WO2002071964A1 - Tubular internal fixation device for bone fractures and prostheses - Google Patents
Tubular internal fixation device for bone fractures and prostheses Download PDFInfo
- Publication number
- WO2002071964A1 WO2002071964A1 PCT/IT2002/000135 IT0200135W WO02071964A1 WO 2002071964 A1 WO2002071964 A1 WO 2002071964A1 IT 0200135 W IT0200135 W IT 0200135W WO 02071964 A1 WO02071964 A1 WO 02071964A1
- Authority
- WO
- WIPO (PCT)
- Prior art keywords
- fixation device
- internal fixation
- bone
- tubular band
- band
- Prior art date
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
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8085—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates with pliable or malleable elements or having a mesh-like structure, e.g. small strips
-
- 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
- A61B17/82—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin for bone cerclage
Definitions
- the present invention concerns a tubular internal fixation device for bone fractures and prostheses. More specifically, the invention relates to a device for reducing and stabilising broken bone fragments, particularly recommended for veterinary use, which comprises, as its main element, a rigid polycompressive band to be applied around the bone at the point of fracture or discontinuity.
- Intramedullary pins undoubtedly have the advantage of avoiding lesions to periosteal tissues and the soft tissues surrounding the bone, but they can only be used in certain types of fractures that are uncomplicated and with no comminuted fragments. However, in order to improve the resulting stability, they are often coupled with transverse screws anchored in the cortical area of the bone. Moreover, in veterinary applications, the main inconvenience lies in the fact that, since the animal feels it can make use of the fractured limb (and having a much higher pain threshold compared to man's), the animal's jumping will cause repeated compressions of the two broken parts and will gradu- ally dislodge the pin.
- cer- clage Another internal fixation device that was widely used in the past but which is now in disuse, above all in human orthopaedics, is the so-called cer- clage, in practice consisting of using orthopaedic wire to wire together fragments of bone in direct contact with the bone surface.
- this wiring technique can be applied, for example, in oblique fractures, while for straight transverse fractures the cerclage wiring technique should be combined with longitudinal metal plates going through the fractured area.
- EP 0019062 One example of a device proposed for cerclage with orthopaedic wire is described in European patent application EP 0019062, in which the object of the invention concerns a mechanical device for holding and closely securing the ends of the wire around the bone.
- the French patent FR 2211851 describes a clip for osteosynthesis that is particularly suitable for use with fractured ribs.
- the clip is composed of an elongated metal alloy sheet, the longer sides of which have some flexible peripheral tongues. These are hooked around the fractured rib and are bent round by using appropriate forceps for a tight fit. This solution obviously does not solve the problem of a close-knit contact with the bone that still compromises periosteal blood supply.
- the device needs a special instrument to push the clasping tongues into the bone and another instrument to slacken the sheet in order to remove it once the fracture has healed.
- the US patent No. 3469573 discloses a flat metal sheet band, largely of the kind referred to before, where the problem of periosteal blood supply is taken into account by equipping the inside of the band with a series of ribs across it (and longitudinal with respect to the bone on which it is then applied). This ribbing is carried out either by parallel folding of the metal sheet or with small bars made of another material (such as plastic) fixed on the inside of the band with appropriate pressure buttons.
- the present invention thus aims to provide an internal fixation device for bone fractures that is based on the cerclage principle, does not interfere with periosteal blood supply, and provides immediate and reliable stabilization of the fractured bone. In this way, the device reduces the risk of postoperative accidents, normally high in the case of animals, and is at the same time simple and economical to make and easy to apply through a much less surgically invasive treatment.
- the present invention proposes a polycompressive fixation device in the form of an incomplete or longitudinally open rigid band that braces the broken bone parts to be immobilised, appropriately adapting its shape to them, and is equipped with a number of internal unaligned and discontinuous protrusions in the form of punches, points or teeth. These are designed to grip the bone surface to be fixed by penetrating into it to a small degree and ensuring that the inside surface of the band itself does not adhere to the bone.
- the band is maintained stably wrapped around the broken bone parts by appropriate cerclage wiring that lies outside the device and does not rest on the bone. This configuration guarantees periosteal blood supply, thus favouring a quick healing process, provides a guide for bone callus and at the same time creates a stable immobilisation of the broken bone parts, allowing immediate mobility after the operation.
- the present invention specifically provides an internal fixation device for bone fractures and prostheses comprising, as the main element, a longitudinally open tubular metal band suitable to be applied around broken bone parts to be fixed, and provided with multiple substantially point-shaped protrusions distributed along its internal surface and enabling a firm grip of the said broken bone parts, said tubular band being sufficiently flexible to adapt its shape to wrap around the said broken bone parts by varying the aperture of its longitudinal opening.
