Source: https://patents.google.com/patent/DE102011053638A1/en
Timestamp: 2019-11-13 16:18:02
Document Index: 466304322

Matched Legal Cases: ['art 14', 'art 14', 'art 14', 'art 14', 'art 14', 'art 25', 'art 25', 'arts 14', 'arts 14', 'art 14', 'art 14', 'art 25', 'art 14', 'art 14', 'art 14', 'art 25', 'art 25', 'art 25', 'art 25', 'art 14', 'art 25']

DE102011053638A1 - Mark Nagel - Google Patents
DE102011053638A1
DE102011053638A1 DE201110053638 DE102011053638A DE102011053638A1 DE 102011053638 A1 DE102011053638 A1 DE 102011053638A1 DE 201110053638 DE201110053638 DE 201110053638 DE 102011053638 A DE102011053638 A DE 102011053638A DE 102011053638 A1 DE102011053638 A1 DE 102011053638A1
DE201110053638
2011-09-15 Application filed by Wittenstein SE filed Critical Wittenstein SE
2011-09-15 Priority to DE201110053638 priority Critical patent/DE102011053638A1/en
2013-03-21 Publication of DE102011053638A1 publication Critical patent/DE102011053638A1/en
An intramedullary nail (1) for distracting a long bone with an at least partially hollow trunk (10) extending in an axial direction of the intramedullary nail (1), locking means for locking the trunk (10) in a first bone fragment (3) of the long bone first inner part (14), which is arranged displaceably in the axial direction within the fuselage (10) and which comprises a radially oriented passage opening for receiving a segment bolt (16) for fixing a bone segment (18) of the long bone, the fuselage (10 ) in the region of the inner part (14) comprises a slot (28) for the passage of the segment pin (16), a drive for axially displacing the first inner part, wherein a second inner part (25) within the fuselage (10) is arranged displaceably in the axial direction ,
The invention relates to an intramedullary nail for a distraction of a long bone and a modular system according to the independent claim.
Intramedullary nails are known from the prior art, which allow a distraction of long bones. Two bone fragments, a distal fragment and a proximal fragment, are displaced relative to one another by means of an intramedullary nail. At the contact point between the two bone fragments bone should regrow. This is achieved by selecting the advancing speed of the intramedullary nail for distraction to be sufficiently small.
Furthermore, it is known from the prior art to use intramedullary nails with a possibility for segment displacement, for example, here is the prior art from the DE 197 08 297 C2 cited. Such segmental displacements allow treatment of large bone defects greater than, for example, 3 cm, as may result from disease or trauma. Also in operations due to bone tumors can cause large bone defects, which can be treated depending on the severity of the disease with an intramedullary nail with segmental displacement.
A challenge with intramedullary nails with segment transport are basically the fixations of the ends of the intramedullary nail in the proximal bone fragment and the distal bone fragment. Another challenge is the stabilization against rotations.
So that beats DE 197 08 297 C2 a guide sleeve, which is fixed with a screwed in the axial direction of the tubular bone screw in the bone fragment. The guide sleeve as an additional component makes the installation of the intramedullary nail in the bone complicated. The guide sleeve also requires extra clearance in the bone fragment, so that the diameter of the opening that must be created in the bone fragment is large. Furthermore, the intramedullary nail of the prior art cited above can not be used for lower leg bones because of its construction.
The object of the invention is to provide an intramedullary nail or a modular system for an intramedullary nail, known from the prior art systems or intramedullary nails are to be improved, in particular, the disadvantages of the prior art should be alleviated or eliminated. It is desirable to have intramedullary nails which require the least possible surgical effort or allow a reliable fixation in the bone fragments. A modular system should be flexibly adaptable to different circumstances, for example different bones or different applications such as segment transport or distraction.
The object is achieved with an intramedullary nail according to claim 1 and a modular system according to the independent claim.
