JP2002506673A - Improved use of orthopedic fixation devices - Google Patents

Abstract

(57) [Summary] The present invention relates to an external fixing device (11) for arranging a first element (15) and the like with respect to a second element (17) and the like. The external fixator (11) comprises a first base (19) attached to the first element (15), a second base (21) attached to the second element (17), a plurality of adjustable effective length struts (23). , 29, 35, 41), a connecting structure (59) for rotatably attaching one end of the first pair of struts to the first base, and one end of the second and third pair of struts (59). 37, 43, 49, 55) to the first base so as to be rotatable with respect to each other, and the other end of the first, second and third pairs of struts to the second base. Connection structure for rotatably attaching to each other. This method is a unique method using an external fixator.

Description

DETAILED DESCRIPTION OF THE INVENTION

[0001] Background This US patent application Ser. No. 08782,731 of currently abandoned and that is a continuation of the 1995 March 1, US patent application Ser. No. 08 / 939,624, filed January 13, 1997 submission of the invention, US Patent 5,702,3
No. 89 / 726,713, which is a continuation-in-part of No. 89.

[0002] 1. FIELD OF THE INVENTION The present invention relates generally to an apparatus that allows for the complete reduction of two interrelated elements. More specifically, the present invention has a mechanism that allows two bone elements or portions to be fixed in relation to each other and allows the two bone elements or portions to be completely reduced in relation to each other. A method of using an improved orthopedic external fixation device.

[0003] 2. BACKGROUND ART Alignment reconstruction, reduction and / or secure locking of two interconnected elements is often required. For example, in a medical setting, bone fragments or the like must be aligned or reconstructed and repositioned in order to restore continuity of bones and skeletal functions. Sometimes this can be achieved by abrupt manipulations, usually with skeletal stabilization using casts, flat plates and screws, intramedullary devices, or external skeletal fixation devices.

[0004] In general, a bone fragment can be moved from its original position, as in the case of non-union or deformed healing, or from its intended position, as in the case of congenital deformation, by three orthogonal translation axes (eg, With a combination of the typical "X", "Y" and "Z" axes) and three orthogonal rotation axes (rotating around the typical "X", "Y" and "Z" axes) There is 6
May move on an independent axis of the book.

[0005] Certain skeletal injuries or skeletal conditions may be caused by external devices attached to the skeleton using threaded and / or smooth pins and / or threaded and / or smooth and / or beaded wires. May be treated with
Such structures are commonly referred to as orthopedic external fixation devices or external skeletal fixation devices (fixation devices are also referred to as fixators or fixators). External fixation devices include acute skeletal fractures, soft tissue damage, slow skeletal healing with slow bone recovery, skeletal non-union where bone does not heal, deformed healing where fractured or fractured bones are healing due to malposition, bone malposition It is used to treat congenital deformities that develop in and bone elongation, enlargement and torsion.

[0006] The structure and capabilities of the external fixation device may vary, and may include multiple or single bars or rods, multiple clamps to adjustably secure the bars to pins or wires that are alternately joined to the skeleton. You may. The pins or wires may extend completely through the skeleton and extend outward from both sides of the limb, or may extend through the skeleton and extend outward from one side of the limb. Pins that extend completely through the skeleton to both sides of the limb are commonly referred to as “penetration fixation pins”. Pins that penetrate the skeleton to one side of the limb are commonly referred to as "half pins." Such external fixation devices may be annular to surround a patient's body component (eg, the patient's femur) or may be unidirectional, extending along one side of the patient's body component. Is also good. Also, one unidirectional external fixation device may be the same length as the body component of the patient. The materials of the fixing devices are also different and include metals, alloys, plastics, composites and ceramics. External fixation devices differ in their ability to accommodate different spatial relationships between the pins and bars.

[0007] Conventional external fixation devices stabilize bone fragments by fixing them in a relatively fixed spatial relationship. Some of the more fully adjustable external fixation devices usually require the physician to loosen one or more clamps to perform the corrective action manually, then re-secure the clamps to stabilize the bone fragments and provide six Some relocate one bone fragment on all axes with a rapid movement relative to the other bone fragment.

[0008] An annular external fixator system was disclosed by GA Ilizarov in the early 1950's. I
lizarov's device consists of at least two rings or "rings" surrounding the patient's body components (eg, the patient's lower limbs), connecting rods extending between the two rings, and a penetration fixation through the patient's bone structure It has a connector for connecting the pin and the through fixing pin to the ring. The use of the Ilizarov device to deal with bending, translation and rotation is described in "Basic Iliza
rov Techniques ", Techniques in Orthopaedics, Vol. 5, No. 4, December 1990,
It is disclosed on pages 55-59.

US Pat. No. 4,620,533, issued on Nov. 4, 1986, discloses at least one adjustable clamp having a connecting ball that provides rotational adjustment of each pin or bar.
A one-way external fixation system having a plurality of fixation pins attached to a single rigid bar is disclosed.

US Pat. No. 5,209,750 Stef, issued May 13, 1993, includes an orthopedic fixation device that rigidly connects a group of pins screwed to a long bone to reduce a fracture in the long bone. A directional external fixator system is disclosed. The fixator includes a telescoping support comprising an elongated tube and an elongated rod slidable within the tube. A first plate is attached to the outer end of the tube, and a second plate is attached to the outer end of the rod. The third and fourth plates are adjustably attached to the first and second plates, respectively, by a threaded rod and a ball-and-socket connection. The holding portions are attached to the third and fourth plates, respectively, to fix the pins to the fixing device.

[0011] Conventional orthopedic external fixation devices differ in their ability to progressively move or adjust one bone fragment relative to another. Some make a gradual translation, while others make a gradual rotation around two axes. Ilizarov's device offers an external fixation device that can provide gradual modifications that rotate around six axes. However, such devices require many parts and are relatively difficult to assemble and use in a clinical setting.

[0012] Orthopedic external fixation devices, such as Ilizarov fixation devices, often need to be modified after initial application. Such corrections are required to convert from one correction axis to another, or to convert the fixator from the first adjustable type to the weighted type, but the relative arrangement for correction is weighted. Some are not sufficiently stable against

[0013] A more simplified external fixation device rotates bone fragments about a center of rotation contained in the external fixation device. This may or may not correspond to the center of rotation required to completely correct the deformation by angle correction alone. In any case, the center of rotation restricted to the external fixation device forms a virtual center of rotation away from the external fixation device, as often required in treating these deformations. Some orthopedic external fixation devices use simple hinges that cannot form a center of rotation remote from the mechanism. Although Ilizarov's device provides a more versatile circumferentially-enclosed fixation device in that it allows the hinge axis to be placed around the bone,
It cannot be rotated on an axis remote from the mechanism. A focal hinge consisting of an arcuate portion of a gear or truck and having a carriage can form a center of rotation remote from the mechanism, which, due to the anatomy or choice, may cause the mechanism to fail. When applied to the concave part of the deformation, especially in the case of severe deformation, where there is no space to apply the long bow of the gear or track necessary to completely correct the deformation May not be applicable.

US Pat. No. 2,391,157, issued Dec. 25, 1945, discloses a pair of telescopically joined hollow tubes, a plurality of pins for penetrating bone elements, and slidable over one tube. A fracture having a first fixing unit mounted on a pair of penetrating fixing pins and connecting the pair of penetrating fixing pins to the tube, and a second fixing unit attached to the end of the other tube and connecting the pair of penetrating fixing pins to the tube. An orthopedic external fixation device for repositioning is disclosed. One tube is telescopically fitted into the other tube. A threaded adjustment shaft is mounted in the tube and can be manually rotated by the tip of a wrench located at the outer end of one tube. The rotation of the shaft causes the nut, which is not rotatable in the tube, to move in the longitudinal direction of the shaft. Coil springs located on either side of the nut within the tube, while transmitting the longitudinal movement of the nut to the tube, allow a certain desired yielding and eliminate completely tight contact. The gear mechanism makes it possible to use the bow of the gear to fit the carriage into the corresponding pinion in order to correct the rotational deformation.

The “Stewart platform” is a completely parallel mechanism, used in airplane and car simulators, robotic end effectors and other applications requiring spatial mechanisms and a high degree of structural rigidity. It has a base platform, an upper platform and six variable rims extending between the base and upper platforms. SV Sreenivasan et al., "Closed-Form Direct Displacement Anal
ysis of a 6-6 Stewart Platform ", Mech. Mach. Theory, Vol. 29, No. 6, pp.
See 855-864, 1994.

None of the prior art discloses or suggests the present invention. For example, none of the prior art simply changes the length of the strut without unclamping the joint.
It does not disclose a fixator that can be adjusted along six axes. Further, any of the prior art generally includes a first member or swash plate for attaching to the first element; a second member or swash plate for attaching to the second element; An effective length adjustable first strut having a first tip movably attached and a second tip movably attached to the second member; a first tip movably attached to the first member. And an effective length adjustable second strut having a second tip movably attached to the second member; a first tip movably attached to the first member and movably attached to the second member. An effective length adjustable third strut having a second tip mounted thereon;
An effective length-adjustable fourth strut having a first tip movably attached to the first member and a second tip movably attached to the second member; movably attached to the first member. An effective length adjustable fifth strut having a first tip mounted thereon and a second tip movably attached to the second member; and a first tip and a second tip movably attached to the first member. An effective length-adjustable sixth strut having a second tip movably attached to the second member, the first tip of the first and second struts being the first tip of the first and second struts; The first ends of the third and fourth struts are joined together such that movement of one first end produces a corresponding movement of the first end of the other strut; Movement of the first tip of one of the third and fourth struts will cause a corresponding movement of the first tip of the other strut. The first ends of the fifth and sixth struts correspond to the movement of the first end of one of the fifth and sixth struts corresponds to the first end of the other strut The second ends of the first and sixth struts are connected to each other so as to cause a movement of the first and sixth struts. The second tip of the second and third struts is joined in relation to each other to cause a corresponding movement of the second tip, the movement of the second tip of one of the second and third struts. Are joined in relation to each other so as to cause a corresponding movement of the second end of the other strut, the second ends of the fourth and fifth struts being connected to the fourth and fifth struts.
No mechanism is disclosed or suggested in which the movement of one second tip of the five struts is joined in relation to each other so as to produce a corresponding movement of the second tip of the other strut.

SUMMARY OF THE INVENTION The present invention places two elements in relation to each other and
A novel device is provided that allows for complete reduction of one element. The basic idea of the present invention is to provide an eight-member device that allows the two elements to be arranged or fixed in relation to each other and to completely reduce the two elements in relation to each other. It is. Further, the invention encompasses a novel use of the device described herein.

In general, the invention relates to a first member (also referred to as a base member or base) or swash plate for attachment to a first element (tissue segment: tissue segment); a second member for attachment to a second element. A second member or swash plate; an effective length adjustable first strut (also with strut) having a first tip movably attached to the first member and a second tip movably attached to the second member. An effective length adjustable second strut having a first tip movably attached to the first member and a second tip movably attached to the second member; movable to the first member First tip and second tip mounted
An effective length adjustable third strut having a second tip movably attached to the first member; a first tip movably attached to the first member and movably attached to the second member. Effective length adjustable fourth strut having a second tip attached thereto; an effective length having a first tip movably attached to the first member and a second tip movably attached to the second member. An adjustable fifth strut having a first tip movably attached to the first member and a second tip movably attached to the second member; Including. The first ends of the first and second struts are such that movement of the first end of one of the first and second struts causes movement corresponding to the first end of the other strut. Are joined in relation to each other. Third and fourth columns
The tip of one of the third and fourth struts is moved by the movement of the first tip of the other strut.
One tip is joined in relation to each other to produce a corresponding movement. The first tips of the fifth and sixth struts are such that movement of the first tip of one of the fifth and sixth struts causes movement corresponding to the first tip of the other strut. Joined in relation to each other. The second ends of the first and sixth struts are connected to the second end of one of the first and sixth struts.
Are moved relative to each other such that movement of the tips of the other struts causes a corresponding movement of the second end of the other strut. The second ends of the second and third struts are moved together such that movement of the second end of one of the second and third struts results in movement corresponding to the second end of the other strut. Joined together. The second ends of the fourth and fifth struts are moved together such that movement of the second end of one of the fourth and fifth struts causes a corresponding movement of the second end of the other strut. Joined together.

According to the unique use of the device of the present invention, the deformation can be substantially modified by simply adjusting the length of one or more adjustable struts. By fully characterizing the skeletal deformation, sizing the appropriate device, and predicting the position of the device on the limb, the surgeon can use the unique method of the present invention to correct substantially complex deformations. Can be. In addition, the fracture piece can be subjected to delayed repositioning without performing a plastic surgery using a device or a pin. Skeletal deformation is fully characterized by measuring six deformation parameters of three projective angles (rotation) and three projective translations between major bone fragments. These angles and the sign of the translation (+/-) are measured by mathematical conventions of the coordinate axes and the right-hand rule. The three device parameters are the proximal ring diameter, the distal ring diameter, and the length of the middle strut. The four mounting parameters are predicted before surgery in the case of chronic conditions, and are measured radiographically and clinically after surgery in the case of acute fractures. These parameters are used in the general deformation equation according to the novel method of the present invention to provide the appropriate post length needed to correct the deformation.

It is an object of the present invention to provide a device that allows complete reduction of two or more elements, such as two or more bone fragments. Another object of the present invention is a device which can achieve, as expected, a sudden reduction of two or more elements, where it remains for an additional period of time or other means for stabilization. It is to provide a device which may be replaced with

Yet another object of the present invention is to provide a gradual reduction of two or more elements over a long period of time, either by increments with careful adjustment or by continuous movement when motorized. It is to provide a device that makes it possible. It is yet another object of the present invention to provide an apparatus that allows for slow controlled reduction of two or more elements. It is yet another object of the present invention to provide a device that can modify all six degrees of freedom and does not become unstable and move significantly unless the full motion lock is released.

Yet another object of the present invention is to provide an apparatus that allows the relative reduction of two or more elements by changing the effective length of six similar struts. It is yet another object of the present invention to provide three orthogonal translation axes (eg, typical "X", "Y" and "Z") whose degree of relative reduction is limited only by physical constraints of the device. Axis) and three orthogonal rotation axes (rotating around the typical "X", "Y" and "Z" axes) in six orthogonal degrees of freedom. Already
The object is to provide a device that can be moved for one piece. It is yet another object of the present invention to provide a device that is relatively small and that fits itself to some extent.