- the proposed fixation device also includes two or more flexible cerclage elements designed to wrap transversally around the said tubular band and are, preferably, composed of orthopaedic wire.
- These flexible elements are housed in specially designed transverse grooves - two or more in number, depending on band length and the characteristics of the fracture and of the broken bone parts - made on the outside surface of the band.
- the proximal and distal margins of the band itself are rounded so that they do not form sharp edges which could damage the soft tissue surrounding the bone or cause traumas by rubbing.
- the sub- stantially point-shaped protrusions provided on the inside surface of the tubular band may be composed of punchings carried out from outside the band itself, for example, of a conical shape, or perforated with four-pointed edges.
- the latter type are to be preferred because they provide greater stability in fixation by more firmly penetrating the bone.
- the protrusions may be created on the metal surface of the band by making drill-holes, where the in-jutting edges of the perforations act as a kind of uneven border around the perforation, which also penetrates and anchors into the surface layer of the bone.
- the device may be advantageously produced by using titanium instead of steel, either in a non-alloyed form or alloyed with small percentages of other metals.
- This material is particularly suitable for making surgical equipment and prostheses due to its greater lightness, at a parity of resistance, with respect to steel.
- titanium is preferred above all for its very high biocompatibility, which makes a perma- nent osteointegrated implant possible, without needing to remove the device once the fracture has healed.
- the cerclage wires can also be, preferably, made of titanium instead of steel - either unalloyed titanium or alloyed with other metals.
- the metal band of the present invention can adapt its shape to that of the bone section it is applied to.
- it may have a largely cylindrical shape, in order to adapt to the diaphysis of long bones, or a substantially truncated cone shape, to adapt to the epiphysis of long bones.
- the band may have a substantially curved shape, adapting to the diaphysis of long bones with a non-perfectly linear shape, not infrequent in animals.
- Figure 1 is a perspective view of a first embodiment of the main band element of the proposed internal fixation device
- Figure 2 is a front view of the same element shown in Figure 1 ;
- Figure 3 is a side view of the same element shown in Figure 1 ;
- Figure 4 is a longitudinal sectional view of the same element, taken along the plane A-A of Figure 3;
- Figure 5 is a front view of a second embodiment of the main band element of the proposed internal fixation device
- Figure 6 is a cross-sectional view of the same element shown in Figure 5;
- Figure 7 is a longitudinal cross-section of the same element, taken along the plane B-B of Figure 6.
- a particularly effective version of the internal fixation device according to the present invention includes, as main element, a tubular cylindrical band (1), open along one longitudinal side. This is made by using a titanium tube element of sufficient thickness to give the fixation device the necessary rigidity, but not so much to make the device too heavy or to make it difficult for the metal band to adapt its shape to the external shapes of the broken bone parts it is applied to.
- the tubular band (1 ) will largely maintain the shape shown in the figures, except for the fact that it may be wrapped around broken bone parts, varying the gap in its longitudinal opening in order to more firmly grip them via the punched protrusions (2).
- the same device can be adapted to various dimensions of bone to be immobilised, thus limiting the range of versions to have available when needing to carry out a quick operation, without having to produce an ad hoc piece according to the fracture to be treated.
- the tubular band (1) is secured by tightening two or more cerclage wires (not shown) around it.
- the wires are housed in the specially designed transverse grooves (3) made in the outer surface of the tubular band (1). It is important to note that, unlike what was used with conventional cerclage, the wires in this case are not fastened around the bone but around the tubular band (1), which rests on the bone only on the points of the punched protrusions (2).
- the wires can be fastened without using complex and cumbersome securing clips such as the ones proposed in the prior art: the said clips not only took up space, but also risked damaging the surrounding soft tissue.
- the ends of the wire are rolled up close to the longitudinal opening of the tubular band (1) and then they are folded, when possible, towards the inside of the band and tucked away in the gap of the tubular band (1).
- a device according to the present invention starting from a tubular element made of titanium or an alloy of titanium (for example, the alloy Ti-6AI-4V for prostheses and surgical applications, that contains about 6% of aluminium and about 4% of vanadium), the tubular element is first cut to size along its length, opened lengthwise and then grooved (3) on a lathe and punched (2) using a suitably shaped punching tool.
- suitable protrusions can also be made on the inner surface of the tubular band (1) by drilling holes that have in-jutting metal edges.
- the device according to the present invention is adaptable to the bone to be treated and is available in the already discussed variations of a largely cylindrical, truncated-conical or curved shape. It can be used not only for the reduction and stable fixation of simple fractures, but also for similar operations on multiple fractures and/or in the presence of bone material destruction caused by, for example, crushing, gunfire wounds and strong violent traumas.
- the device according to the present invention will stabilise the two broken bone elements maintaining the physiological distances and optimally guiding the growth of bone callus.
