WO2002071963A1 - Guide plate for 95° angled plates in orthopedic surgery - Google Patents

Abstract

Whenever placement of 95° angled plates is indicated in orthopedic surgery, the plate is frequently misaligned in relation to the bone due to the fact that there is no instrument to accurately and reliably guide the guide nail when it is initially introduced since current techniques and instruments are only visual. The inventive implant is precisely indicated for the treatment of certain femur fractures. To solve the above-mentioned problem, a guide plate comprising two main components is provided: 1.- The main male plate, on which bone fragments are reduced in a coherent and safe manner, shows beforehand the position the definitive implant will adopt thereby solving the problem of plate-bone misalignment. 2.- The dismountable female plate together with the above-mentioned plate form a tunnel for the guide chisel thereby solving the problem of plate nail alignment and enabling visualization of the exact position of the definitive implant by placing the implant through the guide plate while preserving alignment of the bones and remaining in correct position.

Description

 GUIDE PLATE FOR ANGLE PLATES 95 ° IN ORTHOPEDIC SURGERY. Background.

So far, in the practice of Orthopedic Surgery, for the placement of angled plates of 95 ° when this implant is indicated, we have as guidance guidance the instruments designed by the Swiss Association for the study of Osteosynthesis (AO). Being basically these; the angle guide (KT5 AESCULAP catalog) nail guide (KT20 cat. AESCULAP) and guide nail (KT22 cat. AESCULAP). With the AO technique described in your osteosynthesis manual, this orientation is only of the visual order. Therefore, the exact placement of the implant is difficult, resulting in a large percentage of cases a bad orientation of the plate. As some surgeons have chosen not to use 95 ° angled plates, we particularly believe that it is a good implant for some femur fractures. The problem lies in the fact that it begins by placing the nail, and having no instrument that gives us the exact orientation, this is left with a deviation of one to several degrees, which affects the final position of the plate in a bad alignment of this with respect to the bone surface. With the purpose of solving the problem described, an instrument of the same material as mentioned above was designed to guarantee the exact placement of the angled plates of 95 °, first stabilizing the fracture and showing in advance the position that the plate will have and the definitive implant nail; which we have called PLACA - GUIA and which is composed of two basic components. 1.- Main male (No. 1, figure 1) .2.- Female assembly (No. 2, figures 1), and it is intended to protect by means of the present application since there is no other with these characteristics that give us a solution in an exact, safe and effective way to the problem described above. This being the main advantage of the new instrument.

Description of the Invention

The details and characteristics of the GUIDE PLATE are clearly shown in the following description and in the drawings of figures 1 to 4.

The GUIDE PLATE consists essentially of two components and is

5 describe as: 1.- Main male component (No. 1, figure 1) and 2.-

Female assembly component (No.2, figure 1).

The main male component (No. 1) consists of a 10-hole condylar plate with characteristics and arrangement thereof to the self-compression ones to which the nail blade has been separated and in its place at the 0 angular end it he has welded a plate perpendicular to this, 2.5 mm. thick, square U-shaped (No. 3, Fig 1), 30mm. long X 16 mm. wide and 6.5 mm. high by its internal surface, and at the ends of its vertical branches have an eyebrow of 2.5mm. (No. 4, Fig 1) towards the outer side and that they cover it in all its extension and end in a stop (No 5, Fig 1) proximal to the end welded to the condylar plate.

The female assembly component (No 2, Fig 1) whose shape is a square C of 30 mm. long X 16 mm. in the opening of its branches which assemble in mirror with the main piece and that together with it or form a cube whose light (No 6, Fig 1) of 30mm. X 16 mm X 6.5mm which will serve to accommodate the guide chisel (KT22, cat. AESCULAP) and whose direction will be given by the orientation of said attachment that will be of entry at 85 ° with respect to the main axis of the GUIDE PLATE and exit of 95 ° angle complementary to the previous (No. 7, fig. 1). Said female component 5 (No 2) has two 1.5mm ducts on its outer and distal face. in diameter (No. 8 fig 1) that run it parallel along of 30mm. centered and separated by 16 mm. Between these ducts in its proximal part to that of the junction with the plate it has a 6mm recess. radius (No. 9 of fig. 1) and on the opposite side a 6mm crest. high by 10mm. long and 3mm. wide (No. 10 fig.l) and that when assembling the two male-female pieces an instrument is represented in Figure No. 2 which we have called

GUIDE PLATE.

