BRPI0713232A2 - user-actuated intramedullary distraction device - Google Patents

Abstract

INTRAMEDULAR DISTRACTION DEVICE WITH DISTRACTION ACTED BY THE USER. an intramedullary distraction device is presented here for bone elongation and for repairing angular or rotational bone deformities, which is completely mechanical in operation, where a new rotary button system allows reversing the ratchet movement of the device, thus allowing the reduction of the length of the device, if necessary, to offer the surgeon operating flexibility before finally anchoring the device to the bone. In addition, a locking system allows the ratchet to be locked once the desired stretch has been achieved, thus avoiding potential wrong stretches. In addition, a single alignment hole provides a simple, precise tool to easily and correctly align the device within the bone. The present device operates without the assistance of external mechanisms, motors, or tools, and once inserted, the user can operate the device without assistance. This device is available in a wide variety of diameters and lengths, and is useful on all long bones.

Description

"INTRAMEDULAR DISTRIBUTION DEVICE WITH USER ACTION"

Field of the invention

This invention generally relates to surgical devices used to mend bones, and specifically to intramedullary devices used to lengthen or mend long bones.

Background of the invention

There are many reasons why a bone or limb may need to be lengthened or mended, such as congenital bone disease, fractures in normal bone development, and many other medical conditions. The resulting difference in limb length or other angular or rotational bone deformities needs to be resolved to provide an acceptable level of quality of life for the patient.

Today, bone stretching is a common procedure in orthopedic medicine. The most realistic and safest surgical options are based on the recently discovered phenomenon of "calotase", or "bone distraction".

Briefly, these means utilizing the body's natural healing process that makes a bone that has been split in two or another damaged by trauma, self-healing creating new tissue to fill the gap and heal the bone. In calotase or bone distraction, the bone is progressively healed and lengthened by the low distraction of the two portions of bone. At the end of the process, the new tissue consolidates into a perfect new bone.

Many related devices, commonly referred to as "distractors," use the aforementioned bone distraction phenomenon to lengthen various bones.

Older, more common devices are external to the body and comprise, for example, sets of outer rings, cords and pins installed around the limb being treated and connected to the bone portions by soft tissues. Such devices cause very severe pain and inconvenience to the patient.

Additionally, such devices penetrate through soft tissues, causing many septic problems and repetitive infections. Additionally, these external devices are clumsy and greatly restrict the patient's ability to move freely.

More recently, the related technique has attempted to provide a solution to these problems by various means by proposing to implant devices within the medullary (intramedullary) bone cavity. To extend the devices and cause desired bone elongation, a mover is required. Different movers have been proposed. Illustrative of such attempts include German Patent No. 4002400, which relates to an intramedullary locking pin with a spring mechanism that is adjustable from the outside; US Patent No. 507882, which discloses a claw for gradually lengthening long bones, wherein the bone is post operatively lengthened by rotation of a distal part of the limb relative to the proximal part of the limb; US Patent Application No. 200430395, which discloses a surgical distraction for applying noninvasively extensor or tractive force to a patient's skeleton that relies on a magnetic acting medium located externally to the patient; and US Patent No. 5961553, which relates to a device for lengthening long bones that includes an electric motor as a means for moving the extension.

Due to the dependence of such devices on external acting sources, patients face a number of new disadvantages from the use of such intramedullary devices. Intramedullary devices tend to have a high cost and limited stretching capabilities. Doctors are struggling to manage treatment programs that require patients to move to a medical facility. Additionally, in addition to requiring the patient to be in a specific location to perform the stretching process, the external means of action itself may restrict the patient's mobility.

In addition, the related technique simply does not provide an effective, inexpensive solution that is comfortable for the patient and provides an easily managed follow-up program where the device is both fully internal and fully mechanical according to the principles. of the present invention.

Summary of the invention

The invention presented herein addresses the disadvantages mentioned above of related art intramedullary distraction devices by providing a device with a number of further improvements.

