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EP0948291A1 - Device for repositioning fractured bone fragments - Google Patents

Device for repositioning fractured bone fragments

Info

Publication number
EP0948291A1
EP0948291A1 EP97944675A EP97944675A EP0948291A1 EP 0948291 A1 EP0948291 A1 EP 0948291A1 EP 97944675 A EP97944675 A EP 97944675A EP 97944675 A EP97944675 A EP 97944675A EP 0948291 A1 EP0948291 A1 EP 0948291A1
Authority
EP
European Patent Office
Prior art keywords
rod
axes
translation
translation means
rotation
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Withdrawn
Application number
EP97944675A
Other languages
German (de)
French (fr)
Inventor
Lutz Claes
Heinz Gerngross
Götz RÜBSAAMEN
Orlando Martinelli
Erwin FLÜHLER
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
AO Technology AG
Original Assignee
Synthes AG Chur
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Synthes AG Chur filed Critical Synthes AG Chur
Publication of EP0948291A1 publication Critical patent/EP0948291A1/en
Withdrawn legal-status Critical Current

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
    • A61B17/66—Alignment, compression or distraction mechanisms

Definitions

  • the invention relates to a device for repositioning bone fracture fragments according to the preamble of patent claim 1.
  • a reduction device is known from WO 95/24161, which, however, has only three degrees of freedom and can only be adjusted in a single plane.
  • the reduction procedure that can be carried out with this consists of the following steps:
  • the reduction unit is attached to the fixation unit so that the center of rotation of the reduction unit is aligned with the center of the fracture. Now the rotative and translational reductions are carried out in a first plane and then the joints of the fixation unit are blocked -> fracture stabilized.
  • the invention seeks to remedy this.
  • the invention is based on the problem of being able to carry out all repositioning operations quickly and safely with a single device.
  • the invention achieves the stated object with a device which has the features of claim 1.
  • This provides the advantage that the reduction around the longitudinal axis of the bone can be achieved by means of a gradually rotatable arc segment, which saves complex assembly times.
  • Figure 1 is a perspective view of the device according to the invention.
  • Fig. 2 is a perspective view of the device according to FIG. 1 after translation in the direction T z and rotation about the axes R y and R z .
  • the device according to the invention for repositioning bone fracture fragments shown in FIGS. 1 and 2 essentially comprises a rod 1 running in the x direction, to the extremities of which a clamping device 2 and 3 can be fastened.
  • Each of the two clamping devices 2 and 3 consists of a connecting jaw 14 and an attachable thereon Clamping jaw 15, which can hold a number of bone fixation means 4, in the form of Schanz screws, for anchoring in the bone fracture fragments 5, 6 to be fixed.
  • the rod 1 has a total of three translating means 7, 8, 9 and three rotating means 10, 11, 12, which change the relative position of the two clamping devices 2, 3 with a total of six degrees of freedom with the axes T ⁇ , T v , T z , R ⁇ , R v , R 2 enables.
  • the axes T ⁇ , T y and T z of the translation means 7, 8, 9 span a right-angled coordinate system. An oblique-angled coordinate system is also conceivable, provided that the data obtained can be recorded and processed by a computer.
  • the rod 1 consists of two separate rod parts la, lb, the one rod part la being displaceable by the rotating means 10 around an arc 13 lying in the y, z plane while maintaining its parallelism to the other rod part lb.
  • the circular arc 13 is rotatably supported in the rotary means 10, which is designed as a cuboid plate, by means of an adjusting mechanism 16.
  • the rod part la is laterally firmly connected to the circular arc 13, so that when the adjusting mechanism 16 rotates, the rod part la moves together with the circular arc 13 relative to the rotation means 10 along the path defined by the circular arc 13.
