CA2009802C - Intramedullary nail with loop tip - Google Patents
Intramedullary nail with loop tipInfo
- Publication number
- CA2009802C CA2009802C CA002009802A CA2009802A CA2009802C CA 2009802 C CA2009802 C CA 2009802C CA 002009802 A CA002009802 A CA 002009802A CA 2009802 A CA2009802 A CA 2009802A CA 2009802 C CA2009802 C CA 2009802C
- Authority
- CA
- Canada
- Prior art keywords
- nail
- filamentary
- retaining
- sleeve
- loop
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
- Expired - Lifetime
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/8861—Apparatus for manipulating flexible wires or straps
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary pins, nails or other devices
Abstract
An intramedullary nail for use in osteosynthesis is provided with means for forming and then tightening a loop of wire extending from its distal end. In the method of its use, a locking bolt which prevents rotation and longitudinal movement of the nail is inserted through the loop more easily than through the bolt holes at the distal end of a conventional nail.
Description
20~98~
INTRAMEDULLARY NAIL WITH
LOOP TIP
FIELD OF THE INVENTION
The invention relates to a method for treating bone fractures by means of an intramedullary nail and to an intramedullary nail for use in treatment of bone fractures.
BACKGROUND OF THE INVENTION
In conventional practice, intramedullary nails are driven down through the medulla of a fractured bone, usually one of the long bones of the leg. The nail is provided with holes through which locking-bolts or retaining pins are inserted transverse to the nail and bone to secure the nail in the desired position.
The locking bolts retain the nail against rotation and longitudinal movement.
In most cases after the nail is inserted into the bone, a first locking bolt is inserted through the bone and through a transverse borehole in the nail towards the distal end of the nail. One or more additional bolts are then inserted through holes near the proximal end of the nail. This procedure is difficult because the transverse locking bolts must meet their respective boreholes precisely, even though these holes are covered by bone and soft tissue. The hole at the distal end of the nail is particularly difficult to locate as it is remote from the area of the surgeon's incision. To locate the boreholes, sighting mechanisms which use X-ray imaging are employed. This -1- ~
technique is complicated and can lead to a high radiation dosage for the patient and possibly for the surgeon. Meanwhile, if the hole location is incorrectly identified, part of the bone is destroyed unnecessarily.
SU~ARY OF THE INVENTION
In one aspect the invention provides a tool useful in osteosynthesis for the insertion and positioning of an intramedullary nail comprising an elongated, tubular sleeve capable of heat sterilization and adapted for insertion into the medulla of a long bone and a looped filamentary retaining element substantially enclosed within said sleeve, said retaining element being extendable to form a loop outside one end of said sleeve.
In another aspect the invention comprises the use of the above described tool in osteosynthesis for the insertion and positioning of an intramedullary nail.
In another aspect the invention comprises an assembly; a sleeve adapted to be inserted into the medulla of a bone;
a filamentary retaining element adapted to be inserted into the sleeve and to form a loop at the distal end thereof; and a nail dimensioned to fit over the sleeve or dimensioned to fit within the sleeve.
In yet another aspect the invention comprises a device for securing the ends of a filamentary retaining element in an intramedullary nail comprising:
2009~02 a hollow retaining cylinder adapted to be inserted in one end of the nail around the ends of said retaining element; and a locking device for insertion into said retaining cylinder thereby to press the end segments of the filamentary retaining element against the interior of the retaining cylinder.
The invention can further include an intramedullary nail having proximal and distal ends, comprising a looped filamentary retaining element for engaging a transverse locking bolt, and further comprising means for extending and withdrawing the loop of said filamentary element beyond the distal end of the nail, said last named means comprising:
a block at the distal end of the nail, said block having means for receiving said filamentary element;
a guide cylinder with means for securing the ends of the filamentary retaining element;
a rod having one end secured to said guide cylinder; and a nut, secured to the nail adjacent its proximal end, the other end of said rod being threaded through said nut, whereby rotation of said nut moves said guide cylinder and said retaining device axially of said rod to extend or withdraw the loop of said device from the distal end of the nail.
