CN1155345C - Intramedullary osteosynthesis nail system capable of being used in all human and animal bones to heal fractures or for lengthening bones - Google Patents

Abstract

The present invention relates to an inner coaptation nail system of a marrow cavity, which is used for fracture treatment or bone extension of all human bones and animal bones and particularly to used for a thigh region. The system comprises an inner coaptation nail of the marrow cavity, wherein the inner coaptation nail of the marrow cavity is used as a basic member and can be connected with at least one implanting piece (5) by connecting devices (3)(4)(6)(10) arranged on the upper end and/or the lower end of the inner coaptation nail according to selection. Consequently, the pin can also be connected with a novel assembly which is in an implanting state. Therefore, the functions can be extended under the condition that the required expense of the complete replacement of an implant does not need to be spent even after a first operation.

Description

Intramedullary Bone Screwing System for Fracture Treatment or Bone Lengthening

technical field

The present invention relates to a system based on intramedullary bone screwing for fracture treatment or bone lengthening of all human and animal bones, especially in the femoral region.

Background technique

Various treatments are known for the various defects that occur. For example, for femoral fractures, intramedullary bone screws are used. Femoral neck screws are used for femoral neck fractures. They are loaded and inserted into the femoral neck through holes made in the intramedullary canal of the nail. For the knee and hip it is known to use specialized prostheses. A revision of the prosthesis may often be involved in a total replacement of the internal prosthesis.

All fractures that occur and bridging bone defects can basically be treated with the aid of the aforementioned implants.

It has been found to be disadvantageous here that, for patients with multiple fractures, possibly different types of implants have to be used, which are not compatible with one another. In the worst case it may result in the entire implant having to be replaced when the patient's clinical picture changes.

Another disadvantage that has been identified is the large number of parts that the surgeon has to store.

Document US-A-5,620,445 discloses an intramedullary bone screw which can be lengthened with one component each at its distal and proximal ends by means of threaded or conical connection means. The extension has a fixing device for fixing a tool for placing or raising the bone insert in the medullary cavity. Both extensions have holes for passing the set screws.

Contents of the invention

The object of the present invention is to prepare an implant for supporting the treatment of fractures or for bridging defective bones, which solves the above-mentioned problems.

According to the present invention, a kind of intramedullary cavity bone screwing system is proposed, which is used for fracture treatment or bone lengthening of human bone and animal bone. The connecting device at its proximal end and/or distal end is connected to another element of the intramedullary cavity bone screwing system, characterized in that: the other element is a support, which can optionally be provided with: a One or more entry holes and one or more exit holes into which the nail is inserted, wherein the exit hole is positioned relative to the entry hole such that when the nail is inserted, it is between the longitudinal axis of the nail and the axis of the bone screw in the medullary cavity. or a prosthetic post to replace the femoral portion of the hip, or a prosthetic post to replace the femoral portion of the knee, or an intramedullary bone screw extension.

The basic idea of the invention is to propose an intramedullary bone screw system based on a basic component. This bone screw can selectively pass through the connecting device at its upper end and/or lower end, with the components selected by the surgeon for the patient's respective condition; at the same time, when necessary, with the components adapted to the change of the condition A suitable connection is made without the need to replace the entire implant in the latter case.

Thus, starting from the intramedullary bone screw, this basic implant can be extended into the knee or hip area if required. It has proven to be an outstanding advantage here that it allows the pins to be connected to new components that are already implanted, so that even after the first surgery it is possible to replace the implant without the expense, such as would be required for a complete implant replacement. extensions.

Advantageously, the system is designed as a combined system, and other components can be expanded or reduced at any time if necessary. The result is shortened operating times and benefits to the patient, as the system can be specifically selected according to the patient's condition, including during the procedure, and adapted to it as the condition changes.

Adaptation of the implant may be necessary, for example, when there is a tumor and parts of the bone have to be removed, the size of which can only be determined during surgery. Based on this result, the surgeon can then make specific decisions about which components should be placed on the intramedullary bone screw.

