SE433166B - Device for withdrawing a pin in a fixing member - Google Patents
Device for withdrawing a pin in a fixing memberInfo
- Publication number
- SE433166B SE433166B SE8205723A SE8205723A SE433166B SE 433166 B SE433166 B SE 433166B SE 8205723 A SE8205723 A SE 8205723A SE 8205723 A SE8205723 A SE 8205723A SE 433166 B SE433166 B SE 433166B
- Authority
- SE
- Sweden
- Prior art keywords
- pin
- sleeve
- end portion
- femoral neck
- nail
- Prior art date
Links
- 210000002436 femur neck Anatomy 0.000 claims abstract description 16
- 230000008878 coupling Effects 0.000 claims abstract description 15
- 238000010168 coupling process Methods 0.000 claims abstract description 15
- 238000005859 coupling reaction Methods 0.000 claims abstract description 15
- 210000000988 bone and bone Anatomy 0.000 claims abstract description 8
- 239000012634 fragment Substances 0.000 claims abstract description 4
- 208000010392 Bone Fractures Diseases 0.000 claims abstract 4
- 238000000605 extraction Methods 0.000 claims description 9
- 208000020089 femoral neck fracture Diseases 0.000 claims 2
- 208000027418 Wounds and injury Diseases 0.000 claims 1
- 230000001747 exhibiting effect Effects 0.000 abstract 1
- 239000000463 material Substances 0.000 description 3
- 230000035876 healing Effects 0.000 description 2
- 230000036770 blood supply Effects 0.000 description 1
- 238000003780 insertion Methods 0.000 description 1
- 230000037431 insertion Effects 0.000 description 1
- 230000000149 penetrating effect Effects 0.000 description 1
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/72—Intramedullary devices, e.g. pins or nails
- A61B17/7233—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone
- A61B17/7258—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
- A61B17/7266—Intramedullary devices, e.g. pins or nails with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods
- 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 or setting implements
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Surgery (AREA)
- Medical Informatics (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Neurology (AREA)
- Surgical Instruments (AREA)
Abstract
Description
8205723-”3 fogade ritningar, på vilka figur 1 med ett längdsnitt illustrerar ett indrivningsinstrument efter införing av collumspiken i en kanal härför i låsbenshalsen men innan utdrivning av ett i collumspiken ingående stift; figur 2 illustrerar instrumentet efter utdrivninq av stiftet in i benmaterialet; figur 3 illustrerar collumspiken fixerad i lårbenshalsen efter borttagning av verktyget; och figur 4 illustrerar collumspiken fixerad i lårbenshalsen och för- sedd med en utdragningsanordning enligt uppfinningen. 8205723- '3 attached drawings, in which figure 1 with a longitudinal section illustrates a collection instrument after insertion of the collum nail in a channel for this in the locking bone neck but before expulsion of a pin included in the collum nail; Figure 2 illustrates the instrument after expulsion of the pin into the bone material; Figure 3 illustrates the collum nail fixed in the femoral neck after removal of the tool; and figure 4 illustrates the collum nail fixed in the femoral neck and provided with a pull-out device according to the invention.
Den på ritningarna illustrerade collumspiken 1 består av en cylindrisk hylsa 2 uppvisande en kanal 3, som är öppen vid hylsans 2 bas- parti 4 men tillsluten vid hylsans spets 5. Kanalens 3 främre begräns- ningsyta 6 är snedställd och mynnar vid en sidoöppning 7 i hylsan 2.The column nail 1 illustrated in the drawings consists of a cylindrical sleeve 2 having a channel 3, which is open at the base portion 4 of the sleeve 2 but closed at the tip 5 of the sleeve 5. The front limiting surface 6 of the channel 3 is inclined and opens at a side opening 7 in sleeve 2.
Collumspiken 1 består dessutom av ett stift 8, vilket är avsett att placeras i hylsans 2 kanal 3 och drivas i riktning mot hylsans 2 spets 5 så, att stiftets 8 ändparti 9 styrs ut genom sidoöppningen 7 av den snedställda begränsningsytan 6.The collum nail 1 also consists of a pin 8, which is intended to be placed in the channel 3 of the sleeve 2 and is driven in the direction of the tip 5 of the sleeve 2 so that the end portion 9 of the pin 8 is guided out through the side opening 7 of the inclined limiting surface 6.