The present invention describes a new implantable intramedullary distraction device for bone elongation as well as repairing angular or rotational deformity which is introduced in a single surgical procedure. Bone elongation occurs by stretching the bone according to the calotase phenomenon described above. Angular or rotational correction of bone deformity occurs by correctly positioning the bone portions and then stretching them according to the calotase phenomenon. Once inserted, the user is able to operate the device without assistance. The frequency of action determined is monitored by the treating physician. Once the bone has been lengthened or repaired and fully consolidated, the device is easily removed in another single surgical procedure.

The device presented here is mechanically operated by means of a subcutaneous button that is actuated by the patient several times a day without the assistance of the physician.

A unique feature of the device is its mechanical and completely independent nature, ie the device operates without the assistance of external mechanisms or tools. Another unique feature of this device is the ratchet assembly which allows its fully mechanical operation. Additionally, the device does not rely on connection to any external power sources for its operation, unlike apparatus of the related art.

A unique feature of the present invention is the alignment holes which provide the doctor with a simple but accurate tool to ensure that the device is correctly aligned within the bone.

Yet another new feature of the invention is the ability not only to lengthen the distraction section of the device, but also to shorten the same section. This feature is particularly useful during insertion and removal of the present invention.

Yet another advantage is that this new device is available in a variety of diameters and lengths, and is useful on all long bones.

Additionally, due to the fully mechanical design that includes minimal moving parts and no external components, the present invention offers a highly reliable, inexpensive, comfortable, and relatively painless bone stretching solution that allows the patient greater freedom of movement, reduced risk of infection, shorter hospital stays, and faster recovery time.

Brief Description of the Drawings

The subject matter seen as the invention will become more clearly understood in light of the following description of embodiments herein, given for exemplary purposes for the purpose of illustrative discussion of the present invention only, with reference to the accompanying drawings, in which: 1 is an elevational view of a configuration of the present invention;

Figure 2 is an exploded view of a ratchet assembly of the configuration of Figure 1;

Figure 3 is a sectional side view of the ratchet assembly of the configuration of Figure 1 in the locked position;

Figure 4 is a cross-sectional side view of the device of the configuration of Figure 1;

Figure 5A is a cross-sectional top view of the ratchet assembly of the configuration of Figure 1 configured for shortening; and

Figure 5B is a cross-sectional top view of the ratchet assembly of the configuration of Figure 1 configured for stretching.

The drawings together with the description make it apparent to those skilled in the art how the invention may be configured in practice.

No attempt is made to show structural details of the invention in more detail than are required for a fundamental understanding of the invention.

It will be appreciated that for simplicity and clarity of illustration, the elements shown in the figures were not necessarily drawn to scale. For example, the dimensions of some of the elements may be exaggerated relative to other elements for clarity. Additionally, where deemed appropriate, reference numerals may be repeated between the figures to indicate corresponding or analogous elements.

Description of the Invention Configurations

A configuration is an example or implementation of inventions. The various views of "one setting", "the setting" or "some settings" do not necessarily all refer to the same settings.

While various features of the invention may be described in the context of a single embodiment, the features may also be provided separately or in any suitable combination. Conversely, although the invention may be described herein in the context of separate settings for clarity, the invention may also be implemented in a single configuration.

Reference in the specification to "a configuration", "the configuration", "some configurations" or "other configurations" means that a particular aspect, structure, or feature described in connection with the configurations is included in at least one configuration, but not necessarily in all embodiments of the invention.

It is understood that the phraseology and terminology employed herein should not be construed as limiting and is for descriptive purposes only.

The principles and uses of the teachings of the present invention may be better understood with reference to the accompanying description, figures and examples.

It should be understood that the details recorded herein do not constitute a limitation to an application of the invention.

Additionally, it should be understood that the invention may be performed or practiced in various ways and that the invention may be implemented in configurations other than those outlined in the description below.

It should be understood that the terms "including", "comprising", "consisting" and grammatical variants thereof do not preclude the addition of one or more components, characteristics, steps, or integers or groups thereof and that the terms shall be construed as specifying components, characteristics, steps or integers.

The phrase "consisting essentially of", and grammatical variants thereof, when used herein shall not be construed as excluding additional components, steps, characteristics, integers or groups thereof, but rather that additional characteristics, integers, steps, components or groups thereof do not materially alter the basic and novel features of the claimed composition, device or method.

If the specification or claims refer to an "additional" element, this does not preclude there being more than one additional element.

It is to be understood that where the claims or specification refer to "one" element, such reference shall not be construed as having only one of that element.

It should be understood that where the specification records that a component, aspect, structure or feature "may", "may be", "is possible to" or "could" be included, that particular component, aspect, structure, or feature is not required to be included.

Where applicable, although state diagrams, flow diagrams, or both may be used to describe configurations, the invention is not limited to those diagrams or corresponding descriptions. For example, the flow need not move through each illustrated box or state, or in exactly the same order as illustrated and described.

The methods of the present invention may be implemented by performing or completing manually, automatically, or a combination thereof, selected steps or tasks.

The term "method" refers to ways, means, techniques and procedures for performing a given task including, but not limited to, those ways, means, techniques and procedures or known to, or readily developed from, known ways, means, techniques and procedures by practitioners of the art to which the invention belongs.

The descriptions, examples, methods and materials set forth in the claims and specification are not to be construed as limiting but rather as illustrative only.

The meanings of technical and scientific terms used herein are to be understood commonly as by one of ordinary skill in the art to which the invention belongs, unless otherwise defined.

The present invention may be implemented in the test or practice with methods and materials equivalent or similar to those described herein.

The terms "bottom", "below", "top" and "above" as used herein do not necessarily indicate that a bottom component is below a "top" component or that a component that is "below" another component or that a component that is "on top" is actually "above" another component. As such, directions, components or both may be turned, rotated, space-moved, placed in diagonal orientation or position, placed horizontally or vertically, or similarly modified. Accordingly, it will be appreciated that the terms "lower", "below", "upper" and "above" may be used herein for exemplary purposes only, to illustrate the positioning or relative placement of certain components, to indicate a first and a second component or to do both.

Any publications, including patents, patent applications, and articles, referenced or referred to in this specification are hereby incorporated in their entirety into the specification, to the same extent as if each individual publication were specifically and individually indicated to be incorporated herein. In addition, citation or identification of any reference in the description of some embodiments of the invention should not be construed as an admission that such reference is available as prior art to the present invention.

The present invention describes an implantable intramedullary distraction device for bone elongation. A feature of this intramedullary device is the ratchet assembly that allows complete mechanical operation by the patient, and the patient can operate the intramedullary device at the push of a button. Another feature of the intramedullary device is that because it is mechanical in nature and completely independent, said intramedullary device can operate without the assistance of external mechanisms, motors, or tools. Once inserted, the user is able to operate the intramedullary device without assistance. Unlike the related technique, thanks to the simplicity of the intramedullary device and therefore the absence of problematic internal parts such as motors, batteries, magnetic devices, etc., this new intramedullary device is available in a wide range of diameters and lengths, and It is useful on all long bones. Another feature of the present invention is an alignment hole that provides the doctor with a simple but accurate tool to ensure that the intramedullary device is correctly aligned within the bone. An additional feature of the intramedullary device is the ratchet mechanism that allows both stretching and shortening of the intramedullary device, thus providing greater flexibility for the physician during the crucial insertion and stretching phase of the process. Another feature of the intramedullary device is that the actuation of said ratchet mechanism can be locked once the stretching is complete, thus preventing further stretching of the bone by unwanted actuation of the knob.

According to one embodiment of the invention, an intramedullary device 50 comprises a ratchet assembly 100 and a clamp assembly 200, as shown in Figure 1. The ratchet assembly 100 houses the various components operating the intramedullary device 50, as clearly seen. in figures 2, 5A, and 5B. The unique features of intramedullary device 50 allow the user to operate ratchet assembly 100 without assistance and without additional external mechanisms or devices. Claw assembly 200 houses the components required to perform bone distraction, these components are described in Figure 4.

A subcutaneous button 115 is located at the outermost end of the ratchet assembly 100. Once the intramedullary device 50 is inserted, the subcutaneous button 116 is positioned below and near the skin surface in a location that is comfortably accessible by the user. The user pushes the subcutaneous button 115 according to a prescribed schedule defined by the medical doctor to initiate the ratchet movement action, thus turning a long spindle 112.

In the event that the length of the ratchet assembly 100 is insufficient to properly position the subcutaneous knob 115, there may be the option of extending the subcutaneous knob 115 to accommodate fat and skin thickness by attaching a spacer 101, seen in figure 3, between a central chamber 110 and the subcutaneous button 115.

According to configurations, one. Funnel-shaped opening 113 may be included at the terminal end of subcutaneous button 115. According to some embodiments, a needle or pin may be inserted into the funnel-shaped opening 113 to permanently lock the entire ratchet assembly 100.

The subcutaneous knob 115 connects to the central chamber 110, which is situated between the subcutaneous knob 115 and the area housing a leveling mechanism 107, as seen in figures 2 and 3. Housed within the central chamber 110 are a cylindrical plate 104 and a locking spring 105. The central chamber 110 may additionally be equipped with at least two diametrically opposed holes 106. According to some embodiments, the cylindrical plate 104 is a substantially U-shaped extruded member. The end of the cylindrical plate 104 closest to the subcutaneous button 115 may have a slight ripple. The cylindrical plate 104 may additionally be equipped with at least two diametrically opposed holes 103. The cylindrical plate 104 may freely slide into the central chamber 110. The locking spring 105 may be located within the cylindrical plate 104. The ends 116 of the locking spring 105 may be formed to protrude in an outward direction.

According to embodiments, while in an actuation position, the ends 116 of the locking spring 105 may rest within holes 103 of the cylindrical plate 104, compressed against the inner wall of the central chamber 110, thereby retaining cylindrical plate 104 in the place. According to embodiments, while in said actuation position, when the cylindrical plate 104 is pushed by a needle inserted through the funnel-shaped opening 113, said cylindrical plate 104 moves forward into the central chamber 110. This moves the free ends 116 of the locking spring 105, which allows the ends 116 to move outwardly into the holes 106 of the central chamber 110. This places the intramedullary device 50 in a locked position, as shown in figure 3, thereby locking ratchet assembly 100 completely.

According to embodiments, the leverage mechanism 107 may be a rocker mechanism that extends the clearance between the central chamber 110 and a gear 111, as seen in Figures 2 and 3. The terminal end of the leverage mechanism 107 is flexibly connected to the central chamber 110. The second end of the leverage mechanism 107 may include a pin 109. While the intramedullary device 50 is in the actuation position, the subcutaneous button 115 with or without the spacer 101 may be tightened, which causes the chamber 110 will move forward and actuate the leverage mechanism. While the leverage mechanism 107 is axially actuated, pin 109 of the leverage mechanism 107 may connect with gear 111, causing gear 111 to rotate.

According to embodiments of the invention, when in the actuation position, fully depressing the subcutaneous button 115 moves the central chamber 110 forward. Leverage mechanism 107 may then be actuated by said central chamber 110. When moved forward by central chamber 110, leverage mechanism 107 may push pin 109 forward. Pin 109y can in turn cause gear 111 and long spindle 112 to rotate a single click, thereby changing the length of intramedullary device 50.

