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WO1991019461A1 - Systeme d'osteosynthese a l'aide d'elements de precontrainte a guidage axial - Google Patents

Systeme d'osteosynthese a l'aide d'elements de precontrainte a guidage axial Download PDF

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Publication number
WO1991019461A1
WO1991019461A1 PCT/GR1991/000009 GR9100009W WO9119461A1 WO 1991019461 A1 WO1991019461 A1 WO 1991019461A1 GR 9100009 W GR9100009 W GR 9100009W WO 9119461 A1 WO9119461 A1 WO 9119461A1
Authority
WO
WIPO (PCT)
Prior art keywords
bone
prestressing
prestressing tendons
fulcrum
tendons
Prior art date
Application number
PCT/GR1991/000009
Other languages
English (en)
Inventor
Constantin Protogirou
Original Assignee
Constantin Protogirou
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 Constantin Protogirou filed Critical Constantin Protogirou
Publication of WO1991019461A1 publication Critical patent/WO1991019461A1/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
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A61B17/7216—Intramedullary devices, e.g. pins or nails for bone lengthening or compression
    • A61B17/7225—Intramedullary devices, e.g. pins or nails for bone lengthening or compression for bone compression
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary devices, e.g. pins or nails
    • A61B17/7208—Flexible pins, e.g. ENDER pins
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86—Pins or screws or threaded wires; nuts therefor

Definitions

  • Fracture means that some force acted on the bone, stronger than its resistance limit, which had as a consequence the solution of its continuity.
  • Intraosseous forces are the total of the intrastructural forces of the bone, which counteract the body weight and the muscular contraction. The intraosseous forces are eliminated after a fracture, and we are seeking the best way for their restoration.
  • Prestressing means to introduce internal stresses into a material to counteract the stresses that will result from applied load.
  • prestressing we need, a material resistant to tensile strength and a non-compressible material resistant to pressure forces.
  • Axial prestressing is the application of prestressing coinciding with the mechanical axis of a body. That is, the introduction of a material resistant to tensile forces under tension into a body resistant to pressure forces, which in our case is the repositioned fractured bone. Anchorage points of the prestressing are the extremities of the bone.
  • the first one to use a kind ot prestressing with wire was Fr. Pauwels (5), (6) (.Zug-Gurtung, Tension Banding;.
  • the purpose was to neutralize the tension forces by a wire bend, mostly on other kinds of fractures than those of long bones.
  • axial prestressing we aim at the restoration of intraosseous forces by using stable and elastic osteosynthesis.
  • the prestressing tendons must coincide with the mechanical axis of the bone, that is, they must be introduced intramedullarly.
  • the system consists of: a) Thin Prestressing Tendons b) Fulcrum for Bone Protection c) Annular Distribution Washer d) Medullary Guide of intraosseous forces and Prestressing Tendons
  • Prestressing Tendons As prestressing bearers we use thin wires or bands (.commonly called 'tendons' . ) that may be made of metal or Carbon fibre plastics, or other absorbable substance ( . 7). Materials which have a great resistance to tension.
  • the one end ot the Prestressing Tendons forms a sphere for the creation of a joint at their points ot anchorage.
  • the Prestressing Tendons are anchored into the Fulcrum tor Bone Protection (Fig. II 6j. Points of anchorage are the epiphyses or the bone cortex near them.
  • the Prestressing Tendons are also anchored into the Medullary Guide.
  • the Fulcrum B.P. has a cylindrical shape, the cavity being of conical shape (female cone; and the base forming a semicircular cross-section (Fig. II 6;.
  • the Fulcrum for Bone Protection protects the bone from the pressure forces caused by the Prestressing Tendons.
  • the Prestressing Tendons are anchored by their spherical end into the conical cavity of the Fulcrum for Bone Protection.
  • the other end of the Prestressing Tendons .is anchored into the conical cavity of the Fulcrum for Bone Protection by a cone (male conej (Fig. II 7), a wedge or an inclined groove on the female cone and a screw.
  • the Prestressing Tendons may be anchored into spongy bone by the special screw, which bears the Prestressing Tendons at its base (Fig. Ill), and is introduced intramedullarl through the epiphyses.
  • the base of the Fulcrum for Bone Protection forms a joint with the Distribution Washer (Fig. II 6;.
  • the Distribution Washer has a concave or a convex shape, depending on the bone surface on which it is adapted.
  • the side adapted to the bone bears dents.
  • the innerside of its aperture is of semicircular cross-section for the formation or an articulation with the base of the Fulcrum for Bone Protection. By its surface, it also serves tor the distribution of pressure forces caused by the Prestressing Tendons. But because the Prestressing Tendons are not able to receive compound forces, we invented the Medullary Guide.
  • the Medullary Guide is a cylindrical body made of thin metal or other material, which can get several shapes, depending on the bone (Fig. I, la, lb;. It is evident that we have several kinds of Medullary Guides (different diameter and length), but because of their shortness, they respect the natural curvature of the bone.
  • the Medullary Guide serves: a) As support for the bone (it holds in place the repositioned fractured bone, i.e. it neutralizes the torque forces, as well as the peripheral forces caused between the fracture angle and the mechanical axis of the bone;. b) It distributes the pressure forces on the fracture surface evenly. c) It determines the direction of the Prestressing Tendons, serving as their guide, and restores the intraosseous forces.
  • the shape of the Medullary Guide allows: a) An elastic compression along its lateral axis for better intramedullary adjustment. b) Great resistance along its longitudinal axis in all directions (which hinders the angling and sliding ot the fragments; . c; The neutralization ot Torque forces with the opposite directed dents with helical course (Fig. I 1;. d; The adjustment of the Prestressing Tendons with joints on its mechanical axis (Fig. I 2;. The . -joints are formed by the hollowness made on the Medullary Guide (Fig. I 2 ) and the spheric end of the Prestressing Tendons. The articulating joints lend elasticity to the system and hinder the material 's weariness.
  • ADVANTAGES a) The system provides a stable and elastic osteosynthesis. Owing to the joints between the Prestressing Tendons and the anchorage and fixing points of the prestressing, we secure the longer duration ot the osteosynthesis. -b- bj It can be used tor a great variety ot tractures. c; The approach ot the fracture area is made only for the insertion of the Medullary Guide and the repositioning of the fracture (Fig. IV 2). and we do not make detachments from the bone. The Prestressing Tendons are introduced intramedullarly, with the help of a guide, through small incisions of the skin near the epiphyses (Fig. IV 1;.