Exemplary intramedullary nails have a hollow body extending in the axial direction of the intramedullary nail. This hull preferably has axially aligned slots for the passage of segment fixing bolts. Placing slots allows a segment of bone to be fixed with a segment fixation pin. The bone segment is usually a part of the bone, which is arranged between a first bone fragment and a second bone fragment. In embodiments, the first bone fragment may be a proximal bone fragment or a distal bone fragment. Accordingly, the second bone fragment is then a distal bone fragment or, in the other case, a proximal bone fragment. Exemplary intramedullary nails are particularly suitable for the treatment of fractures or other damage to long bones, with other lesions such as bone loss due to tumors or trauma may be. Bones that can be treated with typical intramedullary nails are the femur and the tibia but may also be humeral, ulna, radius and fibula. Typical intramedullary nails described herein are particularly suitable for short-lived or under-age patients, since the construction of exemplary intramedullary nails of the invention requires a comparatively short length of bone fragments for locking.
Typical intramedullary nails of the invention include a locking means for locking the trunk in the first bone fragment of the long bone. In this way, the trunk can be fixed with a first bone fragment of the long bone in all directions and all directions of rotation get connected. The trunk is thus fixed in all degrees of freedom with the bone fragment fixed. In particular bolts or screws come into consideration as locking means, which engage in the radial direction through the hull. The screws or bolts allow anchoring of the trunk in the bone fragment.
Typically, the intramedullary nail comprises a drive for axially displacing a first inner part. The first inner part is slidably disposed within the hull in the axial direction. Typical embodiments of the inner part are at least substantially cylindrical. The inner part is preferably free from deformation, i. it has, for example, no radially outwardly projecting pins, or only has openings. The inner part preferably has an internal thread which extends at least over part of the inner circumferential surface near the opening for receiving the drive spindle. Typically, the hull is also cylindrical. Usual hull dimensions have a diameter of the hull over its entire length or at least substantially unchanged over its entire length of a maximum of 13 mm. Other typical intramedullary nails of the invention have trunk diameter of a maximum of 12 mm or a maximum of 11 mm. A small diameter offers advantages, as it facilitates insertion of the intramedullary nail, if necessary, and requires drilling of the medullary cavity only to a small degree.
Preferred first internal parts of the intramedullary nail have at least one radial passage opening for receiving a segment bolt for fixing a bone segment of the long bone. Due to the fact that the segment fixing bolt can also be guided by two oppositely disposed axially aligned slots of the fuselage, the inner part relative to the fuselage is simultaneously locked relative to the fuselage with respect to the rotational freedom about the longitudinal axis of the intramedullary nail. Furthermore, this offers the advantage that the bone segment does not rotate about the longitudinal axis of the intramedullary nail during a treatment.
Other embodiments include a latch for fixing the bone segment. Such a bar offers the advantage of a simple structure. The latch is preferably aligned transversely to the direction of a drive spindle. The latch thus preferably integrally forms both the first inner part and the fixing means. Exemplary multi-piece latch embodiments include an inner member, typically similar to a nut, and a radially extending latch member. For this purpose, the latch is typically provided with a recess. This recess preferably engages positively in a seated on the spindle inner part, which is designed as a threaded member having a centrally disposed internal thread, a. This embodiment allows a reduction in the length or the ability to realize larger Distraktionsstrecken.
The drive is typically received fixed in the hull, so that an insertion of the intramedullary nail is made possible in the tubular bones with recorded drive.
In typical embodiments, the intramedullary nail is constructed so that an insertion of the intramedullary nail into the tubular bone is made possible with the drive received, that is, with the drive received in the trunk. Preferred intramedullary nails allow a procedure with prior installation of the drive (before insertion into the bone) during operations, where fragment fixation bolts or other locking means can be anchored in the bone and intramedullary nail even when already inserted drive. In further embodiments, the drive can also be used later during an operation in the intramedullary nail. In embodiments, in particular in those with subsequently usable drive, means are typically provided for preventing rotation.
Typical intramedullary nails comprise a second inner part, which is arranged to be displaceable within the trunk in the axial direction. By providing a first and a second inner part can be achieved that a segment displacement and also a distraction of the entire bone, that is, a displacement of the two bone fragments can be achieved relative to each other. In particular, in such embodiments, the end of the trunk, which is in the region of the second inner part, displaceable after installation in a bone in the corresponding bone fragment. The bone fragment is typically held over fragment fixation means or fragment fixation pins of the second inner part.