A
DESCRIPTION OF THE DRAWINGS
The invention will be further described with reference to the accompanying drawings in which:
FIG. 1 is a schematic view of a device according to the invention comprising a sleeve and a looped internal filamentary retaining element;
FIG. 2 is a schematic view of the sleeve of Fig. 1 inserted in a bone with the loop of the filamentary element extending from the distal end of said sleeve;
FIG. 3 is a schematic view showing a locking bolt inserted in the looped filamentary element;
FIG. 4 is a schematic view of a device according to the invention showing a locking bolt inserted in the distal end of a bone, with a filamentary element tightly looped around it, and an intramedullary nail partially inserted into the bone around the filamentary element;
FIG. 5 is a schematic view of an intramedullary nail fully inserted and secured by locking bolts at its distal and proximal ends;
FIG. 6 is a perspective view of a section of a intramedullary nail with apparatus for locking the ends of the filamentary element;
i ..
INTRAMEDULLARY NAIL WITH
LOOP TIP
FIELD OF THE INVENTION
The invention relates to a method for treating bone fractures by means of an intramedullary nail and to an intramedullary nail for use in treatment of bone fractures.
BACKGROUND OF THE INVENTION
In conventional practice, intramedullary nails are driven down through the medulla of a fractured bone, usually one of the long bones of the leg. The nail is provided with holes through which locking-bolts or retaining pins are inserted transverse to the nail and bone to secure the nail in the desired position.
The locking bolts retain the nail against rotation and longitudinal movement.
In most cases after the nail is inserted into the bone, a first locking bolt is inserted through the bone and through a transverse borehole in the nail towards the distal end of the nail. One or more additional bolts are then inserted through holes near the proximal end of the nail. This procedure is difficult because the transverse locking bolts must meet their respective boreholes precisely, even though these holes are covered by bone and soft tissue. The hole at the distal end of the nail is particularly difficult to locate as it is remote from the area of the surgeon's incision. To locate the boreholes, sighting mechanisms which use X-ray imaging are employed. This -1- ~
technique is complicated and can lead to a high radiation dosage for the patient and possibly for the surgeon. Meanwhile, if the hole location is incorrectly identified, part of the bone is destroyed unnecessarily.
SU~ARY OF THE INVENTION
In one aspect the invention provides a tool useful in osteosynthesis for the insertion and positioning of an intramedullary nail comprising an elongated, tubular sleeve capable of heat sterilization and adapted for insertion into the medulla of a long bone and a looped filamentary retaining element substantially enclosed within said sleeve, said retaining element being extendable to form a loop outside one end of said sleeve.
In another aspect the invention comprises the use of the above described tool in osteosynthesis for the insertion and positioning of an intramedullary nail.
In another aspect the invention comprises an assembly; a sleeve adapted to be inserted into the medulla of a bone;
a filamentary retaining element adapted to be inserted into the sleeve and to form a loop at the distal end thereof; and a nail dimensioned to fit over the sleeve or dimensioned to fit within the sleeve.
In yet another aspect the invention comprises a device for securing the ends of a filamentary retaining element in an intramedullary nail comprising:
2009~02 a hollow retaining cylinder adapted to be inserted in one end of the nail around the ends of said retaining element; and a locking device for insertion into said retaining cylinder thereby to press the end segments of the filamentary retaining element against the interior of the retaining cylinder.
The invention can further include an intramedullary nail having proximal and distal ends, comprising a looped filamentary retaining element for engaging a transverse locking bolt, and further comprising means for extending and withdrawing the loop of said filamentary element beyond the distal end of the nail, said last named means comprising:
a block at the distal end of the nail, said block having means for receiving said filamentary element;
a guide cylinder with means for securing the ends of the filamentary retaining element;
a rod having one end secured to said guide cylinder; and a nut, secured to the nail adjacent its proximal end, the other end of said rod being threaded through said nut, whereby rotation of said nut moves said guide cylinder and said retaining device axially of said rod to extend or withdraw the loop of said device from the distal end of the nail.
