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WO2023075358A1 - Mécanisme de réduction utilisé pour la réduction de fracture comminutive - Google Patents

Mécanisme de réduction utilisé pour la réduction de fracture comminutive Download PDF

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Publication number
WO2023075358A1
WO2023075358A1 PCT/KR2022/016341 KR2022016341W WO2023075358A1 WO 2023075358 A1 WO2023075358 A1 WO 2023075358A1 KR 2022016341 W KR2022016341 W KR 2022016341W WO 2023075358 A1 WO2023075358 A1 WO 2023075358A1
Authority
WO
WIPO (PCT)
Prior art keywords
sheet member
fractured
bone
fastening part
fastening
Prior art date
Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
Ceased
Application number
PCT/KR2022/016341
Other languages
English (en)
Korean (ko)
Inventor
손국희
이진우
박정규
Current Assignee (The listed assignees may be inaccurate. Google has not performed a legal analysis and makes no representation or warranty as to the accuracy of the list.)
Gil Medical Center
Original Assignee
Gil Medical Center
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Priority claimed from KR1020220043604A external-priority patent/KR102801546B1/ko
Application filed by Gil Medical Center filed Critical Gil Medical Center
Publication of WO2023075358A1 publication Critical patent/WO2023075358A1/fr
Anticipated expiration legal-status Critical
Ceased legal-status Critical Current

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Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • 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
    • 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
    • A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
    • 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
    • A61B17/84—Fasteners therefor or fasteners being internal fixation devices
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F5/00—Orthopaedic methods or devices for non-surgical treatment of bones or joints; Nursing devices ; Anti-rape devices
    • A61F5/01—Orthopaedic devices, e.g. long-term immobilising or pressure directing devices for treating broken or deformed bones such as splints, casts or braces
    • A61F5/04—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints
    • A61F5/05—Devices for stretching or reducing fractured limbs; Devices for distractions; Splints for immobilising
    • A61F5/058—Splints
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y10/00—Processes of additive manufacturing
    • B—PERFORMING OPERATIONS; TRANSPORTING
    • B33—ADDITIVE MANUFACTURING TECHNOLOGY
    • B33Y—ADDITIVE MANUFACTURING, i.e. MANUFACTURING OF THREE-DIMENSIONAL [3-D] OBJECTS BY ADDITIVE DEPOSITION, ADDITIVE AGGLOMERATION OR ADDITIVE LAYERING, e.g. BY 3-D PRINTING, STEREOLITHOGRAPHY OR SELECTIVE LASER SINTERING
    • B33Y80/00—Products made by additive manufacturing

Definitions

  • the present invention relates to a reduction instrument used to reduce a plurality of fractured bones.
  • Fractures can occur when a strong external force is applied to the bone.
  • a comminuted fracture is a fracture in which the bone is pulverized and fragmented.
  • it is difficult and time-consuming to unite multiple bones compared to simple fractures in which two fracture fragments are formed by one fracture line.
  • Comminuted fractures can damage surrounding blood vessels or tissues as multiple bones break, which is accompanied by bruising and swelling. Broken bones can damage blood vessels, causing internal bleeding, and damage surrounding tissue, resulting in severe swelling.
  • FIG. 1a and 1b are photographs of a conventional treatment method for comminuted fractures when a finger bone is comminuted.
  • 1a and 1b conventionally, several pins were driven into a plurality of fractured bones to fix the bones.
  • 1A is a state in which a plurality of pins are inserted into a patient's hand
  • FIG. 1B is an x-ray picture of a hand with pins.
  • the patient continuously experiences pain in the corresponding area, more specifically, the hand, and cannot move, causing great discomfort to the patient.
  • the applicant of the present invention has developed additional research and development to wrap and fuse the plurality of fractured bones without using pins in order to solve the problems of the conventional treatment method in which the above-described plurality of pins are directly driven into the fractured bones to allow the bones to fuse. proceeded.
  • