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WO1990011055A1 - Fixateur externe - Google Patents

Fixateur externe Download PDF

Info

Publication number
WO1990011055A1
WO1990011055A1 PCT/HU1990/000019 HU9000019W WO9011055A1 WO 1990011055 A1 WO1990011055 A1 WO 1990011055A1 HU 9000019 W HU9000019 W HU 9000019W WO 9011055 A1 WO9011055 A1 WO 9011055A1
Authority
WO
WIPO (PCT)
Prior art keywords
implantations
fixateur
externe
fixateur externe
nut
Prior art date
Application number
PCT/HU1990/000019
Other languages
English (en)
Inventor
Péter TATÁR
László ÖRDÖGH
István KÁDAS
Péter FRÖHLICH
István Szigeti
Original Assignee
Tatar Peter
Oerdoegh Laszlo
Kadas Istvan
Froehlich Peter
Szigeti Istvan
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Tatar Peter, Oerdoegh Laszlo, Kadas Istvan, Froehlich Peter, Szigeti Istvan filed Critical Tatar Peter
Publication of WO1990011055A1 publication Critical patent/WO1990011055A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/645—Devices extending alongside the bones to be positioned comprising a framework
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6466—Devices extending alongside the bones to be positioned with pin-clamps movable along a solid connecting rod

