WO1991009571A1 - Support plate for cervical and cervicotrochanterian fractures - Google Patents

Support plate for cervical and cervicotrochanterian fractures Download PDF

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Publication number
WO1991009571A1
WO1991009571A1 PCT/FR1991/000005 FR9100005W WO9109571A1 WO 1991009571 A1 WO1991009571 A1 WO 1991009571A1 FR 9100005 W FR9100005 W FR 9100005W WO 9109571 A1 WO9109571 A1 WO 9109571A1
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WO
WIPO (PCT)
Prior art keywords
plate
plate according
rods
bone
screw
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Application number
PCT/FR1991/000005
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French (fr)
Inventor
Jean-Marie Hardy
Original Assignee
Hardy Jean Marie
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Filing date
Publication date
Application filed by Hardy Jean Marie filed Critical Hardy Jean Marie
Publication of WO1991009571A1 publication Critical patent/WO1991009571A1/en

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    • 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
    • A61B17/74—Devices for the head or neck or trochanter of the femur
    • A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
    • A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head

Definitions

  • this type of fracture which relates more particularly to the femur, is reduced by means of a cephalic screw placed by an appropriate ancillary in the head of the femur.
  • the screw is arranged very substantially in the middle of the neck and the head and cooperates with a nail or a plate, both screwed onto the femur. Either of these solutions has certain drawbacks.
  • the cephalic screw In the case of a nail, the cephalic screw must be of reduced diameter and consequently not very effective. In addition, it is the nail which indirectly determines the placement of the screw by constraining it, which is not good for reducing the fracture. Finally, in an important way, it turns out to be necessary to practice a bore for the installation of the nail in the bone. Note also that reducing the fracture is very complex with this technique.
  • the cephalic screw is engaged in the bore of a cylindrical barrel formed angularly from the diaphyseal support plate fixed to the femur by screws. It is necessary to have right and left plates, of different lengths, and of different angulation compared to the barrel.
  • Figure 4 shows a cervical fracture reduced by a plate according to the state of the art. It appears in the case of an elderly patient, a downward translation of the femoral head under the effect of bone lysis around the screw cephalic (figure 3). In the case of cervicotrochanteric fractures, in particular when the internal support strap is broken, depending on the age of the patient, there may be a break in the support plate below the fracture in the case of a young subject in particular ( Figure 2), or the tearing of the fixing screws (Figure 4), in the case of an elderly subject ( Figure 1).
  • a plate has been designed which takes account of the fact in particular that all the stresses imparted by the weight of the body are transmitted to the cephalic screw, then to the barrel of the plate receiving it.
  • One of the problems which the invention proposes to solve is not to constrain the cephalic screw in order not to stress in a harmful manner the focal point of the fracture.
  • Such a problem is solved in that the plate is profiled and dimensioned so as to be able to bear at the level of the greater trochanter and the femoral shaft while being arranged to allow the free engagement and positioning of at least one rod in the medullary canal so to control the position of the plate relative to the cephalic screw.
  • the plate has vertically several parallel through holes, arranged in the same alignment and the width of said plate, said holes being oriented to direct the rods into the medullary canal, in particular bearing against the internal walls of the diaphyseal barrel.