The inner parts are usually arranged axially one behind the other in the hull. In embodiments, the internal parts are immediately adjacent or may even abut one another. This offers the advantage that after a segment transport then an immediate power transmission from inner part to inner part for a distraction is possible. In further embodiments, abutting of the inner parts is not provided. This offers the advantage that at the end of a segment transport when the bone segment bumps against one of the bone fragments, a high pressure can be exerted between the segment and the bone fragment, so that the bone segment merges with the bone fragment is enabled even during distraction following segment transport. In this case, a feed force from the first inner part with bone segment is transmitted to the bone fragment and the second inner part connected thereto, which is thereby pushed backwards in the fuselage.
Typically, the segment transport is such that the bone segment is slowly translated from one bone fragment toward the other bone fragment, with bone growing in the resulting interspace between the initial bone fragment and the bone segment. Details can the patent DE 197 08 279 C2 be removed.
Preferably, the two internal parts are arranged axially behind one another in the hull without a fixed connection. The inner parts are usually displaceable only in the axial direction. In typical intramedullary nails, the inner parts are axially guided. The second inner part is displaceable independently of the first inner part in typical embodiments.
In the region of the second inner part, the fuselage preferably has further oblong holes for the passage of at least one fragment fixing bolt for fixing a second bone fragment of the bone. Typically, two elongated holes aligned in the axial direction of the fuselage are provided opposite in the fuselage for passing the fragment fixing bolt or the plurality of fragment fixing bolts. In this case, "in the region of the second inner part" means, for example, a region in which passage openings of the second inner part lie when the second inner part is displaced in use as intended.
Usually, the second inner part has a radially oriented passage opening for receiving the Fragmentfixierungsbolzens. In typical embodiments, the inner part has two or more radially aligned passage openings for receiving Fragmentfixierungsbolzen.
This offers the advantage that the second bone fragment can be securely locked.
Typical intramedullary nails have a non-driving second inner part. In this case, "without drive" means that the second inner part does not have an independent drive or is not connected to the drive, for example by a spindle engagement or a push rod. In embodiments, the first inner part is fixedly connected to a drive, whereas the second inner part is freely displaceable. In this case, the displacement of the second inner part is preferably limited by a stop or by the first inner part. In operation, in embodiments, the second inner part is displaced only when the bone segment abuts the second bone fragment or when the first inner part abuts directly against the second inner part.
Preferably, a dome curvature is provided at one end of the trunk. This offers the possibility to insert the intramedullary nail in a lower leg bone (tibia). Preferably, the dome curvature is provided at the end of the drive. In typical embodiments, the drive is arranged opposite to the second inner part, that is to say that the first inner part lies between the second inner part and the drive. Preferably, with the exception of the dome curvature and the openings for passing bolts or locking means, the hull is ideally cylindrical. In this case, "ideally cylindrical" means that in particular no other pins or lugs or longitudinal openings are provided on the fuselage. In typical embodiments, the intramedullary nail is formed such that the dome curvature and the drive are disposed proximally. Typically, the drive is distal, i. behind or below, the dome curvature arranged.
As drive, an electric motor with gear and spindle is preferably provided. The transmission is preferably a planetary gear, since it allows high ratios. For power supply and control of the drive, a control unit is typically provided, which can be supplied with power or control signals wirelessly from outside a body, in which the intramedullary nail is inserted, via an antenna. In embodiments, the control unit is capable of wirelessly transmitting or transmitting sensed quantities, such as a force required for displacement or an already traveled displacement. In further embodiments, a shape memory alloy or another drive is provided as drive.
Typically, the first inner part and the second inner part have a cylindrical shape. In conventional embodiments, the diameter of the first inner part and the second inner part is identical. In preferred embodiments, the inner parts have no formations, the inner parts are thus formed without form. This offers the advantage of easy manufacture and safe avoidance of tilting or the like. However, it is also possible to provide lugs in order to specify the position of the internal parts in the hull in addition to the fixing bolts. The term "Ausformungslos" refers to the outer boundary surface of the respective inner part, in particular the first inner part usually has an internal thread. The first inner part is preferably formed as a sleeve which has an internal thread for engagement with the spindle. The second inner part is preferably designed as a cylinder. The first inner part is linearly driven by the spindle element and the adjoining drive positioned in the drive body.
