DE102006032814A1 - Proximal femoral nail - Google Patents

Abstract

The invention relates to a proximal femoral nail with a femoral neck member received in a bore. According to the invention, the femoral neck support element has a shape which extends at least in sections in the longitudinal direction and which extends into the bore and / or projects into the bore and / or fastening element in order to form a rotational security for the femoral neck support element. In one embodiment, the support element is designed as a support screw. The support screw in this case has a longitudinal slot extending through a passage slot and has at the self-tapping thread opposite end of the support screw extending in the longitudinal axis threaded bore for receiving a compression screw with a threaded bore complementary external thread. The hole is made to receive a locking pin in Nagelkopflängsrichtung over the area for receiving the support screw. In this case, the locking pin druchdringt in the inserted state, the passage slot and thereby causes a rotational security of the support screw, with the operation of the compression screw into abutment with the part located in the passage slot of the locking pin, so that a relative movement between the femoral neck screw and femur nail can be generated.

Description

The The invention relates to a proximal femoral nail with a in one Bore received femoral neck support element, according to the preamble of Claim 1.

proximal femoral nails belong for stabilizing pertrochanteric, intertrochanteric or high subtrochanteric Fractures to the state of the art. Known femoral nails have a proximal one End with larger diameter and a distal nail end, which have some flexibility can to minimize stress concentrations. Also, it is already known that the femur nail expediently an angle adapted to the anatomy of, for example, 6 ° about the longitudinal axis has.

Of the Head of known femoral nails is locked by a screw, which at the same time able is a self-tapping hip screw in the nail to secure against rotation or displacement. A correspondingly large inner bore takes the femoral neck screw necessary to stabilize the fracture which is normally self-tapping. The hip slide provides with respect to the femoral neck screw a rotation lock dar. Usually the femoral neck screws still have a slip-through protection on.

At the Distal nail end holes are inserted, which are the recording serve at least one locking bolt. The above briefly explained Femoral nail becomes operative as possible deep into the femoral opening introduced, in which case then an introduction of the Hüftgleitschraube and the femoral neck screw with the aid of drilling templates is made. This introduction is done by using Guidewires, with direction and position over suitable image rendering technique during the execution of this operational step is controlled. After a determination the lengths the hip slide and femoral neck screw, these are using a special key screwed. For the case that compression of the fracture is required exists in known solutions the possibility, on the aiming arm to provide a compression nut. With the help of this compression nut can then over the femoral neck screw will compress the fracture. After losing weight of the aiming arm However, in these known nails compression is not more is possible. The explained state the technology goes back on the offered and sold by Synthes PFN Femurnagel.

at the femur nail TARGON PF, manufactured and sold by the company Aeskulap, this consists of the intramedullary nail, a screw and a support sleeve, into which the support screw can telescope. In addition, another screw provided that an undesirable Rotation of the femoral neck screw blocked. The femoral neck screw can in this variant of the prior art in intramedullary nail in slide in their longitudinal direction, which allow sintering of the fracture should.

It However, this is not without additional in this femoral nail design Application of special target devices possible, to effect a defined compression of the fracture.

Out The above, it is therefore an object of the invention, an advanced proximal femoral nail with femoral neck support received in a bore indicate, with this femur nail on the one hand the possibility an integral compression of the fracture and on the other hand the possibility there is a simple way to effect a rotation backup, and without a separate Hüftgleitschraube with additional Bore in the bone must be provided.

The solution The object of the invention is carried out with a proximal femoral nail according to the combination of features according to claim 1, wherein the dependent claims at least expedient embodiments and represent further education.

According to the invention characterized by the proximal femoral nail and the femoral neck member characterized that the femoral neck support element at least in sections longitudinally extending, to extend in the bore and / or projecting into the bore Form and / or fasteners suitable form for forming a Anti-rotation lock for having the femoral neck support element.

This inventive idea may through various embodiments be realized. In a first embodiment, the femoral neck support member an edged profile shape, in particular a cross profile, and the bore edged bore profile, in particular a cross-slot profile, for one sliding, rotation-secured insert of the femoral neck support element on. This embodiment is without additional Fastener feasible and accesses a simple positive connection between the support element and the hole in the proximal femoral nail back.

The femoral neck support member is preferably formed in this embodiment as a femoral neck nail. This is along the profile form closure through the hole of the proximal femur nails slid into the bone tissue.

at a further embodiment the femoral neck support member is received in the bore self-tapping femoral neck screw and the femur nail points an insertable at the proximal end in Nagelkopflängsrichtung locking pin and at least one locking bore provided at the distal end on. In this case, the support screw extending over a longitudinal section Through slot on. At the opposite end of the self-tapping thread the support screw has this one extending in the longitudinal axis direction Tapped hole for receiving a compression screw with one of the Complementary threaded hole External thread.

The Bore for receiving the locking pin is in Nagelkopflängsrichtung to about guided the area for receiving the support screw, wherein the locking pin in the inserted state penetrates the through slot and thereby a rotation of the backing screw causes.