Collumspiken 1 manövreras med hjälp av ett indrivningsinstrument 10, som består av tre delar, nämligen ett manöverdon 11, ett indrivnings- don 12 och ett förbindelseorgan 13. Manöverdonet 11 består av en cylind- risk hylsa 14 med en genomgående kanal 48 och en Iytterdiameter, som mot- svarar hylsans 2 ytterdiameter. Manöverdonets 11 hylsa uppvisar ett änd- narti med radiellt utgående manövreringsvingar 15, 16 och ett motstående ändparti med en eller flera axiellt utskjutande klackar 17, som¿är av- sedda att ingripa i motsvarande fördjupningar 18 i collumspikens hylsa 2. Förbindelseorganet 13 består av en cylindrisk hylsa 19 med en genom- gående kanal 20, varvid dess ena ändparti uppvisar yttergängor 21 av- sedda att skruvas in i ett med innergängor 22 försett parti av collum- spikhylsan 2. Förbindelseorganets 13 cylindriska hylsa 19 uppvisar dess- utom ett något utvidgat ändparti 23, som inpassar i ett motsvarande änd- parti 24 i manöverdonet 11 och hylsans 19 utvidgande ändparti 23 övergår i ett parti med radiellt utåtriktade manövreringsvingar 25, 26 som är avsedda för att spänna fast förbindelseorganet 13 i förhållande till hylsan 2 och manöverdonet 11. Indrivningsdonet 12 består av en stång 27 med ett tvärgående handtag 28. Stången 27 kan skjutas in i förbindelse- organets 13 kanal 20 tills ett gängat parti 29 (anordnat på ganska stort avstånd från en främre ändyta 30 hos stången 27) når ett gängat parti 31 i förbindelseorganets 13 kanal 20. För att förflytta indrivningsdonet 12 längre in i förbindelseorganet 13 efter det att dess gängor 29 nått förbindelseorganets 13 inre gängor, måste detsamma således skruvas in. 8205723-3 Före indrivningen av collumspiken 1 appliceras denna på instru- mentet 10. Detta sker genom att manöverdonet 11 kopplas vridfast till collumspikhylsan 2, vilket uppnås då klacken 17 griper in i motsvarande fördjupning 18 i hylsan 2. Manöverdonet 11 hålles fast i detta läge vid collumspikhylsan 2 med hjälp av förbindelseorganet 13, vars gängade änd- parti 21 skruvas fast vid collumspikhylsans 2 gängade parti 22 och denna inskruvning fortsättes tills förbindelseorganets 13 utvidgade parti 23 bottnat i den utvidgade delen 24 hos manöverdonets 11 kanal 48. Då de sålunda hopkopplade delarna 1, 11 och 13 erhållit sina exakta hopkopp- lingslägen, införes indrivningsdonet 12 i förbindelseorganet 13 tills dess gängade parti 29 når förbindelseorganets 13 gängade parti 31. Då indrivningsdonet 12 införts så långt i förbindelseorganet 13 ( och eventuellt efter något varvs inskruvning av dess gängade parti 29 på det gängade partiet 31) intar stången 27 ett sådant läge att dess främre ändyta 30 ligger an mot stiftets 8 basyta 32 eller omedelbart invid denna, dock utan att stiftets 8 främre ändparti 9 drivits ut ur sido- öppningen 7. Indrivningsdonet 12 uppvisar lämpligen en markering 33, som medger att man kan fastställa att det intar utgångsläge för indriv- ning av stiftet 8.The column nail 1 is operated by means of a driving instrument 10, which consists of three parts, namely an actuator 11, a driving device 12 and a connecting member 13. The actuator 11 consists of a cylindrical sleeve 14 with a through-going channel 48 and an outer diameter, which corresponds to the outer diameter of the sleeve 2. The sleeve of the actuator 11 has an end portion with radially extending actuating wings 15, 16 and an opposite end portion with one or more axially projecting lugs 17, which are intended to engage in corresponding depressions 18 in the sleeve 2 of the collum nail. The connecting member 13 consists of a cylindrical sleeve 19 with a through-going channel 20, one end portion of which has outer threads 21 intended to be screwed into a portion of the collum nail sleeve 2 provided with inner threads 22. The cylindrical sleeve 19 of the connecting member 13 also has a slightly widened end portion. 