Landscapes

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

Abstract

Système permettant l'application d'une précontrainte axiale afin de réaliser une ostéosynthèse stable et élastique des fractures. La stabilité du système est assurée par l'action coopérative des tendons d'application de la précontrainte axiale, du dispositif de guidage médullaire, et de la fracture remise en place. On obtient une ostéosynthèse élastique et durable à l'aide d'un ancrage articulé des tendons de précontrainte. Le système comporte: a) des tendons minces de précontrainte; b) un point d'appui protecteur d'os (Fig. II 6); c) une rondelle annulaire de distribution (Fig. II 8); et d) un dispositif de guidage médullaire guidant les forces intra-osseuses et les tendons de précontrainte (Fig. I, Ia, Ib). Les tendons de précontrainte sont des fils minces ou des bandes minces en métal ou en un autre matériau. L'une des extrémités de chaque tendon forme une sphère destinée à créer un joint au niveau du point de jonction entre le tendon et le dispositif de guidage médullaire et le point d'appui protecteur. L'autre extrémité est ancrée dans la cavité conique (cône femelle) dudit point d'appui. Ledit point d'appui (Fig. II 6) met l'os à l'abri des forces de pression dues aux tendons de précontrainte. La rondelle de distribution (Fig. II 8), présente une forme concave ou convexe en fonction de la surface de l'os auquel elle est adaptée. Le dispositif de guidage médullaire (Fig. I, Ia, Ib) est constitué d'un corps cylindrique pouvant avoir plusieurs formes différentes en fonction de l'os. Il est compressible élastiquement le long de son axe transversal et résistant le long de son axe longitudinal, et forme des joints avec les extrémités sphériques des tendons de précontrainte.
PCT/GR1991/000009 1990-06-18 1991-06-17 Systeme d'osteosynthese a l'aide d'elements de precontrainte a guidage axial WO1991019461A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
GR900100453 1990-06-18
GR90100453 1990-06-18

Publications (1)

Publication Number Publication Date
WO1991019461A1 true WO1991019461A1 (fr) 1991-12-26

Family

ID=10940167

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/GR1991/000009 WO1991019461A1 (fr) 1990-06-18 1991-06-17 Systeme d'osteosynthese a l'aide d'elements de precontrainte a guidage axial

Country Status (4)

Country Link
EP (1) EP0487669A1 (fr)
AU (1) AU7960391A (fr)
GR (1) GR1000871B (fr)
WO (1) WO1991019461A1 (fr)