  • the circular arc 13 has a radius of 50-200 mm, preferably 80-130 mm. The larger the radius of the circular arc 13, the further away the reduction device can be mounted away from the longitudinal axis of the bone. However, the size of the radius is limited by the use of conventional Schanz screws as bone fixation means.
  • the translation means 7 for the x-axis consists on the one hand of the rod part la and on the other hand of a hollow cylindrical part 29 in which the rod part la is mounted.
  • Rod part la and the hollow cylindrical part 29 are by means of an adjusting means 30, e.g. in the form of a screw / nut drive, can be moved against each other in the x direction.
  • the order of the translation means 7, 8, 9 and rotation means 10, 11, 12 corresponds - seen in the x direction - to the sequence x 'x' z ' ⁇ y' ⁇ z ' ⁇ y *
  • the translation means 8, 9 for the axes T y , T z and the rotation means 10 for the axis R ⁇ are connected to one unit; but they can also be designed individually or in pairs.
  • the translation means 9 for the z-axis consists of two parallelepiped-shaped plates which can be displaced in the z-direction by means of a drive 17, one plate part 18 is fixedly connected to the rotation means 10 and has a groove-shaped path in which the other plate part 19 is movably slidably arranged and can be displaced by means of the drive 17.
  • the translation means 8 for the y-axis likewise consists of two cuboid plates which can be displaced in the y direction by means of a drive 20, the one plate part 21, which is designed as a slide, being fixedly connected to the slide-shaped plate part 19 of the translation means 9 and can be moved within the groove-shaped path of the other plate part 22 by means of the drive 20.
  • the plate part 22 of the translation means 8 is fixedly connected to the rotation means 12, which consists of two parts 23, 24 which are connected to one another in an articulated manner and which can be rotated relative to one another about the axis of rotation Rz by means of an adjustment mechanism 25.
  • One hinge part 23 is fixedly connected to the plate part 22 of the translation means 8, while the other hinge part 24 is connected to the rotation means 11.
  • the rotation means 11 also consists of two parts which are connected to one another in an articulated manner, one part consisting of the joint part 24 of the rotation means 12 and the other Part 26 is firmly connected to the rod part lb.
  • the two joint parts 24 and 26 can be rotated relative to one another about the axis of rotation Ry by means of an adjusting mechanism 27.
  • the joint part 24 consists - in order to be able to perform its function - from two semicircular arcs rotated by 90 ° relative to one another, each with a peripheral ring gear 28.
  • Both fracture fragments are each provided with 2 Schanz screws, which are then connected to a standard jaw of the fixation unit.
  • the reduction unit is connected to the standard jaws using two jaw adapters. This assembly forms the starting situation for the subsequent reduction.
  • the first step is to perform an angle correction on the fracture.
  • the device according to the invention can also be used for angle-stable plating of bone fractures or for nailing with intramedullary nails.
  • angle-stable plating the use of non-invasive bone staples (according to EP 457.017) instead of Schanz screws has proven to be advantageous.

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  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Surgical Instruments (AREA)

Abstract

A device for repositioning fractured bone fragments has a rod (1) which extends in the x direction. A clamping device (2, 3) can be secured to each extremity of the rod and receive a number of bone fixing means (4) for anchoring in the fractured bone fragments (5, 6) to be fixed. The rod (1) has two translation means (7, 8) and one rotation means (11) for altering the relative position of the two clamping devices (2, 3). The rod (1) also has an additional translation means (9) and two additional rotation means (10, 12), so that the device has in total 6 degrees of freedom along the axes Tx, Ty, Tz, Rx, Ry and Rz.