- the same device can also be used in cases of bone malformations, when it becomes necessary to remove part of the bone following abnormal growth or in the presence of pathologies such as bone tumours, where the tubular band can be easily used in order to replace the amputated parts.
- the proposed tubular band may also be an integral part of articular prostheses, such as hip prostheses, instead of the infibula and cements currently used to keep prostheses in place.
- the latter materials in fact, besides being invasive, also have the inconvenience of wearing over time.
- the use of the tubular band of the present invention allows bone callus growth inside the band and thus affords a more reliable and permanent stabilisation of the prosthetic implant.
- the treatment of bone fractures is mainly carried out for small animals.
- Large animals, such as adult cattle and horses, that have a fracture are normally put down due to the difficulties in applying the known methods to these large heavy creatures.
- the device according to the present invention can also be used with large animals, due to its ease and speed of application and considering that, if made in the appropriate material, it must not be removed later; all this along with the fact that it is also an economical treatment means that there is no need to put down large animals in case of bone fractures.
- FIG. 5-7 Another series of embodiments of the device according to the present invention that is suitable for particularly advantageous applications is shown in Figures 5-7.
- the protrusions in the tubular band (1) are provided by screws (4), which are inserted in the holes (5) made in the tubular band (1).
- the latter has elements corresponding to those of the device shown in Figures 1-4, including the rounded-off edges (not shown), and transverse grooves (3) for housing the cerclage wires (not shown). It is obvious that creating the protrusions with screws, nails or similarly pointed elements affords maximum flexibility in the use of the device, allowing, for example, the calibration of the length and the number and distribution of screws (4) as required.
- this type of realisation may be advantageously used in the treatment of young animals for which a non-negligible growth in the bone concerned is to be expected.
- a tubular band (1) of a greater diameter than the one required at the time of the surgical op- eration but with longer screws (4).
- the points of the screws (4) will still enable the device to firmly grip the broken bone elements to be immobilised, thus providing the necessary stability to the bone concerned, but at the same time allowing the normal growth of the animal without the tubular band (1) interfering with new bone formation.
- the screws (4) will become embedded in the new bone formation and the structure will present a complete osteointegration.
- the internal fixation device offers the advantage of considerable ease and speed of application, perfect bone reduction and stability, with the possibility of immediate mobility after the operation, a practically negligible interference with periosteal blood supply, as well as the capacity to reduce postoperative accidents because the device can stand up to torsion, longitudinal compression, stretching and bending.
- the proposed internal fixation device when made of titanium or titanium alloy, is osteocompatible and lightweight, and can be left permanently in place. Finally, it can be adapted to any long bone by appropriately changing its shape quickly and immediately before the operation.
Abstract
Description
Claims
Priority Applications (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US10/470,512 US20040087955A1 (en) | 2001-03-09 | 2002-03-04 | Tubular internal fixation for bone fractures and prostheses |
EP02717039A EP1365694A1 (en) | 2001-03-09 | 2002-03-04 | Tubular internal fixation device for bone fractures and prostheses |
Applications Claiming Priority (2)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
IT2001RM000123A ITRM20010123A1 (en) | 2001-03-09 | 2001-03-09 | INTERNAL BAND FIXER FOR FRACTURE AND BONE PROSTHESIS. |
ITRM01A000123 | 2001-03-09 |
Publications (1)
Publication Number | Publication Date |
---|---|
WO2002071964A1 true WO2002071964A1 (en) | 2002-09-19 |
Family
ID=11455310
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
PCT/IT2002/000135 WO2002071964A1 (en) | 2001-03-09 | 2002-03-04 | Tubular internal fixation device for bone fractures and prostheses |
Country Status (4)
Country | Link |
---|---|
US (1) | US20040087955A1 (en) |
EP (1) | EP1365694A1 (en) |
IT (1) | ITRM20010123A1 (en) |
WO (1) | WO2002071964A1 (en) |