Cited By (8)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2692138A1 (fr) * 1992-06-16 1993-12-17 Dev Implants Orthop Et Med Dispositif de stabilisation d'un moyen de coupe pour la pose d'une prothèse en chirurgie osseuse.
EP0689800A3 (fr) * 1994-07-01 1996-03-27 Kessler Sigurd Système de fixation et de mise en position pour éléments de transfert de charge intramédullaires
US8287538B2 (en) 2008-01-14 2012-10-16 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US8906022B2 (en) 2010-03-08 2014-12-09 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US8961518B2 (en) 2010-01-20 2015-02-24 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US9730739B2 (en) 2010-01-15 2017-08-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE913228C (de) * 1943-12-14 1954-06-10 Dr Med H C Ernst Pohl Quer elastische Innenschiene fuer Roehrenknochen
US3441017A (en) * 1965-03-24 1969-04-29 Hans Jurgen Kaessmann Apparatus for the treatment of fractures of tubular bones
EP0134406A2 (fr) * 1983-08-19 1985-03-20 Waldemar Link (GmbH & Co.) Tige de soutien intramédullaire
DE8809715U1 (de) * 1988-07-28 1988-10-20 Mecron Medizinische Produkte Gmbh, 1000 Berlin Distraktionsnagelbausatz zur Anwendung bei Knochenfrakturen

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE913228C (de) * 1943-12-14 1954-06-10 Dr Med H C Ernst Pohl Quer elastische Innenschiene fuer Roehrenknochen
US3441017A (en) * 1965-03-24 1969-04-29 Hans Jurgen Kaessmann Apparatus for the treatment of fractures of tubular bones
EP0134406A2 (fr) * 1983-08-19 1985-03-20 Waldemar Link (GmbH & Co.) Tige de soutien intramédullaire
DE8809715U1 (de) * 1988-07-28 1988-10-20 Mecron Medizinische Produkte Gmbh, 1000 Berlin Distraktionsnagelbausatz zur Anwendung bei Knochenfrakturen

Cited By (17)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0575231A1 (fr) * 1992-06-16 1993-12-22 Developpement Implants Orthopediques Et Medicaux Dispositif de stabilisation d'un moyen de coupe pour la pose d'une prothèse en chirurgie osseuse
US5490855A (en) * 1992-06-16 1996-02-13 Developpement D'implants Orthopediques Et Medicaux Device to stabilze a cutting means for the fitting of a prosthesis in bone surgery
FR2692138A1 (fr) * 1992-06-16 1993-12-17 Dev Implants Orthop Et Med Dispositif de stabilisation d'un moyen de coupe pour la pose d'une prothèse en chirurgie osseuse.
EP0689800A3 (fr) * 1994-07-01 1996-03-27 Kessler Sigurd Système de fixation et de mise en position pour éléments de transfert de charge intramédullaires
US9788870B2 (en) 2008-01-14 2017-10-17 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US8287538B2 (en) 2008-01-14 2012-10-16 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US11399878B2 (en) 2008-01-14 2022-08-02 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US10603087B2 (en) 2008-01-14 2020-03-31 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9517093B2 (en) 2008-01-14 2016-12-13 Conventus Orthopaedics, Inc. Apparatus and methods for fracture repair
US9730739B2 (en) 2010-01-15 2017-08-15 Conventus Orthopaedics, Inc. Rotary-rigid orthopaedic rod
US9848889B2 (en) 2010-01-20 2017-12-26 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US8961518B2 (en) 2010-01-20 2015-02-24 Conventus Orthopaedics, Inc. Apparatus and methods for bone access and cavity preparation
US9993277B2 (en) 2010-03-08 2018-06-12 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US8906022B2 (en) 2010-03-08 2014-12-09 Conventus Orthopaedics, Inc. Apparatus and methods for securing a bone implant
US10022132B2 (en) 2013-12-12 2018-07-17 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10076342B2 (en) 2013-12-12 2018-09-18 Conventus Orthopaedics, Inc. Tissue displacement tools and methods
US10918426B2 (en) 2017-07-04 2021-02-16 Conventus Orthopaedics, Inc. Apparatus and methods for treatment of a bone

Also Published As

Publication number Publication date
EP0487669A1 (fr) 1992-06-03
AU7960391A (en) 1992-01-07
GR1000871B (el) 1993-03-16
GR900100453A (en) 1992-08-25

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