Description

Vorrichtung r.mm Reponieren von KnochenfrakturfragmentenDevice r.mm reposition of bone fracture fragments
Die Erfindung betrifft eine Vorrichtung zum Reponieren von Knochenfrakturfragmenten gemäss dem Oberbegriff des Patentanspruchs 1.The invention relates to a device for repositioning bone fracture fragments according to the preamble of patent claim 1.
Aus der WO 95/24161 ist eine Repositionsvorrichtung bekannt, die allerdings nur über drei Freiheitsgrade verfügt und nur in einer einzigen Ebene verstellbar ist. Der damit durchführbare Repositionsablauf besteht aus folgenden Schritten:A reduction device is known from WO 95/24161, which, however, has only three degrees of freedom and can only be adjusted in a single plane. The reduction procedure that can be carried out with this consists of the following steps:
Die Repositionseinheit wird so an die Fixationseinheit angebracht, dass das Drehzentrum der Repositionseinheit mit dem Zentrum der Fraktur fluchtet. Nun werden die rotativen und translativen Repositionen in einer ersten Ebene durchgeführt und danach die Gelenke der Fixationseinheit blockiert -> Fraktur stabilisiert.The reduction unit is attached to the fixation unit so that the center of rotation of the reduction unit is aligned with the center of the fracture. Now the rotative and translational reductions are carried out in a first plane and then the joints of the fixation unit are blocked -> fracture stabilized.
Nun werden die Verbindungsschrauben zwischen Repositionseinheit und Fixationseinheit gelöst und die ganze Repositionseinheit in eine zweite, vorzugsweise senkrecht zur ersten Ebene stehenden Ebene geschwenkt. Die Verbindungsschrauben werden wieder angezogen. Nun werden die Gelenke der Fixationseinheit wieder gelöst und die Reposition in der zweiten Ebene durchgeführt. Die Gelenke der Fixationseinheit werden erneut blockiert.Now the connecting screws between the reduction unit and the fixation unit are loosened and the entire reduction unit is pivoted into a second plane, preferably perpendicular to the first plane. The connecting screws are tightened again. Now the joints of the fixation unit loosened again and the reduction was carried out on the second level. The joints of the fixation unit are blocked again.
Die Nachteile dieser Anordnung bestehen darin, dass zur Durchführung einer rotativen Reposition um die Knochenlängsachse ein gelenkiges Parallelogramm zwischen die Fixationseinheit und Repositionseinheit montiert werden muss, was aufwendig und kompliziert ist.The disadvantages of this arrangement are that an articulated parallelogram has to be mounted between the fixation unit and the reduction unit in order to carry out a rotary reduction around the longitudinal axis of the bone, which is complex and complicated.
Hier will die Erfindung Abhilfe schaffen. Der Erfindung liegt das Problem zugrunde, mit einer einzigen Vorrichtung alle Repositionsvorgänge rasch und sicher durchführen zu können.The invention seeks to remedy this. The invention is based on the problem of being able to carry out all repositioning operations quickly and safely with a single device.
Die Erfindung löst die gestellte Aufgabe mit einer Vorrichtung, welche die Merkmale des Anspruchs 1 aufweist.The invention achieves the stated object with a device which has the features of claim 1.