Families Citing this family (16)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US20050171547A1 (en) * | 2004-01-29 | 2005-08-04 | Aram Tony N. | Surgical instrument, and related methods |
US8430879B2 (en) | 2007-03-22 | 2013-04-30 | Sonoma Orthopedic Products, Inc. | Segmented intramedullary structure |
US9049989B2 (en) | 2008-04-11 | 2015-06-09 | Physcient, Inc. | Methods and devices to decrease tissue trauma during surgery |
US9402610B2 (en) * | 2009-04-13 | 2016-08-02 | Physcient, Inc. | Rib-protecting devices for thoracoscopic surgery, and related methods |
US9439685B2 (en) | 2009-05-12 | 2016-09-13 | Bullard Spine, Llc | Multi-layer osteoinductive, osteogenic, and osteoconductive carrier |
US8568426B2 (en) | 2010-09-15 | 2013-10-29 | Ethicon, Inc. | Ligation device and method |
US8906074B2 (en) | 2011-01-25 | 2014-12-09 | DePuy Synthes Products, LLC | Expandable bone fixation implant |
CN103829995A (en) * | 2012-11-20 | 2014-06-04 | 苏芳庆 | Bone fixing plate |
US9999454B2 (en) | 2013-12-05 | 2018-06-19 | A&E Advanced Closure Systems, Llc | Bone plate system and method |
US9936991B2 (en) * | 2015-01-30 | 2018-04-10 | Union Surgical, Llc | Bone fracture treatment apparatus and method |
US10123831B2 (en) | 2015-03-03 | 2018-11-13 | Pioneer Surgical Technology, Inc. | Bone compression device and method |
US9474592B1 (en) | 2015-10-14 | 2016-10-25 | Roderick Andrew Vaughan | Barbed sleeve for use in medical procedures |
RU2672526C1 (en) * | 2017-10-06 | 2018-11-15 | Общество с ограниченной ответственностью "Медико-инженерный центр сплавов с памятью формы" | Brace for osteosynthesis of oblique and comminuted fractures of tubular bones and tool for deformation and removal of brace |
CN112367937A (en) | 2018-06-29 | 2021-02-12 | 先锋外科技术公司 | Bone plating system |
US11109900B2 (en) * | 2018-11-29 | 2021-09-07 | Gbr99 Ip, Llc | Extramedullary compression and fixation device, system and method |
US11877779B2 (en) | 2020-03-26 | 2024-01-23 | Xtant Medical Holdings, Inc. | Bone plate system |
Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4263904A (en) * | 1978-02-10 | 1981-04-28 | Judet Robert L | Osteosynthesis devices |
DE3244680A1 (en) * | 1982-12-02 | 1984-06-14 | Peter Dr. 8445 Schwarzach Clarenz | Device for holding the parts of a broken bone together |
DE3427590A1 (en) * | 1984-07-26 | 1986-02-06 | Slobodan Dr.med. 5620 Velbert Konjovic | Cerclage for osteosynthesis |
EP0295041A1 (en) * | 1987-06-08 | 1988-12-14 | Chonglin Zhou | Apparatus for internal fixation of bone fractures |
DE3808937A1 (en) * | 1988-03-17 | 1989-10-05 | Fischer Artur Werke Gmbh | Connecting element for connecting and stabilising a bone in the region of a fracture |
US5443483A (en) * | 1993-04-22 | 1995-08-22 | Axel Kirsch | Appliance for accelerating the healing of a bone surgery site |
WO2000062693A1 (en) * | 1999-04-21 | 2000-10-26 | Eaves Felmont F Iii | Bone fracture fixation clip |
Family Cites Families (2)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US3469573A (en) * | 1966-05-04 | 1969-09-30 | Michael A Florio | Orthopedic clamp |
US5964769A (en) * | 1997-08-26 | 1999-10-12 | Spinal Concepts, Inc. | Surgical cable system and method |
-
2001
- 2001-03-09 IT IT2001RM000123A patent/ITRM20010123A1/en unknown
-
2002
- 2002-03-04 EP EP02717039A patent/EP1365694A1/en not_active Withdrawn
- 2002-03-04 WO PCT/IT2002/000135 patent/WO2002071964A1/en not_active Application Discontinuation
- 2002-03-04 US US10/470,512 patent/US20040087955A1/en not_active Abandoned
Patent Citations (7)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
US4263904A (en) * | 1978-02-10 | 1981-04-28 | Judet Robert L | Osteosynthesis devices |
DE3244680A1 (en) * | 1982-12-02 | 1984-06-14 | Peter Dr. 8445 Schwarzach Clarenz | Device for holding the parts of a broken bone together |
DE3427590A1 (en) * | 1984-07-26 | 1986-02-06 | Slobodan Dr.med. 5620 Velbert Konjovic | Cerclage for osteosynthesis |
EP0295041A1 (en) * | 1987-06-08 | 1988-12-14 | Chonglin Zhou | Apparatus for internal fixation of bone fractures |
DE3808937A1 (en) * | 1988-03-17 | 1989-10-05 | Fischer Artur Werke Gmbh | Connecting element for connecting and stabilising a bone in the region of a fracture |
US5443483A (en) * | 1993-04-22 | 1995-08-22 | Axel Kirsch | Appliance for accelerating the healing of a bone surgery site |
WO2000062693A1 (en) * | 1999-04-21 | 2000-10-26 | Eaves Felmont F Iii | Bone fracture fixation clip |
Also Published As
Publication number | Publication date |
---|---|
ITRM20010123A0 (en) | 2001-03-09 |
US20040087955A1 (en) | 2004-05-06 |
EP1365694A1 (en) | 2003-12-03 |
ITRM20010123A1 (en) | 2002-09-09 |
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