23, which fits into a corresponding end portion 24 of the actuator 11 and the widening end portion 23 of the sleeve 19 merges into a portion with radially outwardly directed actuating wings 25, 26 which are intended to clamp the connecting member 13 relative to the sleeve 2 and the actuator 11. The actuator 12 consists of a rod 27 with a transverse handle 28. The rod 27 can be pushed into the channel 20 of the connecting member 13 until a threaded portion 29 (arranged at a fairly large distance from a front end surface 30 of the rod 27) reaches a threaded portion 31 in the channel 20 of the connector 13. To move the actuator 12 further into the connector 13 after its threads 29 have reached the interior of the connector 13. threads, the same must thus be screwed in. 8205723-3 Before driving in the collum nail 1, it is applied to the instrument 10. This is done by coupling the actuator 11 rotationally to the collum nail sleeve 2, which is achieved when the lug 17 engages in the corresponding recess 18 in the sleeve 2. The actuator 11 is held in this position at the collum nail sleeve 2 by means of the connecting member 13, the threaded end portion 21 of which is screwed to the threaded portion 22 of the collum nail sleeve 2 and this screwing is continued until the enlarged portion 23 of the connector 13 bottoms in the expanded portion 24 of the actuator 11 channel 48. 1, 11 and 13 have obtained their exact coupling positions, the actuator 12 is inserted into the connecting member 13 until its threaded portion 29 reaches the threaded portion 31 of the connecting member 13. When the actuator 12 is inserted so far into the connecting member 13 (and possibly after screwing its threaded portion 29 on the threaded portion 31), the rod 27 assumes such a position that its front end surface a 30 abuts the base surface 32 of the pin 8 or immediately adjacent thereto, but without the front end portion 9 of the pin 8 being driven out of the side opening 7. The actuator 12 suitably has a marking 33, which allows it to be determined that it assumes a starting position for actuation. ning of the pin 8.
Som visas i figurerna har lårbenshalsen en fraktur 34 och i lår- benshalsen 35 och lårbenshuvudet 36 har borrats en kanal 37 för collum- spiken 1. Denna kanal 37 är liksom collumspikhylsan 2 cirkulär och har sådan diameter i förhållande till collumspikhylsan 2 att hylsan 2 utan svårighet och utan slag med lätt tryck kan föras in i kanalen 37 ända fram till sitt önskade ändläge. Härigenom elimineras risken för att collumspiken 1 åstadkommer en spalt mellan lårbenshalsen 35 och lårbens- huvudet 36 då den når fram till frakturen 34 och börjar tränga inši lår-_ benshuvudet 36. När collumspiken 1 drivits in till önskat ändläge i kanalen 37 kontrolleras om sidoöppningen 7 är riktad mot den del 38 av omgivande benmaterial av lårbenshuvudet 36, i vilket stiftets 8 ändparti 9 skall tränga in. Denna kontroll kan utföras genom att man kontrollerar om ett märke 47 (motsvarande sidoöppningens 7 läge) på manöverdonet 11 intar förutbestämt läge i förhållande till lårbenshalsen eller ej. Om märket 47 intar rätt läge kan indrivningen av stiftet 8 äga rum men om så ej är fallet vrides collumspiken 1 i kanalen 37 med hjälp av manöver- donet 11 tills rätt läge på märket 47, det vill säga rätt läge på sido- önpningen 7 uppnåtts. Vid denna vridning av indrivninqsinstrumentet 10 förflyttas inte instrumentdelarna axiellt i förhållande till varandra och indrivningsdonet 12 bibehåller sitt utgångsläge för indrivning.As shown in the figures, the femoral neck has a fracture 34 and in the femoral neck 35 and the femoral head 36 a channel 37 for the collum nail 1 has been drilled. This channel 37 is like the columnar nail sleeve 2 circular and has such a diameter relative to the columnar nail sleeve 2 that the sleeve 2 without difficulty and without blows with light pressure can be inserted into the channel 37 all the way to its desired end position. This eliminates the risk of the collum nail 1 creating a gap between the femoral neck 35 and the femoral head 36 as it reaches the fracture 34 and begins to penetrate the femoral head 36. When the columnar nail 1 is pushed into the desired end position in the channel 37, the side opening 7 is checked. is directed towards the part 38 of surrounding bone material of the femoral head 36, into which the end portion 9 of the pin 8 is to penetrate. This check can be performed by checking whether a mark 47 (corresponding to the position of the side opening 7) on the actuator 11 assumes a predetermined position in relation to the femoral neck or not. If the mark 47 assumes the correct position, the drive-in of the pin 8 can take place, but if this is not the case, the collum nail 1 is turned in the channel 37 by means of the actuator 11 until the correct position on the mark 47, i.e. the correct position on the side opening 7 is reached . During this rotation of the driving instrument 10, the instrument parts are not moved axially relative to each other and the driving device 12 maintains its initial position for driving.
