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
  • A61B17/7216—Intramedullary devices, e.g. pins or nails for bone lengthening or compression
• • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
  • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
  • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
  • F16B7/00—Connections of rods or tubes, e.g. of non-circular section, mutually, including resilient connections
  • F16B7/18—Connections of rods or tubes, e.g. of non-circular section, mutually, including resilient connections using screw-thread elements
  • F16B7/182—Connections of rods or tubes, e.g. of non-circular section, mutually, including resilient connections using screw-thread elements for coaxial connections of two rods or tubes
• • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
  • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
  • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
  • F16B15/00—Nails; Staples

Definitions

• the invention is related to prolonged nail, embedded in a protective case and moving in said case and provided to rotate by externally applying pressure, used in orthopedic bone lengthening surgeries.
• tubular bone shaft fractures One of the common fractures in Orthopedics and Traumatology is tubular bone shaft fractures. Increased industrialization causes both increasing of traffic accidents and accidents at work. This situation increases incidence of tubular bone shaft fracture especially in young population.
• tubular bone fractures are often developed due to high-energy trauma, it may be seen with additional injuries. Consequently, death rate is high even in isolated tubular bone fractures.
• Purpose of treatment of long bone shaft fractures is to provide integrity of extremity (arm or leg) and to provide the functions for the patient earlier.
• Various treatment methods are available for this purpose and today surgical treatment became standard treatment as a result of complications due to long term fixation seen in preventive treatment and complications due to treatment such as angular-rotational deviation, shortness, joint stiffness and sude atrophy, said various treatment methods don't apply to excessive or heavy treatment attempts. Traction, casting and brace can be used for conservative treatment.
• External fixation and internal fixation are available amongst surgical treatment methods [osteosynthesis with plate and screw (Putting mechanical devices (screw, wire, nail or plate) in a fractured bone and bringing the ends together and removal process after the fracture union).
• External fixers provide convenience in wound care in compound fractures but pin tract infection and limitation of movement in adjacent joints are important disadvantages.
• Advantages of osteosynthesis with plate are; allowing rigid fixation by completely seeing fracture line and allowing earlier movement. But as well as causing a poor image from cosmetic point of view, it causes increase in risk of infection and long boiling time because of large amounts of tissue stripping, fracture hematoma (blood found between the broken bone fragments and starting fracture union) evacuation.
• Intramedullary nails became golden standard today in treatment of tubular bone shaft fractures because they provide good stabilization, early weight bearing and joint movement, they can be applied by causing less soft tissue injuries, they have less angular and rotational frequency of deformities, they have high fracture union rate.
• First info about using intramedullary nails in fracture treatment is based on 16 lh century. During this period, the Incas and the Aztecs used to drive the resinous wooden nails on medullary canal in treatment of non-union long-bone fractures. In 1986 Bircher et al provided fixation by driving the ivory nails on medullary canal.
• Intramedullary nailing is one of the most important surgical inventions in orthopedics history. Long tubular bone shaft fractures can be life-threatening. Today by closed intramedullary nailing while expected union rate in these fractures vary between 95%-99%, infection rate is less than 1% (15,23,72). Poor bone fusion (Mahmion) as a result of wrong placement of fractures after intramedullary nailing in tubular bone shaft fractures, is very rare. Also, adding locking screws to modern nailing systems, expanded indications of this procedure including separated fractures, remote and proximal shaft fractures (8, 14,15). For these reasons, closed locked intramedullary nailing is the preferred treatment method in treatment of long tubular bone shaft fractures. Intramedullary nails used widely today are as follows:
• Standard intramedullary nails Nails such as Kiintcsher, AO, Schneider, Samson. They work with stability restoration principle by endo-steal contact from multi-points by filling the canal along the length of the bone. Their indication is istmic regional fractures.
• Rush and Ender nails are in this group. Ender nail is the most used one in this group in child tubular bone shaft fractures. It acts on the principle of three-point. It is used without reamer (hole punch tool and tool for carving medullary (inner) space of long tubular bone).
• Locked intramedullary nails They are obtained by adding proximal and/or remote locking screws to intramedullary nail. Locking screws are sent to both cortexes. Basically there are two methods in fracture fixation with intramedullary nail.
• Static locking means placement of proximal and remote locking screws. This method is used in comminuted fractures and in less cortical contact such as for example femur Winquist Hansen Type 3 and 4 fractures.
• Dynamic locking is defined as placement of one of the proximal or remote locking screws. It is necessary for the fractures in stable and istmic areas such as femur Winquist Hansen Type 1 and 2.
• Length and rotation is under control in static locking. If dynamic method is especially used in comminuted fractures, it can't control the rotation and the length.
• Intramedullary nails are designed mainly to ensure load carrying and to minimize the movement in the fracture zone.
• Locked intramedullary nails can generally be used in open fractures to Type 3a if foreign objects or non-viable tissues are cut out and if wound is cared.
• External guide is placed on the in bone nail and locking (screwing) process is carried out by applying screw and by determining the screw holes, by drilling them and by using x- ray machine in the guidance of external guide after sending the nail to the bone.
• Locking (screwing) process is carried out by applying screw and by determining the screw holes, by drilling them and by using x-ray machine by free-hand technique without external guide after sending the in bone nail to the bone.
• Locking (screwing) process is carried out by applying screw and by determining the screw holes, by dril ing them and by seeing the screw holes and by removing a piece of bone from the front side of the bone by placing an external guide on in bone nail after sending the nail to the bone.
• the invention is related to prolonged nail, embedded in a protective case and moving in said case and provided to rotate by externally applying pressure, used in orthopedic bone lengthening surgeries characterized with an outer case (1 ), a nail (2), an articulated apparatus (3), a screw (4), a resistance spring (5), a spring blocking part (6), a reducer (7), a one-way locked bearing (8), a spring (9), Distal holes (10), proximal holes(l 1) and articulation (12).
• nail (2) is prolonged by means of articulated apparatus (3) moving with pressure applied externally, consequently the leg is prolonged.
• the system consists of an endless screw (4), a nail (2) which is the extending part of the system and which acts as nut in which this screw (4) can enter, one-way locked bearing (8), small spring (9) which will return this one-way locked bearing (8) to its previous position, articulated apparatus (3) rotating the locked bearing (8) by applying force on it, reducer (7), big resistance spring (5) pushing the nail (2) and resisting to pull back force applied by leg muscles and an outer case (1 ) protecting the system.
• the system is fixed to the bone from the proximal hole (11) on the outer case (1 ) and from the distal holes (10) on the nail (2).
• the system is ready to operate in this state. After the surgery is completed, bone is prolonged by applying pressure to the articulated apparatus (3) moving by a pressure out of the skin after the desired time.

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• Health & Medical Sciences (AREA)
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• Orthopedic Medicine & Surgery (AREA)
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Citations (4)

• 2012
  • 2012-02-24 TR TR2012/02107A patent/TR201202107A2/xx unknown
• 2013
  • 2013-02-21 WO PCT/TR2013/000088 patent/WO2013126025A1/fr not_active Ceased

Patent Citations (4)

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