WO2000006040A1

WO2000006040A1 - Bolt for immobilizing a bone fracture

Info

Publication number: WO2000006040A1
Application number: PCT/EP1999/005534
Authority: WO
Inventors: Roland Eberlein; Lothar Wilberg
Original assignee: Impag Gmbh Medizintechnik
Priority date: 1998-07-30
Filing date: 1999-07-30
Publication date: 2000-02-10
Also published as: DE19834326C2; DE19834326A1

Abstract

A bolt (10; 24) for immobilizing the fracture of a bone (12) of the human or animal skeleton. The inventive bolt can be fixed to parts of the bone by means of screws (31), nails or the like. It consists of one or several modular elements (16, 18, 20, 22; 26) that can be assembled to form a coherent structure.

Description

Bar for the restoration of a fracture of a bone

The invention relates to a latch for immobilizing a fracture of a bone of the human or animal skeleton, which can be fastened to the bone parts to be connected by means of screws, nails or the like.

Such a bar is generally known. In the event of a bone fracture, a plate-shaped latch is attached to the bone parts for osteosynthesis, ie to support the growing together of the broken bone parts or of chipped or chipped pieces of bone. The site is spanned roughly across the course of the fracture and the parts of the bone that are to grow together are fixed together.

The conventional bars are designed as one-piece rigid plates which are fastened to the bone parts by means of screws, nails or the like.

The one-piece, rigid bars, usually made of stainless steel, are disadvantageous. With these one-piece plate-shaped bars, only those fractured areas of the skeleton can be fixed that have an essentially flat, flat structure, that is to say generally only bone plates. However, these conventional one-piece plate-shaped bars cannot be attached to such broken bone parts which are essentially not flat, but rather, owing to the anatomical structure, form corners, edges, bulges, bends or the like.

In other words, the conventional bars are not adapted to all complicated anatomical structures of the skeleton. The lower jaw bone of the human skeleton, for example, has an arched structure in the chin area. If the chin breaks in the area of the chin tip, the two chin parts cannot therefore be fixed to one another by means of a conventional latch, since its geometry is not adapted to the special curved structure of the chin. In this case, it would be necessary to produce a one-piece bar that is shaped accordingly. However, such a specially shaped bar could then only be used for the application for which it was specially manufactured. Because the human or animal skeleton, however has countless different spatial or flat structures, it would therefore be necessary to have a correspondingly large number of specially shaped bars ready. The production, warehousing and storage during an operation of bars specially shaped for each special application in the area of the entire skeleton would be cumbersome and associated with prohibitively high costs.

The geometry of the bar to be used may also depend on the course of the fracture itself. If, for example, the course of the fracture has many branches, or if many fragments of bone are chipped off in the event of debris, it would be necessary to adapt the conventional bar to the specific course of the fracture. The number of bars to be kept would thus increase even further.

Bars are also known which are made with a lower material thickness and which are then bent to the required structure during or shortly before the operation. However, the flexible one-piece latches are also disadvantageous. Due to their flexibility, these bars have a reduced stiffness, which means that a secure fixation of the broken bone is not guaranteed.

The invention is therefore based on the object of developing a latch of the type mentioned in such a way that the latch can be used to immobilize a single or multiple fracture of a bone at any point in the human or animal skeleton, the costs for the latch being kept low should. According to the invention, this object is achieved in that the latch is formed from one or more module modules which can be joined together to form a coherent structure.

The latch according to the invention therefore differs from the conventional one-piece plate-shaped latches in that it is formed from one or more module modules, in such a way that one module or one or more module modules can be used to produce a latch with a coherent flat or spatial structure, which is adapted to the particular structure of the bone to be treated. The adaptation of the bar to the structure of the bone parts to be connected is thus not achieved by having a specially shaped one-piece bar available for each skeletal area, but rather by holding one or more modular building blocks in the manner of a modular system, which are arranged in a manner that corresponds to the structure of the structure to be joined together to connect the bone parts. The inventive design of the bar significantly reduces the cost, while at the same time increasing the versatility of the bar. The number of module modules used depends on the respective application. In the simplest case, it may be sufficient to attach a module block, in the case of more complicated structures or fracture profiles, several module blocks can be put together. In contrast to the known flexible bars, the module blocks can be designed with high rigidity or even rigid. The object underlying the invention is thus completely achieved.