Damit ist der Vorteil erzielbar, das die Reposition um die Knochenlängsachse mittels eines graduell drehbaren Bogenseg- mentes realisiert werden kann, was aufwendige Montagezeiten erspart. This provides the advantage that the reduction around the longitudinal axis of the bone can be achieved by means of a gradually rotatable arc segment, which saves complex assembly times.
Die durch die Erfindung erreichten Vorteile sind im wesentlichen darin zu sehen, dass dank der erfindungsge ässen Vorrichtung eine rasche Reposition der Knochenfragmente, ohne umständliches Umklappen in zwei verschiedenen Ebenen (iteratives Verfahren nach dem Stand der Technik) , ermöglicht.The advantages achieved by the invention are essentially to be seen in the fact that, thanks to the device according to the invention, a rapid reduction of the bone fragments is possible without cumbersome folding in two different levels (iterative method according to the prior art).
Die Erfindung und Weiterbildungen der Erfindung werden im folgenden anhand der teilweise schematischen Darstellungen mehrerer Ausführungsbeispiele noch näher erläutert. Es zeigen:The invention and further developments of the invention are explained in more detail below on the basis of the partially schematic representations of several exemplary embodiments. Show it:
Fig. 1 eine perspektivische Darstellung der erfindungsgemässen Vorrichtung; undFigure 1 is a perspective view of the device according to the invention. and
Fig. 2 eine perspektivische Darstellung der Vorrichtung ge äss Fig. 1 nach erfolgter Translation in Richtung Tz und Rotation um die Achsen Ry und Rz .Fig. 2 is a perspective view of the device according to FIG. 1 after translation in the direction T z and rotation about the axes R y and R z .
Die in den Fig. 1 und 2 dargestellte erfindungsgemässe Vorrichtung zum Reponieren von Knochenfrakturfragmenten umfasst im wesentlichen einen in x-Richtung verlaufenden Stab 1 an dessen Extremitäten je eine Klemmvorrichtung 2 und 3 befestigbar ist. Jede der beiden Klemmvorrichtungen 2 bzw. 3 besteht aus einer Verbindungsbacke 14 und einer daran befestigbaren Klemmbacke 15, welche eine Anzahl von Knochenfixationsmitteln 4, in Form von Schanzschen Schrauben, zur Verankerung in den zu fixierenden Knochenfrakturfragmenten 5,6 aufnehmen kann.The device according to the invention for repositioning bone fracture fragments shown in FIGS. 1 and 2 essentially comprises a rod 1 running in the x direction, to the extremities of which a clamping device 2 and 3 can be fastened. Each of the two clamping devices 2 and 3 consists of a connecting jaw 14 and an attachable thereon Clamping jaw 15, which can hold a number of bone fixation means 4, in the form of Schanz screws, for anchoring in the bone fracture fragments 5, 6 to be fixed.
Der Stab 1 verfügt über insgesamt drei Translationsmittel 7,8,9 und drei Rotationsmittel 10,11,12, welche eine relative Lageänderung der beiden Klemmvorrichtungen 2,3 mit insgesamt sechs Freiheitsgraden mit den Achsen Tχ,Tv,Tz,Rχ,Rv,R2 ermöglicht. Die Achsen Tχ,Ty und Tz der Translationsmittel 7,8,9 spannen dabei ein rechtwinkliges Koordinatensystem auf. Denkbar ist auch ein schiefwinkliges Koordinatensystem, sofern die anfallenden Daten durch einen Rechner erfasst und verarbeitet werden können.The rod 1 has a total of three translating means 7, 8, 9 and three rotating means 10, 11, 12, which change the relative position of the two clamping devices 2, 3 with a total of six degrees of freedom with the axes T χ , T v , T z , R χ , R v , R 2 enables. The axes T χ , T y and T z of the translation means 7, 8, 9 span a right-angled coordinate system. An oblique-angled coordinate system is also conceivable, provided that the data obtained can be recorded and processed by a computer.