Yet another object of the present invention is any method requiring relative movement between elements, including compression (shortening), distraction (extension), parallel movement, angulation or rotation or any combination of these movements. The aim is to provide a universal device that can also be used in locations. Yet another object of the invention is to provide a center of rotation of the elements to be fixed in relation to each other, which is separate from the device itself and can be rotated in or near the device area. To provide a device that can

Yet another object of the present invention is to provide a device that allows coarse and / or fine adjustment of the relative position of two or more elements. Yet another object of the present invention is to correct the angular and translational displacements in severe fracture pieces and to correct for angular and translational displacements such as in non-union and deformed healing between two bone elements. It is to provide a mechanism for causing a defined relative position change in cooperation with an external fixation device for a bone element. Yet another object of the present invention is to provide a device having universal reduction characteristics.

Yet another object of the present invention is to provide a device which has an overall simple structure and a different use than other external fixation devices. It is yet another object of the present invention to provide an apparatus having six similar struts of adjustable length and attached to two end members by passive clamping or non-clamping joints at both ends. It is. Yet another object of the present invention is to provide a device that is self-locking and does not cause spontaneous slippage due to the inherent stability of the strut adjustment mechanism to withstand rotation during extension or compression. . The post adjustment mechanism includes a tightening screw fitting, a gear and a rack, a screw and a nut, a hydraulic cylinder, or the like. It may also have means for making coarse and fine adjustments to make a quick estimate and subsequent accurate adjustment.

It is yet another object of the present invention to provide an apparatus that utilizes struts that are intentionally angled with respect to the long axis. This angulation provides a mechanical property that allows the invention to modify all six degrees of freedom. Yet another object of the present invention is to adjust the movement of an element, such as a bone fragment, from one relative position to another without losing control over the element, as well as the position of the element fixation pin or wire and An object of the present invention is to provide a device that can always use all degrees of freedom without changing the mounting position of a support. Yet another object of the present invention is to provide a device that can be completely repositioned by adjusting the effective length of one or more struts to change the effective length of the struts.

Yet another object of the present invention is to provide, but is not limited to, a device specifically intended to stably fix bone elements, reduce bone elements, and regenerate joint movement. It is. Yet another object of the present invention is to provide an apparatus that may be used to reduce any two members associated with each other. Yet another object of the present invention is to provide a first mirror mounted on one swash plate, a second mirror mounted on the opposite swash plate, and a mirror / lens that not only acts to stabilize the device but also The object is to provide a device that can be used as a self-contained device with six posts that provide a means for aligning and positioning with each other.

Yet another object of the present invention is an apparatus that can be used to position components in a laboratory and can be used to change the position of two members in a structure. It is to provide. Yet another object of the present invention is to provide a device that can be considered as both a locking device and a mechanism. To the extent that each combination of six strut lengths results in a stable structure, the present invention provides a function as a device for stabilizing bone fragments and a device for external fixation to the skeleton. To the extent that varying the effective length of one or more struts results in relative movement between the swashplates, the present invention provides a mechanism for moving bone fragments.

Yet another object of the present invention is to attach to either side of a bone joint,
A device that can be used to restore osteoarticular movement following an injury or disease by moving one bone fragment along another six bones along six independent axes. It is an object of the present invention to provide a device for reproducing not only hinge movements such as elbow joints and ankle joints, but also more complex movements such as instantaneous change of the center of rotation or spherical movement such as a hip joint.

It is yet another object of the present invention to provide a device that does not have to be accurately mounted on a particular axis during initial installation or surgery. It is yet another object of the present invention that the positioning of the device relative to the bone joint can be determined after application of the device, after which the relative extension or shortening of the six struts required to provide favorable movement is determined. Is to provide a device that can do this. It is yet another object of the present invention to provide a device having a ball-like joint consisting of two hemispheres, or a hyperhemisphere coinciding with a hypohemisphere.

Yet another object of the present invention is to provide an apparatus having three or more members housed in a spherical socket. Yet another object of the present invention is to provide an apparatus that operates as a strictly parallel synchronous manipulator. Yet another object of the present invention is to provide the necessary adjustment to correct one or six orthogonal deformations, regardless of whether parallel or angulation or a combination of three orthogonal rotations and three orthogonal translations is required. Is to provide a device that simply changes the length of the strut. Yet another object of the present invention is to provide an apparatus that is not limited to a "continuous" mechanism or process for achieving six-axis correction.

It is yet another object of the present invention to provide a device in which all struts are free to rotate at each end. Yet another object of the present invention is to provide a device that does not limit the six-axis correction to an immediate correction to release multiple joints or all joints, move the device, and then re-secure the joints. It is. Yet another object of the present invention is a device in which all joints (posts and end plates) are unclamped, providing stability even if they are unclamped by their joints and angled posts. It is to provide a device. Yet another object of the present invention is to provide an apparatus for connecting six struts to two end plates or members using passive unclamping joints. It is yet another object of the present invention to provide an apparatus that can control 6-axis deformation under control.

Yet another object of the present invention is to provide a stable device having six angled struts with the joint at the end of each strut being free to rotate. It is an object of the present invention to provide a device having a connection structure of a column fixing device. Yet another object of the present invention is to provide an apparatus that allows for slow controlled reduction of two or more bone fragments only during stretching along the long axis and while correcting for angular deformation. It is. Yet another object of the present invention is to provide a device that allows for a gradual or abrupt adjustment of the effective length.

Yet another object of the present invention is to provide a device that provides a biologically compatible relative speed between bone fragments in millimeters per day. Yet another object of the present invention is to provide a device that can produce small displacements between bone fragments as expected and reproducibly. Still another object of the present invention is to perform coordinate transformation based on mathematical calculation of only three points on one end plate, and as a result, it is possible to change the length of six columns covering only six points. It is to provide a device.

Yet another object of the present invention is to provide, in kinematic terms, a device which generally functions as a parallel manipulator in which the basic device can achieve a simultaneous movement of six degrees of freedom of the bone fragments associated with each other. It is to provide. Yet another object of the present invention includes two base members joined by a plurality of struts having an adjustable effective length, the ends of each strut being covalently joined (ie, shared with another strut end). Or a non-covalent connection to the base member. Yet another object of the present invention is to provide an external device that allows surgery to reduce bone fragments without first releasing the joints and reducing the bone fragments and then re-securing the joints. It is to provide a fixing device. It is yet another object of the present invention to provide a device having at least six posts that couples to two base members in a device for connecting posts to six common vertices or base members.

Yet another object of the present invention is to provide the ball-socket of the present invention in addition to the four degrees of freedom (rotation in three orthogonal axes typically achieved by conventional ball-socket couplings). The connection further comprises a hemisphere, the hemisphere being free to rotate about an axis perpendicular to a plane passing through the center line of each hemisphere).

Yet another object of the present invention is a device having a post attached to an end plate or base member by a coupling device, wherein the coupling device allows rotation (the exact number of rotations is (Determined by the type), not by maintaining its position until the length of one or more struts has been adjusted, allowing a gradual corrective movement as expected, and by creating a clamping force at the coupling device , To provide a device having the stability provided by intentionally tilting the struts to form a "triangle" that impedes movement on orthogonal axes.

Yet another object of the present invention is to provide a device that does not require a coupling between the strut and the base member to be clamped to prevent unwanted movement or movement after repositioning. is there. It is yet another object of the present invention to provide an apparatus that maximizes the amount of space on the end plate for mounting the pin clamp and reduces space limitations. It is yet another object of the present invention to provide a device that can be used on a small scale in situations where space is at a premium, such as external fixation of pediatric bone.

Yet another object of the present invention is to provide an external fixation device, a self-contained device, a laboratory jack or a structure jack. Yet another object of the present invention is to provide a new use of the Stewart platform. Specifically, another object of the present invention is to use a Stewart platform for orthopedic surgery to fix the first and second bone fragments in relation to each other. Yet another object of the present invention is to provide a novel technique for using the device of the present invention. Specifically, it is an object of the present invention to provide a technique for systematically determining the appropriate post length required to use the device of the present invention and correcting the deformation.

Yet another object of the present invention is to provide a novel technique for using the device of the present invention to correct acute deformation. Yet another object of the present invention is to provide a novel technique for using the device of the present invention to correct chronic deformation.

Yet another object of the present invention is a novel and computer-aided computer or computer to determine the appropriate post length required when using the device of the present invention to correct for deformation. To provide systematic technology. Yet another object of the present invention is to provide a novel technique for using the device of the present invention in a manner that minimizes the risk to structures such as nerves surrounding the deformity.

Description of the Preferred Embodiment A first preferred embodiment of the present invention is designated by the reference numeral 11 in FIGS. The external fixator 11 is a part of a circumfacial external orthopedic fixator 13 for fixing the first bone element 15 to the second bone element 17.

The external fixator 11 includes a first base member 19 for fixing to the first bone element 15, a second base member 21 for fixing to the second bone element 17, An adjustable effective length first strut 23 having an end 25 and a second end 27, and an adjustable effective length second strut 23 having a first end 31 and a second end 33. A strut 29, an adjustable effective length third strut 35 having a first end 37 and a second end 39, and an adjustment having a first end 43 and a second end 45. A fourth strut 41 of possible effective length, and a fifth strut 47 of adjustable effective length having a first end 49 and a second end 51;
Adjustable effective length sixth strut 5 with first end 55 and second end 57
3 and first connector means (rotating means) for rotatably attaching the first ends 25, 31 of the first and second struts 23, 29 to each other and to the first base member 19. 59) and the first end 3 of the third and fourth struts 35, 41.
The second connector means 61 for rotatably attaching 7, 43 to each other and to the first base member 19, and the first ends 49, 55 of the fifth and sixth struts 47, 53 are connected to each other. And third connector means 63 for rotatably mounting to the first base member 19, and second ends 27, 57 of the first and sixth struts 23, 53 to each other and to the second base member. Fourth connector means 65 for rotatably mounting to the member 21 and second ends 33, 39 of the second and third struts 29, 35 to each other and to the second base member 21. Fifth connector means 67 for rotatably mounting, and second ends 45, 51 of the fourth and fifth struts 41, 47 to be rotatable with respect to each other and with respect to the second base member 21. And sixth connector means 69 for attachment.

Here, the phrase “rotatable mounting” when describing the mounting between two or more parts or between elements means that the part or element referred to is rotatable between the two. Means attached to each other.

The first and second base members 19, 21 can be configured in various ways and from various materials and in various shapes and sizes. Therefore, for example, each base member 19,
21 comprises a single or multiple configuration Ilizarov-type ring or ring 71, which surrounds the patient's limb, etc., and as will be understood by those skilled in the art, has a penetration fixation screw, wire or wire. It may be fixed to one of the bone elements 15, 17 by a pin 73 or the like. Each ring 71 preferably has a plurality of spaced apart openings 75 through which through fixation screws, wires or wires as will be understood by those skilled in the art. The pin 73 and the like can be fixed thereto by a normal fixing device clamp 77 or the like. Openings 75 provided at intervals provide various connector means 59, 61, 63.
, 65, 67, 69 can also be used to connect to each ring 71. However, with respect to the preferred embodiment shown in FIGS. 1-7, each ring 71 is preferred,
It differs from a conventional Isarob ring in that it has a plurality of partial spherical cavities for reasons that will become apparent below. This partial spherical cavity 79 may be formed integrally with the ring 71, as is clearly shown in FIGS. Conversely, each partial spherical cavity 79 is formed in a plate member 80, as clearly shown in FIG. 25 and as will be understood by those skilled in the art, and It may be bolted or fixed. Also, each partial spherical cavity 79 is formed partially on the ring 71 and also on a separate plate member, such that they cooperate with each other and form this partial spherical cavity 79. Is also good.

Each of the struts 23, 29, 35, 41, 47, 53 is preferably similar in shape to one another. The structure and operation of each strut 23, 29, 35, 41, 47, 53 may be different and may be designed so that its effective length can be roughly and / or precisely adjusted. Here, the term "effective length" when describing the length of one or more struts 23, 29, 35, 41, 47, 53 means that the two connector means 59, 61, 63, 6
5, 67, 69 means the distance between the centers of rotation. The embodiment of each of the struts 23, 29, 35, 41, 47, 53 shown generally in FIGS. 1-9 includes a first component 81, a second component
A connecting means 85 is provided for adjustingably connecting the 83, the first and second components 81, 83. Each first component 81 preferably comprises an elongated rod 87 having a threaded end 89. Each second component 83 preferably comprises an elongate rod 91 having a threaded end 93. Each connecting means 85 is preferably
A first threaded portion 95 for cooperating with a threaded end 89 of a rod 87 of one component 81 and a threaded end 93 of a rod 91 of a second component 83 And a second threaded portion 97 for cooperating with. In a preferred design of the threaded end 89, the threaded end 93, the first threaded section 95 and the second threaded section 97, the longitudinal axis of the coupling means 85 is centered. By this rotation, the first and second components 81 and 83 are moved in opposite directions. Thus, for example, the threaded end 89 of the first component 81 and the first threaded end 95 of the coupling means 85 have cooperating right-hand threads and the second component The threaded end 93 of 83 and the second threaded portion 97 of the coupling means 85 may have cooperating left hand threads, as will be appreciated by those skilled in the art. , Or vice versa, so that by rotating the coupling means 85 about its longitudinal axis, the associated part acts like or as a turnbuckle, the first and the The second components 81, 83 extend or contract with respect to each other and the coupling means 85, thereby adjusting or changing the overall length of each strut 23, 29, 35, 41, 47, 53 be able to. Also, threaded end 89 of rod 87 and rod 91
The threaded end 93 is shown in the drawing as a male thread and the threaded portions 95, 97 of the coupling means 85 are shown in the drawing as female threads, but the reverse configuration could be used (
That is, the threaded end 89 of the rod 87 and the threaded end 93 of the rod 91
Are female threads, and the threaded portions 95 and 97 of the connecting means 85 are male threads).

The effective length of each strut 23, 29, 35, 41, 47, 53 can be adjusted by various methods and various means. For example, each strut 23, 29, 35, 41, 47, 53 is provided with a hydraulic or pneumatic piston, an electric motor, a gear part, etc., and various adjusting means, and the strut 23, 29, The effective length of 35, 41, 47, 53 may be easily and precisely adjusted. Furthermore, as described in more detail below with reference to the embodiment of FIG. 27, each strut 23, 29, 35, 41, 4
7, 53 consist of a one-piece integrally formed rod with threaded ends,
Each connector means 59, 61, 63, 65, 67, 69 has a threaded opening and can cooperate with this opening.

The instrument 11 is provided with indicating or gauge means 99 by which the effective length of each strut 23, 29, 35, 41, 47, 53 is displayed or measured relatively. May be. For example, as shown in FIGS. 8 and 9, each strut 23, 29
, 35, 41, 47, 53 have one or more elongated slots 101 through which each strut 23, 29, 35, 41, 47, 53 component 81 , 83
Can be seen, and a plurality of indication marks 103 and the like provided at intervals along the effective length of the slot 101 serve as a scale ruler, and thereby, a predetermined portion of each of the constituent elements 81 and 83 can be seen. By simply reading the position with respect to the indication mark 103, accurate display of the effective length of each strut 23, 29, 35, 41, 47, 53 can be performed easily and immediately. Thus, for example, as clearly shown in FIG.
By calibrating 03, as will be understood by those skilled in the art, when the distal end 104 of each elongated rod 87, 91 is aligned with a predetermined indicator mark 103, each strut is
The entire length of 23, 29, 35, 41, 47, 53 may be displayed or relatively measured.

In the embodiment shown in FIGS. 1-7 and 10, the connector means 59, 61, 63, 65, 67
, 69 each comprise a split ball connector, the split ball connector comprising an end of one of the struts 23, 29, 35, 41, 47, 53.
A first partially spherical member 105 attached to one end of one of 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57, and struts 23, 29, 35, Ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one other strut of 41, 47, 53
A second partially spherical member 107 attached to one end of the second member.
Each of the partial spherical members 105, 107 of the connector means 59, 61, 63, 65, 67, 69 preferably has a planar portion 109. Each of the partial spherical cavities 79 of the ring 71 of each base member 19, 21 preferably rotatably captures each pair of partial spherical members 105, 107 of the connector means 59, 61, 63, 65, 67, 69. The plane portions 109 are sized and designed to be movably held with respect to each other (see, for example, FIG. 4). Although not necessarily, each connector means 59, 61, 63, 65, 67, 69 centers the center of each planar portion 109 of a pair of cooperating partial spherical members 105, 107, as clearly shown in FIG. A rocking means such as a rocking rod 111 extending therethrough may be provided, by means of which the pair of partial spherical members 105, 107 are connected.

The split ball connectors of FIGS. 1-7 and 10 are advantageous in certain respects. These connectors save space, because one swash plate or three split ball joints per base member 19, 21 are required, whereas one spherical ball is used for each strut 23, 29, 35 , 41, 47
, 53 would require six separate joints. Further, when a spherical ball joint is used at the end of each strut 23, 29, 35, 41, 47, 53, the effective length of any of the struts 23, 29, 35, 41, 47, 53 is determined by using FIGS. Adjustment using the turnbuckle arrangement shown in Figure 2 tends to rotate the threaded half shaft and ball, making it impossible to adjust the strut length in advance. However, the split ball connectors of FIGS. 1-7 and 10 have hemispheres attached to adjacent struts, and none of the hemispheres rotate independently about their strut axis and are mated. The split ball joint rotates about three axes as a unit. Therefore, by rotating the connecting means 85, any individual strut 23, 29, 35
, 41, 47, 53, the rotation of the corresponding rods 87, 91 is prevented by the cooperation of the split ball connectors. As will be appreciated by those skilled in the art, if a spherical ball joint is used at the end of each strut 23, 29, 35, 41, 47, 53, then whenever the coupling means 85 is rotated, a corresponding Rod
It is necessary to prevent the rotation of 87 and 91.

In the embodiment of FIGS. 11 and 12, each of the connector means 59, 61, 63, 65, 67, 69 comprises a split U-shaped joint connector or the like. Although only connector means 65 is shown in FIGS. 11 and 12, the other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. The split U-shaped connector shown in FIGS. 11 and 12 includes a first member 113 and a shaft for attaching the first member 113 to each of the first and second base members 19 and 21. The member 115, the second member 117, and the second member 117 are attached to the first member 113. At this time, the shaft 121 in the longitudinal direction thereof intersects the shaft 123 in the longitudinal direction of the shaft member 115 at right angles. The moving member 119 and the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one of the struts 23, 29, 35, 41, 47, 53 One of the ends and the ends 25, 27, 31, 33 of the other one of the struts 23, 29, 35, 41, 47, 53
, 37, 39, 43, 45, 49, 51, 55, 57 are attached to the second member 117 (the end 27 of the strut 23 and the end 57 of the strut 53 are attached to the second member 117). At this time, a swing member 125 having a longitudinal axis 127 perpendicularly intersecting a longitudinal axis 121 of the swing member 119 is provided. Ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55 of struts 23, 29, 35, 41, 47, 53
, 57 may have a large head portion 129 through which the swing member 125 passes, as shown in FIGS. The shaft member 115 may be screwed or pressure fitted to the first member 113, or may be fixedly attached to the first member 113, as will be understood by those skilled in the art, or may be integral with the first member 113. May be formed as a single unit, or may be rotatably fixed to the respective base members 19 and 21 by a normal holding clip or the like, whereby the first member 113 is connected to the first and the first members. It is swingably attached to each of the two base members 19, 21. The rocking member 119 may be pressure-fitted or fixedly mounted to the second member 117, as will be understood by those skilled in the art,
It may be formed as a single unit with the second member 117, or may be rotatably fixed to the first member 113 by a normal holding clip or the like. The rocking member 125 may be press fit or fixedly attached to one of the cooperating members (ie, the second member 117, or one of the large head portions 129), or may be a member of the cooperating member. One (ie,
The second member 117, or one of the large head portions 129), may be formed as a one-piece unit, or as will be understood by those skilled in the art, such as a normal retaining clip. May be rotatably fixed to each cooperating member.

In the embodiment shown in FIGS. 13 and 14, the connector means 59, 61, 63, 65, 67,
Each of 69 comprises a split chain link connector or the like. Although only connector means 65 is shown in FIGS. 13 and 14, other connector means 59, 61, 63, 67, 69
Preferably has a similar or identical structure. The split chain link shown in FIGS. 13 and 14 includes a first ring member 131 and the first ring member 131.
Shaft member 13 for attaching to the first and second base members 19 and 21 respectively
3 and one of the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one of the struts 23, 29, 35, 41, 47, 53 Attached to the end (
Attached to the end 27 of the strut 23), a first ring member 131 pivotally attached to the first ring member 131, and a strut.
Ends 25, 27, 31, 33, 37 of another strut of 23, 29, 35, 41, 47, 53
, 39, 43, 45, 49, 51, 55, 57 at one end (strut 53
And a third ring member 137 that is swingably attached to the first and second ring members 131 and 135. Each first ring member 131 is preferably a U-shaped member 139 extending through the second and third ring members 135, 137, and the U-shaped member 139 is a second and third ring member 135. , 137, after passing through the central hole, the bridge member 14 for closing the U-shaped member 139.
And is formed from one. The bridge member 141 may be rotatably attached to the U-shaped member 139 with a screw 142 or the like (see FIG. 14). The shaft member 133 may be bolted or press fitted or fixedly attached to the bridge member 141, as will be understood by those skilled in the art, or may be an integral part of the bridge member 141. It may be formed in a unit of individual configuration, or it can be a bridge
141 and the respective base members 19, 21 may be rotatably fixed, whereby the first ring member 131 swings about one of the first and second base members 19, 21, respectively. Mounted as possible. The second and third ring members 135 and 137 are
, 29, 35, 41, 47, 53 each end 25, 27, 31, 33, 37, 39, 43, 45, 49,
The manner of attachment to 51, 55, 57 can be varied as will be appreciated by those skilled in the art. Thus, for example, each ring member 135, 137 may have a respective end 25, 27, 31, of a respective strut 23, 29, 35, 41, 47, 53, as will be understood by those skilled in the art. 33, 37, 39, 43, 45, 49, 51, 55, and 57 may be formed as a single unit.

In the embodiment shown in FIGS. 15 and 16, the connector means 59, 61, 63, 65, 67,
Each of 69 comprises a flexible or elastic connector. Connector means 65
15 and 16 only, the other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. The flexible or elastic connector shown in FIGS. 15 and 16 includes a Y-shaped main body member 143 made of flexible or elastic rubber or the like, and the Y-shaped main body member 143 includes A trunk portion 145 for attachment to each one of the second base members 19, 21 and an end 25, 27, 31, 33 of one of the struts 23, 29, 35, 41, 47, 53 , 37, 39,
A first arm 147 for attachment to one end of 43, 45, 49, 51, 55, 57 (shown attached to end 27 of strut 23); Ends 25, 27, 31, 33 of one of the struts 23, 29, 35, 41, 47, 53
, 37, 39, 43, 45, 49, 51, 55, 57 to one end (strut 53
(Shown attached to the end 57 of the second arm 149)
have. The trunk portion 145 has first and second trunks due to its flexibility or elasticity.
The second base member 19, 21 may be fixedly attached to each one, or a shaft member 151 may be provided, and the trunk portion 145 may be connected to the first and second base members 19, 21 by the shaft member 151. May be connected to one each. The shaft member 151 is
As will be appreciated by those skilled in the art, the trunk 145 may be bolted or press fitted or fixedly mounted, or may be integral with the trunk 145.
It may be formed in an individual unit, or may be rotatably fixed to both of the respective base members 19 and 21 by a normal holding clip or the like, whereby the trunk portion 145 is connected to the first and second trunk members. Each of the base members 19 and 21 is swingably attached to one of the base members 19 and 21. First and second arms 147, 149 are struts 23, 29, 35, 41, 47
, 53, the manner of attachment to the respective ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 will vary as will be appreciated by those skilled in the art. You can also.
Thus, for example, each end 25, 27, of struts 23, 29, 35, 41, 47, 53,
External threads were cut into 31, 33, 37, 39, 43, 45, 49, 51, 55, 57, and each arm 147, 149
May be provided with threaded openings 153, whereby the respective ends 25, 27, 31, 33, 37, 39, 43, 45 of the struts 23, 29, 35, 41, 47, 53 are provided. , 49, 51,
55 and 57 are received with screws. This threaded opening 153 may be formed in a tubular metal insert provided in each arm 147, 149, as will be appreciated by those skilled in the art.

In the embodiment shown in FIGS. 17 and 18, the connector means 59, 61, 63, 65, 67,
Each of 69 comprises a flexible or elastic connector. Connector means 65
17 and 18 only, the other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. This flexible or resilient connector shown in FIGS. 17 and 18 can be used with the first and second base members 19 and 21 respectively.
One and one of the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one of the struts 23, 29, 35, 41, 47, 53 A first body means 154 attached to the end, and a first body means 154 attached to each of the first and second base members 19, 21 at a position near and independent of the first body means 154; and One of the struts 23, 29, 35, 41, 47, 53 has an end 25, 27,
31, 33, 37, 39, 43, 45, 49, 51, 55, 57
And two main body means 155. Each body means 154, 155 preferably comprises a flexible or elastic body member 156 made of flexible or elastic rubber or the like, the body member 156 comprising a first and a second base member. A first end 157 for attachment to each one of 19, 21 and an end 25, 27, 31, 33, 37 of one of the struts 23, 29, 35, 41, 47, 53; , 39, 43, 45, 49, 51, 55, 57 having a second end 159 for attachment to one end (in FIGS. 17 and 18, the first body means). 154 is attached to end 27 of strut 23 and second body means 155 is attached to end 57 of strut 53). The first end 157 may be fixedly attached to each of the first and second base members 19 and 21 by its flexibility or elasticity, or a shaft member 161 may be provided. By 161
One end 157 may be coupled to each one of the first and second base members 19,21. The shaft member 161 may be bolted or pressure fitted or fixedly attached to the first end 157, as will be understood by those skilled in the art,
It may be formed as a single unit with the one end 157, or may be rotatably fixed to the respective base members 19, 21 by a normal holding clip or the like. , A first end 157 is swingably attached to each one of the first and second base members 19,21. How to attach the respective ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of the struts 23, 29, 35, 41, 47, 53 to the second end 159 Can be varied as will be appreciated by those skilled in the art. Thus, for example, the respective ends 25, 27, 31, of the struts 23, 29, 35, 41, 47, 53,
33, 37, 39, 43, 45, 49, 51, 55, 57 are externally threaded, and each end 159 is provided with a threaded opening 163 for receiving the strut. 23, 29
, 35, 41, 47, 53 each end 25, 27, 31, 33, 37, 39, 43, 45, 49, 51,
55 and 57 are received with screws. The threaded opening 163 may be formed in a tubular metal insert provided in each arm 147, 149, as will be appreciated by those skilled in the art.

In the embodiment shown in FIGS. 19 and 20, the connector means 59, 61, 63, 65, 67,
Each of 69 consists of a pair of spherical members. 19 and 20 with only connector means 65
, The other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. This connector means, shown in FIGS. 19 and 20, provides for the end 25, 27, 31, 33, 37 of one of the struts 23, 29, 35, 41, 47, 53.
, 39, 43, 45, 49, 51, 55, 57, a first spherical member 165 attached to one end of one of the struts 23, 29, 35, 41, 47, 53; And a second spherical member 167 attached to the other one of the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57. 19 and 20, a first spherical member 165 is attached to end 27 of strut 23 and a second spherical member 167 is attached to end 57 of strut 53. For the embodiment shown in FIGS. 19 and 20, each base member
Each ring 71 of 19,21 is formed with a plurality of partial spherical cavities 169 sized and designed to rotatably capture one of the spherical members 165,167. This partial spherical cavity 169 may be formed integrally with the ring 71, as clearly shown in FIGS. On the other hand, each partial spherical cavity 169 or a pair of cooperating partial spherical cavities 169 is formed in the plate member 170, as is clearly shown in FIG. 26 and will be understood by those skilled in the art. The plate member 170 may be bolted or fixedly mounted to one of the rings 71. Further, each partial spherical cavity 169 is partially formed in the ring 71 and partially in a separate plate member, and the ring 71 and the separate plate members cooperate with each other to form the partial spherical cavity 169. May be formed.