The invention also has the advantage that the fracture treatment as a universal tool with the aid of the system according to the invention is simple and safe.

With regard to intramedullary bone screws, it is preferred to use a nail having equidistant detent slots and small target holes along the entire length of the nail and two large auxiliary holes at the distal and proximal ends. The auxiliary hole enables the precise positioning of the intramedullary bone screw in the ray path of the X-ray system and temporarily fixes the screw for final fixing in the bone with fixing pins which are inserted into the grooves. Positioning solely by means of slots is inconvenient since, unlike a circular hole, a slot always appears as a slot in the ray path irrespective of whether it is in an orthogonal position. Here, the term "orthogonal" means that the holes are oriented perpendicular to the ray trajectory and thus behave as full circles. The outer groove makes the intramedullary bone screw less bending rigid and thus allows a better transmission of forces into the bone.

The intramedullary bone screw as the basic component of the system according to the invention is adapted to the anatomical shape of the bone and can be implanted proximally or distally as desired.

The present invention provides that connecting devices are provided at both ends of the intramedullary bone screw so as to cover the greatest possible range of indications, that is to say, the intramedullary bone screw as a basic component is extended to allow it to be used in the knee region. Also allowed in the hip area.

These connecting means are preferably designed as internal or external cones or as threads.

But it is also completely possible to use the intramedullary bone screw as a common locking screw without being connected with the component.

The intramedullary bone screw can be removed by screwing or mounting a rod-like device on or over the nail's connector, at which time the nail can be pulled out of the bone after the stop screw has been removed. It should be noted that when installing the rod-shaped removal device there is a bracket to ensure that no torque is transmitted into the bone.

A further aspect of the invention is to provide a support which can be used in particular as a component of the system according to the invention.

This bearing unites several normally necessary parts: it is used to mount and fix eg a femoral neck screw, which is then pushed through the femoral neck into the femoral head.

The support member is used as a dedicated implant component of the intramedullary bone screw of the system, and according to the invention, there are one or more inlet holes and always a plurality of outlet holes, the outlet holes are preferably on the opposite side with respect to each inlet hole. The holes are arranged at an oblique angle so that the nails can pass through the support in an angular position selectable during insertion. The support element can be connected at its lower end to the intramedullary bone screw via a connecting device, preferably via a conical connecting device. The channel of the femoral neck screw preferably has a shape that matches the screw, and it is preferably not round to prevent rotation of the femoral neck screw.

Preferably three outlet openings are provided in the support. Their centerlines may intersect at one point. The angular condition of the entry hole relative to the exit hole is adjusted in such a way that the center of rotation of the nail to be inserted coincides with the entry hole, but it could also be located elsewhere.

In addition to the support, various prosthetic components are provided as further components of the system according to the invention. An example of this is the placement of a prosthetic post on the hip side. It is used, for example, as a revision prosthesis in connection with intramedullary bone screws.

A knee side prosthetic component can be adorned similarly at the lower end of nail. It is also used, for example, as a revision prosthesis in connection with bone screws in the bone marrow. To bridge larger defects, both prosthetic components can also be used together.

At its end facing away from the intramedullary bone screw, the support is provided with another connecting device for connecting with other components.

Each channel for a nail in the support has a cross-sectional shape that matches the nail to be passed therethrough.

Finally, the intramedullary bone screw can be supplemented with a similar extension, for example in the case of a bone defect.

Description of drawings

The present invention is further illustrated below by means of examples.

in:

Fig. 1 is as by the intramedullary cavity bone screw of basic component in the system of the present invention;

Fig. 2 is a partial sectional view of Fig. 1, with an inner cone as a connecting device, which can be mounted on an extension;

Fig. 3 has the bearing of the head and the femoral neck substitute on the hip side;

Fig. 4 represents the support of the possible position of the inserted femoral neck nail; And

Figure 5 Cross-section of the femoral neck screw.