A
DESCRIPTION OF THE DRAWINGS
The invention will be further described with reference to the accompanying drawings in which:
FIG. 1 is a schematic view of a device according to the invention comprising a sleeve and a looped internal filamentary retaining element;
FIG. 2 is a schematic view of the sleeve of Fig. 1 inserted in a bone with the loop of the filamentary element extending from the distal end of said sleeve;
FIG. 3 is a schematic view showing a locking bolt inserted in the looped filamentary element;
FIG. 4 is a schematic view of a device according to the invention showing a locking bolt inserted in the distal end of a bone, with a filamentary element tightly looped around it, and an intramedullary nail partially inserted into the bone around the filamentary element;
FIG. 5 is a schematic view of an intramedullary nail fully inserted and secured by locking bolts at its distal and proximal ends;
FIG. 6 is a perspective view of a section of a intramedullary nail with apparatus for locking the ends of the filamentary element;
i ..
2(~8~
FIG. 7 is a top view of the assembled apparatus of FIG. 6, with the wire loose;
FIG. 8 is a top view of the assembled apparatus of FIG. 6, with the wire tightened;
FIG. 9 is a longitudinal cross-section of an intramedullary nail according to a preferred embodiment of the invention;
FIG. 10 is a side view of block 19 shown in Fig. 9;
FIG. 11 is a top view of block 19;
FIG. 12 is a side view in cross-section of cylinder 20 shown in Fig. 9;
FIG. 13 is a cross-section of cylinder 20 taken at line 13-13 of Fig. 12; and FIG. 14 is a side view in cross section of nut 22 shown in Fig. 9.
DETAILED DESCRIPTION
Referring first to Figs. 1-5, a device according to the invention in its basic form is shown in Fig. l. As shown there it comprises a sleeve ll and a looped filamentary element 14.
The sleeve may be made out of various materials, for example physiologically acceptable metal or synthetic resin. If a synthetic resin is used it should be capable of heat sterilization. The filamentary element is preferably a metal wire or cable again made of a physiologically acceptable metal.
In some instances an inert synthetic resin yarn or line may be used. Again the material should be capable of heat sterilization.
`- 201~98~)~
The sleeve is, of course, open at both ends and is flexible enough to follow the contours of the medulla as it is inserted.
In use, as shown in Fig. 2, sleeve 11 is inserted into the reamed-out medulla of bone 12 down to the position to which the intramedullary nail is desired to extend. As shown in Fig. 1, the element 14 is already inside the plastic sleeve 11; however it may be inserted after the sleeve 11 is in place. When the sleeve 11 is seated in the medulla, the element 14 is pushed down so that it forms loop 16 beyond the distal tip 15 of the sleeve.
Within the constraints of the bore in the medulla, loop 16 may be made as large as desired, so that a transverse locking bolt or retaining pin may be inserted without fine aiming. As shown in Fig. 3, locking bolt 17 is then inserted through loop 16. After the locking bolt 17 is inserted, the element 14 is pulled tight and kept under tension. The plastic sleeve 11 may then be removed and, as shown in Fig. 4, an intramedullary nail 13 inserted into the bone 12 around filamentary element 14.
Alternatively, the sleeve may be left in place and the nail inserted over or within it. The proximal end of the nail may be secured by locking bolts 18 in the conventional way and the ends of the filamentary element are secured under tension to the proximal end of the nail, preferably in the manner described below.
A preferred device and method of securing the ends of the filamentary element to the nail is illustrated in Figs. 6, 7 and 8. As shown in Fig. 6 the proximal segment 4 of nail 13 is in the shape of a truncated cone, with the proximal end wider. The - 20~98~2 inner surface of proximal segment 4 is threaded. A conical retainer 2 is provided, having its outer surface threaded to engage internal threads of the proximal segment 4 of the nail 13.
The inside of retainer 2 has straight (i.e., not tapered) sides with opposing longitudinal grooves 5. Both ends of filamentary element 14 run inside retainer 2, lying in the grooves 5. A
locking device 1 is provided to lock the filamentary element in the retainer 2. Locking device 1 has a stem 6 and a top 7 with curved sides 7a. Indentations 8 which can accommodate element 14 are formed in the curved sides 7a. A hexagonal longitudinal hole 3 is provided through the center of the device.