Der Stab 1 besteht aus zwei separaten Stabteilen la, lb, wobei der eine Stabteil la durch das Rotationsmittel 10 um einen in der y,z-Ebene liegenden Kreisbogen 13 unter Beibehaltung seiner Parallelität zum anderen Stabteil lb verschiebbar ist. In dem als quaderförmige Platte ausgebildeten Rotationsmittel 10 ist mittels eines Verstellmechanismus 16 der Kreisbogen 13 drehbar gelagert. Der Stabteil la ist lateral fest mit dem Kreisbogen 13 verbunden, so dass sich bei einer Drehung des Verstellmechanismus 16 der Stabteil la zusammen mit dem Kreisbogen 13 gegenüber dem Rotationsmittel 10 längs der vom Kreisbogen 13 definierten Bahn bewegt. Der Kreisbogen 13 weist einen Radius von 50 - 200 mm, vorzugsweise von 80 - 130 mm auf. Je grösser der Radius des Kreisbogens 13 ist, umso entfernter kann die Repositionsvorrichtung von der Knochenlängsachse weg montiert werden. Allerdings sind der Grosse des Radius durch die Verwendung herkömmlicher Schanzscher Schrauben als Knochenfixationsmitteln 4 Grenzen gesetzt.The rod 1 consists of two separate rod parts la, lb, the one rod part la being displaceable by the rotating means 10 around an arc 13 lying in the y, z plane while maintaining its parallelism to the other rod part lb. The circular arc 13 is rotatably supported in the rotary means 10, which is designed as a cuboid plate, by means of an adjusting mechanism 16. The rod part la is laterally firmly connected to the circular arc 13, so that when the adjusting mechanism 16 rotates, the rod part la moves together with the circular arc 13 relative to the rotation means 10 along the path defined by the circular arc 13. The circular arc 13 has a radius of 50-200 mm, preferably 80-130 mm. The larger the radius of the circular arc 13, the further away the reduction device can be mounted away from the longitudinal axis of the bone. However, the size of the radius is limited by the use of conventional Schanz screws as bone fixation means.
Das Translationsmittel 7 für die x-Achse besteht einerseits aus dem Stabteil la und anderseits aus einem hohlzylindrischen Teil 29 in welchem der Stabteil la gelagert ist. Stabteil la und der hohlzylindrischen Teil 29 sind mittels eines Verstellmittels 30, z.B. in Form eines Schrauben/Mutter-Antriebs, in x-Richtung gegeneinander verschiebbar.The translation means 7 for the x-axis consists on the one hand of the rod part la and on the other hand of a hollow cylindrical part 29 in which the rod part la is mounted. Rod part la and the hollow cylindrical part 29 are by means of an adjusting means 30, e.g. in the form of a screw / nut drive, can be moved against each other in the x direction.
Die Reihenfolge der Translationsmittel 7,8,9 und Rotationsmittel 10,11,12 entspricht - in x-Richtung gesehen - der Sequenz x' x' z '^y'^z '^y*The order of the translation means 7, 8, 9 and rotation means 10, 11, 12 corresponds - seen in the x direction - to the sequence x 'x' z '^ y' ^ z '^ y *
Bei der in Fig. 1 gezeigten Ausführung sind die Translationsmittel 8,9 für die Achsen Ty,Tz und das Rotionsmittel 10 für die Achse Rχ zu einer Einheit verbunden; sie können aber auch jedes für sich oder paarweise verbunden ausgebildet sein.In the embodiment shown in FIG. 1, the translation means 8, 9 for the axes T y , T z and the rotation means 10 for the axis R χ are connected to one unit; but they can also be designed individually or in pairs.