In a preferred embodiment, at least a first component of module components is provided, which comprises at least one plate-shaped locking element, at least two of which can be connected essentially rigidly to one another in a substantially straight extension.

With this first type of module building blocks, an essentially straight plate-shaped bar can be assembled, which, however, has the considerable advantage over the conventional one-piece bars that the length of the bar assembled in this way can be varied by using a smaller or higher number of module building blocks of this type. These locking elements can have a uniform length, or two or three basic lengths can be provided.

In a further preferred embodiment, at least one second component of module components is provided which has at least one plate-shaped locking element which has a joint, the axis of which extends in the plane and transverse to the longitudinal direction of the two parts of the locking element.

With this second component, a module component is provided in the manner of a hinge, so that the two parts of the two-part plate-shaped locking element which are connected to one another by the joint can be pivoted against one another out of their respective planes. With such a module, parts of the bone can be fixed to one another at convex or concave areas of the skeleton generally in areas where the bone parts to be connected are not in the same plane. The joint preferably permits an angular position of one part of the locking element relative to the other part in the range from -90 ° to + 90 ° with respect to the longitudinal direction of the other part. According to the invention, the bolt is also formed by such a bolt element alone.

In a further preferred embodiment, at least a third component of module components is provided, which has at least one plate-shaped locking element, the at least one longitudinal end of which, with a longitudinal end of at least one further locking element of this component, can be mutually at least partially overlapping and pivoted about an axis transverse to the level of the locking elements is.

This component is also advantageous because it creates the possibility of assembling two plate-shaped locking elements of this component into a two-part bolt, in which both parts are arranged in one plane, but the two parts are pivoted against one another in this plane, i.e. the longitudinal axis of one part forms an angle with the longitudinal axis of the other part. With this module, for example, elongated angled bone parts can be fixed to each other.

It is preferred if two locking elements of the third component are connected to one another by means of a joint, the joint axis of which runs transversely to the plane and transversely to the longitudinal direction of the locking elements. This measure has the advantage that two locking elements of the aforementioned third component are already pre-assembled into a two-part locking element. According to the invention, the bolt is also formed by such a bolt element in isolation.

Furthermore, it is preferred if the longitudinal ends of the locking elements of the third component are flattened on one side in the overlap region.

This measure has the advantage that in each case two locking elements of the third component form a surface in the assembled overlapped state due to the flattened longitudinal ends, which is essentially free of projections, steps or the like.

In a further preferred embodiment, the third component comprises a further locking element, the at least one longitudinal end of which is flattened on both sides.

This measure has the advantage that three locking elements of the third component can be joined together to form a T or Y-shaped structure with variable angles between the legs or branches, the joined structure then being free of projections, steps or the like . With this configuration, the latch according to the invention can be designed with arms that branch off at any angle.

In a further preferred embodiment, each component has at least one locking element, one longitudinal end of which has a first engagement means which is associated with a second complementary tär engaging means at a longitudinal end of a locking element of the same component or possibly a different component can be brought into engagement.

This measure has the advantage that the locking elements of each component can be combined with locking elements of the same component or with locking elements of other components. The engagement means mentioned can be designed identically for each component, as a result of which the number of module components can be further reduced.

It is further preferred if the first engagement means and the second engagement means are designed as plug-in means.

This measure has the advantage that two latch elements can be connected to one another in an easy-to-use manner, as a result of which the latch can be quickly assembled into the desired structure in the event of an operation. As a result, several module modules can be temporarily put together quickly to find the optimal bar for the specific application by trying it out.

In a further preferred embodiment, the first engagement means and the second engagement means secure the two interlocking locking elements to one another in the longitudinal direction and in the direction transverse to the level of the locking elements.

The advantage here is that the two locking elements connected to one another via the engagement means are secured to one another without additional fastening elements, as a result of which on the one hand the attachment of the locking elements to the bone parts is facilitated and on the other hand further parts are saved.

In a further preferred embodiment, the first engagement means and the second engagement means are mirror-symmetrical to one another.

This measure has the advantage that the number of different module components for producing the latch can be further reduced with any flat or spatial structures, because in this configuration the first engagement means and the second engagement means can be designed identically except for the mirror symmetry.