In use, retainer 2 is screwed into the socket at the proximal end 4 of nail 13, the ends of filamentary element 14 being removed from the grooves 5 as this occurs. When the retainer is fully seated, the end segments of the filament are placed in grooves 5 and locking device 1 is slid down, the sleeve 6 sliding into the central hole of the retainer 2 with flanged upper surface 7 of locking device 1 seated on the rim of the retainer, but inside the nail 13. This arrangement is shown in Fig. 7, with the end segments of the filamentary element 14 lodged in the grooves 5 and seated in the indentations 8 of the top of the locking device 1. Using a hexagonal screwdriver the locking device is then turned clockwise. The top of the locking device then bears against the end segments of the filamentary element as shown in Fig. 8, forcing them into the grooves 5 and firmly retaining them in their desired positions in nail 13.
Z0098~)2 In the method disclosed in Figs. 1-5, a sleeve is used to position the filamentary element in the medulla before the nail is inserted. It is, however, possible to use a nail specifically designed to be used with a filamentary retaining element and to position the filamentary element in the medulla without the use of an auxiliary sleeve. Such a device is ~hown in Figs. 9-14.
Referring to Fig. 9 an intramedullary nail 13 has the usual elongated tubular casing 13a with an aperture 13b at its distal end. Inside the nail at its distal end is positioned a block 19, shown in detail in Figs. 10 and 11. The block 19 has an enlarged head l9a and an extended cylindrical body l9b. The body l9b is approximately the same diameter as the internal diameter of nail 13, so that when inserted in the distal end of the nail the shoulders l9c of the head of the block abut the edge or rim of the end of the nail.
The head l9a of the block has a semi-circular cutout section l9d adapted to receive a transverse locking bolt. Grooves 24 for receiving a filamentary retaining element 14 are provided along the sides of block 19.
Proximal to the block 19 inside nail 13 is positioned a guide cylinder 20, shown in detail in Figs. 12 and 13. Cylinder 20 in one transverse dimension has the same diameter as the inner diameter of the nail 13. Its sides in the transverse direction have flats 20a. Two holes 26 running parallel to the longitudinal axis of the cylinder 20 and extending about half way into the cylinder are provided for receiving the ends of the filamentary element. Transverse screw holes 27 for screws 27a 20(~98~)2 are provided for retaining the ends of the filamentary element in the holes 26.
The cylinder 20 is further provided at its proximal end with a tapped socket 2Ob which receives the threaded end of a rod 21.
Rod 21, which has a diameter smaller than the interior diameter of nail 13, extends toward the proximal end of the nail and is threaded into a nut 22 shown in detail in Fig. 14. Nut 22 has a cylindrical body 28 of a diameter approximating that of the interior of nail 13 and an extension 30 which may be given a hexagonal configuration of lesser width. The distal end of the nut has a conical entry 31, and a central passage 3la which leads to a tapped section 31b in the hexagonal extension into which rod 21 is threaded.
In use, the nail is assembled by loading the block 19, cylinder 20 and rod 21 into the nail through its distal end. The block 19 is retained in the nail by crimping the nail to engage the dimple 25 in the side of the block. The nut 22 is then slipped over the proximal end of rod 21 and engaged in the threaded extension 30, the hexagonal outer surface of the extension providing operating surfaces for a suitable socket wrench. Crimp 29 in nail 13 prevents nut 22 from moving farther distally within the nail.
Thus assembled, the nail is inserted in the medulla of the bone to be treated in the normal way. By turning hexagonal extension 30 in one direction rod 21 is moved in a distal direction, moving cylinder 20 on rod 21 and also moving filamentary element 14 distally to form a large loop at the 200~8~:)2 distal end of the nail. A transverse locking-bolt 17 (Fig. 9) may then be inserted through the loop of element 14. The loop is tightened about the bolt by turning the nut extension 30 in the opposite direction. This draws rod 21 in the proximal direction pulling cylinder 20 in the same direction and with it the filamentary element 14.
FIG. 7 is a top view of the assembled apparatus of FIG. 6, with the wire loose;
FIG. 8 is a top view of the assembled apparatus of FIG. 6, with the wire tightened;
FIG. 9 is a longitudinal cross-section of an intramedullary nail according to a preferred embodiment of the invention;
FIG. 10 is a side view of block 19 shown in Fig. 9;
FIG. 11 is a top view of block 19;
FIG. 12 is a side view in cross-section of cylinder 20 shown in Fig. 9;
FIG. 13 is a cross-section of cylinder 20 taken at line 13-13 of Fig. 12; and FIG. 14 is a side view in cross section of nut 22 shown in Fig. 9.