Definitions

  • This invention relates to a fixateur adhere for osteosy ⁇ thesis and for healing of bone fractures comprising implantations drawn into the bones to be fixed and guiding rods as well as fixing elements connecting the implantations and the guiding rods to each other.
  • implanta ⁇ tions such as Schanz screws or Steinma ⁇ n nails made of tissue-friendly material are drawn into the healthy bone parts by boring holes into them and screwing or striking the implantations in.
  • the implantations are than connected to each other by guiding rods outside the body. After the implantations and, with this, the broken bone parts being positioned, the implantations and the guiding rods are fixed to each other by fixing elements.
  • each fixing element has a vice and a joint. It is advantageous in this system that quite few parts are necessary but only in simple cases. More complicated montage can be built only with difficulties and with the application of numerous parts. Therefore, these montages are weighty and not stable enough. Furthermore, only the contraction and distraction can be carried out as corrections of the fixture and only with special tools.
  • the weight of the montage is lessened in another solution, wherein tubes are used instead of guiding rods.
  • the fixing elements are basically not different, thus, repositioning the fractures is not possible, neither the torsion can be corrected.
  • more than one implantations or guiding rods can be clamped and their position can be varied.
  • contraction and distraction are possible herein, too and only with the interconnection of a special part.
  • the conventional fixateur ester have numerous problems.
  • the bone pieces can get unconveniently displaced since the loose elements can move on the guiding rods practically u ⁇ limitedly. Further ⁇ more, the movement being necessary to tighten the vices falls in the same direction as one possible direction of adjustment of the montage.
  • the arrangement can be moved out of the justified position when fixing the vices.
  • the pressure force of the loosening movement results sometimes in collapse of the entire assembly.
  • the main object of the invention is to eliminate the above mentioned deficiencies of the conventional assembles as well as to solve the newly emerged requirements and to provide a fixateur adhere for osteosy ⁇ thesis and for healing of bone fractures which has very few components and, nevertheless, a greater flexibility than the previous solutions, and which can easily be used in all operative situations.
  • the fixing elements have tension jaws fixing the implantations and the guiding rods to each other by detachable connection and being parts of a ball joint as well as means for stiffening the ball joint in a desired position.
  • the tension jaws have a U-like groove for accommodating the implantations or the guiding rods and opposite to the U-like groove, a spherical surface, and the fixing elements have holding plates each having a spherical groove for supporting the spherical surface of the tension jaws.
  • the U-like grooves can have dimensions for accommo ⁇ dating the implantations or the guiding rods, respectively, with tight fit or the U-like groove can be tighter at its outer opening than elsewhere for snap-in of the implantations or guiding rods.
  • the U-like groove of the tension jaws accommodating the guiding rods can be wider by at least 0,05 mm than the diameter of the guiding rods.
  • each holding plate has a bore at its middle part and the bore is provided with an inner thread
  • each tension jaw has an extension at a middle part of the spherical surface comprising a head portion provided with an outer thread fitting into the inner thread of the bore as well as a neck portion between the head portion and the spherical surface having a smaller diameter than that of the bore.
  • the holding plates are attached to each other by braces pivotally jointed to opposite sides of the holding plates, and a length of at least one of the braces is variable.
  • the pivotal joints between the holding plates and the braces are made for having a loose fit providing a spatial backlash between the parts connected to each other by the joints.
  • the brace with variable length is formed as a screw and a nut attached to each other, and the screw is pivotally jointed with loose fit in one of the holding plates and the nut is attached to the other holding plate by detachable connection.
  • the embodiment of the invention is also preferred, wherein the nut of the brace with variable length has a head portion connected to the holding plate and a neck portion attached to the head portion, and the head portion has a spherical surface at the connection of the neck portion and the holding plate has a seat with a spherical hollow having a hole in its middle for letting through the neck portion of the nut.
  • a slit starting from the hole is provided in the holding plate in a plane of rotation of the brace with variable length, and the slit is at least as bright as the hole.
  • the head portion of the nut has an orifice or at least on a part of the nut a hexagon outer surface is provided for connection of a tightening tool.
  • the braces have impact surfaces at the pivotal joints for providing a u ⁇ iplanar arrangement of all parts of the fixing element in its open position.
  • the screw has a further impact surface cooperating with the holding plate at their pivotal joint for determining a perpendicular position of the brace to the holding plate.
  • Fig. 1 shows a portion of a preferred embodiment of the fixateur adhere in this invention: the fixing element in dismounted position,
  • Fig. 2 is the same portion: the fixing element in mounted position and in perspective view,
  • Fig. 3 is the same portion but in cross section
  • Fig. 4 illustrates the fixateur adhere in this invention in an application situations. Detailed Description of the Preferred Embodiment
  • Fig. 1 shows a fixing element 1 in dismounted situation.
  • Two tension jaws 2, 3 are taken out of their seats formed in holding plates 4, 5.
  • One tension jaw 2 is formed for accommodating an implantation, the other tension jaw 3 for hosting a guiding rod.
  • the difference between the tension jaws 2, 3 is in the dimensions of U-like grooves 6 , 1 provided in the tension jaws 2, 3, respectively.
  • U-like grooves 6, 7 have the same width as the implantations or the guiding rod with a great accuracy.
  • the orifice of the U-like grooves 6, 7 defined by the outer ends of the legs of the U-form is narrower by e. g. 0,05 mm than the other parts of U-like grooves 6, 7. With -this, the implantations or the guiding rod can be snapped into U-like grooves 6, 7 and the guiding rod or the implantation will not fall out accide ⁇ tly.
  • Tension jaws 2, 3 have cylindrical mantels 8 the diameter of which is preferably the same for tension jaw 2 as for tension jaw 3.