  • the problem posed is resolved in that the rods are straight with capacity for elastic deformation to absorb the stresses and compensate for the possible bending of the head of the bone.
  • a shim is placed between the plate and the bone, above the cylindrical barrel, to compensate for the flexing effect at the head of the head. 'bone, or to adjust the angle between the neck and the femoral shaft. the angle between the cylindrical barrel and the plate.
  • the upper part of the plate receives a shutter member of the cap type.
  • Figures 1, 2, 3 and 4 are sectional views. schematic character showing different types of lesions likely to occur in the case of cervical and cervico-trochanteric fractures reduced by means of a plate according to the prior art.
  • Figure 5 is a perspective view showing the main elements of the support plate according to the invention.
  • Figure 6 is a longitudinal sectional view showing the placement of the plate in the case of a basi-cervical fracture of a femur.
  • Figure 7 is a partial sectional view showing the establishment of the plate and its elements according to the invention, taking into account the constraints resulting from the weight of the body.
  • the support plate (1) comprises a cylindrical barrel (1a) able to cooperate freely coullsse-ent, with a cephalic screw (2) previously placed in the head of the femur or other.
  • a cephalic screw (2) previously placed in the head of the femur or other.
  • the installation and the design of the cephalic screw are not described because they are perfectly known by a person skilled in the art and do not form part of the specific object of the invention.
  • the screw (2) has a threaded end (2a) and a smooth surface (2b) on which is engaged the cylindrical barrel (1a) of the plate (1).
  • the length of the screw (2) is variable depending in particular on the type of fracture and the dimensioning of the bone considered.
  • the plate (1) is profiled and dimensioned of short length to bear on the level of the greater trochanter and the femoral barrel in opposition to the known bearing plates which are dimensioned to bear only on the outside of the barrel diaphyseal of the bone. Under these conditions, the plate (1) can, if the fracture does not touch the trochanteric mass (true cervical fracture), bear on the external cortex of the greater trochanter and on the external cortex of the femoral shaft.
  • the plate (1) is arranged to allow the free engagement and positioning of at least one rod (3) in the medullary canal. This or these rods (3), as will be indicated in the following description, have the effect of controlling the position of the plate (1) relative to the cephalic screw (2). It therefore appears that the angular positioning of the screw (2), taking into account the fracture to be reduced, is not constrained by the plate, as is the case according to the state of the art.
  • the plate (1) extends on either side of the cylindrical barrel (1a).
  • the plate has vertically several through and parallel holes (1c), for the engagement and positioning of the rods (3).
  • These holes (1c) are arranged in the same alignment and across the width of the plate.
  • these holes are oriented to direct the rods (3) into the medullary canal, in particular bearing against the internal walls of the diaphyseal barrel ( Figure 6).
  • the plate (1) is pierced with three holes (1c).
  • Each rod (3) is rectilinear with elastic deformation capacity to absorb the stresses and compensate for the possible bending of the head of the bone.
  • each wedge (4) is made of polyethylene or other material capable of absorbing stresses. These shims are self-supporting by the plate (1).
  • the cylindrical barrel (1a) of the plate (1) and the cephhlic screw (2) have in combination arrangements complementary (1a1) and (2b1), to ensure the locking in rotation of said screw (2).
  • these arrangements may result from flats formed respectively in the bore of the cylindrical barrel (1a) and on the smooth surface (2b) of the screw (2).

