GB747876A - Internal fixation of fractures - Google Patents

Abstract

747,876. Splicing bones. CAESAR, O. S Jan. 28, 1954 [Feb. 28, 1953], No. 2605/54- Class 81(2). [Also in Group XXIII] The healing of fractured bones is aided by leaving within the body splint members one within the bone and one without permanently connected together by clamping elements the members both extending longitudinally of the bone across the line of fracture. The apparatus shown for reducing and fixing the fractured bone is used as follows. After exposing about 60 degrees of the bone a clamping device comprising a pair of members 26 pivotally attached at 24 to each end of a rigid bar 20 is applied such that a pair of members 26 is partially surrounding each bone piece. Each member 26, which is formed with an upward extension 28, is loosely connected at its lower end to an end of a bar 38 such that the clamping device when straddling the broken bone has three bar members, each formed with bone gripping teeth 22, 40, placed and held securely longitudinally thereof. Each extension 28 is provided with a tong engaging hole 46 at its upper end and is slotted such that a locking threaded stud and nut 34, 36 may be incorporated.in each pair of members 26. A pair of tongs 50, provided at its lower ends 56 with pins 48 for engaging the holes 46, is used to place each pair of members 26 in gripping position about its bone piece only being removed from each pair when the appropriate nut 36 has been spun into locking position. A drill jig 58, Fig. 5, is then placed over the bar 20 and attached thereto by a winged nut and stud 60. This jig has pairs of drill guide tubes 66, 70, 72, such that the holes 66a, 70a, 72a, shown in Fig. 11 may be drilled in the bone on each side of the fracture line the pairs 66a and 70a being angularly placed around the bone at 60 degrees to each other whilst the angular displacement between pairs 66a and 72a is slightly greater than this. Before the drill guide tube pairs 66, 70, 72, are used bushes 74 are inserted into each of tubes 72 such that a hole of smaller diameter is drilled right through the bone. After removing the bush a drill of normal size is used in each tube 72 but only to drill into the bone adjacent the tube whereas the tube pairs 66, 70, are used to guide the same sized drill right through the bone. The drill jig is then removed and the holes 66a utilised for fixing in position a bone saw which cuts a slot longitudinally of the bone joining the holes. This saw comprises a housing formed by two plates 80, 82, secured together and so recessed on their inner and adjacent faces that a sectorshaped oscillatable saw blade 94 may be pivotally mounted therebetween. The plates are also recessed such that a block 102 may be housed within for reciprocatory motion the latter being imparted to the block by an eccentrically mounted disc 108 formed at one end of a shaft 110 adapted for rotational drive via the chuck 112 of an electric drill. The block is partially split to accommodate the top end of the saw blade and is provided with a pin 104 which engages a slot 100 formed in said top end. The block is also provided with a cavity to accommodate the disc 108 and in order to limit the width of the saw housing the plates 80, 82, are provided with openings 124 through which the disc 108 may protrude. The saw housing is provided with means whereby the body of the electric drill may be securely connected thereto by an internally threaded cylindrical sleeve 114. The housing is also provided with locating pins 130 securely attached thereto by nuts 132 and flanges 134 and slotted at 136 such that when oscillated the saw blade enters therein. This ensures that when the pins 130 are passed through the bone holes 66a and the saw operated the longitudinal slot 94a cut in the bone extends into the holes. As shown in Fig. 8 a slight recess is cut in the other or lower bone wall. The saw is then removed and, Fig. 11, the splint members and clamping elements placed in position. A metal plate 140 with pins 142, slots 144 and holes 146 screw-tapped at an angle of 60 degrees to the plate is then inserted in the slot 94a and holes 66a the tab 148 coming to rest in the above-mentioned slight recess. A metal plate 150 with screw-tapped holes 156 and provided with pins 152 is applied to the bone pieces the pins being passed through the holes 70a on either side of the bone and the slots 144 in the plate 140. Screws 158 with guiding tips 160 of reduced diameter are then screwed into the holes 156 and 146 the tips being finally located in the holes of reduced diameter in the farther wall of the bone. The damping device is then removed and the wound dressed.