  • the U- like grooves 6, 7 are worked in.
  • a spherical surface 9 and means for attaching tension jaws 2, 3 to holding plates 4, 5 are provided.
  • Spherical surface 9 and the attaching means are the same for all tension jaws 2, 3 providing the i ⁇ tercha ⁇ geability of these elements .
  • the attaching means has an extension 10 in the middle of spherical surface 9 comprising a head portion 11 provided with an outer thread as well as a neck portion 12 between head portion 10 and the spherical surface 9.
  • Neck portion 12 has a smaller diameter than that of the outer thread of head portion 10.
  • tension jaw 2 is attached to holding plate 4 and tension jaw 3 to holding plate 5.
  • Each of holding plates 4, 5 has a spherical seat 13 (fig. 1) having the same shape as spherical surfaces 9 of tension jaws 2, 3 and supporting them.
  • a bore 14 is made with an inner thread.
  • the outer thread of extension 10 of tension jaws 2, 3 fits into the inner thread of bore 14 of holding plates 4, 5.
  • Holding plates 4, 5 are attached to each other by braces 15, 16 pivotally jointed in opposite sides of holding plates 4, 5.
  • the length of brace 16 is variable and brace 15 is a fix element.
  • Holding plates 4, 5 and braces 15, 16 are connected to each other by these pivotal joints like members of a chain with a certain backlash allowing certain "wobble" of the pieces. The backlash is of course very precisely determined and it remains the same for all fixing elements 1.
  • the pivotal joints are formed as follows.
  • a bore 31 is made perpendicularly to braces 15, 16 in holding plates 4, 5 as well as in braces 15, 16, respectively, but in braces 15, 16, the bores 31 have a somewhat greater diameter than in holding plates 4, 5.
  • a slot 32 is formed for accommodating ends of braces 15, 16 cooperating with holding plates 4, 5 in the pivotal joints.
  • the width of slots 32 is greater than the thickness of said ends of braces 15, 16.
  • Braces 15, 16 have impact surfaces at the pivotal joints for providing a u ⁇ iplanar arrangement of all parts of fixing element 1 in its open position.
  • the very ends of braces 15, 16 lie against the bottom of the slots 32.
  • screw 18 of brace 16 has a further impact surface cooperating with the bottom of the slot 32 of holding plate 5 at their pivotal joint for determining a perpendicular position of brace 16 in respect to holding plate 5.
  • both ends of stable brace 15 are pivotally jointed to holding plates 4, 5 whilst variable brace 16 is pivoted only at its one end. At the other end, a detachable connection is provided as it will be described hereinafter.
  • Brace 16 with variable length is formed as a screw IB and nut 20 assembly. Screw IB is pivoted at bolt 17 in holding plate 5 as described above.
  • Nut 20 in turn, has a neck 20 and a head 21 on it. Neck 20 has a smaller diameter than head 21 or other parts of nut 20.
  • head 21 has a spherical surface 22 similarly to spherical surface 9 of tension jaws 2, 3. Accordingly, a spherical seat 23 is formed in holding plate 4 at the connection of brace 16 with a hole 24 in its middle letting neck 20 through.
  • the diameter of the hole 24 is smaller than that of head 21 but greater than that of neck 20.
  • Hole 24 is cut up outwards, i. e. a slit 25 starting at hole 24 is formed in holding plate 4 in a plane of rotation of brace 16. Slit 25 is at least as wide as hole 24.
  • Nut 20 has to means for connecting a tightening tool.
  • an orifice such as a hexagonal orifice 33 for bolt wrench or a slot for screw driver can be provided.
  • a hexagon outer surface can be formed for a fork wrench.
  • fixing element 1 is shown in assembled position in Fig. 2 (perspective view) and in Fig. 3 (cross section).
  • the outer thread of neck portion 12 of tension jaws 2, 3 are driven through the inner thread of bores 14 of holding plates 4, 5. After leaving outer thread the inner thread, neck 20 with smaller diameter is at the inner thread of tension jaws 2, 3, thus, tension jaws 2, 3 settle themselves by the cooperation of spherical surface 9 and seat 13.
  • Steinmann nails 27, 28 are fixed on both sides of a fracture in the bone as usually. Firstly, Steinmann nails 28 being more apart from the fracture are arranged. A guiding rod 29 is connected to Steinmann nails 28 with four fixing elements 1. For this, Steinmann nail 28 is snapped-in into U-like groove 7 of tension jaw 3 and by holding plate 5, the whole assembly is rotated around neck portion 12 of tension jaw 3 for choosing - li ⁇
  • fixing element 1 is closed by turning holding plate 4 with tension jaw 2 onto tension jaw 3 and pushing head 21 of nut 20 of brace 16 through slit 25 into seat 23 of holding plate 4. Thereafter, first guiding rod 29 is pushed into and through U-like groove 6 of tension jaw 2.
  • screw 18 is lightly tightened which allows the adjustment of the parts but holds them in their position. If a guiding rod 29 is already applied, U-like groove 6 will also be snapped on guiding rod 29 and the assembly tightened. ;Now the montage is self-holding but not loadable.
  • the holes for further Steinmann nails 27 can be bored through further fixing element 1 arranged on guiding rod 29.
  • a unilateral duplex montage can be applied as shown in Fig. 4.
  • Schanz screws can of course be used instead of Steinmann nails 27, 28.
  • Parallelly to guiding rod 29, a second guiding rod 30 is mounted with fixing elements 1 in this assembly .
  • the implantations need not to be so parallel to each other as in the figure, since fixing elements 1 are able to compensate these inaccuracies.
  • the broken bone parts can be repositioned as required.
  • fixing element 1 are stiffened and the assembly is a load carrying one.
  • the two guiding rods 29, 30 enlarge the stiffness and the security of the montage.
  • dynamization i. e. displacement in the direction of the axle of the bone is required.
  • the proximal fixing elements 1 above the fracture are opened and tension jaw 2 accommodating guiding rods 29, 30 are interchanged with a tension jaw 2 having a U-like groove 6 which is wider by 0,05 mm than the diameter of the guiding rod 29, 30.
  • guiding rods 29 and 30 can be arranged on different sides of the extremity to be operated. On the left and right side of the bone, respectively, implantations are •applied which will be interconnected by these rods 29, 30 with the aid of fixing elements 1.
  • the V montage or camp montage is applied.
  • three guiding rods 29 are used around the extremity.
  • Steinmann nails 27 are frequently used instead of Schanz screws in these cases. Thanks to the flexible variability of fixing elements 1, the most convenient lay-out of the montage can be found. With this, the bigger splinters near to the fracture can be held on their place, too.