A new feature of the invention is that the central chamber 110, together with the leverage mechanism 107 and a mainspring 117, can rotate, for example, 180 degrees about a longitudinal axis, allowing pin 109 to be positioned on the side. opposite to its original position of the ratchet assembly 100. As a result, the gear 111 and hence the long spindle 112 may rotate in a direction opposite to the previous movement. For example, where the intramedullary device 50 is positioned for stretching as shown in Fig. 5B, rotating the above referenced components allows to shorten the length of the intramedullary device 50 as shown in Fig. 5A.

In some embodiments, a floating stop 108 may be mounted within the ratchet assembly 100 between the leverage mechanism 111 ensuring that gear 111 can always rotate in any desired direction. Thus, during the insertion and stretching phase, when the intramedullary device 50 is inserted into the bone and then extended, the stop 108 can ensure that the rotation of the gear 111 and long spindle 112 is in a direction that causes the intramedullary device to stretch. 50, while at the same time preventing any movement of either gear 111 or long spindle 112 in a reverse direction.

During said insertion and stretching phase, circumstances may require that the initial length of intramedullary device 50 be adjusted. For example, a mistake can be made in estimating the required length, resulting in the intramedullary device 50 being over elongated prior to its final positioning in the bone. According to some embodiments, the surgeon is optionally able to make use of an innovative and unique feature of the present invention, wherein the intramedullary device 50 may be shortened prior to final anchorage by rotating the central chamber 110 as described above, and then pressing the button. 115 to rotate gear 111 and long spindle 112 in a direction that will reduce the length of intramedullary device 50. This bidirectional feature can also be used for other purposes, such as, but not limited to, assisting removal of intramedullary device 50 where the locking spring mechanism 105 has not been moved to a locked position. A ratchet cap 114, seen in Fig. 4, ensures that the ratchet mechanism is sealed.

A screw 118 holds the ratchet cap 114 in place and ensures that the leverage mechanism 107 remains in the desired position.

The ratchet assembly 100 is engaged such that depression of the subcutaneous knob 115 rotates the long spindle 112 an amount equivalent to a tooth in gear 111, providing very precise control of extension activity.

Gear diameter 111 and gear tooth size and amount 111 may vary according to different embodiments of the present invention.

According to one embodiment of the present invention, the top of the jaw assembly 200 is rigidly connected to the ratchet assembly 100, and at substantially a right angle.

According to some other configurations, the clamp assembly 200 may be connected to the ratchet assembly 100 at a greater or less than a right angle.

Claw assembly 200, shown in Figure 4, as is well known in the art devices, is a long, substantially tubular shaped metal part designed to be inserted into the prepared medullary cavity of a long bone. Unlike the related technique, the clamping assembly 200 of the intramedullary device 50 can be manufactured in a wide range of diameters and lengths and is therefore suitable for a wide variety of long bone sizes, making the intramedullary device 50 applicable to a wide range. of patients.

In one embodiment of the present invention, the jaw assembly 200 is comprised of an outer tube 201 into which an inner tube 202 is seated, as seen in Figure 4. Long spindle 112 runs through the central length of both outer tube 201 as the inner tube 202, connecting the outer tube 201 to the inner tube 202.

The outer tube 201 of the present invention may be anchored to the upper position of the patient's bone by inserting, for example, pins or screws through at least two upper anchor holes 203, as seen in figure 4.

Inner tube 202 moves longitudinally within outer tube 201 in a stable, precise manner. In some configurations, the upper section of the inner tube 202 may be guided into the lower section of the outer tube 201 by means of a keyway 207, where the outer tube 201 has a channel and the inner tube 202 has a sliding protrusion within. of said channel. The keyway system 207 ensures smooth, stable, and accurate longitudinal relative motion of the inner tube 202, with no tolerance for any rotational movements that may cause instability of the intramedullary device 50. According to some alternative configurations, other guide systems may be employed.

According to one embodiment, the long spindle 112 enters the top of the inner tube 202 and may be connected to the inner tube 202, for example by combining threads in the inner tube 202 and long spindle 112. During the distraction phase, the set of The ratchet 100 rotates the long spindle 112, which in turn pushes the inner tube through the keyway 207, causing the intramedullary device 50 to lengthen.