Abstract

The support plate comprises a cylindrical shaft (1a) designed to cooperate with a cephalic screw (2) previously placed in the corresponding part of the caput of the bone. This plate (1) has a shape and size which allow it to rest on the whirlbone while being arranged to allow at least one stem (3) to be freely engaged and positioned in the medullary canal so that the position of the plate (1) is controlled by the cephalic screw.

Description

Plaque d'appui pour fractures cervicales et cervico-trochantériennes. Support plate for cervical and cervico-trochanteric fractures.
Généralement, ce type de fractures qui concernent plus particulièrement le fémur, esrt réduit au moyen d'une vis céphalique mise en place par un ancillaire approprié dans la tête du fémur. La vis est disposée très sensiblement au milieu du col et de la tête et coopère avec un clou ou une plaque, l'un et l'autre vissés sur le fémur. L'une ou l'autre de ces solutions présentent certains inconvénients.Generally, this type of fracture which relates more particularly to the femur, is reduced by means of a cephalic screw placed by an appropriate ancillary in the head of the femur. The screw is arranged very substantially in the middle of the neck and the head and cooperates with a nail or a plate, both screwed onto the femur. Either of these solutions has certain drawbacks.
Dans le cas d'un clou, la vis céphalique doit être de diamètre réduit et par conséquent peu efficace. De plus, c'est le clou qui, indirectement, détermine la mise en place de la vis en la contraignant, ce qui n'est pas bon pour la réduction de la fracture. Enfin, d'une manière importante, il s'avère nécessaire de pratiquer un alésage pour la mise en place du clou dans l'os. A noter également que la réduction de la fracture s'avère très complexe avec cette technique.In the case of a nail, the cephalic screw must be of reduced diameter and consequently not very effective. In addition, it is the nail which indirectly determines the placement of the screw by constraining it, which is not good for reducing the fracture. Finally, in an important way, it turns out to be necessary to practice a bore for the installation of the nail in the bone. Note also that reducing the fracture is very complex with this technique.
Dans l'autre solution, la vis céphalique est engagée dans l'alésage d'un fût cylindrique formé angulairement à partir de la plaque d'appui diaphysaire fixée sur le fémur par vis. Il est nécessaire d'avoir des plaques droites et gauches, de différentes longueurs, et d'angulation différente par rapport au fût.In the other solution, the cephalic screw is engaged in the bore of a cylindrical barrel formed angularly from the diaphyseal support plate fixed to the femur by screws. It is necessary to have right and left plates, of different lengths, and of different angulation compared to the barrel.
Cet état de la technique peut être illustré par l'enseignement du brevet US 4657001 qui divulgue une plaque pour fractures cervico-trochantériennes, qui est totalement rigide, en étant fixée sur le fémur par des vis.This state of the art can be illustrated by the teaching of US Pat. No. 4,657,001, which discloses a plate for cervico-trochanteric fractures, which is completely rigid, by being fixed to the femur by screws.
La figure 4 montre une fracture cervicale réduite par une plaque selon l'état de la technique. Il apparaît dans le cas d'un patient âgé, une translation vers le bas de la tête fémorale sous l'effet de la lyse osseuse autour de la vis céphalique (figure 3). Dans le cas des fractures cervicotrochantériennes, notamment lorsque le ceintre d'appui interne est rompu, il peut se produire, en fonction de l'âge du patient, une cassure de la plaque d'appui en dessous de la fracture dans le cas d'un sujet jeune notamment (figure 2), ou l'arrachement des vis de fixation (figure 4), dans le cas d'un sujet âgé (figure 1).Figure 4 shows a cervical fracture reduced by a plate according to the state of the art. It appears in the case of an elderly patient, a downward translation of the femoral head under the effect of bone lysis around the screw cephalic (figure 3). In the case of cervicotrochanteric fractures, in particular when the internal support strap is broken, depending on the age of the patient, there may be a break in the support plate below the fracture in the case of a young subject in particular (Figure 2), or the tearing of the fixing screws (Figure 4), in the case of an elderly subject (Figure 1).
Pour remédier à ces inconvénients, il a été conçu une plaque qui tient compte du fait notamment que toutes les contraintes imprimées par le poids du corps se transmettent à la vis céphalique, puis au fût de la plaque la recevant.To overcome these drawbacks, a plate has been designed which takes account of the fact in particular that all the stresses imparted by the weight of the body are transmitted to the cephalic screw, then to the barrel of the plate receiving it.