Another aspect relates to a modular system for intramedullary nails, in particular for intramedullary nails for a distraction of a long bone. The modular system comprises a locking body having locking means for locking the locking body in a first bone fragment of the long bone, an axially extending hollow sub-body in which a first inner part is disposed, which is slidably disposed within the sub-body in the axial direction, and which comprises in the radial direction aligned passage opening for receiving a bolt. The stud is typically a fixation stud, particularly a segment fixation stud or a fragment fixation stud for securing a bone segment or a second bone fragment. Furthermore, the modular system typically comprises a drive body comprising a drive disposed in the drive body for axially displacing a first inner part. The locking body, the drive body and the sub-hull are connected in this order with each other to form an intramedullary nail. Welding is used in particular as a connection technique, but it is also possible to provide screw connections or other connections. Welded joints have the advantage that they are space-saving. Preferably, the locking body, the drive body and the sub-body are designed with an identical or in the direction of enumeration decreasing diameter, so that an intramedullary nail can be created, which is easy to insert. In particular, the partial hull preferably has at least an equal or smaller diameter than the drive hull. The locking body or part of the body are preferably made hollow. A hollow executed locking body allows the implementation of a feed line or an antenna or the inclusion of a control unit. The locking means of the locking body typically include radially extending openings for receiving locking bolts or fragment fixing bolts for fixing the first bone fragment to the locking body. In principle, the features described above in connection with the intramedullary nail are also advantageously usable or applicable in the modular system.
In embodiments of the modular system, a partial fuselage with two pairs of opposite oblong holes and additionally a partial fuselage with only one pair of opposite oblong holes are provided. In the latter variant may additionally be provided at least one radial opening for hull-fixed assembly of bolts or no further opening.
In typical embodiments, two variants of locking bodies are provided, wherein a first variant is formed axially straight and a second variant is formed axially angled. The axially straight variant of the locking body is particularly suitable for the treatment of femurs (femur), whereas the variant of the locking body with Herzogkrümmung is particularly suitable for a treatment of the tibia (tibia). In this way, a modular system is created with identical parts, such as drive hull and part of the body, with which several different intramedullary nails can be produced. This can reduce production costs.
Advantageously, the partial hull has a second axially displaceable inner part. Furthermore, the partial hull comprises corresponding axially aligned longitudinal openings, through which further bolts can be passed. In this way it is possible with two displaceable inner parts and corresponding oblong holes in the partial hull to create a possibility for a distraction intramedullary nail with segment displacement.
Generally, in this application, "axial" is used for a direction along the longitudinal axis of the intramedullary nail.
Embodiments will be explained in more detail below with reference to the attached figures, wherein the figures show:
1 shows in a schematic overview an intramedullary nail with segment transport and subsequent distraction in an outline sketch;
2 shows a section of the intramedullary nail of 1 in an initial situation in a sectional view;
3 shows the intramedullary nail the 1 after completed segment transport in a sectional view;
4 shows parts of the intramedullary nail of the 1 in a sectional view after additional disctraction;
5 shows an alternative arrangement of an intramedullary nail in a bone;
6 shows an arrangement of an intramedullary nail in a different bone than in the 1 to 5 ;
7 shows a composite of a modular system first intramedullary nail schematically; and
8th shows a composite of the same modular system further intramedullary nail in a schematic view.
Exemplary embodiments will be explained below with reference to the figures, wherein the same reference numerals are used for the same or similar parts. The same or similar parts may not be explained again in connection with each figure.
In the 1 is an intramedullary nail 1 which is shown in a first bone fragment 3 is locked. The intramedullary nail 1 is with two locking bolts 5 , which serve as locking means, in the first bone fragment 3 fixed. The locking bolts 5 are aligned substantially parallel to the sagittal plane. The intramedullary nail 1 includes a hull 10 , in which passage openings for the locking bolt 5 are arranged. At the end of the intramedullary nail 1 which is in the first bone fragment 3 is locked, is a supply line 12 intended to supply the intramedullary nail with energy and control data.
The hull 10 of the intramedullary nail 1 is partially hollow. In the hull 10 is at the end where the supply line 12 is attached, a drive (in 1 not shown) in the intramedullary nail 1 intended. The drive serves to a first inner part 14 drive. The inner part 14 has a passage opening in which a segment pin 16 is arranged. The segment bolt 16 fixes a bone segment 18 relative to the first inner part 14 , By pressing the drive, the first inner part 14 from the first bone fragment 3 be moved away. The shift direction is with an arrow 20 characterized.
