively thin (EP 1294298 (A1) - 2003-03-26).
  • a known bone plate and a bone plate system containing a plate equipped with holes for installing screws (WO2012042592 (A1) - 2012-04-05).
  • a set of bone plates for orthopedic injury is known, which for the construction of a block of bone plates (100) for fixing broken bones includes many plate elements (104,116), a connecting element (108) for storing many plate elements in the desired configuration and many blocking elements (140) for attaching plate elements to the connecting element (EP1958580 (A1) - 2008-08-20).
  • Known bone plate with an elongated hole with a partial thread which includes the upper part (1), the lower part (2) to create contact with the bone and several holes (4) created along the longitudinal axis of the plate (3) and connecting the upper part and the lower part (1) and (2) for holding bone screws (11).
  • the diameter di of at least one of these holes (4) is larger along the longitudinal axis of the plate (3) than the diameter d q transverse to the longitudinal axis of the plate (3).
  • at least one of these holes (4) has an internal thread (5). This internal thread (5) tightens the arc by at least 180 °.
  • this bone plate can be applied as a compression plate, as well as the so-called internal system that does not cause risk (Pat. Jf2 2 367 085 sa. publ. 2007/08/07).
  • Known bone plate with dynamic compression suitable for internal fixation and stabilization of bone fractures includes: an elongated structure capable of shortening in the longitudinal direction and having at least two ends, a structure having at least two fixation points adapted to fix to broken bones with fixation points on the opposite side of the fracture.
  • An elastic polymer cable stretches longitudinally and connects when tensioned to an elongated structure that can cause longitudinal contraction of the structure (WO2007149325 (A2) - 2007-12-27).
  • the known bone plate has a complex structure and, in addition, there are no needles (thin rods) for reinforcing articular surfaces and creating dynamic fixation.
  • the known technique of bone osteosynthesis does not allow to combine the use of knitting needles for reinforcing bone fragments and pins, and does not allow creating the effect of damping dynamic fixation of bone fragments.
  • the design of the known plate does not provide for the use of knitting needles to reinforce bone fragments and pins, and does not allow the creation of damping dynamic fixation of bone fragments.
  • the basis of the present invention is the creation of a damping dynamic fixation of bone fragments by combining the reinforcement of the articular surfaces with beams of cantilever knitting needles and screws fixed to the bone plate.
  • the osseous fixation system contains a set of standard sizes of supports made in the form of support plates, washers, attachments, connecting elements, and knitting needles, while in each set the support plate is made in the form of a stepped prism equipped with evenly spaced connecting holes , part of these holes has a thread, part without a thread, the washers are cylindrical, at least one groove is made on one of the end surfaces of the holes, in addition, the washers are made of prisms ical on one of its surfaces formed sipe, reconstructive console console is formed as a step plate, wherein the plate is formed one step shaped and is equipped with a threaded hole, and the other formed prismatic and equipped with a rectangular figured groove divided into several threaded half-openings, in addition, on the base plate by means of connecting elements, prismatic and cylindrical washers, spokes are cantileverly fixed at one end, a cantilever reconstructive attachment is fixed at the other end, which is made stepwise and curly in the form of polyhedra inter
  • each connecting hole in the base plate shaped, from interconnected holes having different diameters, and to equip one of them with thread.
  • each of the connecting element is made in the form of a compression screw for the possibility of fixing bone fragments with a screw at the location of the compression screw.
  • the support plate can be shortened, containing at least two steps, with each step having one connecting figured hole.
  • the connecting elements in the form of shortened compression screws, which will prevent migration in the postoperative period.
  • the curly groove is equipped with limiters, which perform, if necessary, in the form of rounded protrusions.
  • the groove and stops form holes equipped with threads for compression screws.
  • the connecting element in the form of a compression screw with a neck.
  • both screws and spokes can be used as fixing elements in the system, which increases the range of its use.
  • Figure 1 characterizes the layout of the osseous fixation system according to the invention
  • FIG. 2 - illustrates a connecting element made in the form of a screw
  • Fig.Z - illustrates a connecting element made in the form of a screw equipped with a neck
  • FIG. 4 - shows a shortened compression bolt
  • FIG. 5 characterizes cylindrical washers equipped with one groove and four, located opposite each other on opposite sides of the central hole;
  • 6 - shows a prismatic washer, one side of which is made with notches located in mutually opposite directions and forming protrusions;
  • FIG. 7 illustrates a cantilever reconstructive attachment in the form of a stepped plate, one step of which is equipped with threaded holes, and the other is a rectangular figured groove equipped with limiters in the form of rounded protrusions forming several threaded holes;
  • FIG. 8 - shows a base plate made of shortened two steps equipped with one connecting curly hole
  • FIG. 9 - shows a lockable screw with a thread on the head
  • Fig, 10 - shows a cortical screw
  • Bone fixation system 1 contains a set of standard sizes of supports made in the form of support plates, washers, attachments, connecting elements, and knitting needles (Figure 1).
  • the support plate 2 is made in the form of a stepped prism having a step 3 higher in height and a step 4 smaller in height.