DETAILED DESCRIPTION
Referring first to Figs. 1-5, a device according to the invention in its basic form is shown in Fig. l. As shown there it comprises a sleeve ll and a looped filamentary element 14.
The sleeve may be made out of various materials, for example physiologically acceptable metal or synthetic resin. If a synthetic resin is used it should be capable of heat sterilization. The filamentary element is preferably a metal wire or cable again made of a physiologically acceptable metal.
In some instances an inert synthetic resin yarn or line may be used. Again the material should be capable of heat sterilization.
`- 201~98~)~
The sleeve is, of course, open at both ends and is flexible enough to follow the contours of the medulla as it is inserted.
In use, as shown in Fig. 2, sleeve 11 is inserted into the reamed-out medulla of bone 12 down to the position to which the intramedullary nail is desired to extend. As shown in Fig. 1, the element 14 is already inside the plastic sleeve 11; however it may be inserted after the sleeve 11 is in place. When the sleeve 11 is seated in the medulla, the element 14 is pushed down so that it forms loop 16 beyond the distal tip 15 of the sleeve.
Within the constraints of the bore in the medulla, loop 16 may be made as large as desired, so that a transverse locking bolt or retaining pin may be inserted without fine aiming. As shown in Fig. 3, locking bolt 17 is then inserted through loop 16. After the locking bolt 17 is inserted, the element 14 is pulled tight and kept under tension. The plastic sleeve 11 may then be removed and, as shown in Fig. 4, an intramedullary nail 13 inserted into the bone 12 around filamentary element 14.
Alternatively, the sleeve may be left in place and the nail inserted over or within it. The proximal end of the nail may be secured by locking bolts 18 in the conventional way and the ends of the filamentary element are secured under tension to the proximal end of the nail, preferably in the manner described below.
A preferred device and method of securing the ends of the filamentary element to the nail is illustrated in Figs. 6, 7 and 8. As shown in Fig. 6 the proximal segment 4 of nail 13 is in the shape of a truncated cone, with the proximal end wider. The - 20~98~2 inner surface of proximal segment 4 is threaded. A conical retainer 2 is provided, having its outer surface threaded to engage internal threads of the proximal segment 4 of the nail 13.
The inside of retainer 2 has straight (i.e., not tapered) sides with opposing longitudinal grooves 5. Both ends of filamentary element 14 run inside retainer 2, lying in the grooves 5. A
locking device 1 is provided to lock the filamentary element in the retainer 2. Locking device 1 has a stem 6 and a top 7 with curved sides 7a. Indentations 8 which can accommodate element 14 are formed in the curved sides 7a. A hexagonal longitudinal hole 3 is provided through the center of the device.
In use, retainer 2 is screwed into the socket at the proximal end 4 of nail 13, the ends of filamentary element 14 being removed from the grooves 5 as this occurs. When the retainer is fully seated, the end segments of the filament are placed in grooves 5 and locking device 1 is slid down, the sleeve 6 sliding into the central hole of the retainer 2 with flanged upper surface 7 of locking device 1 seated on the rim of the retainer, but inside the nail 13. This arrangement is shown in Fig. 7, with the end segments of the filamentary element 14 lodged in the grooves 5 and seated in the indentations 8 of the top of the locking device 1. Using a hexagonal screwdriver the locking device is then turned clockwise. The top of the locking device then bears against the end segments of the filamentary element as shown in Fig. 8, forcing them into the grooves 5 and firmly retaining them in their desired positions in nail 13.
Z0098~)2 In the method disclosed in Figs. 1-5, a sleeve is used to position the filamentary element in the medulla before the nail is inserted. It is, however, possible to use a nail specifically designed to be used with a filamentary retaining element and to position the filamentary element in the medulla without the use of an auxiliary sleeve. Such a device is ~hown in Figs. 9-14.