In the embodiment shown in FIGS. 21 and 22, each connector means 59, 61, 63, 65, 67
, 69 each comprise a pair of U-joint connectors. Connector means 65
15 and 16 only, the other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. This U shown in FIGS. 21 and 22
The joint-type connector comprises one end of each of the first and second base members 19, 21 and one of the struts 23, 29, 35, 41, 47, 53, the end 25, 27,
31, 33, 37, 39, 43, 45, 49, 51, 55, 57
One U-joint connector 171 and a strut 23, attached to each one of the first and second base members 19, 21 at a location near and independent of the first U-joint connector 171; One of the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55 and 57 of the other strut of 29, 35, 41, 47 and 53
And a second U-shaped connector 173 mounted at one end. Each U-shaped joint connector 171, 173 is preferably a first member 175 and a shaft member 177 for attaching the first member 175 to each of the first and second base members 19, 21. And the second member 179, and the second member 179 is attached to the first member 175. At this time, the longitudinal axis 183 intersects at right angles with the longitudinal axis 185 of the shaft member 177. The rocking member 181 and the end 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one of the struts 23, 29, 35, 41, 47, 53 Is attached to the second member 179, and the longitudinal axis 189 of the second member 179 is
And a rocking member 187 that intersects the axis 183 in the longitudinal direction at right angles. Strut 23,
The ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of the 29, 35, 41, 47, 53, as shown in FIGS. May have a large head portion 191 penetrating therethrough. The shaft member 177 may be connected to the first member 17 as will be understood by those skilled in the art.
5 may be screwed or press-fit or fixed
May be formed as a unitary unit with the member 175, or may be rotatably fixed to the respective base members 19 and 21 by a normal holding clip or the like, whereby the first member 175 is swingably attached to each of the first and second base members 19 and 21. The pivot member 181 may be a second member, as will be understood by those skilled in the art.
The second member may be attached to the member 179 by pressure fit or fixedly.
It may be formed as a single unit with the 179, or may be rotatably fixed to the first member 175 by a normal holding clip or the like. Swing member 187 is press fit or fixed to one of the cooperating members (ie, second member 179 or respective large head portion 191), as will be appreciated by those skilled in the art. It may be attached, formed as a unitary unit with one of the cooperating members (ie, the second member 179 or the respective large head 191), or may be a conventional retaining clip or the like. Thus, it may be rotatably fixed to each cooperating member (that is, the second member 179 or the large head portion 191).

In the embodiment shown in FIGS. 23 and 24, the connector means 59, 61, 63, 65, 67,
Each of 69 consists of a pair of chain link connectors. Although only the connector means 65 is shown in FIGS. 23 and 24, the other connector means 59, 61, 63, 67, 69 preferably have a similar or identical structure. This chain link connector, shown in FIGS. 23 and 24, comprises an end 25 of one of the first and second base members 19, 21 and one of the struts 23, 29, 35, 41, 47, 53, respectively. 27, 31, 33,
A first chain link connector 193 attached to one end of one of 37, 39, 43, 45, 49, 51, 55, 57 and a position near and independent of the chain link connector 193; At one end of each of the first and second base members 19, 21 and at the ends 25, 27, 31, of the other one of the struts 23, 29, 35, 41, 47, 53. 33, 37, 39, 43, 45, 49, 51, 55, and 57, and a second chain link connector 195 attached to one end. Each chain link connector 193, 195 is preferably a first ring member 197 and the first ring member 197 is swingably attached to one of the first and second base members 19, 21, respectively. The rocking member 199 and one of the ends 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 of one of the struts 23, 29, 35, 41, 47, 53 are struck. 23, the second ring member 201 of the first ring connector 193 is attached to the end 27 of the strut 23, and the second ring member 201 of the second ring connector 195 is attached to the second ring connector 195 in FIGS. The ring member 201 is attached to the end 57 of the strut 53 in FIGS. 23 and 24), and the second ring member 201 that is swingably attached to the first ring member 197.
And Each first ring member 197 is preferably a U-shaped member 203 extending through the second ring member 201, and after this U-shaped member 203 has passed through the central hole of the second member 201, And a bridge member 205 for closing the U-shaped member 203. The bridge member 205 may be rotatably attached to the U-shaped member 203 with a screw 207 or the like (see FIG. 24). As will be appreciated by those skilled in the art, the rocking member 199 may be mounted to the bridge member 205 by a press fit or in a fixed manner, or may be a unitary unit with the bridge member 205. It may be formed, or may be rotatably fixed to the bridge member 205 and the respective base members 19 and 21 by a normal holding clip or the like. Connect the second ring member 201 to the struts 23, 29, 35, 41
, 47, 53, the manner of attachment to each end 25, 27, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57, as will be appreciated by those skilled in the art, It can be changed. Thus, for example, each ring member 197, 201 has a respective end 25, 27 of a respective strut 23, 29, 35, 41, 47, 53, as will be appreciated by those skilled in the art.
, 31, 33, 37, 39, 43, 45, 49, 51, 55, 57 may be formed as a single unit.

In the embodiment shown in FIG. 27, each adjustable effective length strut 23, 29,
Each of the connector means 35, 41, 47, 53 may comprise an integrally formed rod 209 having a left external thread at one end 211 and a right external thread at the other end 213. 59
, 61, 63, 65, 67, 69 may have an appropriately threaded opening 215 for receiving one of the ends 211, 213 of the rod 209 by a screw. Although only the connector means 59, 65 are shown in FIG. 27, the other connector means 61, 63, 67, 69 may have a similar or identical structure. Similarly, struts 23, 29, 35, 41, 47,
Although only a portion of 53 is shown in FIG. 27, the other struts 35, 41, 47 may have similar or identical structures. Each rod 209 has gripping means between its opposing ends, which aid in rotating it about its longitudinal axis. This grip means simply consists of a lateral opening provided through the rod 209, through which a bar or the like (not shown) can be inserted and inserted. As will be appreciated, a handle is provided that allows the rod 209 to easily rotate about its longitudinal axis. The intermediate portion of each rod 209 may be enlarged near the lateral opening 217 for reasons such as reinforcement. When the rod 209 rotates, the associated connector means 59, 61, 63, 65, 67, 69 provided at the opposite end approach each other as will be appreciated by those skilled in the art. Moving away will change the effective length of rod 209 and will cause a corresponding or related movement of base members 19,21. Although FIG. 27 shows the split ball connector of FIGS. 1 to 7 and 10, the present invention is not limited to this, and a connector of the type shown in FIGS.

A second preferred embodiment of the present invention is indicated by reference numeral 2.11 in FIG. This external fixator 2.11 is part of a one-way orthopedic external fixator 2.13 for fixing the first bone element 2.15 to the second bone element 2.17.

The external fixator 2.11 comprises a first base member 2.1 for fixation to the first bone element 2.15.
19; a second base member 2.21 for fixation to the second bone element 2.17; an adjustable effective length first strut 2.23 having a first end and a second end; An adjustable effective length second strut 2.29 having one end and a second end;
An adjustable effective length third strut 2.35 having a first end and a second end, and an adjustable effective length fourth strut having a first end and a second end. Strut 2
.41, an adjustable effective length fifth strut 2.47 having a first end and a second end, and an adjustable effective length having a first end and a second end First strut 2.53 and first connector means 2. for rotatably attaching the first ends of the first and second struts 2.23, 2.29 to each other and to the first base member 2.19.
59; second connector means 2.61 for rotatably attaching the first ends of the third and fourth struts 2.35, 2.41 to each other and to the first base member 2.19; Third connector means 2.63 for rotatably attaching the first ends of the struts 2.47, 2.53 of each other and to the first base member 2.19, and the second of the first and sixth struts 2.23, 2.53. Fourth connector means 2.65 for rotatably attaching the ends of the second and third struts 2.29, 2.35 to each other and to the second base member 2.21. Fifth connector means 2.67 for rotatably mounting the second base member 2.21 to the second base member 2.21 and the second end of the fourth and fifth struts 2.41 and 2.47 to each other and to the second base member 2.21. And a sixth connector means 2.69 for rotatably mounting. .

The first and second base members 2.19, 2.21 can be configured in various ways and from various materials and in various shapes and sizes. Therefore, for example, each base member
2.19, 2.21 may consist of a single or multiple configuration plate 2.71 which is coaxially secured to a rigid elongated rod 2.72, etc., such as by a series of conventional screws. A typical penetrating fixation screw, wire or pin 2.73 is connected to the base member 2.19, 2.21 via various connectors 2.74, as will be appreciated by those skilled in the art. The connector 2.74 may be mounted on the plate 2.71 or may be a part integrally formed therewith, or may be directly mounted on the rod 2.72 as shown in FIG.

The struts 2.23, 2.29, 2.35, 2.41, 2.47, 2.53 and the connector means 2.59, 2.
61, 2.63, 2.65, 2.67, 2.69 are preferably the various struts 23, 29, 35, 41, 47, 53 and connector means 59, 61, 63, 65, 67, disclosed above with respect to the device 11.
Since it is the same as 69, struts 2.23, 2.29, 2.35, 2.41, 2.47, 2.
In order to fully understand the various possible configurations of 53 and connector means 2.59, 2.61, 2.63, 2.65, 2.67, 2.69, the various struts 23, 29, 35, 41, 47, 53 and connector means 59, 61 , 63, 65, 67, 69. Each plate 2.71 is configured to use connector means 2.59, 2.61, 2.63, 2.65, 2.67, 2.69. Thus, for example, for the embodiment shown in FIG.
Preferably has a plurality of partial spherical cavities 2.79 for rotatably capturing each pair of partial spherical members of the illustrated split ball connector means.

A third preferred embodiment of the present invention is indicated in FIG. 29 by reference numeral 3.11. The external fixator 3.11 is part of a one-way orthopedic external fixator 3.13 for fixing the first bone element 3.15 to the second bone element 3.17.

The external fixator 3.11 comprises a first base member 3.1 for fixation to the first bone element 3.15.
19; a second base member 3.21 for fixation to a second bone element 3.17; an adjustable effective length first strut 3.23 having a first end and a second end; An adjustable effective length third strut 3.29 having one end and a second end;
An adjustable effective length third strut 3.35 having a first end and a second end, and an adjustable effective length fourth strut having a first end and a second end. Strut 3
.41, an adjustable effective length fifth strut 3.47 having a first end and a second end, and an adjustable effective length having a first end and a second end First strut 3.53 and first connector means 3. for rotatably attaching the first ends of the first and second struts 3.23, 3.29 to each other and to the first base member 3.19.
59, third connector means 3.61 for rotatably attaching the first and third ends of the third and fourth struts 3.35, 3.41 to each other and to the first base member 3.19; Third connector means 3.63 for rotatably attaching the first ends of the struts 3.47, 3.53 of each other and to the first base member 3.19, and the second of the first and sixth struts 3.23, 3.53. Fourth connector means 3.65 for rotatably attaching the ends of the second and third struts 3.39, 3.35 to each other and to the second base member 3.31, and connecting the second ends of the second and third struts 3.39, 3.35 to each other and to the second. Fifth connector means 3.67 for rotatably mounting to the base member 3.21 and the second end of the fourth and fifth struts 3.41, 3.47 to each other and to the second base member 3.21. And a sixth connector means 3.69 for rotatably mounting. .

The first and second base members 3.19, 3.21 can be configured in various ways and from various materials and in various shapes and sizes. Therefore, for example, each base member
3.19, 3.21 may consist of a single or multi-piece plate 3.71 coaxially fixed to a rigid elongated rod 3.72 or the like, such as by a series of ordinary screws. A typical penetrating fixation screw, wire or pin 3.73 connects to the base member 3.19, 3.21 and rod 3.72 via various connectors 3.74. This connector 3.74 may be mounted on or integral with plate 3.71, as will be understood by those skilled in the art, and may be a rod as shown in FIG. 29. It may be mounted directly on 3.72.

The struts 3.23, 3.29, 3.35, 3.41, 3.47, 3.53 and the connector means 3.59, 3.
61, 3.63, 3.65, 3.67, 3.69 are preferably the various struts 23, 29, 35, 41, 47, 53 and connector means 59, 61, 63, 65, 67,
Since it is the same as 69, struts 3.23, 3.29, 3.35, 3.41, 3.47, 3.
In order to fully appreciate the various possible configurations of 53 and connector means 3.59, 3.61, 3.63, 3.65, 3.67, 3.69, the various struts 23, 29, 35, 41, 47, 53 and connector means 59, 61 , 63, 65, 67, 69. Each plate 3.71 is configured to use connector means 3.59, 3.61, 3.63, 3.65, 3.67, 3.69. Thus, for example, for the embodiment shown in FIG. 29, each plate 3.
71 preferably has a plurality of partial spherical cavities 3.79 for rotatably capturing each pair of partial spherical members of the illustrated split ball connector means.

The present invention, configured as described above, provides a novel external fixator and reduction mechanism. The fixator preferably comprises two base members or swash plates interconnected by six struts of adjustable length. However, the fixator of the present invention may include more or less than six struts. Preferably, the device comprises two to eight struts of adjustable length. These struts are inclined relative to each other in the rest position. In a preferred embodiment, these struts are regularly spaced and similarly manufactured to aid assembly and clinical use.
Even if dissimilar struts are randomly placed, six axial corrections will be made gradually. Each strut in one preferred embodiment is a turnbuckle attached to the hemisphere on both sides. One hemisphere mates with the strut hemisphere near the partially encapsulated socket, and there are three such sockets on each of the swashplates. When viewed from the axial direction, the sockets of one swashplate are staggered with respect to the sockets of the other swashplate. This partial socket, which limits the split ball, may be a part integrally formed with the swash plate or may be additionally mounted.

The present invention functions as a fixing device and a mechanism in which the rotation of the ball is not clamped by the socket. Ideally, there is sufficient clearance, the ball rotates about three axes, and each hemisphere rotates about an axis that is perpendicular to the plane of each hemisphere and passes through the center point of the hemisphere. There is no excessive play along the two translation axes.
Although it is possible to further clamp the ball to prevent movement, this device additionally allows the hemispheres to move around each other and / or around the ball joint pair in the socket by changing the length of the struts. Can function as a reduction mechanism by rotating.

The present invention can function as a stabilizing fixture, but the ball rotates freely without being tightly clamped. The external fixator pin clamp may be a part integrally formed with the swash plate or may be attached. These clamps are then attached to pins or wires attached to the bone fragments. The position of the bone fragments can be changed by adjusting the effective length of the six struts accordingly. Each of the six new coordinate positions that one fragment takes with respect to the other fragment can be obtained by changing the effective length of the six struts. Each combination of strut lengths determines each of the six unique coordinate positions of one fragment relative to the other. No change in position between fragments can occur unless the effective length of one or more struts is changed. There is no excessive restriction that any change in the length of any strut results in a change in the position of one fragment relative to the other. By manual calculation, computer or computer coordinate transformation, one can move one fragment to a certain extent relative to the other by precisely changing the length of each strut.

Alternatively, a similar accessory swashplate showing only the center of the split ball can be used to determine the initial strut length. X-rays are taken perpendicular to the deformed limb and these and careful physical testing assess or measure the deformation. In the deformed position, one fragment is considered to have moved from its initial position or from a preferred position due to a shift along and / or about the six axes, which shift is a factor of the present invention. It can be corrected by an external fixator. Assuming the neutral or home position of the present invention, the attached swashplate is held in a similar home position. One accessory swashplate is then offset from the other accessory swashplate along and / or about six axes by an amount equal to the degree of deformation measured by x-ray and physical tests. The distance between the marks corresponding to the split ball joint is measured while the attached swash plate is held in the positional relationship of the deformed space. The corresponding struts are then adjusted and engaged. This is repeated for the remaining five struts. At the end of this step, the invention is exactly as deformed as the limb. The invention is then fixedly attached to the bone fragment with a skeletal pin or wire. The strut is then gradually or abruptly adjusted to its initial or home length. Since the present invention is attached to the bone, correcting the present invention corrects the deformation of the bone.