Das Translationsmittel 9 für die z-Achse besteht aus zwei in z-Richtung mittels eines Antriebs 17 gegeneinander verschieb- lichen quaderförmigen Platten, wobei der eine Plattenteil 18 fest mit dem Rotationsmittel 10 verbunden ist und eine nutenformige Bahn aufweist, in welcher der andere Plattenteil 19 als Schlitten beweglich gleitend angeordnet ist und mittels des Antriebs 17 verschoben werden kann.The translation means 9 for the z-axis consists of two parallelepiped-shaped plates which can be displaced in the z-direction by means of a drive 17, one plate part 18 is fixedly connected to the rotation means 10 and has a groove-shaped path in which the other plate part 19 is movably slidably arranged and can be displaced by means of the drive 17.
Das Translationsmittel 8 für die y-Achse besteht ebenfalls aus zwei in y-Richtung mittels eines Antriebs 20 gegeneinander verschieblichen, quaderförmigen Platten, wobei der eine - als Schlitten ausgebildete - Plattenteil 21 fest mit dem schlitten- förmigen Plattenteil 19 des Translationsmittels 9 verbunden ist und innerhalb der nutenförmigen Bahn des anderen Plattenteils 22 mittels des Antriebs 20 verschoben werden kann.The translation means 8 for the y-axis likewise consists of two cuboid plates which can be displaced in the y direction by means of a drive 20, the one plate part 21, which is designed as a slide, being fixedly connected to the slide-shaped plate part 19 of the translation means 9 and can be moved within the groove-shaped path of the other plate part 22 by means of the drive 20.
Der Plattenteil 22 des Translationsmittels 8 ist fest mit dem Rotationsmittel 12 verbunden, welches aus zwei gelenkig miteinander verbundenen Teilen 23,24 besteht, welche mittels eines Verstellmechanismus 25 um die Rotationsachse Rz gegeneinander rotiert werden können. Der eine Gelenkteil 23 ist fest mit dem Plattenteil 22 des Translationsmittels 8 verbunden währenddem der andere Gelenkteil 24 mit dem Rotationsmittel 11 verbunden ist.The plate part 22 of the translation means 8 is fixedly connected to the rotation means 12, which consists of two parts 23, 24 which are connected to one another in an articulated manner and which can be rotated relative to one another about the axis of rotation Rz by means of an adjustment mechanism 25. One hinge part 23 is fixedly connected to the plate part 22 of the translation means 8, while the other hinge part 24 is connected to the rotation means 11.
Das Rotationsmittel 11 besteht ebenfalls aus zwei gelenkig miteinander verbundenen Teilen, wobei das eine Teil aus dem Gelenkteil 24 des Rotationsmittels 12 besteht und das andere Teil 26 mit dem Stabteil lb fest verbunden ist. Die beiden Gelenkteile 24 und 26 sind mittels eines Verstellmechanismus 27 um die Rotationsachse Ry gegeneinander rotierbar.The rotation means 11 also consists of two parts which are connected to one another in an articulated manner, one part consisting of the joint part 24 of the rotation means 12 and the other Part 26 is firmly connected to the rod part lb. The two joint parts 24 and 26 can be rotated relative to one another about the axis of rotation Ry by means of an adjusting mechanism 27.