Further advantages result from the following description and the attached drawing.

It goes without saying that the features mentioned above and those yet to be explained below can be used not only in the combination indicated in each case, but also in other combinations or on their own without departing from the scope of the present invention.

Exemplary embodiments of the invention are shown in the drawing and are described in more detail below with reference to the figures. Show it:

Figure 1 is a side view of a lower jaw bone with several bars according to the invention attached to it in various embodiments. 2 shows a lower jaw bone in a front view with a further latch according to the invention fastened thereon;

3 shows an exemplary embodiment of a locking element of a first component of module components for the locking bar in FIG. 1 in a view from below;

Figure 4 shows the locking element in Figure 3 in plan view.

5 shows the locking element in FIGS. 3 and 4 in a section along the line V-V in FIG. 4 with further locking elements connected to the locking element;

6 shows an exemplary embodiment of a locking element of a second component of module components for the locking bar in FIG. 1 or the locking bar in FIG. 2 in a top view;

7 shows a further exemplary embodiment of a locking element of the second component which, in contrast to the locking element in FIG. 6, can be connected to the locking element in FIGS. 3 to 5;

8 shows a section through the locking element in FIG. 6 along the line VIII-VIII;

9 shows a section through the locking element in FIG. 6 along the line IX-IX in FIG. 6; 10 shows an exemplary embodiment of a locking element of a third component as a module component for the locking bolts in FIG. 1 in a top view;

11 shows a locking element of the third component similar to the locking element in FIG. 10, which can be connected to the locking element in FIGS. 3 to 5 or the locking element in FIG. 7;

12 shows the locking element in FIG. 10 in a section along the line XII-XII;

13 shows a further locking element of the third component in a top view;

14 shows the locking element in FIG. 13 in a section along the line XIV-XIV;

15 shows a further exemplary embodiment of a locking element of the third component, which is preassembled from two locking elements corresponding to FIG. 10 to form a two-part locking element, in a top view;

16 shows the locking element in FIG. 15 in a view from below;

FIG. 17 shows the locking element in FIG. 15 in a section along the line XVII-XVII in FIG. 15; and 18 shows a composite arrangement consisting of two locking elements according to FIG. 10 and the locking element according to FIG. 14.

1 and 2 show an embodiment of a latch 10 for immobilizing a bone 12 having a multiple fracture, in this case the lower jaw bone of the human skeleton. The multiple fracture of the bone 12 is exemplified by lines 14.

The latch 10 is formed from individual module components 16, 18, 20, 22, which are joined together to form a coherent, flat and spatial structure. In the exemplary embodiment shown in FIG. 1, the latch 10 is assembled from a total of four different module components. Another latch 24 is only constructed from a module block 26.

The individual module components 16, 18, 20, 22 are essentially adapted to the respective structure of the bone parts to be connected to one another.

2 shows a front view of a further lower jaw bone, a latch 28 which is formed from a module 30 which is fastened to the chin tip of the lower jaw bone.

All model blocks are immovably screwed to the bone parts with letter 31. 3 and 4, a locking element 32 of a first component is shown, wherein the locking element 32 corresponds to the module module 20 in FIG. 1. The locking element 32 is designed as an elongated plate, in which two through bores 34, 36 are provided, through which a screw (see FIG. 1) for screwing the locking element 32 to the bone 12 can be passed.

The locking element 32 has a first engagement means 38 at its one longitudinal end and a second engagement means 40 at its other longitudinal end. The first engagement means 38 and the second engagement means 40 are mirror-symmetrical to one another. The first engagement means 38 and the second engagement means 40 have a curved groove 42 which is open on both longitudinal sides of the locking element 32 and whose outer end is delimited by a web 44 which has been reworked in the longitudinal direction of the locking element 32. The groove 42 and the web 44 are designed to be complementary to one another.

5, three such locking elements 32, 32 'and 32' 'are shown connected one behind the other in the longitudinal direction, the first engagement means 38, the locking element 32 with the second engagement means 40' of the locking element 32 'and the second engagement means 40 of the locking element 32 with the the first engagement means 38 ″ of the locking element 32 ″ is engaged.