Indrivning av stiftets 8 ändparti 9 i delen 38 av lårbenshuvudet 8205723-5 36 sker genom att indrivningsdonet skruvas in i förbindelseorganet 13, varvid de gängade partierna 29, 31 samverkar med varandra. Genom denna inskruvning av indrivningsdonet 12 kommer indrivningsdonet 12 att via sin främre ändyta 30 trycka mot stiftets basyta 32 och stiftet 8 kommer att drivas längre in i collumspikhylsan 2. Härvid kommer stiftets främre ändparti 9 att styras åt sidan ut genom sidoöppningen 7, varigenom änd- partiet 9 kommer att kröka sig till en i delen 38 av benmaterialet in- trängande hake. Härigenom kommer collumspiken 1 att förankras vid ben- fragmentet 36 och collumspiken 1 kommer i sin tur att fixera lårbenshal- sen 35 och lårbenshuvudet 36 så att de inte kan rotera eller förskjutas i sidled i förhållande till varandra under läkning av brottet men väl komprimeras axialt till fördel för blodförsörjning och därigenom för läkningsprocessen. Stabiliteten i fraktursystem och fixation ökar med två till tre spikar.Drive-in of the end portion 9 of the pin 8 in the part 38 of the femoral head 8205723-5 36 takes place by the drive-in device being screwed into the connecting member 13, the threaded portions 29, 31 cooperating with each other. By this screwing in the collecting means 12, the collecting means 12 will press against its front end surface 30 against the base surface 32 of the pin and the pin 8 will be driven further into the collum nail sleeve 2. In this case the front end portion 9 of the pin will be guided laterally out through the side opening 7. the portion 9 will bend to a hook penetrating into the part 38 of the bone material. As a result, the collum nail 1 will be anchored to the bone fragment 36 and the collum nail 1 will in turn fix the femoral neck 35 and the femoral head 36 so that they can not rotate or displace laterally relative to each other during healing of the fracture but are well compressed axially to benefit for blood supply and thereby for the healing process. The stability of fracture systems and fixation increases with two to three nails.
För skonsam utdragning av stiftet 8 användes ett stiftutdragnings- organ 40 av speciell typ. Enligt uppfinningen uppvisar detta ett kopp- lingsparti 43 via vilket det är anslutbart till ett motsvarande kopp- lingsparti 39 hos stiftet 8. Stiftutdragningsorganet 40 uppvisar ett stödparti 46 via vilket det är anläggningsbart mot ett motsvarande stöd- parti 45 hos hylsan 2 för att hylsan 2 skall bilda mothåll vid indrag- ning av stiftändpartiet 9 in i hylsan 2 via sidoöppningen 7 i denna innan utdragning av stiftet ur hylsan 2. Detta innebär att hylsan 2 inte utsättes för några axiella belastningar vid indragning av stiftändpartiet 9 och stiftet 8 kan tagas ut ur hylsan 2 i sin helhet utan att såret oroas i alltför stor omfattning. Därefter kan hylsan 2 dragas ut utan svårigheter, varefter alla främmande organ är avlägsnade ur lårbenshalsen Stiftutdragningsorganets 40 kopplingsparti_utgöres företrädesvis av innergängor 43 i ett hylsformigt ändparti 44 och stiftets 8 kopp- lingsparti utgöres företrädesvis av yttergängor på ett stiftändparti 39.For gentle extraction of the pin 8, a pin extraction member 40 of a special type is used. According to the invention, this has a coupling portion 43 via which it is connectable to a corresponding coupling portion 39 of the pin 8. The pin pulling member 40 has a support portion 46 via which it can be mounted against a corresponding support portion 45 of the sleeve 2 so that the sleeve 2 shall form a resistance when retracting the pin end portion 9 into the sleeve 2 via the side opening 7 therein before pulling the pin out of the sleeve 2. This means that the sleeve 2 is not subjected to any axial loads when the pin end portion 9 is retracted and the pin 8 can be removed from sleeve 2 in its entirety without worrying the wound too much. Thereafter, the sleeve 2 can be pulled out without difficulty, after which all foreign members are removed from the femoral neck. The coupling portion 40 of the pin pulling member 40 is preferably constituted by inner threads 43 in a sleeve-shaped end portion 44 and the coupling portion of the pin 8 is preferably outer threads on a pin end portion 39.