An important feature of the present invention is an alignment hole 205, located at the lower end of the inner tube 202. The alignment hole 205 comprises a bore section of inner tube 202 which provides the clinician with a simple tool to ensure that the intramedullary device 50 is positioned correctly within the bone after insertion. Alignment hole 255 allows the doctor to adjust the alignment of the jaw assembly 200 by rotating the intramedullary device 50 if required to its correct position. When intramedullary device 50 is correctly aligned, alignment hole 205 will appear as a single X-ray circle. This feature is important because the intramedullary device 50 must be correctly aligned to ensure that anchor bolts are inserted into the correct part of the bone while preventing undue damage to surrounding tissue.

Inner tube 202 of the present invention may also house at least one lower anchor hole 204. Inner tube 202 may be anchored to the lower portion of the patient's bone by inserting, for example, pins or screws through at least one lower anchor hole 2 04. After the intramedullary device 50 is correctly aligned, the alignment hole 205 may, according to some configurations, function additionally as a hole for inserting additional anchor bolts.

According to some embodiments, there may be a plug 206 installed in the lower portion of inner tube 202 to seal inner tube 202. In other embodiments, inner tube 202 may be constructed as a single component.

The various components of intramedullary device 50 may be constructed of, for example, titanium alloys, stainless steel, or other materials acceptable for implanted medical devices.

Operation

The bone is prepared, including performing the osteotomy, according to standard procedures known to those skilled in the art. The present invention may then be inserted as a single unit.

After the jaw assembly 200 is inserted into the bone, the intramedullary device 50 should be aligned. Claw assembly 200 is rotated slightly about its longitudinal geometry axis until alignment hole 205 appears correctly aligned on the X-ray, that is, showing itself as a single circumference. This indicates that the lower anchor hole 204 and alignment hole 2005 are correctly positioned. It is important that the intramedullary device 50 be attached to the bone, that each screw enters the bone at the correct location so as not to damage blood vessels, tissues, and surrounding muscles in the area.

As soon as the intramedullary device 50 is inserted into the bone and aligned, pins or screws can be inserted through the upper anchor hole 203, lower anchor hole 204, and optionally alignment hole 205 to secure the intramedullary device 50 in place. . The central chamber 110 is then rotated to allow gear 111, and long spindle 112 to rotate in the desired direction.

Once the length of the intramedullary device 50 is adjusted and the intramedullary device 50 is fixed to the bone, the intramedullary device 50 is ready for use.

The user may activate the intramedullary device 50, thereby extending the claw assembly 200v by pressing the subcutaneous button 115 according to the prescribing physician's instructions. Pressing the subcutaneous knob 115 presses the central chamber 110 against the leverage mechanism 107, causing the leverage mechanism 107, in conjunction with pin 109, to rotate gear 111 at a tooth angle. Gear 111 in turn rotates long spindle 112 at the same angle. When the long spindle 112 rotates, it causes the inner tube to slide longitudinally away from the outer tube 201 and the rest of the jaw assembly 200, effectively stretching the intramedullary device 50 and the bone.

The ratchet assembly 100 is engaged such that a single push of the subcutaneous knob 115 will cause the long spindle 112 to rotate a specific amount, allowing very precise control of extension activity.

After the distraction phase is complete, a medical doctor can insert a needle through the funnel-shaped opening 113. Pressing of the needle 102 forces the cylindrical plate 104 to move forward, and allows holes 103 in the cylindrical plate 104 and holes 106 in the central chamber 110 align. Once the holes 106 and 103 are aligned, the ends 116 of the locking spring 105 spring out through the holes 106, as seen in figure 3.

When the locking spring 105 is positioned in this way, the subcutaneous knob 115 is prevented from further actuating the leverage mechanism 107 and pin 109 or turning the long spindle 1112, thereby permanently locking the entire ratchet assembly 100.