The engagement means 38 and 40 'or 40 and 38''are interleaved and thus, due to their design, secure the locking element 32''on the locking element 32 and the locking element 32 on the locking element 32' in the longitudinal direction of the locking elements 32, 32 'and 32 '' and in the direction transverse to the plane of the Bolt elements 32, 32 ', 32 *', ie in the directions of a double arrow 46.

The locking elements 32, 32 'and 32' 'are thus essentially rigidly connected to one another in a substantially straight extension.

The locking elements 32 and 32 'or 32' 'can be connected to one another in a simple manner by the engagement means 38 and 40 "or 40 and 38" being pushed one inside the other.

The number of locking elements 32 used can be used, for example, to adapt the length of the locking bar 10 to the particular bone to which the locking bar 10 is to be attached. Locking elements corresponding to the locking element 32 can also be provided, which have interventions only at one end, which then cannot be used as intermediate pieces, but as end pieces.

6 to 9, a locking element 48 of a second component is shown, which corresponds to the module block 16 of the locking bar 10 in FIG. 1.

The locking element 48 is formed from two parts, a first part 50 and a second part 52.

The first part 50 and the second part 52 are connected to one another via a joint 54. The joint 54 is formed by a projection 56 of the first part 50, which engages in a corresponding recess 58 of the second part 52. A pen 60 is inserted through two legs 62 and 64 of the second part 52 and the projection 56 of the first part 50. A hinge axis 66 formed by the pin 60 thus runs in the plane and transverse to the longitudinal direction of the two parts 50 and 52. The first part 50 is relative to the second part 52 about the hinge axis 66 according to two double arrows 68 over an angular range of -95 ° up to + 95 °, based on the longitudinal direction of part 52, pivotable.

The locking element 48 can be used to span concave or convex parts of the bone.

While the bolt 28 in FIG. 2 is formed solely from the bolt element 48, a variant is shown in FIG. 7, in which a bolt element 70 is essentially identical to the bolt element 48, but with a first engagement means 72 and at its two longitudinal ends has a second engagement means 74 which are identical to the engagement means 38 and 40 of the locking element 32. The locking element 70 can thus be combined with the locking element 32.

10 and 12 show a further locking element 76 of a third component, which corresponds to the module block 22 of the locking bar 10 in FIG. 1 or the module block 26 of the locking bar 24 in FIG. 1, the locking bar 24 only comprising the module block 26 alone is formed.

The locking element 76 is in turn formed from an elongated plate, one longitudinal end 78 of which is flattened on one side. A continuous bore 80 is also provided in the longitudinal end 78. Two such locking elements 76, 76 " can now be joined together with mutually overlapping longitudinal ends 78, 78 ', the locking elements 76 and 76' being fastened to one another by a screw, not shown, which is passed through the bores 80 "and 80. It follows that the locking element 76 'can be joined in a pivoted manner with respect to the locking element 70 about an axis 82 which extends transversely to the plane of the locking elements 76' and 76. The locking elements 76 and 76 'can thus be in their common plane to form a V-shaped or L-shaped structure with a adjustable angle between the two are joined, the connection being brought about by the screw through the bores 80 and 80 '.

15 to 17 show an exemplary embodiment similar to the previous exemplary embodiment, in which parts 84 and 86 corresponding to the locking elements 76 and 76 'are pivotably connected to one another via a joint 88 in the form of a rivet 90 or the like to form a two-part locking element 83 . The first part 84 can be pivoted relative to the second part 86 according to double arrows 92 over an angular range from approximately -95 ° to approximately + 95 °. In this exemplary embodiment, the parts 84 and 86 are accordingly preassembled to form the two-part locking element 83.

FIG. 11 shows a further locking element 94 which has an engagement means 96 at one longitudinal end, and is otherwise designed like the locking element 76. The engagement means 96 is again identical to the engagement means 38 and 40 of the locking element 32 in FIGS. 3 and 4 and to the engagement means 72 and 74 of the locking element 70 in FIG. 7, so that these locking elements can be joined together as desired.

Finally, another locking element 98 of the third component is shown in FIGS. 13 and 14, one longitudinal end 100 of which is flattened on both sides. The locking element 98 can, as shown in FIG. 18, with two locking elements 100 and 102, which are designed in the manner of the locking element 76, but the longitudinal ends of which are flattened in the overlap region to one third of the material thickness of the locking element 76 any Y-shaped or T-shaped structure. The locking elements 98, 100 and 102 can be oriented at any relative angular position to one another.