Referring to Fig. 9 an intramedullary nail 13 has the usual elongated tubular casing 13a with an aperture 13b at its distal end. Inside the nail at its distal end is positioned a block 19, shown in detail in Figs. 10 and 11. The block 19 has an enlarged head l9a and an extended cylindrical body l9b. The body l9b is approximately the same diameter as the internal diameter of nail 13, so that when inserted in the distal end of the nail the shoulders l9c of the head of the block abut the edge or rim of the end of the nail.
The head l9a of the block has a semi-circular cutout section l9d adapted to receive a transverse locking bolt. Grooves 24 for receiving a filamentary retaining element 14 are provided along the sides of block 19.
Proximal to the block 19 inside nail 13 is positioned a guide cylinder 20, shown in detail in Figs. 12 and 13. Cylinder 20 in one transverse dimension has the same diameter as the inner diameter of the nail 13. Its sides in the transverse direction have flats 20a. Two holes 26 running parallel to the longitudinal axis of the cylinder 20 and extending about half way into the cylinder are provided for receiving the ends of the filamentary element. Transverse screw holes 27 for screws 27a 20(~98~)2 are provided for retaining the ends of the filamentary element in the holes 26.
The cylinder 20 is further provided at its proximal end with a tapped socket 2Ob which receives the threaded end of a rod 21.
Rod 21, which has a diameter smaller than the interior diameter of nail 13, extends toward the proximal end of the nail and is threaded into a nut 22 shown in detail in Fig. 14. Nut 22 has a cylindrical body 28 of a diameter approximating that of the interior of nail 13 and an extension 30 which may be given a hexagonal configuration of lesser width. The distal end of the nut has a conical entry 31, and a central passage 3la which leads to a tapped section 31b in the hexagonal extension into which rod 21 is threaded.
In use, the nail is assembled by loading the block 19, cylinder 20 and rod 21 into the nail through its distal end. The block 19 is retained in the nail by crimping the nail to engage the dimple 25 in the side of the block. The nut 22 is then slipped over the proximal end of rod 21 and engaged in the threaded extension 30, the hexagonal outer surface of the extension providing operating surfaces for a suitable socket wrench. Crimp 29 in nail 13 prevents nut 22 from moving farther distally within the nail.
Thus assembled, the nail is inserted in the medulla of the bone to be treated in the normal way. By turning hexagonal extension 30 in one direction rod 21 is moved in a distal direction, moving cylinder 20 on rod 21 and also moving filamentary element 14 distally to form a large loop at the 200~8~:)2 distal end of the nail. A transverse locking-bolt 17 (Fig. 9) may then be inserted through the loop of element 14. The loop is tightened about the bolt by turning the nut extension 30 in the opposite direction. This draws rod 21 in the proximal direction pulling cylinder 20 in the same direction and with it the filamentary element 14.
Claims (14)
1. A tool useful in osteosynthesis for the insertion and positioning of an intramedullary nail comprising an elongated, tubular sleeve capable of heat sterilization and adapted for insertion into the medulla of a long bone and a looped filamentary retaining element substantially enclosed within said sleeve, said retaining element being extendable to form a loop outside one end of said sleeve.
2. The use of the tool of claim 1 in osteosynthesis, for the insertion and positioning of an intramedullary nail.
3. An assembly comprising:
a sleeve adapted to be inserted into the medulla of a bone;
a filamentary retaining element adapted to be inserted into the sleeve and to form a loop at the distal end thereof; and a nail dimensioned to fit over the sleeve or dimensioned to fit within the sleeve.
a sleeve adapted to be inserted into the medulla of a bone;
a filamentary retaining element adapted to be inserted into the sleeve and to form a loop at the distal end thereof; and a nail dimensioned to fit over the sleeve or dimensioned to fit within the sleeve.
4. A device for securing the ends of a filamentary retaining element in an intramedullary nail comprising:
a hollow retaining cylinder adapted to be inserted in one end of the nail around the ends of said retaining element; and a locking device for insertion into said retaining cylinder thereby to press the end segments of the filamentary retaining element against the interior of the retaining cylinder.
a hollow retaining cylinder adapted to be inserted in one end of the nail around the ends of said retaining element; and a locking device for insertion into said retaining cylinder thereby to press the end segments of the filamentary retaining element against the interior of the retaining cylinder.