When moving the bone segment 18 grows at a sufficiently slow rate of advance bone after. The regrowing bone arises at the interface between the first bone fragment 3 and the bone segment 18 , After a sufficiently wide feed path, the bone segment hits 18 on a second bone fragment 23 at. In the 1 For example, a distal fragment of a femur bone (thigh) is shown as the first bone fragment and a proximal fragment of the femur bone is shown as a second bone fragment.
Depending on the size of the bone fragments, an opposite insertion of the intramedullary nail may be useful, see 5 , In further embodiments, the drive is not arranged on the locking side end, but on the locking side opposite end. A drive arranged at the locking end presses against the first inner part during displacement of the first inner part, whereas a drive arranged at the opposite end moves the inner part in a pulling manner.
After abutment of the bone segment 18 on the second bone fragment 23 is at further feed in the direction of displacement 20 of the first interior part 14 also a pressure on the second bone fragment 23 exercised. To move the second bone fragment 23 relative to the first bone fragment 3 to enable, so to allow a distraction, is the second bone fragment 23 at a relative to the hull 10 sliding second inner part 25 arranged. The second bone fragment 23 is with two fragment fixing bolts 27 on the second inner part 25 attached. The fragment fixing bolts 27 are identical to the segment pin 16 and the locking bolt 5 educated.
All bolts for fixing are in the 1 and in the 2 aligned substantially parallel to the sagittal plane. Typically, however, a lock is made perpendicular to the sagittal plane. This offers the advantage that setting the bolts or locking means is simplified. Locking in one direction only offers the advantage that the bolts can be set more easily since they all have to be set in the same direction.
By doing that, the advance of the second bone fragment 23 in the distraction after the segment transport of the bone segment 18 about the contact between the bone segment 18 and the second bone fragment 23 takes place between these two bone parts, a pressure which is usually sufficiently large to coalesce the bone segment 18 with the second bone fragment 23 to support.
In the embodiment of the 1 Thus, the first inner part and the second inner part are designed such that the advance of the second bone fragment 23 not over a contact of the internal parts 14 and 25 takes place, but by a contact of the bone segment 18 with the second bone fragment 23 , This offers the advantage that a large pressure can be built up at the contact surface of the bone sections. Alternatively, however, it is also possible for the transmission of force to be carried out at least partially directly from one inner part to the other inner part, for example also by means of one inside the fuselage 10 arranged intermediate part between the two inner parts 14 and 25 ,
In the hull 10 of the intramedullary nail 1 are for the segment bolt 16 in the axial direction of the intramedullary nail 1 aligned slots 28 provided, which a passage of the segment pin 16 allow. From the oblong holes 28 only one is shown.
On the back there is another slot 28 , For the fragment fixing bolts 27 are also long holes 29 at one end of the hull 10 of the intramedullary nail 1 provided, with the end of the slots 29 the end with the locking bolts 5 opposite. The long holes 28 and 29 are arranged axially one behind the other and allow a guide of the bolt.
Typical embodiments have two oppositely disposed axially aligned slots in the region of the inner part or first inner part. Other embodiments have only one side of a slot. In addition, a further elongated hole or can be provided more slots, in particular in the region of a second inner part. The at least one further slot is typically axially displaced from the at least one first slot, i. arranged at a position different in the axial direction of the intramedullary nail.
Furthermore, in the 1 dashes the position of the second bone fragment 23 shown after distraction. The bone can be extended by embodiments of the invention after completed segment transport to a considerable extent.
In the 2 to 4 are different states of the intramedullary nail 1 of the 1 shown in the 2 to 4 only a section of the intramedullary nail and the bone is shown very schematically. For example, the locking means for locking the intramedullary nail 1 in the first bone fragment 3 not shown.
In the 3 is also a drive motor 30 partially shown. The drive motor 30 is in the multi-part hull 10 added. The multipartite of the hull 10 will be later related to the 7 and 8th explained in more detail. With the engine 30 is about a gearbox 32 a spindle 34 driven, which with an internal thread of the first inner part 14 is engaged. With the drive, it is possible a segment transport of the bone segment 18 perform by passing over the spindle 34 the first inner part 14 in the direction of the second inner part 25 is pressed.