Detailed ways

Figure 1 shows a known intramedullary bone screw 1 which has been used as a tibial nail. It is correspondingly larger for use in the femoral region. The intramedullary bone screw 1 has an external groove 2 as well as small and large holes, some of which are used as auxiliary holes to facilitate the positioning of the intramedullary bone screw in the beam path. The bone plug in the bone medullary cavity of the basic component has connecting devices 3, 4 and 10 at its upper and lower nail ends. Components can be mounted force-transmittingly and/or rigidly via these connections. The connections shown here are designed as cones or threads.

FIG. 2 shows an inner cone 6 as connection means, which on the extension 9 can be mounted on the outer cone of FIG. 1 .

FIG. 3 shows the bearing part 5 , which can be connected to the bone screw 1 in the bone marrow cavity by means of an inner cone 6 . This support 5 is provided with a hip prosthetic post 7 .

At its end facing away from the intramedullary bone screw, the support member 5 is provided with another connecting device 11 for connecting to other components.

The elongated hole 8 can accommodate a locking screw, so that the torque introduced into the component can be further transmitted to the bone. This prevents possible tearing.

FIG. 4 shows the bearing 5 and the various possibilities for penetrating the femoral neck screw. These nails are used for the treatment of fractures, which are tensioned, for example, with the two trochanters (pertrochantr of the greater trochanter). The nails that fit into the bearing extend through the neck of the femur into the femoral head and form a cantilever that bears bending and rotational forces in this area. The support 5 has an inlet hole and a plurality of outlet holes. The femoral neck screw can thus be fixed in one of the selectable angular positions.

The groove of the support has the same cross-sectional shape as the associated nail.

Figure 5 shows a known modified cross-sectional shape of a femoral neck screw.

Claims (11)

1. A bone insertion nail system in the medullary cavity is used for fracture treatment or bone lengthening of human bones and animal bones. The components of the system include a bone insertion nail (1) in the bone marrow cavity as a basic component, which can be passed through Its proximal and/or distal connection means (3, 4, 6, 10) are connected to another element of the intramedullary cavity bone screwing system, characterized in that said other element is a support (5) , the support can optionally be provided with: - one or more entry holes and one or more exit holes into which the nail is inserted, wherein the exit hole is in a position relative to the entry hole such that when the nail is inserted, the longitudinal axis of the nail is aligned with the intramedullary cavity the axes form different angles between each other, or - a prosthetic post (7) to replace the femoral part of the hip joint, or - a prosthetic post to replace the femoral portion of the knee joint, or - An intramedullary bone screw extension. 2. The intramedullary cavity bone screwing system according to claim 1, characterized in that: the connecting device of the intramedullary cavity bone screw is designed as a cone (3, 4, 6). 3. The intramedullary bone screwing system according to claim 2, characterized in that the connection means are an inner cone or an outer cone (3, 4, 6). 4. The intramedullary cavity bone screwing system according to claim 1, characterized in that: the connecting device of the intramedullary cavity bone screw is a thread (10). 5. The intramedullary cavity bone screwing system according to claim 4, characterized in that: the connecting means involves internal threads (10) or external threads. 6. According to the intramedullary cavity bone screwing system according to any one of the preceding claims, it is characterized in that: the support member (5) is provided with another connecting device (11) at its end facing away from the intramedullary bone screwing screw ) for connecting with other components. 7. The intramedullary bone screwing system according to claim 6, characterized in that each channel for a nail in the support element (5) has a cross-sectional shape adapted to the nail to be passed through. 8. The intramedullary bone screw insertion system according to claim 7, characterized in that: the nail is a femoral neck nail. 9. The intramedullary cavity bone screw insertion system according to claim 6, characterized in that: three or more outlet holes for the nail are set. 10. The intramedullary canal bone screwing system according to claim 6, characterized in that a hole (8) is made in the support (5) for receiving a stop screw for transmitting torque to the bone. 11. The intramedullary cavity bone screwing system according to claim 10, characterized in that: the hole (8) is an elongated hole.