5. A device claimed in claim 4 wherein:
said retaining cylinder has grooves for receiving the end segments of the filamentary retaining element;
and the locking device comprises a rotatable sleeve for insertion into the retaining cylinder and a top for pressing the end segments of the retaining device into the grooves, when said sleeve is rotated.
said retaining cylinder has grooves for receiving the end segments of the filamentary retaining element;
and the locking device comprises a rotatable sleeve for insertion into the retaining cylinder and a top for pressing the end segments of the retaining device into the grooves, when said sleeve is rotated.
6. A device claimed in claim 5 wherein the top of the locking device has curved sides.
7. An intramedullary nail comprising a casing, a filamentary element in said casing, and means for forming a loop of said filamentary retaining element extending beyond one end of the nail.
8. An intramedullary nail having proximal and distal ends, comprising a looped filamentary retaining element for engaging a transverse locking bolt, and further comprising means for extending and withdrawing the loop of said filamentary element beyond the distal end of the nail, said last named means comprising:
a block at the distal end of the nail, said block having means for receiving said filamentary element;
a guide cylinder with means for securing the ends of the filamentary retaining element;
a rod having one end secured to said guide cylinder; and a nut, secured to the nail adjacent its proximal end, the other end of said rod being threaded through said nut, whereby rotation of said nut moves said guide cylinder and said retaining device axially of said rod to extend or withdraw the loop of said device from the distal end of the nail.
a block at the distal end of the nail, said block having means for receiving said filamentary element;
a guide cylinder with means for securing the ends of the filamentary retaining element;
a rod having one end secured to said guide cylinder; and a nut, secured to the nail adjacent its proximal end, the other end of said rod being threaded through said nut, whereby rotation of said nut moves said guide cylinder and said retaining device axially of said rod to extend or withdraw the loop of said device from the distal end of the nail.
9. A nail according to claim 8 wherein the block comprises a head adapted to engage a locking bolt.
10. A nail according to claim 8 wherein the block has transverse grooves adapted to receive the filamentary element.
11. A nail according to claim 8 wherein the block has a dimple for retaining it in the nail by crimping.
12. A nail according to claim 8 wherein the means for holding the ends of the filamentary element comprises holes extending into the guide cylinder parallel to its longitudinal axis to receive the ends of the filamentary element, and means for securing the ends of the filamentary element in said holes.
13. A nail according to claim 8 wherein the proximal end of the guide cylinder comprises a tapped socket and the distal end of the rod is threaded.
14. A nail according to claim 8 wherein said nut comprises:
a cylindrical body;
a hexagonal extension of lesser diameter than said cylindrical body; and a conical entry at its distal end, adapted to receive the rod.
a cylindrical body;
a hexagonal extension of lesser diameter than said cylindrical body; and a conical entry at its distal end, adapted to receive the rod.
Applications Claiming Priority (2)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| US439,706 | 1989-11-21 | ||
| US07/439,706 US5034012A (en) | 1989-11-21 | 1989-11-21 | Intramedullary nail with loop tip |
Publications (2)
| Publication Number | Publication Date |
|---|---|
| CA2009802A1 CA2009802A1 (en) | 1991-05-21 |
| CA2009802C true CA2009802C (en) | 1995-08-15 |
Family
ID=23745811
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| CA002009802A Expired - Lifetime CA2009802C (en) | 1989-11-21 | 1990-02-12 | Intramedullary nail with loop tip |
Country Status (5)
| Country | Link |
|---|---|