Typical embodiments include a motor as a drive. Other drives that can be used advantageously are permanent magnets driven by external magnetic fields, piezo elements, shape memory alloys or pneumatic drives.
In the 3 are also the slots 28 Once again, showing the passage of the segment pin 16 (Slots 28 ) and the fragment fixing bolt 27 (Slots 29 ) enable.
In the 3 the intramedullary nail is shown in a state in which the first inner part 14 so far shifted that the bone segment 18 on the second bone fragment 23 abuts. Will now be the engine 30 continue to operate and thus the first inner part 14 pressed further, there is a shift of the second bone fragment 23 in the direction of the displacement direction of the first inner part 14 , About the second bone fragment 23 is also the second inner part 25 towards the end of the intramedullary nail 1 postponed. This causes, after segmental transport of the bone segment 18 towards the second bone fragment 23 a distraction takes place. This requires a displaceable arrangement of the hull 10 in the second bone fragment 23 , The length of the maxillary bone structure of the intramedullary nail 3 determined by the length of the slot 28 , wherein the distance of the possible segment transport from the length of the slot 28 less the length of the slot 29 results.
In the 4 the state is shown at the conclusion of the distraction shift. The second inner part 25 is shifted so far that the end of the two fragment fixing bolts 27 at the end of the slot 29 of the hull 10 abuts. It should be noted that in the 2 to 4 not the regrown bone between the first bone fragment 3 and the bone segment 18 is shown. This is only for clarity.
The gear 32 is a planetary gear and allows a high gear ratio. Furthermore, the intramedullary nail comprises 1 a control unit, which via the supply line 12 with the intramedullary nail 1 connected is. The control unit enables wireless communication from outside the body to the control unit and thus wireless control of the intramedullary nail 1 , The engine can also be controlled via the control unit 30 of the intramedullary nail 1 be supplied with energy, wherein the power transmission to the control unit is also wireless.
In the 5 is one opposite the 1 opposite insertion of the intramedullary nail 1 in shown in a femur bone. In the embodiment of the 5 is the first bone fragment 3 the proximal fragment of the bone and the second bone fragment 23 the distal bone fragment of the bone. Otherwise, analogously to the description of 1 directed. The configuration of 5 can offer particular advantages when the distal bone fragment is particularly small.
In the 6 is the installation of an intramedullary nail 1 shown in a tibia bone. The locking of the intramedullary nail 1 takes place in the frontal or lateral plane. It is also possible to use intramedullary nails for tibial bone with a dome curvature, as in the example of 8th is shown. Furthermore, a reverse installation of the intramedullary nail in a tibial bone is possible, wherein in a reverse installation, the supply line 12 preferably at the end of the second inner part 25 is arranged. This allows insertion of the intramedullary nail 1 in the tibial bone from the distal side of the tibial bone, in which case can be dispensed with the Herzogkrümmung.
The 7 and 8th show different intramedullary nails 1 which can be assembled with a modular system according to embodiments.
The modular system comprises various modules, wherein two variants of locking bodies are provided for the locking module, namely a first locking body 41 , which is currently formed and a second locking body 42 , which is angled axially. "Axial Angled" means that the locking body 42 in the axial direction of the intramedullary nail 1 has an angle of a few degrees, for example between 2 ° and 20 ° or between 3 ° and 15 °, a so-called dome curvature. Therefore, the intramedullary nail 1 of the 8th with the dome curvature of the lock hull 42 especially suitable for tibia bones.
To the lock hulls 41 and 42 is each a drive hull 45 welded, in which a drive, for example. A motor, and a transmission are added. To the drive hulls 45 is at the other end again in each case a partial body 47 welded, which axially aligned slots 28 and 29 having. The drive hulls 45 and the sub-hulls 47 are at the medulla nails the 7 and 8th identical. For this reason, with a limited number of parts, it is possible to manufacture various intramedullary nails, which can reduce production costs. Furthermore, it is possible to variably provide a segment transport or execute the intramedullary nail only as Distraktionsmarknagel. So includes the intramedullary nail 1 of the 7 only one segment bolt 16 which, however, is used for fixing a second bone fragment, that is to say as a fragment fixing bolt. The second inner part 25 will not be needed then. Alternatively, a first inner part can be used, which then shifts a second inner part directly by contact between the inner parts. Typically, all slots remain, so first slots 28 and second slots 29 to reduce the number of parts also obtained when using the intramedullary nail as a pure distraction nail. However, if a longer distraction distance is required or if the intramedullary nail has to be shortened for anatomical or other reasons in comparison to the distraction length, the oblong hole can 29 fall off and the intramedullary nail are shortened.