Landscapes

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

Abstract

L'invention concerne un fixateur externe d'ostéosynthèse et de consolidation de fractures osseuses, comprenant des implants brochés dans les os à fixer, ainsi que des tiges de guidage et des éléments de fixation reliant les implants et les tiges de guidage les uns aux autres. Selon l'invention, les éléments de fixation comportent des mâchoires de tension (2, 3) fixant les implants et les tiges de guidage (29, 30) les uns aux autres par un raccordement séparable, et faisant partie d'une articulation à rotule, ainsi qu'un moyen de raidissement de ladite articulation à rotule dans la position voulue.
PCT/HU1990/000019 1989-03-14 1990-03-14 Fixateur externe WO1990011055A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
HU121689A HU209061B (en) 1989-03-14 1989-03-14 External fastener for medicating fractures of bone
HU1216/89 1989-03-14

Publications (1)

Publication Number Publication Date
WO1990011055A1 true WO1990011055A1 (fr) 1990-10-04

Family

ID=10953386

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/HU1990/000019 WO1990011055A1 (fr) 1989-03-14 1990-03-14 Fixateur externe

Country Status (3)

Country Link
AU (1) AU5287490A (fr)
HU (1) HU209061B (fr)
WO (1) WO1990011055A1 (fr)

Cited By (11)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0578320A1 (fr) * 1992-07-06 1994-01-12 Bristol-Myers Squibb Company Dispositif de liaison de tiges vertébrales
US7708736B2 (en) * 2006-02-22 2010-05-04 Extraortho, Inc. Articulation apparatus for external fixation device
US8241285B2 (en) 2007-09-27 2012-08-14 Extraortho, Inc. Method and clamping apparatus for external fixation and stabilization
US8728078B2 (en) 2010-11-04 2014-05-20 Zimmer, Inc. Clamping assembly with links
US8734446B2 (en) 2010-10-12 2014-05-27 Zimmer, Inc. External fixation surgical clamp with swivel
US8840611B2 (en) 2010-10-12 2014-09-23 Zimmer, Inc. Single lock external fixation clamp arrangement and method
WO2014140879A3 (fr) * 2013-03-15 2015-01-08 Biomet C.V. Logement à pivotement polyaxial pour système de fixation externe
US9138260B2 (en) 2010-07-01 2015-09-22 Zimmer, Inc. Multi-locking external fixation clamp
US9149296B2 (en) 2010-12-09 2015-10-06 Zimmer, Inc. Cam driven jaw for external fixation clamps
US9186179B2 (en) 2010-12-09 2015-11-17 Zimmer, Inc. Revolving lock for external fixation clamps
US9277937B2 (en) 2011-05-17 2016-03-08 Zimmer, Inc. External fixation clamp using a trigger mechanism and stored spring energy

Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2847006B1 (de) * 1978-10-28 1980-05-08 Aesculap Werke Ag AEussere Spannvorrichtung fuer chirurgische Zwecke
US4299212A (en) * 1977-09-08 1981-11-10 Nederlandsch Central Organisatie voor Toegepast-Natuurwetenschappelijk Onderzoek External fracture immobilization splint
FR2499400A1 (fr) * 1981-02-06 1982-08-13 Tornier Sa Fixateur perfectionne pour fractures complexes, et notamment du type epiphysaire