  • Step 3 is equipped with evenly spaced connecting holes 5 of complex shape made of two connected holes, one of which has a tapered thread and the other has no thread, but is made in the form of an oval shape, the number of which depends on the length of the step 3.
  • Step 4 is equipped with a hole 6 , the execution of which is similar to the hole 5.
  • the washers 7 are made cylindrical, on one of the end surfaces of which no more than four grooves 8 are made (Fig. 1, 5).
  • the washers 9 are made prismatic and equipped with holes located along its longitudinal axis (Fig. 1, 6). Notches 10 are made on one of the surfaces of each washer 9. The latter are made in mutually opposite directions parallel to the one and the other sides of the prism forming protrusions.
  • Console reconstructive prefix 11 is made in the form of a stepped plate, which consists of protrusions (steps) 12 connected by prismatic jumpers. One of the sides of such a jumper is equal to the side of the hexagon.
  • each protrusion 12 of the cantilevered reconstruction plate 11 is made shaped, in particular in the form of a hexagonal prism. Each protrusion 12 is equipped with a cylindrical hole 13.
  • the reconstructive plate 11 may have protrusions 12 from one or more.
  • the number of protrusions 12 depends on the treatment task.
  • Another stage 14 is made prismatic and equipped with a rectangular figured groove 15. The latter is divided by several stops in the form of rounded protrusions, forming several holes with threads.
  • the height of the step 14 is two times less than the height of the reconstructive plate 11.
  • spokes 16 are cantilevered at one end (FIG. 1).
  • a cantilever reconstructive attachment 11 is fixed at the other end via a step 14 and a fastening connecting element 17.
  • Cortical screws 23 are placed on the supporting plate 2 in the connecting holes 5.
  • Locking screws 22 are placed on the supporting plate 2 in the connecting holes 24.
  • the connecting elements 17 and 18 can be structurally made in the form of screws (Fig. 2, 3, 4, 9).
  • a spoke is fixed in the middle part of the plate with a washer 7 and a compression connecting screw 21 to the plate 2, a spoke is fixed.
  • each of the connecting element 17, 18 is made in the form of a compression screw to prevent the bone fragment from escaping from the cortical layer and fixation strength (Figs. 2, 3, 4, 9).
  • the connecting elements 17, 18 be made in the form of shortened compression screws, which will prevent migration in the postoperative period (Fig. 4).
  • the figured groove 15 is equipped with stops 19, which, if necessary, are made in the form of rounded protrusions (Fig. . 7). These stops divide the figured groove 15 into several half-openings having a tapered thread corresponding to the thread of the tapered part of the elements 21,17,18.
  • each connecting element 17, 18 in the form of a screw it is advisable to each connecting element 17, 18 in the form of a screw to perform with the neck 20 (Fig. 3).
  • Bone fixation system is used as follows.
  • a support plate 2 is attached along the bone fragment (Fig. 1).
  • a support plate 2 is attached along the bone fragment (Fig. 1).
  • the connecting elements 17, 18, 21, 9 which can be used either with compression or lockable screws.
  • screws 10 which are used as cortical screws.
  • washers 7 or an additional cantilever reconstructive plate 1 are used.
  • the design of the support plate 2, in particular the stage 4, allows to fix the stage 14 of the cantilever reconstruction plate 11 in the cylindrical part equipped with a thread 24 of the figured hole 5 (Fig. 1).
  • the step 14 has a prismatic shape and a rectangular figured groove 15.
  • the figured groove 15 is equipped with limiters 19 (Fig. 7).
  • Each of the stops 19 is made in the form of rounded protrusions forming a cell-holes.
  • each of the three cell-holes has a thread corresponding to the thread of the conical part of the element 17, 18, 21, 22 (Fig. 2, 3, 4).
  • the stage 12 of the cantilever reconstruction plate 11 is made shaped, in the form of 3 (several) hexagonal prisms that connect the prismatic bridges, one of the sides of such a bridge is equal to the side of the hexagon.
  • Hexagonal steps 12 are equipped with connecting holes that are axially evenly spaced relative to each other 13.
  • the connection of the base plate 2 and the cantilever reconstructive prefixes 1 1 using steps, respectively, 4 and 14 allows you to assemble the support plate 2 and the console reconstructive console 1 1, with a minimum vertical size (Fig. 1). If necessary, depending on the treatment tasks, due to the prismatic sections, the cantilever reconstructive prefix 11 can be bent to reduce its length, or bent at the required angle to fix the bone fragment.
  • the proposed osseous fixation system allows reinforcing joint surfaces and bone fragments with knitting needles, carried out in different directions and strained or stretched using this system; fixing them to the osseous plate superimposed on one of the bone fragments.
  • This connection allows you to create a damping dynamic fixation of bone fragments through the use of fixation elements in the form of a console mounted on the osseous plate by means of connecting elements.
  • the proposed osseous fixation system expands the fixation capabilities of the known osseous fixators, depending on the treatment tasks, and allows more reliable fixation of comminuted, intraarticular fractures and fragments of various sizes by changing the shape of the osseous system by a combination of its various elements.
  • the proposed system with the movement of the limb and dynamic loads on its fragments allows you to create a deformation of the spokes, causing micromotion at the fracture level and stimulating osteogenesis.
  • the proposed bone system is easy to manufacture, has a low cost and is easy to use during surgical intervention in the treatment of various injuries and diseases of bone tissue and articular ends.
  • the proposed osseous fixation system is universal, can be easily converted depending on the medical tasks and the capabilities of the medical institution and has a minimum size.