Method of Using the Device of the Invention The method of new use of the invention will now be described with reference to a preferred embodiment of the new fixture shown in FIG. As described above, this embodiment of the device has two circular base members 71.
And six length-adjustable struts 301 interconnecting two base members 71 (each having 2
3, 29, 35, 41, 47, 53). The column 301 is attached to the base member 71 by six divided ball connectors. In addition, most of the detailed descriptions of the methods provided herein, in particular, relate to deformities of hard tissue, particularly tibia. The following methods are illustrated by this preferred embodiment of the present invention and the tibia deformities, but those skilled in the art will readily understand that these methods can be readily applied to other embodiments of the present invention and other tissue deformities. Applicable.

I. Method Overview A new method using the apparatus of the present invention employs projection geometry, trigonometry and matrix algebra and provides a general deformation equation that mathematically characterizes the deformation. The general deformation equation determines each length of the adjustable strut and causes the device to take a form that mimics or mirrors the deformation. The general deformation equation is based on a plurality of parameters, including the position of the bone relative to the device (ie, device parameters and eccentricity) and the relative position of the bone fragments (ie, deformed portion parameters).

Due to the new design of the external fixture, by adjusting the length of one or more adjustable struts, the device is configured to substantially mimic or mirror any bone deformities. Can be taken. As shown in FIGS. 30 and 31, there are two preferred methods of using the apparatus of the present invention. According to the first method shown in FIG. 30, there are generally three methods. First, a device in a neutral position is set as a deformable part (I). next,
The deformed part is analyzed and characterized by various parameters (II). These parameters are then used to determine the appropriate length of each strut necessary to cause the device to take the form of reflecting the deformation (III), thereby correcting the deformation. This method is referred to herein as the acute deformation technique. According to the second method of the present invention shown in FIG. 31, the deformed part is first characterized by various parameters and the expected attitude of the device (I). Next, the length of each strut is adjusted, and the apparatus is set as a deformed part in a form imitating the deformed part (II). The length of each strut is readjusted and the device is reconfigured to return to a neutral position (III), thereby correcting any deformities. This method is referred to herein as the chronic deformation technique. As will be described in further detail below, the strut length required to reconstruct (ie, chronic) or compensate (ie, acute) a given deformity is determined using a variety of orthopedic and geometric principles. It is determined.

A third preferred method of using the device of the present invention can be used for either chronic deformities or residual deformities. According to this technique, a deformed device (that is, a device in which the lengths of the columns are not equal) is set in the deformed portion, and the deformed portion is corrected based on the geometric relationship between the segments of the deformed portion and the device. The new effective strut length required to perform this is determined, but such a new effective length is not the same, i.e., the device remains deformed after the deformation is corrected.

A fourth preferred method of using the device of the present invention can also be used for chronic or residual deformation. According to this technique, the device is placed on a tissue segment such that each base member is orthogonal to the corresponding tissue segment. The length of one common neutral strut is calculated by determining how far the base member must move to correct the deformation. By adjusting the struts to neutral length, the tissue segments are repositioned to one another without applying any rotational mathematics to the system.

A. Chronic Technique The chronic technique of the present invention is generally used to correct incomplete or unbound deformities of congenital deformities and acquired or subsequent trauma. Generally, the first
And a new method of using the device according to the invention by means of a chronic technique for correcting the deformation between the second bone segments comprises the following steps. Referring to FIG. 31 (I), the chronic technique measures the surgeon's anterior-posterior radiograph 313 and lateral-intermediate radiograph 315 and performs a bone clinical test to obtain six deformable parameters. Based on yet other clinical trials, the surgeon determines the size of the device to use. The selected device size provides three device parameters. Next, the surgeon predicts the relative position of the deformity to the device based on the pre-operative plan. These thirteen parameters are input to a deformation computer or computer program based on a general deformation equation, which computer or program has six specific new strut lengths that cause the device 11 to take the form of accurately mimicking the deformation. Answer Next, the strut is adjusted to the new strut length and the device is attached to its framework (II). The deformation is corrected when the strut is returned to neutral length (III).

A new method of using the device of the present invention by a chronic technique to correct a deformity between the first and second bone segments comprises, inter alia, the following steps. 1. Determine the deformed part parameters. The determination includes making the following measurements of the position of the first bone segment relative to the second bone segment determined from radiographs and clinical trials. a; forward-backward (AP) displacement as seen in the lateral-middle diagram, b; lateral-central (LAT) displacement as seen in the AP diagram, c; axial displacement as seen in either the LAT or AP diagram, d: AP angle seen in LAT diagram, e: LAT angle seen in AP diagram, f: Axial rotation determined by clinical trial.

2. The origin, which serves as a convenient reference point, is determined as the deformation site. The origin is preferably at the measured level of the AP and LAT displacement. 3. Select an appropriately sized device to provide device parameters. The parameters include the effective diameter of the first base member, the effective diameter of the second base member, and the initial neutral length of the strut.

[0079] 4. Predetermining an appropriate position on the first bone segment 309 for attaching the first base member 305 to the first bone segment 309, and determining an eccentricity of the device when the device is installed at the predetermined appropriate position. . The eccentricity of the device is: a. A vertical distance from the first base member 305 to the origin, b. A horizontal displacement of the origin from the centerline of the device 11, where the horizontal displacement includes a forward-backward displacement and a lateral-center displacement, c. Including a preset rotational orientation of the device and the amount by which the second bone segment rotates about its axis from its corrected position, wherein the first base member is considered a moving base member and the second base member is stationary. Considered a base member.

[0080] 5. When the device is set to the bone segments 39 and 311 at an appropriate position determined in advance, the effective length of each strut 301 required to cause the device to imitate the deformed portion is calculated. 6. The effective length of each strut 301 is adjusted to cause the device to take the form of imitating a deformed part. 7. The first attachment mechanism is attached to an appropriate predetermined position of the first bone, and the second attachment mechanism is attached to the second bone. 8. The effective length of each strut 301 is adjusted to the initial neutral length, thereby substantially correcting the deformation.

B. Acute Techniques Acute techniques are usually used for reduction of acute fractures. Generally, the method of using the device of the present invention by an acute technique includes the following steps.

Referring again to FIG. 30, first the surgeon places an appropriately sized device around the fracture,
Attach the column with its neutral length (I). Three device parameters are determined based on the selected device size. Standard reduction techniques are used when a neutral device is applied. AP and LAT radiographs 313 and 315 are obtained after surgery and clinical trials are performed (II). From these radiographs and clinical tests, six fracture deformity parameters and four mounting parameters are measured. These 13 parameters are entered into a deformation computer or computer program based on a general deformation equation, which answers six specific new strut lengths that adjust fixture 11 to accurately represent the deformation. The deformity is fully corrected as the strut moves to its new length (III).

A new method of using the device of the present invention by an acute technique to correct a deformity between the first and second bone segments comprises, inter alia, the following steps. 1. The appropriate size device is selected, and the first attachment mechanism is attached to the first bone segment 309, and the second attachment mechanism is attached to the second bone segment 311. The selected device size provides the device parameters, which parameters include the effective diameter of the first base member,
Including the effective diameter of the second base member and the initial neutral length of the strut.

2. Determine the deformed part parameters. The parameters include a subsequent measurement of the position of the first bone segment 309 relative to the second bone segment 311. a. AP displacement seen in LAT diagram, b. LAT displacement seen in AP diagram, c. Axial displacement as seen in the LAT or AP diagram, e. LAT angle seen in AP diagram, f. Shaft rotation determined by clinical trial. 3. Determine the origin at the deformed part as a convenient reference point. It is preferably at the same level where the AP and LAT displacements are measured.

[0085] 4. Determine the eccentricity of the device. The eccentricity includes: a. A vertical distance from the first base member to the origin, b. Horizontal displacement of the origin from the center line of the device, where the horizontal displacement includes forward-backward displacement and lateral-center displacement, c. The predetermined rotation orientation of the device and the amount of rotation about the axis from the corrected position of the second bone segment. Here, the first base member is considered a moving base member and the second base member is considered a stationary reference base member.

[0086] 5. The effective length of each column 301 required to cause the device 11 to take a form that reflects the deformed portion is calculated. 6. The effective length of each strut 301 is adjusted to cause the device 11 to take the form of reflecting the deformed portion, thereby substantially correcting the deformed portion.

II. Device Parameters In both the deformity technique and the acute technique, the surgeon must select an appropriate device size, ie, device parameters. There are three device parameters,
They are the effective diameter of the first base member 305, the effective diameter of the second base member 307, and the strut 30.
Initial neutral length of 1. The effective diameter of the base member 71 is the diameter of a circle that substantially intersects the connector 303 coupled to such a base member. According to the preferred embodiment of this device shown in FIG. 1, the base member 71 is circular, so that its effective diameter is the actual diameter of the base member 71. However, different base member shapes can be used in the device of the present invention.

III. Locating the first bone segment relative to the second bone segment (deformation parameters) The deformation parameters include six measurements that characterize the deformation. In particular, the six measurements represent the position of one bone segment or fragment relative to the second bone segment or fragment. The six deformation parameters are AP translation, LAT translation, axial translation, AP angulation,
Includes LAT angulation and rotation about an axis. Determining the deformation parameters is a step of both the chronic technique (step 1, above) and the acute technique (step 2, above).

Generally, the orthopedic surgeon uses the bone segments 309, 311 to use when measuring.
A common axis (anatomical or mechanical) must be identified for
AP and LAT X-rays are taken and a long film (X-ray graduated) with anatomical or mechanical axes helping the surgeon to identify the deformation parameters
(Including hip, knee and ankle joints).

It has proven useful to consider one bone fragment as a fixed reference and consider the other bone fragment to move or deform. Orthopedic arrangements typically characterize the deformation of the distal fragment relative to the proximal fragment, that is, the proximal fragment is the reference fragment and the distal fragment is the moving fragment. However, certain methods of using the fixator of the present invention can also be used when considering the distal bone fragment as a reference bone fragment and the proximal bone fragment as a moving or deformed bone fragment. This atypical characterization of the deformity (ie, using the proximal bone fragment as a moving or deformed bone fragment) is particularly useful in malunion or malunion of the proximal tibia with short proximal bone fragments . The location of the attachment of the proximal foundation (using the articular surface and the fibula head as landmarks) is more accurate in preoperative planning and surgery than at the level of attaching the distal foundation to its long distal bone fragment. To decide. It also allows the surgeon to characterize the deformation well, although the radiograph is too short to include the level of attachment of the distal foundation.

Before specially addressing the determination of the deformation parameters, the sign agreement (+/-)
Must be adopted for the orthopedic standard terminology typically used when examining the human body. Those skilled in the art will appreciate that the sign convention we adopt is free and that any other sign convention can be used. It is only important that once a standard is selected, it must be applied consistently.

Referring now to FIG. 33, an illustration of a preferred embodiment of the present invention illustrates the sign convention we have employed. We set the sagittal plane as the YZ plane, the coronal plane as the XZ plane, and the transverse plane as the XY plane. The point of interest, or the origin we describe, is the zero point of our coordinate system. As shown in FIG. 33, all points above the origin along the Z axis are positive, all points above the origin along the Y axis are positive, and X is assumed to be your own. All points to the right of the origin along the axis are positive.

The sign convention must also be applied to rotational movement. According to the preferred method of the present invention, the right-hand rule should be applied to the determination of the sign for the rotational movement. According to the right hand rule, when pointing with the right thumb along the positive reference axis, a positive rotation about that axis is the direction of the tip of the finger. Arrow 319 in FIG. 33 indicates the positive direction of rotation about each axis as determined by the right hand rule.

To further illustrate the use of the preferred sign convention, the following table summarizes the prior art for various translations and rotations of the moving distal bone relative to the reference proximal bone for the left and right tibia. List orthopedic terms and corresponding mathematical symbols.

[0095]

[Table 1]

To further illustrate the use of the preferred sign convention, the following table summarizes the prior art for various translations and rotations of the moving proximal bone fragment relative to the left and right tibia reference distal bone fragments. List orthopedic terms and corresponding mathematical symbols.

[0097]

[Table 2]

After checking the common axis 317 and adopting the sign agreement, the deformation parameters can be determined. FIG. 32 illustrates how to determine deformation parameters for the deformed tibia. In this illustration, we have selected the proximal fragment 309 as the reference fragment and the proximal fragment 311 as the moving fragment. APX (I) and X-ray (II) are made by deformation. As shown in FIG. 32, a center line 317 of the reference bone piece 309 and a center line 317 ′ of the deformed moving bone piece 311 are drawn. Both centerlines 317, 317 'extend along the common axis of the modified bone. AP angulation is indicated by arrow 321; LAT angulation is indicated by arrow 323;
It is determined by measuring the opening angle of the center lines 317 and 317 'drawn in FIG.
The rotation around the axis (III) (inside or outside rotation) is evaluated calmly or with special films. As shown by arrow 325, rotation about the axis is the amount of rotation about the bone centerline from its normal position.

According to a preferred method of using the apparatus of the present invention, the translation parameters are determined as follows. As shown in FIG. 32, AP translation (I) and LAT translation (II) (ie, excursion) are perpendicular at the level of the origin from the centerline 317 of the reference bone fragment to the centerline 317 'of the moving bone fragment. The distance, the origin of which is usually the inner edge of the moving bone fragment 311. The AP excursion in FIG. 32 is indicated by arrow 329. The LAT excursion in FIG. 32 is indicated by arrow 328. The axial translation can be measured on an AP or LAT radiograph, and the axial translation can be measured along the bone fragment 309, measured along the centerline 317 of the reference bone fragment.
311 is the distance between the inside edges. The axial translation in FIG. 32 is indicated by arrow 331. The sign of each deformation parameter is based on the coordinate axes and right hand rules as discussed above.

IV. Determining the Origin In addition to determining the deformation parameters characteristic of the orientation of the bone fragment relative to the bone fragment or bone fragment, the surgeon also determines the eccentricity characteristic of the direction relative to the device. There must be. As a result, one point must be selected on the skeleton and serve as a reference to characterize the orientation of the skeleton with respect to the device. We refer to that reference point as “
"Origin".

According to both the chronic technique (step 2, top) and the acute technique (step 3, top)
The surgeon must determine the "origin." According to a preferred method of using the apparatus of the present invention, the origin is the point at which the correct rotation occurs. The Z coordinate of the origin is AP and L
It is preferably the same as the level for measuring the AT deviation. Appropriate selection of the origin and avoiding compression, splitting or excursion at the site of osteotomy / osseous fusion while correcting the deformation must be avoided.