Method to use the GUIDE PLATE.

In the fractures of the femur; intertrocantereas, subtrocantereas, supracondylar (No 11, Fig 5), and in osteotomies of the same regions and in whose osteosynthesis the angular plates of 95 ° are used, with the known surgical techniques and exposed the bone fragments (No 12, Fig 5), with the GUIDE PLATE assembled (Figures 3 and 4), this will serve as a support to anatomically reduce these fractures (Figure 5), which gives us a great advantage to the previously known method, and placing the GUIDE PLATE in the proper position (No 1, Fig 5) the two Kirschner or Steinmann 1.5mm pins are passed. (No 13, Fig 6), through the conduits that the female assembly presents and passing them through the entire bone (No 14, fig. 6) which allows us a direct visualization of the position and direction that the guide nail will follow (KT22 ), being able at this time to make the pertinent corrections if necessary, as well as to pass screws (No 15, Fig 6) if necessary to give greater strength to the system, since the arrangement of the holes is the same as that of the angled plates these screws will serve for the definitive implant, being another advantage to the previously used method. If everything is correct, the pins are removed and the guide nail KT22 (No. 16, Fig. 7) is introduced, being able to control the required depth through the recess of the assembly (No. 9, Fig. 7), it is removed the guide nail and screws if they had been used with the GUIDE PLATE, and with the definitive implant, 95 ° angled plate (No 17, Fig 8), mounted on the KT26 extractor impactor, Cat. AESCULAP (No 18, Fig 8 ) the same is introduced (Fig. 8) through the light cube of the GUIDE PLATE which ensures us that occupies the exact position of the same, and as far as this is permitted (Fig. 9), at this time the female component (No 2, Fig 9) is removed by pulling it from the crest (No 10, Fig. 9), and sliding the main male component (No 1) to the anterior bone face (Fig. 10) keeping; This position with the reduction forceps is finished by introducing the definitive implant (No. 17, Fig. 1), leaving it in the correct position, fixed with the corresponding screws (No. 15) to the bone.

Claims

Claims Having sufficiently described my invention, I consider it as a novelty and therefore claim as my exclusive property contained in the following clauses: 1.- GUIDE PLATE for 95 ° angular plates, in orthopedic surgery, which are made up of two basic components; .1.- main male and 2.- female assembly. The main male component is formed by a 95 ° angular plate with 10 self-compression holes to which the nail blade has been removed, leaving only the plate which is characterized by an attachment that has been welded at the end angular and perpendicular to this, said attachment consists of a square U-shaped plate that in its vertical branches has an eyebrow or flange towards the external side that travel it in its entire extension ending at a stop proximal to the point of union with the plate angled The female assembly component whose shape is a square C and its branches mirror together with the eyebrows of the male component already described, and together with this form a tunnel that serves to accommodate the guide chisel in a way that enters 85 ° with with respect to the main axes plate - attachment and with an exit of 95 ° angle corresponding to the nail blade of the 95 ° angular implants, which assures us that there will be no variation in the final nail-plate position. The female assembly component has on its external face two ducts that run along its entire length and will serve to house the Steinmann guide pins, which will give us the orientation of the guide chisel, in the middle of these ducts at the end proximal to the plate It has a recess that will serve to control the depth of the guide chisel, at the opposite end it presents a crest that serves to manipulate SUBSTITUTE SHEET (RULE 26) by sliding this female component. 2.- Improvements to the guides for guide nails, characterized by the detachable male-female system and the orientation ducts for the guide pins. SUBSTITUTE SHEET (RULE 26)