The intramedullary nail 1 of the 8th includes such as those related to 1 to 6 described intramedullary nails a first inner part 14 together with a segment bolt 16 so with the intramedullary nail 1 of the 8th a segment transport is possible.
Next to it is the intramedullary nail 1 of the 8th also over a second inner part 25 for a distraction.
In further embodiments, the second inner part is lockable. This offers the advantage that in applications in which no distraction distance is required, a corresponding intramedullary nail with segment transport can be created by simply locking the second inner part. Further embodiments of a modular system additionally comprise a partial body which has only slots for receiving a fixation means for a bone segment. Fixing means for fixing the second bone fragment are received in such embodiments in radial openings of the partial hull, wherein a displacement of the fixing means for the second bone segment is not possible, for example by fixed radial openings.
The modular design of the modular system allows the execution of different intramedullary nails with a limited number of parts. Beyond the examples shown, there are further possibilities for assembling intramedullary nails with the components shown. For example, it is possible to provide shorter or longer sub-hulls to produce intramedullary nails for different bone lengths with the same drive hull. The invention is not limited to the embodiments described above, but the scope of the invention is determined by the claims. In particular, not all parts shown are necessarily features of the invention, this is particularly true for the human bones shown.
First bone fragment
First inner part
Second bone fragment
Second inner part
Fragment fixation pin
locking hulls
part fuselage
DE 19708297 C2 [0003, 0005]
DE 19708279 C2 [0017]
Intramedullary nail ( 1 ) for a distraction of a long bone with - in an axial direction of the intramedullary nail ( 1 ) extending at least partially hollow fuselage ( 10 ), - a locking means for locking the hull ( 10 ) in a first bone fragment ( 3 ) of the long bone, - a first inner part ( 14 ), which within the fuselage ( 10 ) is arranged displaceably in the axial direction and a fixing means ( 16 ) for fixing a bone segment ( 18 ) of the long bone, the trunk ( 10 ) in the region of the inner part ( 14 ) at least one slot ( 28 ) for carrying out the fixing agent ( 16 ), - a drive for axially displacing the first inner part, characterized by a second inner part ( 25 ), which within the fuselage ( 10 ) Is arranged displaceably in the axial direction.
Intramedullary nail ( 1 ) according to claim 1, characterized in that the hull ( 10 ) in the region of the second inner part ( 25 ) at least one additional slot ( 29 ), in particular opposite elongated holes ( 29 ), for carrying out at least one fragment fixing bolt ( 27 ) for fixing a second bone fragment ( 23 ) of the long bone.
Intramedullary nail ( 1 ) according to claim 1 or 2, characterized in that the second inner part ( 25 ) at least one aligned in the radial direction passage opening for receiving the Fragmentfixierungsbolzens ( 27 ).
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the first inner part ( 14 ) aligned in the radial direction passage opening for receiving a segment pin ( 16 ) as a fixing agent.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the internal parts ( 14 . 25 ) axially one behind the other in the hull ( 10 ) are arranged.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the drive is fixed in the hull ( 10 ), so that insertion of the intramedullary nail ( 1 ) is possible in the long bones with recorded drive.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the diameter of the hull ( 10 ) is unchanged over its entire length and / or maximum 13mm.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that at one end of the hull ( 10 ) a Herzogkrümmung is provided.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the drive in the fuselage ( 10 ) opposite the second inner part ( 25 ) is arranged.
Intramedullary nail ( 1 ) according to one of the preceding claims, characterized in that the first inner part ( 14 ) and / or the second inner part ( 25 ) have a cylindrical shape.