FIGS. 34-36 illustrate preferred origins for some situations. As shown in FIG. 34, if the deformation consists only of translation, the center of the base member 305 at the level of the inner end of the moving bone fragment can be set as the origin 333. However, any point may be selected as the origin 333 when including pure translational deformation. As shown in FIG. 35, if the deformation has significant angulation, a point on the convex cortex at the medial end of the moving bone fragment is selected as the origin 333, and the compression hinge or excessive preload on the pin and wire. Should be prevented. As shown in FIG. 36, if the deformation involves significant rotation,
The origin 333 should be selected as the center of the moving bone fragment in the deformation to prevent unnecessary translation during rotation of the moving bone fragment. Alternatively, the origin may be located at the convex portion of the deformation from the center of the moving bone fragment. Rotation in the convex cortex is necessary, especially for correction of congenital deformities, malunion and rigid bone malunion. Alternatively, too large implants and excessive constraints in the convex cortex may result in excessive preloading of the pins and wires and insufficient correction of deformation.

V. Calculating the Orientation of the Skeleton with respect to the Device (Eccentricity of the Device) After selecting the origin 333, the surgeon can characterize the position of the device 11 with respect to the origin 333. In accordance with a preferred method of the present invention, the position of the device relative to the bone is characterized by the eccentricities of the four devices, including the eccentricity in the axial direction, the lateral eccentricity, the AP eccentricity, and the rotational eccentricity. Figures 37-43 illustrate the determination of the eccentricity of the device. For illustration purposes, the distal bone fragment and the base member should be considered here, the reference bone fragment and the base member, and the movement of the proximal bone fragment and the base member. . In particular, the second bone fragment 311 and the second base member 307 are considered with respect to the reference point,
Then, the first base member 305 and the first bone fragment 309 consider a moving component. As outlined above, the eccentricity of the device can be compared between chronic technology (step 3, top) and acute technology (step 4).
, Above).

A. Sign (+/-) Arrangement for Eccentricity As noted above, it is important to adopt a stable sign arrangement and apply it consistently according to the specific methods described herein. In accordance with the preferred code agreement discussed above, the following table generally indicates what the codes are for various eccentricities.

[0105]

[Table 3]

B. Axial Eccentricity As illustrated in FIG. 37, the axial eccentricity is indicated by the arrow 335 and is a measure of the length from the level of the moving base member 305 to the origin 333 parallel to the central axis 337 of the device. It is. This can be almost measured on a LATX photograph (I) or an APX photograph (II). This measurement partially identifies the orientation of the bone with respect to device II.

C. AP and lateral eccentricity of the bone with the device Most tibia installations using a circular fixator place the tibia anterior to the geometric center of the underlying member. Referring to FIG. 38, a radiograph of the deformation is shown in FIG.
In accordance with the preferred method of the present invention, as illustrated at
Must be measured from the center line 337 to the origin 333 in a plane parallel to the moving base member 305. This distance is the AP eccentricity as shown by arrow 339. Referring now to FIG. 39, an APX photograph is shown. Figures 39 and 40
If the tibial bone fragment is not centered in the APX radiograph, as illustrated in FIG. Should be measured. This distance is the lateral eccentricity as indicated by arrow 341. In accordance with the chronic techniques outlined above, the position of the bone relative to the device 11 can be predicted when treating rigid bone malunion, malunion and congenital malformation. The values corresponding to the axial eccentricity, lateral eccentricity, lateral eccentricity and AP eccentricity are entered into the general deformation equation described below to determine the exact strut length of the device and Simulate the deformation given while maintaining the expected relative position.

Following the acute technique outlined above, new fractures, axial eccentricity, lateral eccentricity, and AP eccentricity are measured on post-operative films. As with the chronic technique, these values are put into a general deformation equation to determine the exact strut length for the device and to compensate for or reproduce acute deformation.

D. Eccentricity in the direction of rotation To characterize the rotational position of the device 11 relative to the skeleton, the device 11 relative to the skeleton
The preferred direction must be adopted to provide a reference physique. One skilled in the art will appreciate that the preferred direction of rotation that we have chosen is arbitrary and that other reference directions can be selected. We have, according to the preferred method of the invention,
Having a connector 59 (i.e., a master connector) of the proximal reference member 305 between the strut 23 and the strut 29 located exactly forward, as the convenient reference orientation is illustrated in FIG. all right. This preferred direction is appreciated for both tibia and both forearms. Referring to FIG. 42, the preferred device orientation is shown for the left and right femur and humerus. The preferred direction for the right femur 343 and the right humerus 345 has a master connector 59 rotated 90 degrees to the right (i.e., -90 degrees). The preferred direction for the left femur 347 and left humerus 349 is 9
It has a master connector 59 rotated by 0 degrees (that is, +90 degrees). FIG. 43 illustrates the eccentricity of the rotation direction with respect to the tibia. The eccentricity in the direction of rotation is shown by line 351 and the eccentricity is clinically determined as the amount of bone rotation relative to the device from the preferred direction.

When used for fractures in accordance with acute techniques, the device 11 may be accidentally turned on and off during operation. To compensate for an irregularly rotated device, the eccentricity in the rotational direction is the anatomical sagittal position of the reference bone fragment relative to the reference base member.

VI. Calculating the Required Length of Each Strut In the nineteenth century, Michel Scharter described a complex repositioning of six-axis (three translations and three rotations) objects, threaded nuts along the screw axis. It was the first time I realized that it could be reproduced by rotation. Generally, this axis is inclined with respect to the reference axis. The offset from the center of the axis corresponds to two translations, and the pitch of the screw corresponds to a third translation. The rotation about the tilt axis corresponds to three orthogonal rotations. As a result, the inclination axis of the shar (shar axis) can serve as a useful model for understanding deformation correction. This tilted shar axis is the ultimate Ilizarov hinge axis because it can correct all three irregular rotations simultaneously.

The method of the present invention uses a general deformation equation based on vector analysis of radiographically measured rotations and clinical examination, which yields a Shar-le-axis and an associated rotation matrix. In general, the particular location of any object can be determined by placing three non-coaxial points on that object. Referring to FIG. 44, the method of using the apparatus of the present invention uses the general deformation equation and the position (P) of the connector 303 of the apparatus 11.
Is determined when the device is in (1) its standard position (I) and (2) its deformed position (II). More specifically, certain methods of the present invention use the general deformation equation to determine the connector coordinates for each strut (ie, P ₁ (X ₁ , Y ₁ , Z ₁ ) for strut 23 in standard position (I). And P ₄ (X ₄ , Y ₄ , Z ₄ ) and the deformation position (
P ₁ against the strut 23 _{II) '(X 1',} Y 1 ', Z 1') and _{P 4 (X 4, Y 4} , Z 4)). The distance between the connectors is then solved using Pythagorean theorem, which is equal to the appropriate length for the struts.

Referring to FIG. 45, when simulating or reproducing deformation, one of the reference members 305
Rotate and / or translate one. According to the chronic method, one starts with standard equipment (
I), and first give a rotational movement (II). Then, give a translational movement (III). Therefore, the general deformation equation includes a rotation component [R] and a translation component [T]. The next consideration is to first analyze the rotational component of the general deformation equation, and then address the translational component.

A. The rotation component of the general inequality The rotation component of the general inequality consists of a rotation matrix based on the Chasles Axis, and is expressed as follows.

[0115]

(Equation 9)

Using this rotation matrix, the second state (for example, the deformed state) can be obtained using the initial coordinate values (X, Y, Z) of any point of interest in one state (for example, normal state). ) Can determine new coordinate values (X ′, Y ′, Z ′) for the same point.

If the above code rules are utilized, the chass axis is developed as a vector having a direction and a magnitude. The three contributions to the vector would be based on three angles (ie, rotation). Two angles are determined from the radiograph and a third angle is determined from the clinical examination.

In the progression from the normal state to the deformed state, this rotation of the notch about the Chares axis is always forced, and the right-hand rule, ie, clockwise along the axis and swinging toward the starting point. It is based on the frog counterclockwise rule. Although the Chares axis is oriented along the positive or negative coordinate axes, it is recognized that the rotation of the Chares axis is always a positive progression from the normal state to the deformed state.

According to a preferred embodiment of the present invention, the following technique is used for determining the chaless axis. In order to explain the method of determining the Charles axis, consider the simplest situation where the deformation is only one-dimensional angular deformation. Consider a radiograph as a projection of a deformation onto a reference plane. FIG. 32 (I) shows such a radiograph. The broken bone has two pieces 309, each part having a respective centerline 317 and 317 '.
And 311. If the angle 321 between the centerlines 317 and 317 ′ is θ, the axis of rotation that occurs (considering the right-hand rule that determines the sign) is perpendicular to the reference plane and in that direction (positive or negative axis). Is determined by the value of tan θ. As shown in FIG. 46, when the angle is greater than −90 ° and smaller than + 90 °, θ is positive, tan θ is negative, and the Chares axis 353 becomes parallel to the positive Y coordinate axis, thus reconstructing the front deformation. To form a sagittal hinge. The magnitude of rotation (σ) in this one-dimensional case is

[0120]

(Equation 10) It is. Where A tan is the arc tangent.

As shown in FIG. 47, the angle in the AP radiograph is −θ,
tan -θ is negative and the charles axis forms a sagittal hinge that reconstructs the front deformation except that it is oriented parallel to the negative Y coordinate axis and in the opposite direction to the first embodiment. If the Chares axis is characterized as a vector with a sense of direction, it will be understood that the effective rotation of the Chares axis in the example described in FIG. 46 is in the opposite direction to that of the Chares axis shown in FIG. The rotation about the Charles axis is always positive based on the right hand rule that is consistent in the examples shown in FIGS. Once we have determined the chares axis, which is a vector and not just a hinge line, we want to remember the sense of direction that always gives the proper way of rotation when the right hand rule is applied. This avoids the problems associated with conventional methods of causing confusion about the direction of rotation about the hinge, especially bi- and tri-plane deformations.

Next, a code based on the right-hand rule is determined to determine the angles appearing in each of two orthogonal radiographs in each radiograph. Taking the angle tan, the values are plotted along a reference coordinate axis orthogonal to the plane of the radiograph. The last axis of rotation is the sum of the vectors of the two orthogonal components. As shown in FIG. 48, the Chares axis 353, as shown in FIG. 48, as well as the last Chares axis lying along the reference axis in the special case, is the spatial axis as determined by the +/- coronary axis and the +/- flex axis. Located in any of the four quadrants. The true magnitude of two-dimensional rotation is

[0123]

[Equation 11] It is. Where θ is the amount of rotation measured in an AP radiograph and φ is LAT
The amount of rotation measured on the radiograph.

Finally, consider the most difficult three-dimensional rotational deformation. The amount of rotation is 2 as the abnormal rotation of the shaft.
Determined from two orthogonal radiographs and laboratory tests. Each radiograph or laboratory determines the angle of the deformation, takes the tan of that angle, and plots the values along a reference axis orthogonal to the radiograph. As shown in FIG. 49, the last rotation axis 353 is a vector of the sum of three orthogonal components. The Chares axis 353 may be located along a reference coordinate axis in a special case, but as shown in FIG.
Residing in any one of the octants determined by the vector axis. The magnitude of the three-dimensional rotation is

[0125]

(Equation 12) It is represented by Here, θ is the amount of rotation measured on the AP radiograph, and δ is the amount of rotation around the axis determined from clinical examination.

Treating the rotation or Chares axis as a vector quantity allows the surgeon to accurately position this axis in any of the octants and reconstruct the deformation by recalling the right hand rule. Can easily be determined. This specificity occurs when the requirements are in the opposite direction and when Ilizarov fixat
or) eliminates the side-effects of assembling. For example, varus / exte
The hinge axis of the deformation is considered to be the same except that the valgus / flexion and rotation are opposite. The surgeon rolls up his trousers leg and double checks in a row to see if he has assembled the opposite device. Imagine that the surgeon routinely tackles the extraordinary longitudinal rotation. again,
The difficulty of maintaining the proper code doubles.

Once the Chares axis (or hinge vector) and the extent of rotation are known, they can be used to create a rotational transformation matrix that accurately replicates the three angular deformations measured in radiographs and clinical examinations. According to a preferred embodiment of the present invention, the matrix we have found to work well for relatively small angular deformations is that three angles from the oblique axis to three orthogonal reference axes are known. A state of rotation was created around an oblique axis.

[0128]

(Equation 13)

The three angles based on this matrix are: true angle alpha (α) (angle with X axis), beta (β) (angle with Y axis) and gamma (γ) (angle with Z axis) It can be seen that the projection angle theta (θ), phi (φ) and delta (δ) are measured by radiography and clinical examination. Three true angles (α, β,
γ) is described by the projection angles (θ, φ, δ) as follows.

[Equation 14] Further, the value of σ is given in advance by the following equation.

[0130]

(Equation 15)

By knowing the three true angles (α, β, γ) and the magnitude of rotation (σ), the rotation matrix is completely solved by the projection angles (θ, φ, δ). Thus, if the coordinates of the three non-coaxial points on the externally anchored base member in a natural or preferred state (ie, for example, the tether) are known, those points can be used when the externally anchored skeleton causes the same angular deformation. New coordinates can be determined.

It can be seen that the above rotation matrix works well when there is almost no axial deformation. In fact, in some applications, there is the fact that this program is relatively simple and can be used for both simulated and mirrored deformations. However, in the case of relatively large axial deformations, the above method has been found to introduce undesirable errors in the calculation of the last rotation. The reason for these slight errors is that the rotation matrix did not take into account the order of rotation about the X, Y, and Z axes in the decision. When applied to points of interest, the respective deflections of the angles act together simultaneously rather than continuously. This is X
And / or has the arithmetic effect of rotating a point about the Z-axis after already partially moving along the Y-axis. Rather than simply transmitting the rotation of the axis (just shifting the axis rotation measured in the laboratory as δ), this matrix has the arithmetic effect of moving the point to a slight spiral.

A more effective matrix combination for calculating the rotation of one point utilizes three projection angles (θ, φ, δ) as defined above. But,
Using three separate matrices so that the arithmetic operations are performed in one continuous manner is close to the way the deformation was actually measured. This set of matrices is described below as the Euler matrix.
The rotation around the z-axis by the Eura matrix is described by the following equation.

[0134]

(Equation 16) here,

[Equation 17] It is.

The rotation around y according to the Eura matrix is described by the following equation.

(Equation 18) here,

[Equation 19] It is. The rotation around x by U20trix is described by the following equation.

(Equation 20) here,

(Equation 21) It is.