Das Gelenkteil 24 besteht - um seine Funktion ausführen zu können - aus zwei um 90° gegeneinander verdrehten Halbkreisbogen mit je einem peripheren Zahnkranz 28. Die als Schnecken ausgebildeten Zahnradantriebe 25 und 27 greifen in die ihnen zugeordneten Zahnkränze 28 ein, so dass dadurch die beiden als Gelenke ausgebildeten Rotationsmittel 11 und 12 um die Achsen Ry und Rz bewegbar sind.The joint part 24 consists - in order to be able to perform its function - from two semicircular arcs rotated by 90 ° relative to one another, each with a peripheral ring gear 28. The gear drives 25 and 27 designed as screws engage in the ring gears 28 assigned to them, so that the two as Articulated rotating means 11 and 12 are movable about the axes Ry and Rz.
Nach einer erfolgten Translation in Richtung T2 und Rotation um ddiiee AAcchhsseenn RRyy uunndd RRzz sstteelllltt ssiicchh ddie erfindungsgemässe Vor- richtung nach Fig. 1 wie in Fig. 2 dar.After a translation in the direction of T 2 and rotation around the axis, the RR yy and the RR zz sstteelllltt ssiicchh d the inventive device according to FIG. 1 as shown in FIG. 2.
Nachstehend wird anhand eines Beispiels das operative Vorgehen bei einer Anwendung der Repositionsvorrichtung mit einem Fixateur externe beschrieben.The operative procedure when using the repositioning device with an external fixator is described below using an example.
Beispiel A) Beide Frakturfragmente werden mit je 2 Schanzschen Schrauben versehen, welche danach mit je einer Standardbacke der Fixationseinheit verbunden werden.example A) Both fracture fragments are each provided with 2 Schanz screws, which are then connected to a standard jaw of the fixation unit.
B) Mittels zweier Backenadapter wird die Repositionseinheit mit den Standardbacken verbunden. Diese Montage bildet die Ausganssituation für die nachfolgende Reposition. Als 1. Schritt wird an der Fraktur eine Winkelkorrektur durchgeführt.B) The reduction unit is connected to the standard jaws using two jaw adapters. This assembly forms the starting situation for the subsequent reduction. The first step is to perform an angle correction on the fracture.
C) Auftretende Translativabweichungen werden durch eine translative Korrektur ausgeglichen. Etwelche Abweichungen in den anderen zwei Ebenen werden wie oben (Punkt B) beschrieben korrigiert. Nach abgeschlossener Prozedur ist die Fraktur vollumfänglich korrigiert. Nun kann ein Längsstab durch die beiden Standardbacken eingeführt und fixiert werden, so dass die Fraktur stabilisiert ist.C) Occurring translative deviations are compensated for by a translative correction. Any deviations in the other two levels are corrected as described above (point B). After the procedure has been completed, the fracture is fully corrected. A longitudinal rod can now be inserted and fixed through the two standard jaws so that the fracture is stabilized.
D) Nun werden die beiden Backenadapter von der Fixationseinheit getrennt. Letztere verbleibt am Patienten, bis die Fraktur abgeheilt ist.D) Now the two jaw adapters are separated from the fixation unit. The latter remains on the patient until the fracture has healed.
Statt der Anwendung mit einem Fixateur externe kann die erfindungsgemässe Vorrichtung auch zur winkelstabilen Verplattung von Knochenfrakturen oder zur Nagelung mit Marknägeln verwendet werden. Für die winkelstabile Verplattung hat sich der Einsatz von nicht-invasiven Knochenklammern (gemäss der EP 457.017) statt der Schanzschen Schrauben als vorteilhaft erwiesen. Instead of being used with an external fixator, the device according to the invention can also be used for angle-stable plating of bone fractures or for nailing with intramedullary nails. For angle-stable plating the use of non-invasive bone staples (according to EP 457.017) instead of Schanz screws has proven to be advantageous.