All locking elements described above are preferably made of titanium. The size of the individual plates is in the range of about 0.5 to 1.5 x 1 to 3 cm, with a thickness of about 0.2 to 0.7 mm. The locking elements or their parts are preferably rigid.

It follows from the foregoing that by means of the previously described locking elements of the different components, the locking bar according to the invention can be assembled with any structure adapted to the bone parts to be connected in each case. Each aforementioned locking element can have engagement means of the type described above at both ends, but locking elements can also be provided within the scope of the invention which have engagement means only at one end or at no end, so that these locking elements stand alone or can be used as end pieces of a composite bolt.

Claims

claims

Bolt for immobilizing a fracture of a bone (12) of the human or animal skeleton, which can be fastened to the bone parts to be connected by means of screws (31), nails or the like, characterized in that the bolt (10; 24; 28) consists of one or is formed from a plurality of module components (16; 18, 20, 22; 26; 30) that can be joined together to form a coherent structure.

Bolt according to claim 1, characterized in that at least a first component of module components (20) is provided which has at least one plate-shaped bolt element (32), at least two of which can be connected essentially rigidly to one another in a substantially straight extension.

Bolt according to claim 1 or 2, characterized in that at least one second component of module components (16; 30) is provided, which has at least one plate-shaped bolt element (48) which has a joint (54) whose joint axis (66) in the Level and transverse to the longitudinal direction of the locking element (48).

4. Bolt according to one of claims 1 to 3, characterized in that at least a third component of module modules (18; 26) is provided which has at least one plate-shaped locking element (76; 84), the at least one longitudinal end (78) of which Longitudinal end (78 ') at least one further locking element (76; 86) of this component can be joined together at least partially overlapping one another and pivoted about an axis (82) transversely to the level of the locking elements (76, 76 ').

5. Bolt according to claim 4, characterized in that in each case two bolt elements (84, 86) of the third component are connected to one another by means of a joint (88), the joint axis of which extends transversely to the plane and transversely to the longitudinal direction of the bolt elements.

6. Bolt according to claim 4 or 5, characterized in that the longitudinal ends (78, 78 ') of the bolt elements of the third component are flattened on one side in the overlap region.

7. Bolt according to one of claims 4 to 6, characterized in that the third bolt component comprises a further bolt element (98), the at least one longitudinal end of which is flattened on both sides.

8. Bolt according to one of claims 2 to 7, characterized in that each component has at least one bolt element (32, 32 ', 32'';70; 94), the at least one longitudinal end of which has a first engagement means (38, 38'';72; 96), which can be brought into engagement with a second complementary engagement means (40, 40 ''; 74) on at least one longitudinal end of a locking element of the same or possibly a different component.

9. Bolt according to claim 8, characterized in that the first engagement means (38, 38 ''; 72; 96) and the second engagement means (40, 40 '; 74) are designed as plug-in means.

10. Bolt according to claim 8 or 9, characterized in that the first engagement means (38, 38 ''; 72; 96) and the second engagement means (40, 40 '; 74) the two interconnected locking elements (32, 32', 32 '") in the longitudinal direction and in the direction transverse to the level of the locking elements.

11. Bolt according to one of claims 8 to 10, characterized in that the first engagement means (38, 38 ''; 72; 96) and the second engagement means (40, 40 '; 74) are mirror-symmetrical to each other.

12. latch for immobilizing a fracture of a bone of the human or animal skeleton, which can be fastened to the parts of the bone to be connected by means of screws, nails or the like, characterized in that the latch (24) has a plate-shaped latch element (48) which a has two parts (50, 52) of the locking element (48) connecting joint (54), the hinge axis (66) in the plane and transverse to the longitudinal direction of the locking element (48).

13. latch for immobilizing a fracture of a bone of the human or animal skeleton, which can be fastened to the bone parts to be connected by means of screws, nails or the like, characterized in that the belt gel (28) has a plate-shaped locking element (83) which has a joint (88) connecting two parts (50, 52) of the locking element (48), the joint axis of which extends transversely to the level of the locking element (83).