Using three separate Eura matrices, the position of the post connector can be rotated around the three axes in the proper order. The purpose is to rotate the position around the z-axis when the rotation of the x-axis and y-axis does not deleteriously affect the final position. When the column is manipulated to simulate mere rotational deformation according to the long-term method described above, the coordinates are transformed into an [Rδ] matrix prior to rotation about the y and x axes using the [Rθ] and [Rφ] matrices. To rotate first about the z-axis. When the strut is manipulated to mimic mere rotational deformation according to the sensitive method described above, the points first rotate around the x and y axes using the [Rφ] and [Rθ] matrices, and then use the [Rδ] matrix. Rotation about the z-axis is performed. The order of the [Rθ] and [Rφ] matrices does not affect the result and can be specified in either way.

The Eura matrix is also first manipulated and then applied to vector coordinates. This has the same effect as operating each rotation matrix in turn. Applying basic matrix arithmetic, the long-term rotation matrix obtained by multiplication [Rδ] × [Rθ] × [Rφ] is

(Equation 22) It is. And the rotation matrix of the exact method obtained by the multiplication [Rφ] × [Rθ] × [Rδ] is

(Equation 23) It is.

If more precision is required than can be obtained by using the Eura matrix, it induces the third rotation matrix to call for the slightest error that can even occur with both of the above rotation systems. These errors are a paralysis match (
paralytic homologue). According to this theory, when an element rotates about two orthogonal axes (eg, the X and Y axes), it appears that the element rotates slightly about a third orthogonal axis (eg, the Z axis). The following matrix derives a way to eliminate this small amount of error. Thus, this matrix is most useful when resources are available that allow for relatively complex calculations with limited precision. This equation also defines the projection angles (θ, φ,
δ).

[0139]

(Equation 24) here

(Equation 25) It is.

For axial rotation to be applied on the side, it depends on whether the AP rotation is chronic or acute measures are required. The matrix stays the same for each rotation, but rotations that are not preferred in this approach are those where the appropriate θ, φ, or δ values are “zeroed” (
zeroing) "to remove from each step. For example,
In order to simulate mere rotation deformation by chronic means, rotation deformation calculation is performed in the following order. Axial rotation; AP rotation; and lateral rotation:

(Equation 26)

In order to reflect a mere rotational deformation by an acute means, the rotational deformation calculation is performed in the following order. AP rotation; and shaft rotation:

[Equation 27] For the Eulerian approach, the order of the APs and lateral rotations is not critical to the result, but has been replaced here for consistency. Approximately, the rotation matrix may be broken up before being applied to the coordinated vector.

B. General Modified Transformation Elements The three transformations observed in radiography measure the offset of a fragment along the X, Y and Z axes. As shown in FIG. 50, these three transforms are equivalent transform vectors 355 [T
] May be added in a vector manner to generate.

[Equation 28] Here, [T] is a conversion element of a general deformation type.

For the same reason that the most accurate results are obtained when the rotation matrix is applied in a reasonable order, the transformation matrix should also be applied in the correct order relative to the rotation matrix. is there. This ensures that the rotation of the point is performed about the selected intentional origin. When the deformation is mimicked (ie, according to a sensitive method), the transformation matrix is applied to the coordinates of the point under consideration before the transformation contribution to the general deformation is added. Therefore, a general variant for chronic methods can be expressed as:

[0144]

(Equation 29) Here, [R] is any one of the above three rotation matrices. X
, Y and Z are the initial coordinates for the position on the working ring. [T] is X, Y
, Z-direction transformation matrix. X ', Y', Z 'are transformation coordinates for the working ring. And a general variant for the sensitive method is given by:

[Equation 30]

C. Rings First Method The “rings first” method of deformity correction involves first attaching the ring of the base member to the corresponding fragment and then applying the struts, but with sensitive fractures or chronic deformities. Applied to This method is advantageous in that it does not require the application of a rotation matrix to reposition the base member. Thus, the surgeon can quickly rearrange the fragments without software assistance.

This method is illustrated in FIG. The base members 305, 307 are initially
Mounted orthogonal to each fragment, then six struts 301 are mounted between the base members (illustrated in I and II in FIG. 53). Reference points 400, 401 are selected at the end of each bone fragment 309, 311 where it is desired that the bone fragments be relocated such that the reference points meet. The height of the neutral frame is determined by measuring the distance from each base member and summing these distances as illustrated in FIG. 53IV. Neutral strut length is to apply the basic geometry to the equilateral triangle defined by adjacent struts and base members (ie, equivalent strut lengths connected by the distance between strut connectors) Is determined by The fragments are compressed as shown in FIG. 53III so that the struts are returned to their neutral length. After bringing the struts to their neutral length, any remaining deformation can be corrected by applying the sharp deformation method described above.

D. Computer / Calculator Program The general variant can be used by developing a computer / calculator program that defines the length of the struts to mimic or reflect the deformation. As shown in FIGS. 1 and 6, according to a preferred embodiment of the present invention, the device includes six adjustable posts interconnecting six separate ball connectors, the length of the posts being: It is determined as follows.

The position of the six ring connectors when the device is in the neutral position is initially characterized by cylindrical coordinates (r, θ, z). These coordinates are then adjusted for rotational eccentricity and axial eccentricity to produce adjusted connector cylindrical coordinates (r, θ ', z'). Next, when the device is in the neutral position, the Cartesian coordinates for the device connector are calculated as:

(Equation 31) Thus, the coordinates of the six connectors are characterized in Cartesian coordinates and adjusted for eccentricity. The Cartesian coordinates of the neutral device can then be adjusted for side eccentricity and AP eccentricity to yield adjusted Cartesian coordinates (x ', y', z '). We can then construct the array.

[0149]

(Equation 32) For adjusted Cartesian coordinates of each connector taking into account various eccentricities. The array of connector coordinates of the working ring is transformed by one of the methods described above. For example, if a chronic method is utilized, the coordinate vectors are first multiplied by a rotation matrix to give new coordinates determined by the angle deformation parameters.

[Equation 33] Then, a deformation matrix based on the deformation transformation is added to produce new ball coordinates that mimic the deformation.

[0150]

(Equation 34) If a sensitive method is used, a transformation matrix is first added to the coordinate vector, and the result is then multiplied by one of the [Rφθδ] matrices to give the new coordinates.

(Equation 35)

Using the Pythagorean theorem, the post length required to mimic or reflect deformation can be determined. For example, the column 23 in FIG.
Assuming that connector 1 is connector 1 and connector 65 is connector 4 and connector 1 is on the working ring, the length of the strut is given by:

[Equation 36] This equation is repeated for each of the remaining five struts to create a new strut length to mimic the deformation.

Using the technique outlined above, to calculate the length of the six columns based on the input of 13 variables, including device parameters, deformation parameters, and eccentricity,
Anyone with ordinary skills in the art can easily program a computer or calculator.

VII. Clinical Considerations A. Compensation for Risk Condition Structure The surgeon is obliged to be aware that there is a risk condition structure on the deformation recess. When dealing with rotation about the vertical axis, in addition to conventional angle correction, the risk may be small or large depending on the direction of rotation on the axis. For example, when compensating for tibia flexion / valgus / external rotation, the peroneal nerve is at increased risk. However, when correcting for flexion / valgus / internal rotational deformation, axial rotation tends to derive dilation of the peroneal nerves created during flexion / valgus correction.

Referring to FIG. 51, a cross section of the tibia 359 is shown with the device 11 of the present invention mounted thereon. When the deformation is first angled, the distance from the temporary hinge axis (origin) 333 to the structure at risk, such as the peroneal nerve 357, is the risk radius indicated by line segment 361. Knowing the actual angle of deformation at the angle (σ) and the radius of the risk (r), the length to be extended into the structure of the risk state to trace the arc segment is given by: .

(37) Alternatively, if the actual angle of the deformation is expressed in radians, the arc length is given by:

[0155]

(38) The length of the arc is probably an overestimate of the required length, but if the structure at risk is swirling around the loose tissue mass or bone fragment. Can be used to determine the safest length, in particular. The shortest length or tendon length between the deformed risk state structure and the normal state structure is given by:

[Equation 39]

Furthermore, using the same program to calculate the new position of the connector of the working ring, with respect to the normal bone origin, the coordinates of the risk state structure are used to determine the coordinates of the deformation state risk state structure. be able to. The additional length needed for the structure of the risk state when the deformation is corrected is simply the distance between these two points solved by Pythagorean theorem.

B. Correction Rate Knowing the distance to correct and the biologically safe speed, you can determine the total number of days required to safely correct the deformation. Generally, a suitable rate will be 1 mm / day. However, one having ordinary skill in the art will determine what is the optimal rate of correction for a particular case. Deformation due to deformation of only three axes is
It does not contribute to rotation.

The full linear movement of any point on the working fragment is given by:

(Equation 40) Using one of the above methods, the total displacement of the structure at maximum risk can be determined. This distance divided by a safe speed will give the total number of days until the deformation is corrected.

From these neutral lengths or “zero” lengths, each strut will be adjusted to a new length to regenerate or compensate for deformation. The sum of the absolute values of the lengths of all new struts represents the total excursion of all struts during deformation correction. Divide the deflection of all struts by the number of days of treatment to get the amount of adjustment needed per day. According to the preferred design of the present invention, one full turn of the tightening screw changes length by 1.6 mm.

One way to adjust the strut to get the full number of tightening screw turns per day is to get the required one day deviation and divide by 1.6 mm. Prop 1
Start with. Make a full turn towards "zero" (for chronic technology).
Continue with struts 2 etc. until the total number of revolutions per day is reached. This sequence is
It can be performed throughout the day until a divided dose is reached. The next day, the patient begins the 1-6 sequence on the next strut. You don't have to change the struts every day. Once the strut reaches the neutral position, the remaining adjustments are skipped. The device can be adjusted in a similar way towards a way point.

C. Clinical Considerations When Correcting Sensitive Deformity-Fractures Fractures should be stabilized by the device in a neutral position. That is, all the columns are set to the neutral position or the zero position. Fractures should be corrected during use in a conventional manner. However, 6 of the device of the invention
Due to the correction of one axis, extra-articular fractures can be blindly stabilized and then corrected by gradually adjusting the struts, eliminating the need for subsequent anesthesia or device changes .

D. Clinical considerations when compensating for chronic deformities Non-orthogonal initial radiographs, errors in measuring radiographs, or excessive preload and bending of wires and pins. In addition, there may still be a sharp deformation when the strut reaches its neutral length. Simply measure the radiographs, conduct clinical tests for abnormal rotation, and determine a new strut length to build a correction device. This situation is similar to a sharp deformation after a fracture has stabilized.

E. Way Points It is desirable to bring fragments to a length before undergoing a transformation in the horizontal plane between significant shortening and correction of deformations with juxtaposition of bayonet pins. In order to increase patient morale, it is desirable to quickly correct the angular alignment and the rotational alignment. A number of mid-points or mid-points of the deformation correction are established and the exact combination of the column lengths is determined to complete the mid-point. According to FIG. 52, the use of a waypoint is illustrated. The initially deformed bone 363 is transformed into deformation parameters (θ, φ, δ,
(X, Y, Z) is shown in (I). If the deformation parameter is (0,0,
An intermediate point of (0, X, Y, 0) is shown at position (II), and all angle transformations and axis transformations are corrected. These waypoint parameters can be introduced into the strut length program and will provide the strut length to establish this intermediate position. The surgeon / patient first adjusts the device gradually to this intermediate position, then finally adjusts the strut length to their neutral position and corrects the deformation as shown in step (III) I do.

Although the invention has been described and illustrated with respect to preferred embodiments and preferred applications, it is understood that improvements and changes may be made within the full intended scope of the invention and, therefore, are not limited thereto. Should not be done.

[Brief description of the drawings]