Dessutom utgöres stiftutdragningsorqanets 40 stödparti lämpligen av en ändkant 46 hos det hylsformiqa ändpartiet 44 och hylsans 2 stödparti lämpligen av en ändkant 45 hos hylsan 2. Härigenom blir möjligheterna att hitta stiftet 8 i såret och koppla till stiftutdragninqsorganet 40 goda och tillkopplingsoperationen skonsamL Dessa möjligheter förbättras ytterligare om stiftändpartiet 39 helt eller delvis är beläget utanför hylsan 2 då tillkoppling av stiftutdragningsorganet 40 skall ske.In addition, the support portion of the pin pulling member 40 is suitably constituted by an end edge 46 of the sleeve-shaped end portion 44 and the support portion of the sleeve 2 is suitably constituted by an end edge 45 of the sleeve 2. As a result, the possibilities of finding the pin 8 in the wound and connecting if the pin end portion 39 is wholly or partly located outside the sleeve 2 then connection of the pin pulling means 40 is to take place.
Stiftutdragningsorganets 40 parti 44 uppvisar dessutom lämpligen i huvudsak samma bredd som hylsan 2 eller mindre bredd än denna, varjämte stiftutdragningsorganet uppvisar ett tvärqående handtag 42 för manuell manövrering därav.In addition, the portion 44 of the pin pulling member 40 preferably has substantially the same width as the sleeve 2 or less than this, and the pin pulling member has a transverse handle 42 for manual operation thereof.
Claims (3)
Priority Applications (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| SE8205723A SE433166B (en) | 1982-10-07 | 1982-10-07 | Device for withdrawing a pin in a fixing member |
Applications Claiming Priority (1)
| Application Number | Priority Date | Filing Date | Title |
|---|---|---|---|
| SE8205723A SE433166B (en) | 1982-10-07 | 1982-10-07 | Device for withdrawing a pin in a fixing member |
Publications (3)
| Publication Number | Publication Date |
|---|---|
| SE8205723D0 SE8205723D0 (en) | 1982-10-07 |
| SE8205723L SE8205723L (en) | 1982-11-12 |
| SE433166B true SE433166B (en) | 1984-05-14 |
Family
ID=20348129
Family Applications (1)
| Application Number | Title | Priority Date | Filing Date |
|---|---|---|---|
| SE8205723A SE433166B (en) | 1982-10-07 | 1982-10-07 | Device for withdrawing a pin in a fixing member |
Country Status (1)
| Country | Link |
|---|---|
| SE (1) | SE433166B (en) |
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10117692B2 (en) | 2012-10-12 | 2018-11-06 | Swemac Innovation Ab | Fixing means for fixation of bone fragments at bone fractures |
-
1982
- 1982-10-07 SE SE8205723A patent/SE433166B/en not_active IP Right Cessation
Cited By (1)
| Publication number | Priority date | Publication date | Assignee | Title |
|---|---|---|---|---|
| US10117692B2 (en) | 2012-10-12 | 2018-11-06 | Swemac Innovation Ab | Fixing means for fixation of bone fragments at bone fractures |
Also Published As
| Publication number | Publication date |
|---|---|
| SE8205723L (en) | 1982-11-12 |
| SE8205723D0 (en) | 1982-10-07 |
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