When the bone is sufficiently repaired, the intramedullary device 50 may be removed according to standard procedures known to those skilled in the art.

While the above description contains many specificities, they should not be construed as limitations on the scope of the invention, but rather as exemplifications of preferred embodiments. Those skilled in the art will imagine other possible variations that are within the scope of the invention. Accordingly, the scope of the invention should be determined by the illustrated embodiment, but by the appended claims and their legal equivalents.

Claims (16)

1. Intramedullary distraction device for bone elongation and repair of angular and rotational deformity based on the calotase phenomenon, which enables activation by a patient, comprising: a claw assembly that is rigidly connected to a joint ratchet mounted within a medullary cavity prepared from a long bone, said claw assembly including at least two interconnected metal parts; a ratchet assembly including a ratchet cap and a long spindle which rotates in an amount equivalent to at least one tooth in a gear, wherein said long spindle rotation alters the length of the jaw assembly; and a subcutaneous button located at the outermost end of said ratchet assembly below and near the skin surface to initiate a ratchet moving action. Device according to Claim 1, characterized in that the ratchet assembly includes a central chamber, a leverage mechanism and a gear, one end of the leverage mechanism being flexibly connected to the central chamber and the second. The end of the lever mechanism is connected to the gear, such that with the push of the subcutaneous button, the central chamber moves forward to actuate the lever mechanism and rotates the gear, while the gear rotation rotates the long spindle. Device according to claim 2, characterized in that it further comprises a floating stop mounted within the ratchet assembly between the lever mechanism and the gear. Device according to claim 2, characterized in that the leverage mechanism includes a pin, with the push of the subcutaneous button, said pin contacts said gear. Device according to Claim 2, characterized in that the central chamber includes a cylindrical plate connecting the subcutaneous button and a locking spring, the cylindrical plate sliding freely within the central chamber. Device according to claim 2, characterized in that the cylindrical plate includes at least two diametrically opposed holes and the locking spring rests within said holes compressed against an inner wall of the central chamber thereby securing the cylindrical plate in place. Device according to claim 1, characterized in that it further comprises a spacer located between a central chamber and the subcutaneous button to extend the subcutaneous button to accommodate the thickness of the fat and skin. Device according to Claim 6, characterized in that it further comprises an opening located at the terminal end of the subcutaneous button and the central chamber comprising at least two holes which are aligned with the holes of the cylindrical plate, whereby by Inserting a pin through the opening, the cylindrical plate moves forward, releasing the ends of the locking spring to move outwardly into the holes of the central chamber, thereby locking said ratchet mechanism. Device according to Claim 2, characterized in that the leverage mechanism is a rocker-type mechanism that expands the clearance between the central chamber and a gear. Device according to claim 2, characterized in that the ratchet assembly further comprises a floating mechanism mounted between the lever mechanism and the gear which ensures that the gear can rotate in any desired direction, making the gear assembly. clamp be shortened or lengthened according to the direction of rotation of the gear. Device according to Claim 1, characterized in that the clamp assembly includes an outer tube and an inner tube seated within the outer tube, with the long spindle running through the central length of both the outer tube and the outer tube. the inner tube by connecting them. Device according to Claim 11, characterized in that the outer tube has at least one hole enabling the anchoring of said tube to the patient's bone. Device according to Claim 11, characterized in that the outer tube includes a guide system where the outer tube has a channel and said inner tube has a protrusion that slides within said channel to support and guide the tube. inner tube movement. Device according to claim 11, characterized in that the inner tube and the long spindle have matching threads allowing the inner tube to be connected to the long spindle. Device according to Claim 11, characterized in that the inner tube includes alignment holes which allow rotation and adjustment of the device to the correct position within the bone. Device according to claim 11, characterized in that the inner tube has at least one hole allowing said tube to be anchored to the patient's bone.