Un des problèmes que se propose de résoudre l'invention est de ne pas contraindre la vis céphalique pour ne pas soliciter d'une manière néfaste le foyer de fracture. Un tel problème est résolu en ce que la plaque est profilée et dimensionnée pour pouvoir prendre appui au niveau du grand trochanter et du fût fémoral en étant agencée pour permettre le libre engagement et le positionnement d* au moins une tige dans le canal médullaire de manière à asservir la position de la plaque par rapport à la vis céphalique.One of the problems which the invention proposes to solve is not to constrain the cephalic screw in order not to stress in a harmful manner the focal point of the fracture. Such a problem is solved in that the plate is profiled and dimensioned so as to be able to bear at the level of the greater trochanter and the femoral shaft while being arranged to allow the free engagement and positioning of at least one rod in the medullary canal so to control the position of the plate relative to the cephalic screw.
Un autre problème que se propose de résoudre l' invention est de supprimer toutes les vis de fixation de la plaque et de la fixer de manière non rigide pour qu'elle puisse absorber par élasticité les différentes contraintes. Dans ce but, la plaque présente verticalement plusieurs trous débouchants parallèles , disposés suivant le même alignement et la largeur de ladite plaque, lesdits trous étant orientés pour diriger les tiges dans le canal médullaire, notamment en appui contre les parois internes du fût diaphysaire.Another problem which the invention proposes to solve is to remove all the screws for fixing the plate and to fix it in a non-rigid manner so that it can absorb the various stresses by elasticity. For this purpose, the plate has vertically several parallel through holes, arranged in the same alignment and the width of said plate, said holes being oriented to direct the rods into the medullary canal, in particular bearing against the internal walls of the diaphyseal barrel.
Avantageusement, le problème posé est résolu en ce que les tiges sont rectilignes avec capacité de déformation élastique pour absorber les contraintes et compenser l'éventuel fléchissement de la tête de l'os.Advantageously, the problem posed is resolved in that the rods are straight with capacity for elastic deformation to absorb the stresses and compensate for the possible bending of the head of the bone.
Dans certains cas, pour résoudre le problème posé du fléchissement de la tête, une cale d'épaisseur est disposée entre la plaque et l'os, au dessus du fût cylindrique , pour compenser l'effet de fléchissement au niveau de la tête de l'os, ou pour ajuster l'angle entre le col et le fût fémoral à. l'angle entre le fût cylindrique et la plaque.In some cases, to solve the problem of head flexing, a shim is placed between the plate and the bone, above the cylindrical barrel, to compensate for the flexing effect at the head of the head. 'bone, or to adjust the angle between the neck and the femoral shaft. the angle between the cylindrical barrel and the plate.
Pour résoudre le problème posé d'éviter tout risque de débordement des tiges de liaison, la partie supérieure de la plaque reçoit un organe obturateur du type capuchon.To solve the problem posed of avoiding any risk of overflow of the connecting rods, the upper part of the plate receives a shutter member of the cap type.
L'invention est exposée, ci-après, plus en détail à l'aide des dessins annexés dans lesquels :The invention is set out below in more detail with the aid of the appended drawings in which:
Les figures 1, 2, 3 et 4 sont des vues en coupe à. caractère schématique montrant différents types de lésions susceptibles d'intervenir dans le cas de fractures cervicales et cervico-trochantériennes réduites au moyen d'une plaque selon l'état antérieur de la technique.Figures 1, 2, 3 and 4 are sectional views. schematic character showing different types of lesions likely to occur in the case of cervical and cervico-trochanteric fractures reduced by means of a plate according to the prior art.
La figure 5 est une vue en perspective montrant les principaux éléments de la plaque d'appui selon l'invention. La figure 6 est une vue en coupe longitudinale montrant la mise en place de la plaque dans le cas d'une fracture basi-cervicale d'un fémur.Figure 5 is a perspective view showing the main elements of the support plate according to the invention. Figure 6 is a longitudinal sectional view showing the placement of the plate in the case of a basi-cervical fracture of a femur.
La figure 7 est une vue partielle et en coupe montrant la mise en place de la plaque et de ses éléments selon l'invention, compte-tenu des contraintes résultant du poids du corps.Figure 7 is a partial sectional view showing the establishment of the plate and its elements according to the invention, taking into account the constraints resulting from the weight of the body.