With pressing the compression screw comes into abutment with the one in the passage slot located part of the locking pin, so that a relative movement between femoral neck screw and femoral nail in the sense of compression can be achieved.

Of the Femoral nail according to the invention has in an advantageous embodiment of the invention a continuous cannulation.

As well cannulated throughout is the carrying screw.

At the end of the support screw, which is the recording of the compression screw serves, the support screw has a slope.

Of the Locking pin is designed as a pin with tapered tip and stepped Diameters executed, being in the area of the external thread a blind hole with polygon for holding a tool, e.g. a hexagon wrench is trained.

Prefers the compression screw is designed as a grub screw. By a provided at the distal end slot as a locking hole there is a dynamic lock, i. the femur nail can still gliding in the distal direction for a given area, before it rests on the distal locking screw.

application point The femoral nail is inserted proximally into the medullary cavity of the femur. hereafter The screw is screwed through the nail in the femoral head and aligned so that the taper of the screw parallel to Axis of the nail head runs. Therefor a special screwdriver is used.

Subsequently, will the locking pin in the longitudinal direction of the nail through the slot of the support screw screwed into the nail. With the introduction of the safety pin is on the one hand, the support screw secured against rotation. On the other hand, the sliding path of the support screw in the nail on the length of the passage slot limited. An emigration from the nail is excluded. The carrying screw remains dynamic, i. movable, causing the perforation of the femoral head during sintering of the fracture zone is effectively prevented.

A desired Intraoperative compression of the fracture gap can be achieved with the help of Compression screw done, which is supported on the locking pin. Of the desired Compression pressure remains according to the position of the compression screw receive.

In an embodiment of the invention has the support screw in the area their oblique a groove of predetermined depth, into which the insertion instrument according to Art a screwdriver is used and guided.

The Invention will be described below with reference to an embodiment and below With the help of figures closer explained become.

in this connection demonstrate:

1 different views of the proximal femoral nail;

2 Side view and sectional view of the self-tapping femoral neck support screw;

3 a view of the locking pin;

4 a representation of the compression screw;

5 a representation of the femoral nail with already introduced Tragschraube;

6 a representation of the proximal femoral nail with screw and impending introduction of the safety pin and

7 a representation of the proximal femoral nail with support screw, inserted locking pin and impending screwing the compression screw in the associated internal threaded portion of the support screw.

8th a representation of a femoral neck nail with a cross profile in a side view and in cross section,

9 one for receiving the femoral neck nail 8th adapted embodiment of the proximal femur nail with profile bore,

10 a representation of the femur nail from 9 with an applied tag behind 8th

The proximal femoral nail 1 According to the figurative representations has a the anatomical conditions of the femur corresponding bend or curvature 2 on.

In the lower part of the femur nail 1 is a hole for the distal locking, in the embodiment in the form of a slot 3 brought in.

In the nail head area there is another hole 4 , which is the inclusion of a femoral neck screw 5 serves.

The angle of the bore 4 to the longitudinal axis of the nail 1 is also chosen according to the anatomical conditions.

The femoral nail according to the picture according to 1 has a continuous cannulation 6 ,

At the proximal end of the femoral nail 1 is a hole 7 introduced with internal thread. This hole 7 with internal thread serves to receive a safety pin 8th (please refer 3 ).

As in particular from the 1 . 6 and 7 The hole is visible 7 for receiving the safety pin 8th in Nagelkopflängsrichtung to over the range of the recording of the support screw 5 guided, with the locking pin 8th in the inserted state, the passage slot 9 penetrates inside the bearing screw.

Above the hole 7 with internal thread is a blind hole 10 , also located with an internal thread, which serves to receive a locking screw, not shown.

The internal thread of the bore 7 does not have to extend over the entire bore length, but only over a partial area, in particular preferably towards the proximal end.

The carrying screw according to 2 has the mentioned passage slot 9 , a continuous cannulation 11 and an end with self-tapping thread 12 ,

On the self-tapping thread 12 opposite end of the support screw 5 is a threaded bore extending in the longitudinal axis direction 13 introduced, the inclusion of a compression screw 14 (please refer 4 ) serves.

The self-tapping thread 12 opposite end of the support screw 5 has a slope 15 on.

In the area of the slope 15 is a groove 16 introduced, which serves to receive a special screwing tool (not shown).

The locking pin 8th according to 3 has a substantially pin shape with conical tip 17 on.

Over the length of the locking pin 8th have a stepped diameter.

In the area of external thread 18 of the safety pin 8th is a blind hole with Innenvielkant 19 introduced, and indeed for receiving a tool, in particular in the form of a hexagon socket wrench.

The compression screw 14 according to 4 preferably has a grub screw shape and also has a blind hole with inner polygon 20 for receiving a screwing tool.