FIG. 1 is a perspective view of a first preferred embodiment of an external fixator of the present invention in combination with an orthopedic external fixator of another element and a fractured tibia. FIG. 2 is an end elevation view of one end plate of the external fixator of FIG. FIG. 3 is an enlarged cross-sectional view substantially taken along line 3-3 of FIG. 2, with parts omitted for clarity. FIG. 4 is an enlarged cross-sectional view taken substantially along line 4-4 of FIG. 1 with parts omitted and shown for clarity. FIG. 5 is an exploded perspective view of one part of the connector means of FIG. FIG. 6 is a diagram of the external fixator of FIG. 1 shown in the first spatial arrangement. FIG. 7 is a view of the external fixator of FIG. 1 in a second spatial arrangement. FIG. 8 is a front view of an adjustable effective length strut portion of the external fixator of FIG. FIG. 9 is a cross-sectional view taken substantially along line 9-9 of FIG. FIG. 10 is a sectional view of a portion of a modified embodiment of the connector means of the present invention. FIG. 11 is a perspective view of a modified embodiment of the connector means of the present invention. FIG. 12 is an exploded perspective view of FIG. FIG. 13 is a perspective view of another modified embodiment of the connector means of the present invention. FIG. 14 is an exploded perspective view of FIG. FIG. 15 is a perspective view of still another modified embodiment of the connector means of the present invention. FIG. 16 is an exploded perspective view of FIG. FIG. 17 is a perspective view of still another modified embodiment of the connector means of the present invention. FIG. 18 is an exploded perspective view of FIG. FIG. 19 is a perspective view of still another modified embodiment of the connector means of the present invention. FIG. 20 is an exploded perspective view of FIG. FIG. 21 is a perspective view of still another modified embodiment of the connector means of the present invention. FIG. 22 is an exploded perspective view of FIG. FIG. 23 is a perspective view of still another modified embodiment of the connector means of the present invention. FIG. 24 is an exploded perspective view of FIG. FIG. 25 is an exploded view of another arrangement of the base member and associated structures used in the embodiment of FIGS. FIG. 26 is an exploded view of another arrangement of the base member and associated structures used in the embodiment of FIGS. FIG. 27 is a cross-sectional view similar to FIG. 4, showing a modified embodiment of the adjustable effective length struts and connector means of the external fixator of the present invention. FIG. 28 combined with other elements of an orthopedic external fixator and a fractured tibia,
FIG. 4 is a perspective view of a second preferred embodiment of the external fixator of the present invention. FIG. 29 shows an orthopedic external fixator of another element and a fractured tibia,
FIG. 8 is a perspective view of a third preferred embodiment of the external fixator of the present invention. FIG. 30 shows the three steps involved in a first unique preferred use of the device of the present invention, a perspective view (I) of a preferred embodiment in a first direction, used in accordance with the unique preferred method of the present invention. Showing measurement of various parameters (II
), And a perspective view (III) of the preferred embodiment in the second direction. FIG. 31 illustrates the three steps involved in a second unique preferred use of the device of the present invention, and illustrates the measurement of various parameters used in accordance with the unique preferred method of the present invention, FIG. Perspective view of preferred embodiment in direction 1 (II
), And a perspective view (III) of the preferred embodiment in the second direction. FIG. 32 illustrates the determination of parameters for a deformed tibia used in accordance with the unique and preferred method of the present invention, a radiograph (I) of the anterior-posterior direction of the fractured tibia, the lateral-inward direction of the fractured tibia. Radiograph (II), and figure (III) showing the clinical test. FIG. 33 shows a sign (+/-) convention used in a particular embodiment of the method of the present invention. FIG. 34 illustrates a preferred selection of an origin according to the method of the present invention, wherein the anterior-posterior view (A), the lateral-inward view (B), of the base member of the present invention attached to a fractured tibia. Including the axial sectional view (C). FIG. 35 shows a preferred selection of the origin according to the method of the invention, showing a front-rear view (A) and a side-inward view (A) of a base member of the invention mounted on a highly angled deformation site. B), including the axial sectional view (C). FIG. 36 shows a preferred selection of the origin according to the method of the invention, showing a front-to-rear view (A) of the base member of the invention mounted on a deformed part rotated largely axially, side-inward. Including figure (B) and axial section (C). FIG. 37 is a perspective view of the base member of the present invention attached to a fractured bone, showing a side-inward radiograph (I) and an anterior-posterior radiograph (II) of the deformed site. FIG. 38 is a perspective view of the base member of the present invention attached to a fractured bone, showing a side-inward radiograph of the deformed site. FIG. 39 is a perspective view of the base member of the present invention attached to a fractured bone, showing a radiograph of the deformed portion in a front-to-back direction. FIG. 40 is a cross-sectional view of the device of the present invention mounted on a fractured tibia, showing off-center deviation in the anterior-posterior direction and off-center deviation in the lateral-inward direction in accordance with a preferred use of the device of the present invention. Indicates a decision. FIG. 41 is a perspective view of the device of the present invention attached to a fractured tibia. FIG. 42 is a perspective view of the ring member of the present invention attached to various parts of the human body. FIG. 43 is a cross-sectional view of the device of the present invention mounted on a fractured tibia, illustrating the determination of off-center in the direction of rotation according to a preferred use of the device of the present invention. FIG. 44 is a partial perspective view of the device of the present invention in the neutral position (I) and the deformed position. FIG. 45 is an application of a general variant rotation and translation component in accordance with a preferred use of the device of the present invention. FIG. 46 shows a vector representation of the Chasles axis for one-dimensional rotational deformation. FIG. 47 shows a vector representation of the Chasles axis for one-dimensional rotational deformation. FIG. 48 shows a vector display of the Chasles axis for the two-dimensional rotationally deformed portion. FIG. 49 shows a vector display of the Chasles axis for the three-dimensional rotationally deformed portion. FIG. 50 is a perspective view of a translation vector showing a combined translation that may be corrected in accordance with a preferred use of the device of the present invention. FIG. 51 is a cross-sectional view of the device of the present invention mounted on a fractured tibia, illustrating the assessment of the risk radius according to a preferred use of the device of the present invention. FIG. 52 is a perspective view of the base member of the device attached to a fracture site, illustrating the use of waypoints in accordance with a preferred use of the device of the present invention. FIG. 53 shows steps involved in a third preferred use of the device of the present invention. FIG. 53 is a perspective view of the preferred embodiment in a first direction with no struts disposed on the device. FIG. Perspective view of a preferred embodiment in a first direction in a mirrored configuration (II), a perspective view of a preferred embodiment in a first direction in a neutral configuration with struts arranged on the instrument (III), and Includes figure (IV) showing the measurement of the neutral distance.

──────────────────────────────────────────────────続 き Continued on front page (72) Inventor Austin, Jean, Edward United States, Tennessee 38134, Bartlett, Steven Franklin Drive 8015 F-term (reference) 4C060 LL18

Claims (29)

[Claims] 1. A first tissue device using an external fixation device having a first base member, a second base member, and a plurality of adjustable length struts interconnecting the first and second base members. A method of using an orthopedic fixation device for reducing a segment from a deformed position to a target position corresponding to a second tissue segment, comprising: a first axis substantially parallel to a centerline of the second tissue segment; and Selecting a Cartesian coordinate system having three orthogonal axes, the second axis and the third axis orthogonal to each other, with the correlation characterizing the deformation based on the parallel vector and the projection rotation angle with respect to the coordinate axis Thus, the step of mathematically correlating the deformation position with the target position, the step of attaching the second base member to the second tissue segment and specifying the position of the second base member, Set the initial position of the first base member Calculating an intermediate position for the first base member having the same amount of rotation and parallel change relative to the initial position as the deformed position of the first tissue has relative to the target position; Calculating a new effective length of each strut required to fit the one base member to the intermediate position, and adjusting the effective length of the strut to the new effective length to cause the fixation device to mimic the relative position of the tissue segment; Attaching the first base member to the first tissue segment; and adjusting the effective length of the strut to an intermediate length to reduce the first tissue segment to a target position. The following steps are performed to calculate the intermediate position mathematically in the order described: a) mimic the angular displacement of the first tissue segment with respect to the first axis; b) angular displacement of the first tissue segment. Mimicking with respect to the second and third axes,
And c) a method of mimicking the parallel displacement of the first tissue segment. 2. The following steps, performed in the order given: a) predetermining an appropriate position on the second tissue segment for attaching the second base member; b) based on the predetermined position. Determining the positions of the first and second base members by c) mimicking the deformation of the first tissue segment before attaching the first and second base members to the first and second tissue segments. The method of claim 1, further comprising the step of: 3. A rotation matrix wherein the angular deformation displacement of the first base member is as follows: (Where [Rδ], [Rθ] and [Rφ] are the first, second and third axes respectively.
1 represents a matrix for calculating the angular deformation of the base member, wherein δ is the projected angular displacement of the first tissue segment with respect to the first axis, θ is the projected angular displacement of the first tissue segment with respect to the second axis, φ Indicates the projected angular displacement of the first tissue segment with respect to the third axis). 4. The method of claim 1, wherein the angular deformation of the first base member is calculated based on a rotation matrix that mathematically mimics rotation about the first axis over rotation about the second and third axes. 2. The method according to 1. 5. The angular deformation of the first base member is given by the following equation: (Where δ is the projected angular displacement of the first tissue segment with respect to the first axis, θ is the projected angular displacement of the first tissue segment with respect to the second axis, and φ is the third axis of the first tissue segment. The method according to claim 4, wherein the calculation is based on a rotation matrix given by: 6. The angular deformation of the first base member is given by the following equation: (Where a = c * TAN (θ); b = c * TAN (φ); c = 1 / [TAN ² (θ) + TAN ² (φ) +1] ^1/2 ; d = e / η; e = (C ² * η ² ) / [c ² * (1 + η ² ) + a ² + 2 * a * b * η + b ² * η ² ]; f = (− 1 / c) * e * ((a / η ) + B); η = TAN (π / 2 + δ); θ = radian LAT angle (taken off LAT view); φ = radian AP angle (taken off LAT view); and δ = axial rotation of radian) It is calculated based on the rotation matrix, mimicking the angular displacement of the first tissue segment relative to the first axis, to set the θ and φ values before applying the R ₁₂ matrix in the first base member located to zero It is achieved by mimicking angular displacement of the first tissue somite to the second and third axes, achieved by setting the δ value before applying the R ₁₂ matrix in the first base member located to zero The method of claim 1, wherein the method is performed. 7. The parallel displacement is a vector element: (Where “AP trans” is the linear displacement of the first tissue segment on the third axis, “LAT
trans is the linear displacement of the first tissue segment on the second axis, and “axial trans” is the linear displacement of the first tissue segment on the first axis. The described method. 8. The method of claim 1, wherein the new length of the adjustable strut is determined using Pythagorean theorem. 9. The method of claim 1, wherein said first and second tissue segments comprise hard and soft tissues. 10. The method of claim 9, wherein said first and second tissue segments are bone. 11. The strut has an initial effective length determined by the effective length before being adjusted to the new effective length, the initial effective lengths of the struts are not all the same, and the new effective length of the strut is The method of claim 1, wherein not all are the same. 12. The safety ratio when adjusting the effective length of the strut to a new effective length is as follows: (1) measuring the maximum total displacement of the structure; (2) clinically measuring the total displacement. Calculating the total number of days required for correction by dividing by the measured safety correction speed; (3) calculating the sum of the absolute value of the difference between the new length of each strut and the corresponding initial length to correct the deformation And (4) dividing the total amplitude by the total number of days required for the correction and converting the total amplitude into a daily adjustment amount to obtain the safety ratio. The method of claim 1. 13. The method of claim 12, wherein the strut is adjusted to the new effective length at the safety ratio. 14. A first tissue device using an external fixation device having a first base member, a second base member, and a plurality of adjustable length struts interconnecting the first and second base members. A method of using an orthopedic fixation device for reducing a segment from a deformed position to a target position corresponding to a second tissue segment, comprising: a first axis substantially parallel to a centerline of the second tissue segment; and Selecting a Cartesian coordinate system having three orthogonal axes consisting of a second axis and a third axis orthogonal to each other, and mathematically correlating the deformation position with the target position, and the correlation is parallel. Characterizing the deformation characteristics based on the vector and the projected rotation angle with respect to the coordinate axes; attaching a second base member to the second tissue segment to characterize the position of the second base member; 1st base attached to 1 tissue segment Characterizing the position of the material; calculating an intermediate position for the first base member having the same amount of rotation and parallel change relative to the initial position as the deformed position of the first tissue has relative to the target position; Calculating the new effective length of each strut required to fit the first base member to the second position; adjusting the effective length of the strut to the new effective length; Reducing the first tissue segment to the target position reflecting the target position, wherein the calculation of the intermediate position for the first base member is performed mathematically in the order described: a) Reflecting the parallel displacement of the first tissue segment; b) reflecting the angular displacement of the first tissue segment with respect to the second and third axes;
And c) reflecting the angular displacement of the first tissue segment with respect to the first axis using the orthopedic fixation device. 15. A rotation matrix in which the angular deformation displacement of the first base member is as follows: (Where [Rδ], [Rθ] and [Rφ] represent matrices for calculating the angular deformation of the first base member with respect to the first, second and third axes, respectively, and δ is relative to the first axis The projected angular displacement of the first tissue segment relative to the second axis, θ represents the projected angular displacement of the first tissue segment relative to the second axis, and φ represents the projected angular displacement of the first tissue segment relative to the third axis. 15. The method of claim 14, wherein the method is calculated. 16. A rotation matrix that mathematically achieves that angular deformation of the first base member sequentially reflects rotation about the first axis prior to rotation about the second and third axes. 15. The method according to claim 14, wherein the method is calculated based on: 17. The angular deformation of the first base member is expressed by the following equation: Where δ is the projected angular displacement of the first tissue segment with respect to the first axis, θ is the projected angular displacement of the first tissue segment with respect to the second axis, and φ is the first tissue segment with respect to the third axis. 17. The method according to claim 16, wherein the method is calculated based on a rotation matrix given by: 18. The angular deformation of the first base member is expressed by the following equation: (Where a = c * TAN (θ); b = c * TAN (φ); c = 1 / [TAN ² (θ) + TAN ² (φ) +1] ^1/2 d = e / η; e = (C ² * η ² ) / [c ² * (1 + η ² ) + a ² + 2 * a * b * η + b ² * η ² ]; f = (− 1 / c) * e * ((a / η) + B); η = TAN (π / 2 + δ); θ = radian LAT angle (taken off LAT view); φ = radian AP angle (taken off LAT view); δ = axis rotation of radian is calculated based on, reflection of the angular displacement relative to the second and third axes of the first tissue segment is to set the δ value before applying the R ₁₂ Matrix scan the first base member located to zero made reaches the imitation of angular displacement with respect to the first axis of the first tissue segment is achieved by setting the θ and φ values before applying the R ₁₂ matrix in the first base member located to zero 15. The method according to claim 14, wherein 19. The parallel displacement is a vector element: (Where “AP trans” is the linear displacement of the first tissue segment on the third axis, “LAT trans” is the linear displacement of the first tissue segment on the second axis, and “axial trans” is the first Of the organizational segment of
15. The method according to claim 14, wherein the method is calculated based on: 20. The method of claim 14, wherein the new length of the adjustable strut is determined using Pythagorean theorem. 21. The method of claim 14, wherein said first and second tissue segments comprise hard and soft tissues. 22. The method of claim 21, wherein said first and second tissue segments are bone. 23. The strut has an initial effective length determined by the effective length before adjusting to the new effective length, and the initial effective lengths of the struts are not all the same, and the new effective lengths of the struts are not necessarily all the same. 15. The method of claim 14, which is not the same. 24. The safety ratio when the effective length of the strut is adjusted to a new effective length is as follows: (1) measuring the maximum total displacement of the structure; and (2) measuring the total displacement clinically. Calculating the total number of days required for correction by dividing by the measured safety correction speed; (3) calculating the sum of the absolute values of the differences between the new length of each column and the corresponding initial length, and correcting the deformation And (4) dividing the total amplitude by the total number of days required for correction and converting the total amplitude into a daily adjustment amount to obtain the safety ratio. 15. The method according to claim 14, wherein 25. The method according to claim 24, wherein the strut is adjusted to a new effective length at the safety ratio. 26. An external fixation device having a first base member, a second base member, and a plurality of adjustable length struts interconnecting the first and second base members. A method of using an orthopedic fixation device to reduce one tissue segment from a deformed position to a target position corresponding to a second tissue segment, wherein the connection between the adjustable strut and the first base member is the first. Defining a surface and attaching the first base member to the first tissue segment such that a centerline of the first tissue segment is perpendicular to the first surface; an adjustable strut and a second base Attaching the second base member to the second tissue segment such that the connection between the members defines a second surface and the center line of the second tissue segment is perpendicular to the second surface. The first reference point on the first tissue segment and the second reference point on the second tissue segment, Selecting the first and second reference points to touch after being reduced to the reference position, the distance between the first plane and the first reference point, and the distance between the second plane and the second reference point. Calculating the distance, the distance between the first surface and the first reference point, and the distance equal to the sum of the distance between the second surface and the second reference point, Using an orthopedic fixation device comprising: calculating an intermediate strut length to be parallel to the plane of the subject; and adjusting the effective length of the strut to an intermediate length to reduce the first tissue segment to a target position. Method. 27. The method of claim 26, wherein the new length of the adjustable strut is determined using Pythagorean theorem. 28. The method of claim 26, wherein said first and second tissue segments comprise hard and soft tissues. 29. The method of claim 26, wherein said first and second tissue segments are bone.