D'une manière connue, la plaque d'appui (1) comprend un fût cylindrique (1a) apte à coopérer à libre coullsse-ent, avec une vis céphalique (2) préalablement mise en place dans la tête du fémur ou autre. La mise en place et la conception de la vis céphalique ne sont pas décrites car parfaitement connues par un homme du métier et ne font pas partie de l'objet spécifique de l'invention. A titre de simple information, on rappelle que la vis (2) présente une extrémité filetée (2a) et une portée lisse (2b) sur laquelle est engagé le fût cylindrique (1a) de la plaque (1). La longueur de la vis (2) est variable en fonction notamment du type de fracture et du dimensionnement de l'os considéré.In a known manner, the support plate (1) comprises a cylindrical barrel (1a) able to cooperate freely coullsse-ent, with a cephalic screw (2) previously placed in the head of the femur or other. The installation and the design of the cephalic screw are not described because they are perfectly known by a person skilled in the art and do not form part of the specific object of the invention. As a simple information, it is recalled that the screw (2) has a threaded end (2a) and a smooth surface (2b) on which is engaged the cylindrical barrel (1a) of the plate (1). The length of the screw (2) is variable depending in particular on the type of fracture and the dimensioning of the bone considered.
Selon l'invention, la plaque (1) est profilée et dimensionnée de petite longueur pour prendre appui au niveau du grand trochanter et du fût fémoral en opposition aux plaques d' appui connues qui sont dimensionnées pour prendre appui uniquement sur l'extérieur du fût diaphysaire de l'os. Dans ces conditions, la plaque (1) peut, si la fracture ne touche pas le massif trochantérien (fracture cervicale vraie), prendre appui sur la corticale externe du grand trochanter et sur la corticale externe du fût fémoral. En outre, d'une manière importante, la plaque (1) est agencée pour permettre le libre engagement et le positionnement, d'au moins une tige (3) dans le canal médullaire. Cette ou ces tiges (3), comme il sera indiqué dans la suite de la description, ont pour effet d'asservir la position de la plaque (1) par rapport à la vis céphalique (2). Il apparaît donc que le positionnement angulaire de la vis (2), compte-tenu de la fracture à réduire, n'est pas contraint par la plaque, comme c'est le cas selon l'état de la technique. La plaque (1) s'étend de part et d'autre du fût cylindrique (1a).According to the invention, the plate (1) is profiled and dimensioned of short length to bear on the level of the greater trochanter and the femoral barrel in opposition to the known bearing plates which are dimensioned to bear only on the outside of the barrel diaphyseal of the bone. Under these conditions, the plate (1) can, if the fracture does not touch the trochanteric mass (true cervical fracture), bear on the external cortex of the greater trochanter and on the external cortex of the femoral shaft. In addition, importantly, the plate (1) is arranged to allow the free engagement and positioning of at least one rod (3) in the medullary canal. This or these rods (3), as will be indicated in the following description, have the effect of controlling the position of the plate (1) relative to the cephalic screw (2). It therefore appears that the angular positioning of the screw (2), taking into account the fracture to be reduced, is not constrained by the plate, as is the case according to the state of the art. The plate (1) extends on either side of the cylindrical barrel (1a).
Comme le montre notamment la figure 5, la plaque présente verticalement plusieurs trous débouchants et parallèles (1c), pour l'engagement et le positionnement des tiges (3). Ces trous (1c) sont disposés suivant le même alignement et dans le sens de la largeur de la plaque. En outre, ces trous sont orientés pour diriger les tiges (3) dans le canal médullaire, notamment en appui contre les parois internes du fût diaphysaire (figure 6). D'une manière préférée, la plaque (1) est percée de trois trous (1c). Chaque tige (3) est rectiligne avec capacité de déformation élastique pour absorber les contraintes et compenser l'éventuel fléchissement de la tête de l'os. A cet effet, comme le montre la figure 7, toutes les contraintes résultant du poids du corps se transmettent à la vis céphalique (2) et par conséquent au fût cylindrique (la) de la plaque (1), de sorte qu'il se produit un effet de fléchissement (tracé traits interrompus -figure 7-). Dès lors, les tiges élastiquesAs shown in particular in Figure 5, the plate has vertically several through and parallel holes (1c), for the engagement and positioning of the rods (3). These holes (1c) are arranged in the same alignment and across the width of the plate. In in addition, these holes are oriented to direct the rods (3) into the medullary canal, in particular bearing against the internal walls of the diaphyseal barrel (Figure 6). Preferably, the plate (1) is pierced with three holes (1c). Each rod (3) is rectilinear with elastic deformation capacity to absorb the stresses and compensate for the possible bending of the head of the bone. For this purpose, as shown in Figure 7, all the stresses resulting from the weight of the body are transmitted to the cephalic screw (2) and therefore to the cylindrical barrel (la) of the plate (1), so that it produces a flexing effect (broken lines - Figure 7-). Therefore, the elastic rods
(3) sont mises en tension. Le risque d'éloignement de la plaque(3) are tensioned. The risk of removing the plate