Patent Citations (3)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4299212A (en) * 1977-09-08 1981-11-10 Nederlandsch Central Organisatie voor Toegepast-Natuurwetenschappelijk Onderzoek External fracture immobilization splint
DE2847006B1 (de) * 1978-10-28 1980-05-08 Aesculap Werke Ag AEussere Spannvorrichtung fuer chirurgische Zwecke
FR2499400A1 (fr) * 1981-02-06 1982-08-13 Tornier Sa Fixateur perfectionne pour fractures complexes, et notamment du type epiphysaire

Cited By (27)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0578320A1 (fr) * 1992-07-06 1994-01-12 Bristol-Myers Squibb Company Dispositif de liaison de tiges vertébrales
US7708736B2 (en) * 2006-02-22 2010-05-04 Extraortho, Inc. Articulation apparatus for external fixation device
US7938829B2 (en) 2006-02-22 2011-05-10 Extraortho, Inc. Articulation apparatus for external fixation device
US8361073B2 (en) 2006-02-22 2013-01-29 Extraortho, Inc. Articulation apparatus for external fixation device
US8888777B2 (en) 2006-02-22 2014-11-18 Zimmer, Inc. Articulation apparatus for external fixation device
US9675383B2 (en) 2006-02-22 2017-06-13 Zimmer, Inc. Articulation apparatus for external fixation device
US8241285B2 (en) 2007-09-27 2012-08-14 Extraortho, Inc. Method and clamping apparatus for external fixation and stabilization
US9750535B2 (en) 2007-09-27 2017-09-05 Zimmer, Inc. Method and clamping apparatus for external fixation and stabilization
US9084631B2 (en) 2007-09-27 2015-07-21 Zimmer, Inc. Method and clamping apparatus for external fixation and stabilization
US10485586B2 (en) 2010-07-01 2019-11-26 Zimmer, Inc. Multi-locking external fixation clamp
US9883890B2 (en) 2010-07-01 2018-02-06 Zimmer, Inc. Multi-locking external fixation clamp
US9138260B2 (en) 2010-07-01 2015-09-22 Zimmer, Inc. Multi-locking external fixation clamp
US9532805B2 (en) 2010-10-12 2017-01-03 Zimmer, Inc. Single lock external fixation clamp arrangement and method
US8734446B2 (en) 2010-10-12 2014-05-27 Zimmer, Inc. External fixation surgical clamp with swivel
US8840611B2 (en) 2010-10-12 2014-09-23 Zimmer, Inc. Single lock external fixation clamp arrangement and method
US9510859B2 (en) 2010-11-04 2016-12-06 Zimmer, Inc. Clamping assembly with links
US8728078B2 (en) 2010-11-04 2014-05-20 Zimmer, Inc. Clamping assembly with links
US9186179B2 (en) 2010-12-09 2015-11-17 Zimmer, Inc. Revolving lock for external fixation clamps
US9149296B2 (en) 2010-12-09 2015-10-06 Zimmer, Inc. Cam driven jaw for external fixation clamps
US9277937B2 (en) 2011-05-17 2016-03-08 Zimmer, Inc. External fixation clamp using a trigger mechanism and stored spring energy
US10702308B2 (en) 2011-05-17 2020-07-07 Zimmer, Inc. External fixation clamp using a trigger mechanism and stored spring energy
US9888943B2 (en) 2011-05-17 2018-02-13 Zimmer, Inc. External fixation clamp using a trigger mechanism and stored spring energy
US9463045B2 (en) 2013-03-15 2016-10-11 Biomet Manufacturing, Llc Polyaxial pivot housing for external fixation system
US9827011B2 (en) 2013-03-15 2017-11-28 Biomet Manufacturing, Llc Polyaxial pivot housing for external fixation system
US10299830B2 (en) 2013-03-15 2019-05-28 Biomet Manufacturing, Llc Clamping assembly for external fixation system
WO2014140879A3 (fr) * 2013-03-15 2015-01-08 Biomet C.V. Logement à pivotement polyaxial pour système de fixation externe
US9393045B2 (en) 2013-03-15 2016-07-19 Biomet Manufacturing, Llc. Clamping assembly for external fixation system

Also Published As

Publication number Publication date
AU5287490A (en) 1990-10-22
HUT62777A (en) 1993-06-28
HU209061B (en) 1994-03-28

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