Landscapes

  • 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 se rapporte au domaine de la médecine, notamment des techniques médicales, et concerne des instruments chirurgicaux permettant de traiter l'appareil locomoteur de personnes, qui sont disposés le long de l'os et sont destinés à l'ostéosynthèse de fragments osseux ; l'invention peut notamment être utilisée en traumatologie afin de traiter diverses blessures des os et des articulations. Ce système de fixation osseuse (1) comprend un ensemble de gabarits de support se présentant sous forme de plaques de support, de rondelles, d'adaptateurs, d'éléments de connexion et de tiges disposés lors du montage en fonction de l'objectif de traitement. Dans chaque ensemble, la plaque de support (2) se présente sous forme d'un prisme gradé comprenant des ouvertures de connexion (5, 6) disposées régulièrement. Les rondelles (7) sont cylindriques et sur une surface d'extrémité de ces dernières est formée au moins une gorge. Les rondelles (9) sont en outre prismatiques et sur une des surfaces de chacune d'elles sont formées des gorges (10). Un adaptateur de reconstruction de type console (11) se présente sous forme d'une plaque gradée. Un degré (12) de la plaque présente des motifs et comprend des ouvertures (13). L'autre degré (14) de l'adaptateur de reconstruction de type console (11) est de forme prismatique et comprend une gorge rectangulaire à motifs (15). Des tiges (16) sont fixées en console sur la plaque de support (2) sur une des extrémités par le biais d'éléments de connexion (17, 18) et des rondelles prismatique et cylindrique (7, 9). Sur l'autre extrémité de la plaque de support (2), un adaptateur de reconstruction de type console (11) est fixé via le degré, et les éléments de connexion (17, 18) sont disposés dans les ouvertures de connexion (5, 6). Les éléments de connexion se présentent sous forme de vis et de boulon de blocage, et les ouvertures de connexion dans la plaque (24) comportent un filetage.
PCT/RU2013/000381 2013-05-06 2013-05-06 Système de fixation osseuse Ceased WO2014182189A1 (fr)

Priority Applications (2)

Application Number Priority Date Filing Date Title
PCT/RU2013/000381 WO2014182189A1 (fr) 2013-05-06 2013-05-06 Système de fixation osseuse
RU2015111297/14A RU2605497C2 (ru) 2013-05-06 2013-05-06 Накостная фиксационная система

Applications Claiming Priority (1)

Application Number Priority Date Filing Date Title
PCT/RU2013/000381 WO2014182189A1 (fr) 2013-05-06 2013-05-06 Système de fixation osseuse

Publications (1)

Publication Number Publication Date
WO2014182189A1 true WO2014182189A1 (fr) 2014-11-13

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PCT/RU2013/000381 Ceased WO2014182189A1 (fr) 2013-05-06 2013-05-06 Système de fixation osseuse

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RU (1) RU2605497C2 (fr)
WO (1) WO2014182189A1 (fr)

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU169624U1 (ru) * 2016-06-08 2017-03-24 Михаил Ефимович Купитман Устройство для остеосинтеза

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996022743A1 (fr) * 1995-01-27 1996-08-01 Collux Ab Plaque pour broche
US20070276405A1 (en) * 2002-11-19 2007-11-29 Huebner Randall J Adjustable bone plates
US20100324602A1 (en) * 2004-04-22 2010-12-23 Acumed Llc Expanded fixation of bones
RU116340U1 (ru) * 2011-12-19 2012-05-27 Алексей Валерьевич Бабовников Фиксатор для остеосинтеза переломов проксимальной части большеберцовой кости

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU2448664C2 (ru) * 2010-06-15 2012-04-27 Николай Владимирович Белинов Устройство для остеосинтеза переломов шейки бедренной кости

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1996022743A1 (fr) * 1995-01-27 1996-08-01 Collux Ab Plaque pour broche
US20070276405A1 (en) * 2002-11-19 2007-11-29 Huebner Randall J Adjustable bone plates
US20100324602A1 (en) * 2004-04-22 2010-12-23 Acumed Llc Expanded fixation of bones
RU116340U1 (ru) * 2011-12-19 2012-05-27 Алексей Валерьевич Бабовников Фиксатор для остеосинтеза переломов проксимальной части большеберцовой кости

Cited By (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
RU169624U1 (ru) * 2016-06-08 2017-03-24 Михаил Ефимович Купитман Устройство для остеосинтеза

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RU2605497C2 (ru) 2016-12-20
RU2015111297A (ru) 2016-11-27

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