(1) au niveau de sa partie inférieure notamment, est supprimé par la pression exercée par chacune des tiges (3) sous le grand trochanter. Eventuellement, on prévoit de disposer une cale d'épaisseur (4), entre la plaque (1) et en appui contre l'os, au dessus du fût cylindrique (la).(1) in particular at its lower part, is eliminated by the pressure exerted by each of the rods (3) under the greater trochanter. Optionally, provision is made to have a thickness spacer (4), between the plate (1) and bearing against the bone, above the cylindrical barrel (la).
Il apparaît donc que l'ensemble de la plaque n'est assujetti à aucune vis, de sorte que la tête fémorale n'a pas tendance à s'user par rapport à la vis céphalique (2), étant donné que les différentes forces exercées sur la tête sont absorbées par l'élasticité des tiges (3).It therefore appears that the entire plate is not subject to any screws, so that the femoral head does not tend to wear compared to the cephalic screw (2), since the different forces exerted on the head are absorbed by the elasticity of the rods (3).
D'une manière avantageuse, compte-tenu de la forme de réalisation de la plaque selon l'invention, un seul type est nécessaire et suffisant, aussi bien pour la droite que pour la auache. A noter que les différences d'angulation entre la plaque, le fût diaphysaire et le grand trochanter, peuvent être compensées par la ou les cales d'épaisseur (4). Avantageusement, chaque cale (4) est en polyêthylène ou autre matière apte à absorber les contraintes. Ces cales sont automaintenues en appui par la plaque (1).Advantageously, taking into account the embodiment of the plate according to the invention, only one type is necessary and sufficient, both for the straight line and for the auache. Note that the differences in angulation between the plate, the diaphyseal barrel and the greater trochanter, can be compensated by the thickness shim (s) (4). Advantageously, each wedge (4) is made of polyethylene or other material capable of absorbing stresses. These shims are self-supporting by the plate (1).
Le fût cylindrique (1a) de la plaque (1) et la vis céphhlique (2) présentent en combinaison des agencements complémentaires (1a1) et (2b1), pour assurer le blocage en rotation de ladite vis (2). Par exemple, ces agencements peuvent résulter de méplats formés respectivement dans l'alésage du fût cylindrique (1a) et sur la portée lisse (2b) de la vis (2).The cylindrical barrel (1a) of the plate (1) and the cephhlic screw (2) have in combination arrangements complementary (1a1) and (2b1), to ensure the locking in rotation of said screw (2). For example, these arrangements may result from flats formed respectively in the bore of the cylindrical barrel (1a) and on the smooth surface (2b) of the screw (2).
On prévoit également d'équiper la partie supérieure de la plaque (1) au niveau de l'introduction des tiges (3), d'un capuchon ou autre, pour éviter tout risque de migration vers le haut desdites tiges (3) après leur mise en place. Bien évidemment, après la mise en place des tiges, leur partie débordante de la plaque (1) est coupée. D'une manière importante, il existe une seule longueur de tige (3) déterminée pour correspondre à tous les cas.There are also plans to equip the upper part of the plate (1) at the level of the introduction of the rods (3), with a cap or the like, to avoid any risk of upward migration of said rods (3) after their implementation. Obviously, after the introduction of the rods, their projecting part of the plate (1) is cut. Importantly, there is only one rod length (3) determined to correspond to all cases.
Les avantages ressortent bien de la description, en particulier on souligne et on rappelle :The advantages clearly emerge from the description, in particular it is emphasized and recalled:
- la simplicité de réalisation.- the simplicity of realization.
- l'efficacité du système, aussi bien pour le maintien des fractures cervicales franches que des fractures cervico-trochantériennes, quel que soit l'âge du sujet.- the efficiency of the system, both for maintaining frank cervical fractures and cervico-trochanteric fractures, whatever the age of the subject.
- la suppression de la lyse de la tête de l'os.- suppression of lysis of the head of the bone.
- la réduction du stock, compte-tenu de la symétrie totale de l'ensemble de la plaque et d'une seule longueur de tige.- reduction of the stock, taking into account the total symmetry of the entire plate and a single length of rod.
- l'élasticité du montage obtenu, résultant du positionnement des tiges.- the elasticity of the assembly obtained, resulting from the positioning of the rods.
- la rapidité de mise en place. Enfin, de manière importante, on rappelle que c'est la vis céphalique, dont la position angulaire est précise et déterminée en fonction du type de fracture, qui asservit la position de la plaque et non pas l'inverse. La visée initiale est donc respectée. - the speed of installation. Finally, importantly, it is recalled that it is the cephalic screw, whose angular position is precise and determined according to the type of fracture, which controls the position of the plate and not the reverse. The initial aim is therefore respected.