Claims

Patentansprüche claims
1. Vorrichtung zum Reponieren von Knochenfrakturfragmenten, mit einem in x-Richtung verlaufenden Stab (1) an dessen Extremitäten je eine Klemmvorrichtung (2,3) befestigbar ist, welche je eine Anzahl von Knochenfixationsmitteln (4) zur Verankerung in den zu fixierenden Knochenfrakturfragmenten (5,6) aufnehmen kann, wobei der Stab (1) über zwei Translationsmittel (7,8) und zwei Rotationsmittel (10; 11) verfügt, welche eine relative Lageänderung der beiden Klemmvorrichtungen (2,3) ermöglichen, dadurch gekennzeichnet, dass der Stab (1) zusätzlich über ein weiteres Translationsmittel (9) und ein weiteres Rotationsmittel (12) verfügt, so dass die Vorrichtung über insgesamt 6 Freiheitsgrade mit den Achsen Tχ,Ty,Tz,Rχ,Ry,Rz verfügt.1.Device for repositioning bone fracture fragments, with a rod (1) running in the x direction, a clamping device (2, 3) can be attached to the extremities of each, which each has a number of bone fixation means (4) for anchoring in the bone fracture fragments to be fixed ( 5,6), the rod (1) having two translation means (7,8) and two rotation means (10; 11), which allow a relative change in position of the two clamping devices (2, 3), characterized in that the Rod (1) additionally has a further translation means (9) and a further rotation means (12), so that the device has a total of 6 degrees of freedom with the axes T χ , T y , T z , R χ , R y , R z .
2. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass die A Acchhsseenn TTχV.,TTyV uunndd TTz7 ddeerr TTrraannssllaattiioonnssmmiittel (7,8,9) ein rechtwinkliges Koordinatensystem aufspannen.2. Device according to claim 1, characterized in that the A Acchhsseenn TT χV. , TT yV and TT z7 ddeerr TTrraannssllaattiioonnssmmiittel (7,8,9) clamp a right-angled coordinate system.
3. Vorrichtung nach Anspruch 2, dadurch gekennzeichnet, dass der Stab (1) aus zwei separaten Stabteilen (la, lb) besteht, wobei der eine Stabteil (la) durch das Rotationsmittel (10) um einen in der y,z-Ebene liegenden Kreisbogen (13) unter Beibehaltung seiner Parallelität zum anderen Stabteil (lb) verschiebbar ist. 3. Device according to claim 2, characterized in that the rod (1) consists of two separate rod parts (la, lb), the one rod part (la) by the rotation means (10) lying around in the y, z plane Circular arc (13) is displaceable while maintaining its parallelism to the other rod part (lb).
4. Vorrichtung nach Anspruch 3, dadurch gekennzeichnet, dass der Kreisbogen (13) einen Radius von 50 - 200 mm.4. The device according to claim 3, characterized in that the circular arc (13) has a radius of 50-200 mm.
5. Vorrichtung nach Anspruch 3, dadurch gekennzeichnet, dass der Kreisbogen (13) einen Radius von 80 - 130 mm aufweist.5. The device according to claim 3, characterized in that the circular arc (13) has a radius of 80-130 mm.
6. Vorrichtung nach einem der Ansprüche 1 bis 5, dadurch gekennzeichnet, dass die Reihenfolge der Translationsmittel (7,8,9) und Rotationsmittel (10,11,12) in x-Richtung gesehen der Sequenz Tχ,Rχ,Tz ,Ty,Rz,Ry entspricht.6. Device according to one of claims 1 to 5, characterized in that the sequence of the translation means (7,8,9) and rotation means (10,11,12) seen in the x direction of the sequence T χ , R χ , T z , T y , R z , R y corresponds.
7. Vorrichtung nach einem der Ansprüche 1 bis 6 , dadurch gekennzeichnet, dass die Translationsmittel (8,9) für die Achsen Ty,Tz zu einer Einheit verbunden sind.7. Device according to one of claims 1 to 6, characterized in that the translation means (8,9) for the axes T y , T z are connected to form a unit.
8. Vorrichtung nach einem der Ansprüche 1 bis 7 , dadurch gekennzeichnet, dass die Translationsmittel (8,9) für die Achsen Ty,Tz und das Rotionsmittel (10) für die Achse Rχ zu einer Einheit verbunden sind.8. Device according to one of claims 1 to 7, characterized in that the translation means (8,9) for the axes T y , T z and the rotation means (10) for the axis R χ are connected to a unit.
9. Vorrichtung nach Anspruch 1, dadurch gekennzeichnet, dass die Achsen Tχ,Ty und Tz der Translationsmittel (7,8,9) ein schiefwinkliges Koordinatensystem aufspannen. 9. The device according to claim 1, characterized in that the axes T χ , T y and T z of the translation means (7,8,9) span an oblique-angled coordinate system.
10. Vorrichtung nach einem der Ansprüche 1 bis 9, dadurch gekennzeichnet, dass die Klemmvorrichtung (2;3) eine Verbindungsbacke (14) und eine daran befestigbare Klemmbacke (15) umfasst und die Knochenfixationsmittel (4) in die Klemmbacke (15) einführbar sind. 10. Device according to one of claims 1 to 9, characterized in that the clamping device (2; 3) comprises a connecting jaw (14) and a jaw (15) which can be fastened thereon and the bone fixation means (4) can be inserted into the jaw (15) .
EP97944675A 1996-11-13 1997-10-27 Device for repositioning fractured bone fragments Withdrawn EP0948291A1 (en)

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DE29619711U DE29619711U1 (en) 1996-11-13 1996-11-13 Device for repositioning bone fracture fragments
DE29619711U 1996-11-13
PCT/CH1997/000406 WO1998020802A1 (en) 1996-11-13 1997-10-27 Device for repositioning fractured bone fragments

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