Modular system for intramedullary nails ( 1 ), in particular for intramedullary nails ( 1 ) for a distraction of a long bone, comprising: - a locking body ( 41 . 42 ) with a locking means ( 5 ) for locking the locking body ( 41 . 42 ) in a first bone fragment ( 3 ) of the long bone, - a hollow partial body extending in an axial direction ( 47 ), in which an inner part ( 14 . 25 ), which within the sub-hull ( 47 ) in the axial direction of the partial hull ( 47 ) is slidably disposed, - a drive body ( 45 ) comprising a drive mounted in the drive body ( 45 ) is arranged for axial displacement of the inner part ( 14 . 25 ), - the locking body ( 41 . 42 ), the drive body ( 45 ) and the partial hull ( 47 ), in particular as prefabricated components, in this order together to form an intramedullary nail ( 1 ) are characterized in that the sub-hull ( 47 ) in the region of the inner part ( 14 ) at least one slot ( 28 ), and further at least one opposite the first slot ( 28 ) axially displaced further slot ( 29 ), in particular further opposite oblong holes ( 29 ), having.
Modular system according to claim 11, characterized in that two variants of locking hulls ( 41 . 42 ) are provided, wherein a first variant of Verrieglungsrümpfe ( 41 ) axially straight and a second variant of Verrieglungsrümpfe ( 42 ) is formed axially angled, so that with the second variant, in particular an intramedullary nail ( 1 ) can be produced with Herzogkrümmung.
Modular system according to claim 11 or 12, characterized in that the partial hull ( 47 ) two axially displaceable internal parts ( 14 . 25 ) having.
Modular system according to claim 11, 12 or 13, characterized in that the first inner part ( 14 ) is designed as a one- or multi-part latch.
DE201110053638 2011-09-15 2011-09-15 Mark Nagel Pending DE102011053638A1 (en)
DE201110053638 DE102011053638A1 (en) 2011-09-15 2011-09-15 Mark Nagel
ES12184025.0T ES2587839T3 (en) 2011-09-15 2012-09-12 Spinal nail
EP12184025.0A EP2570092B1 (en) 2011-09-15 2012-09-12 Marrow nail
PL12184025.0T PL2570092T3 (en) 2011-09-15 2012-09-12 Marrow nail
US13/613,932 US9138266B2 (en) 2011-09-15 2012-09-13 Intramedullary nail
DE102011053638A1 true DE102011053638A1 (en) 2013-03-21
ID=46924289
DE201110053638 Pending DE102011053638A1 (en) 2011-09-15 2011-09-15 Mark Nagel
US (1) US9138266B2 (en)
EP (1) EP2570092B1 (en)
DE (1) DE102011053638A1 (en)
ES (1) ES2587839T3 (en)
PL (1) PL2570092T3 (en)
EP2990002A1 (en) 2014-09-01 2016-03-02 Wittenstein AG Intramedullary nail
DE102016104115A1 (en) 2016-03-07 2017-09-07 Wittenstein Se Receiver
CN103479420A (en) * 2013-10-12 2014-01-01 李建民 Intramedullary nail
TR201414656A2 (en) * 2014-12-04 2016-06-21 Salih Bugra Erdem A biomedical intramedullary device.
EP3437577A1 (en) 2017-08-01 2019-02-06 Medizinische Hochschule Hannover Universal modular bone segment transport device
2011-09-15 DE DE201110053638 patent/DE102011053638A1/en active Pending
2012-09-12 PL PL12184025.0T patent/PL2570092T3/en unknown
2012-09-12 EP EP12184025.0A patent/EP2570092B1/en active Active
2012-09-12 ES ES12184025.0T patent/ES2587839T3/en active Active
2012-09-13 US US13/613,932 patent/US9138266B2/en active Active
DE102014112573A1 (en) 2014-09-01 2016-03-03 Wittenstein Ag Mark Nagel
EP3216491A1 (en) 2016-03-07 2017-09-13 Wittenstein Se Receiver
PL2570092T3 (en) 2016-12-30
EP2570092A2 (en) 2013-03-20
ES2587839T3 (en) 2016-10-27
US20130072932A1 (en) 2013-03-21
EP2570092B1 (en) 2016-06-22
EP2570092A3 (en) 2013-04-17
US9138266B2 (en) 2015-09-22
JP2011507639A (en) 2011-03-10 Surgical drill sight
JP5797646B2 (en) 2015-10-21 K-wire and surgical method