| US (1) | US5034012A (en) |
| EP (1) | EP0428985B1 (en) |
| JP (1) | JPH0640885B2 (en) |
| CA (1) | CA2009802C (en) |
| DE (1) | DE69017844T2 (en) |
Families Citing this family (48)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US5281225A (en) * | 1989-06-07 | 1994-01-25 | Guglielmo Vicenzi | Intramedullary pin with self-locking end for metadiaphyseal fractures of long bones |
| US5190549A (en) * | 1990-08-02 | 1993-03-02 | Exactech, Inc. | Locking surgical tool handle system |
| US5179915A (en) * | 1992-01-06 | 1993-01-19 | Osteonics Corporation | Anatomically matching intramedullary alignment rod |
| US5266075A (en) * | 1992-10-05 | 1993-11-30 | Roy Clark | Tendon threader for endosteal ligament mounting |
| US5429638A (en) * | 1993-02-12 | 1995-07-04 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US5626579A (en) * | 1993-02-12 | 1997-05-06 | The Cleveland Clinic Foundation | Bone transport and lengthening system |
| US5350379A (en) * | 1993-02-18 | 1994-09-27 | Genesis Orthopedics | Bone and tissue lengthening device |
| US5536269A (en) * | 1993-02-18 | 1996-07-16 | Genesis Orthopedics | Bone and tissue lengthening device |
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| EP2501312B1 (en) * | 2009-11-16 | 2016-07-20 | The Research Foundation for The State University of New York | Pre-curved intramedullary clavicle nail and method of using same |
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| EP3016604B1 (en) * | 2013-07-02 | 2018-10-10 | Cmarr Enterprises | Curved tibiotalar fusion nail |
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|---|---|---|---|---|
| DE532698C (en) * | 1929-07-13 | 1931-09-02 | Moritz Borchardt Dr | Device for tightening the wires used to strengthen bone fractures |
| US2049361A (en) * | 1934-10-27 | 1936-07-28 | Ericsson Ernst Axel Johan | Wire or ribbon tightening apparatus |
| CH275268A (en) * | 1949-07-13 | 1951-05-15 | Sannmann Alfred | Apparatus for braiding the ends of a wire tied around an object. |
| DE1248228B (en) * | 1965-03-24 | 1967-08-24 | Hans Juergen Kaessmann Dr | Device for the treatment of broken tubular bones by means of pressure osteosynthesis |
| US4409974A (en) * | 1981-06-29 | 1983-10-18 | Freedland Jeffrey A | Bone-fixating surgical implant device |
| EP0070252A1 (en) * | 1981-07-08 | 1983-01-19 | Ciba-Geigy Ag | Machine for checking the completion of the filling of press-through packs |
| US4574795A (en) * | 1982-12-24 | 1986-03-11 | Mecron Medizinische Produkte Gmbh | Compression nail assembly |
| DE3347333A1 (en) * | 1982-12-24 | 1984-06-28 | Mecron Medizinische Produkte Gmbh, 1000 Berlin | Compression nail arrangement |
| SU1111748A1 (en) * | 1983-04-08 | 1984-09-07 | Киевский медицинский институт | Apparatus for osteosynthesis of tubular bones |
| US4557259A (en) * | 1983-08-10 | 1985-12-10 | Henry Ford Hospital | Surgical method and apparatus for inserting wire into the spine |
| US4561432A (en) * | 1983-09-15 | 1985-12-31 | Floyd A. Coard, M.D. | Fractured femur fixation system |
| CH668173A5 (en) * | 1984-05-14 | 1988-12-15 | Synthes Ag | DEVICE FOR FIXING TUBE BONE FRACTURES WITH A BONE MARBLE NAIL AND AT LEAST ONE CROSS-BOLT LOCKING. |
| GB8721661D0 (en) * | 1987-09-15 | 1987-10-21 | Showell A W Sugicraft Ltd | Spinal/skull fixation device |
-
1989
- 1989-11-21 US US07/439,706 patent/US5034012A/en not_active Expired - Lifetime
-
1990
- 1990-02-12 CA CA002009802A patent/CA2009802C/en not_active Expired - Lifetime
- 1990-11-14 EP EP90121754A patent/EP0428985B1/en not_active Expired - Lifetime
- 1990-11-14 DE DE69017844T patent/DE69017844T2/en not_active Expired - Fee Related
- 1990-11-20 JP JP2313013A patent/JPH0640885B2/en not_active Expired - Lifetime
Also Published As
| Publication number | Publication date |
|---|---|
| JPH03173555A (en) | 1991-07-26 |
| DE69017844T2 (en) | 1995-07-27 |
| US5034012A (en) | 1991-07-23 |
| CA2009802A1 (en) | 1991-05-21 |
| DE69017844D1 (en) | 1995-04-20 |
| JPH0640885B2 (en) | 1994-06-01 |
| EP0428985B1 (en) | 1995-03-15 |
| EP0428985A1 (en) | 1991-05-29 |
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