Claims

R E V E N D I C A T I O N SR E V E N D I C A T I O N S
-1- Plaque d'appui pour fractures cervicales et cervicotrochanteriennes comprenant un fût cylindrique (1a) apte à coopérer avec une vis céphalique (2) préalablement mise en place dans la partie correspondante de la tête de l'os, caractérisée en ce que ladite plaque (1) est profilée et dimensionnée pour pouvoir prendre appui au niveau de la tête fémorale en étant agencée pour permettre le libre engagement et le positionnement d'au moins une tige (3) dans le canal médullaire de manière à asservir la position de la plaque (1) par rapport à la vis céphalique.-1- Support plate for cervical and cervicotrochanteric fractures comprising a cylindrical barrel (1a) capable of cooperating with a cephalic screw (2) previously placed in the corresponding part of the bone head, characterized in that said plate (1) is profiled and dimensioned to be able to bear on the level of the femoral head while being arranged to allow the free engagement and the positioning of at least one rod (3) in the medullary canal so as to control the position of the plate (1) relative to the cephalic screw.
-2- Plaque selon la revendication 1, caractérisée en ce qu'elle présente verticalement plusieurs trous débouchants parallèles (1c), disposés suivant le même alignement et la largeur de la dite plaque (1) les dits trous étant orientés pour diriger les tiges (3) dans le canal médullaire, notamment en appui contre les parois internes du fût diaphysaire.-2- Plate according to claim 1, characterized in that it has vertically several parallel through holes (1c), arranged in the same alignment and the width of said plate (1) said holes being oriented to direct the rods ( 3) in the medullary canal, in particular bearing against the internal walls of the diaphyseal shaft.
-3- Plaque selon la revendication 1, caractérisée en ce que les tiges (3) sont rectilignes avec capacité de déformation élastique pour absorber les contraintes et compenser l'éventuel fléchissement de la tête de l'os.-3- Plate according to claim 1, characterized in that the rods (3) are rectilinear with elastic deformation capacity to absorb the stresses and compensate for the possible bending of the head of the bone.
-4- Plaque selon l'une quelconque des revendications 1 à 3, caractérisée en ce qu'elle s'étend de part et d'autre du fût cylindrique recevant la vis céphalique (2).-4- Plate according to any one of claims 1 to 3, characterized in that it extends on either side of the cylindrical barrel receiving the cephalic screw (2).
-5- Plaque selon l'une quelconque des revendications 1 et 5, caractérisée en ce qu'une cale d'épaisseur (4) est disposée entre ladite plaque (1) et l'os, pour compenser l'effet de fléchissement au niveau de la tête de l'os et réduire les différences d'angulation en ajustant l'angle col - fût fémoral à l'angle fût cylindrique (1a) - plaque (1).-5- Plate according to any one of claims 1 and 5, characterized in that a thickness spacer (4) is disposed between said plate (1) and the bone, to compensate for the effect of bending at of the head of the bone and reduce the differences in angulation by adjusting the neck angle - femoral shaft at the angle of the cylindrical shaft (1a) - plate (1).
-6- Plaque selon la revendication 1, caractérisée en ce qu'elle reçoit un organe obturateur du type capuchon pour éviter tout risque de migration vers le haut des tiges.-6- Plate according to claim 1, characterized in that it receives a shutter member of the cap type to avoid any risk of upward migration of the rods.
-7- Plaque selon la revendication 1, caractérisée en ce que le fût cylindrique et la vis céphalique présentent en combinaison des agencements complémentaires pour assurer le blocage en rotation de ladite vis.-7- Plate according to claim 1, characterized in that the cylindrical barrel and the cephalic screw have in combination complementary arrangements to ensure the locking in rotation of said screw.
-8- Plaque selon la revendication 3, caractérisée en ce que les tiges (3) sont d'une seule longueur déterminée pour correspondre à tous les cas. -8- Plate according to claim 3, characterized in that the rods (3) are of a single length determined to correspond to all cases.
PCT/FR1991/000005 1990-01-05 1991-01-04 Support plate for cervical and cervicotrochanterian fractures WO1991009571A1 (en)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
FR9000400A FR2656789A1 (en) 1990-01-05 1990-01-05 SUPPORT PLATE FOR CERVICAL AND CERVICO-TROCHANTERIAL FRACTURES.
FR90/00400 1990-01-05

Publications (1)

Publication Number Publication Date
WO1991009571A1 true WO1991009571A1 (en) 1991-07-11