5 shows how the femoral neck screw 5 into the hole 4 of the femur nail 1 was introduced. After the femoral neck screw 5 screwed into the femoral head, not shown, and was aligned so that the beveled end 15 runs substantially parallel to the proximal cylindrical nail, the insertion of the locking pin takes place 8th via the associated hole 7 in the nail 1 ,

With the introduction of the safety pin 8th on the one hand, the femoral neck screw 5 secured against rotation. On the other hand, the sliding path of the support screw 5 to the length of the passage slot 9 limited. An emigration from the nail is excluded.

The carrying screw 5 remains movable, whereby the perforation of the femoral head during sintering of the fracture zone and the associated shortening of the bone during healing can be prevented.

After according to 7 the locking pin 8th in the hole of the nail 1 was introduced, the compression screw 14 into the threaded hole 13 used. The desired intraoperative compression of the fracture gap is achieved using the compression screw 14 who are at the backup pen 8th supports, secured.

In summary causes the locking pin in conjunction with the transverse slot or the through slot in the support screw a rotation lock, further wherein a sliding path of the support screw in accordance with Length of the Passage slot is maintained.

With In addition, it is possible to use the compression screw one To achieve relative movement between the propeller and nail, taking the compression screw on the locking pin, which is already screwed is supported.

8th shows a support nail 21 with a Tragnagel tip 22 and a Tragelagel head 23 , The support nail has a profile shaft 24 on, which is formed in this case in the form of a cross profile. The cross profile is shown in the adjacent cross section. The support nail, although not shown in the figure shown here, the already mentioned passage slot 9 additionally have. The so formed Tragnagel 21 corresponds to the in 9 shown embodiment of the femur nail with a profile hole 25 in the form of a cross slot.

The femur nail points in the in 9 embodiment shown in addition to the already mentioned cannulation 6 , the hole 7 with the corresponding internal thread and the blind hole 10 on and therefore can the locking pin 8th additionally record. In the case of a through slot introduced into the support nail, the securing pin in this case does not serve to prevent rotation, but to prevent slipping of the support nail or to limit the sliding path in the cross-slot bore of the femoral nail.

The in 8th Tragnagel shown is inserted and guided in the Phillips hole and secured in such a manner against rotation by the

Phillips bore driven. 10 shows one in the corresponding profile hole 25 inserted support nail 21 with its profile shaft 24 ,

The illustrated embodiments can in the context of expert Be modified. Other embodiments will be apparent in particular from the dependent claims.

1

Femoral Nail

2

curvature

3

Long hole

4

drilling

5

Femoral neck support screw

6

cannulation in the nail

7

drilling with internal thread

8th

safety pin

9

Through slot

10

blind with internal thread

11

cannulation the carrying screw

12

Self-tapping thread

13

threaded hole

14

compression screw

15

slope

16

groove

17

conical top

18

external thread

19 20

Internal polygon

21

supporting nail

22

Supporting nail tip

23

Supporting nail head

24

profile shaft

25

profile drilling

Claims (10)

A proximal femur nail with a femoral neck support member received in a bore, characterized in that the femoral neck support member is a form suitable for forming a rotational security for at least partially extending longitudinally extending into the bore and / or into the bore into protruding form and / or attachment elements having the femoral neck support element. Proximal femoral nail according to claim 1, characterized in that the femoral neck support element has an angular profile shape, in particular a cross profile, and the bore an angular bore profile, in particular a Phillips profile, for a sliding, rotation-secured insert of the femoral neck support element having. Proximal femoral nail after one of the previous ones Claims, characterized in that the femoral neck support member is a femoral neck nail is. Proximal femoral nail according to claim 1, characterized in that the femoral neck support member is a self-tapping femoral neck screw inserted into the bore and the femur nail has a locking pin insertable at the proximal end in nail head longitudinal direction and at least one locking bore provided at the distal end, wherein the support screw has a longitudinal slot extending through a passage slot and on the self-tapping thread opposite end of the support screw this has a longitudinal axis extending threaded hole for receiving a compression screw with a threaded bore complementary external thread, the bore for receiving the locking pin in Nagelkopflängsrichtung to beyond the area Recording of the support screw is guided, wherein the locking pin penetrates the through slot in the inserted state and thereby causes a rotation of the securing screw, with the operation of the compression screw into abutment with the located in the passage slot part of the locking pin, so that a relative movement between the femoral neck screw and femur nail can be generated. Femoral nail according to claim 4, characterized that this one in Nagelkopflängsrichtung continuous cannulation having. Femoral nail according to claim 4 or 5, characterized that the support screw has a continuous cannulation. Femoral nail according to one of claims 4 to 6, characterized that the support screw at the end for receiving the compression screw a slope having. Femoral nail according to one of claims 4 to 7, characterized that the locking pin is a pin shape with conical tip and has stepped diameter, wherein in the region of the external thread a blind hole with polygon for holding a tool is trained. Femoral nail according to one of claims 4 to 8, characterized that the compression screw is designed as a grub screw. Femoral nail according to one of claims 4 to 9, characterized that provided at the distal end locking hole as a slot is trained.