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Application Number Title Priority Date Filing Date
PCT/FR1991/000005 WO1991009571A1 (en) 1990-01-05 1991-01-04 Support plate for cervical and cervicotrochanterian fractures

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EP (1) EP0462263A1 (en)
JP (1) JPH04506025A (en)
AU (1) AU7056191A (en)
FR (1) FR2656789A1 (en)
WO (1) WO1991009571A1 (en)

Cited By (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0546460A1 (en) * 1991-12-13 1993-06-16 Pennig, Dietmar, Dr. Osteosynthesis helping device for femoral neck fractures
US5356410A (en) * 1991-12-13 1994-10-18 Dietmar Pennig Adjuvant for osteosynthesis in the case of pertrochanteric fracture of the neck of the femur
EP0689800A3 (en) * 1994-07-01 1996-03-27 Kessler Sigurd Fixation and positioning system for intramedullary load carriers
AT510553A4 (en) * 2011-05-13 2012-05-15 Christian Dipl Ing Maier ELEMENT FOR FIXING A BRAND NAIL AND FIXATION SYSTEM WITH SUCH A FIXING ELEMENT
US8753343B2 (en) * 2004-12-23 2014-06-17 Hans Ulrich Staeubli Bone fixing device

Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4169470A (en) * 1977-10-19 1979-10-02 Ender Hans G Surgical nail for use in setting bone fractures, and tool for emplacing same
US4473069A (en) * 1981-07-17 1984-09-25 Lars Kolmert Device for interconnecting an elastic nail and a cross screw
EP0140790A2 (en) * 1983-10-28 1985-05-08 William Peze Apparatus for the dynamic correction of rachidian deformations
US4657001A (en) * 1984-07-25 1987-04-14 Fixel Irving E Antirotational hip screw
WO1987004612A1 (en) * 1986-01-31 1987-08-13 John Stefan Nilsson A fixating device

Family Cites Families (1)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
DE2756861C2 (en) * 1977-12-20 1983-11-24 Max Planck Gesellschaft zur Förderung der Wissenschaften e.V., 3400 Göttingen Method for changing the position of the Fermi level of amorphous silicon by doping by means of ion implantation

Patent Citations (5)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4169470A (en) * 1977-10-19 1979-10-02 Ender Hans G Surgical nail for use in setting bone fractures, and tool for emplacing same
US4473069A (en) * 1981-07-17 1984-09-25 Lars Kolmert Device for interconnecting an elastic nail and a cross screw
EP0140790A2 (en) * 1983-10-28 1985-05-08 William Peze Apparatus for the dynamic correction of rachidian deformations
US4657001A (en) * 1984-07-25 1987-04-14 Fixel Irving E Antirotational hip screw
WO1987004612A1 (en) * 1986-01-31 1987-08-13 John Stefan Nilsson A fixating device

Cited By (7)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
EP0546460A1 (en) * 1991-12-13 1993-06-16 Pennig, Dietmar, Dr. Osteosynthesis helping device for femoral neck fractures
WO1993011714A1 (en) * 1991-12-13 1993-06-24 Dietmar Pennig Osteosynthesis aid for pertrochanteric fractures of the neck of the femur
US5356410A (en) * 1991-12-13 1994-10-18 Dietmar Pennig Adjuvant for osteosynthesis in the case of pertrochanteric fracture of the neck of the femur
EP0689800A3 (en) * 1994-07-01 1996-03-27 Kessler Sigurd Fixation and positioning system for intramedullary load carriers
US8753343B2 (en) * 2004-12-23 2014-06-17 Hans Ulrich Staeubli Bone fixing device
AT510553A4 (en) * 2011-05-13 2012-05-15 Christian Dipl Ing Maier ELEMENT FOR FIXING A BRAND NAIL AND FIXATION SYSTEM WITH SUCH A FIXING ELEMENT
AT510553B1 (en) * 2011-05-13 2012-05-15 Christian Dipl Ing Maier ELEMENT FOR FIXING A BRAND NAIL AND FIXATION SYSTEM WITH SUCH A FIXING ELEMENT

Also Published As

Publication number Publication date
JPH04506025A (en) 1992-10-22
EP0462263A1 (en) 1991-12-27
FR2656789A1 (en) 1991-07-12
AU7056191A (en) 1991-07-24

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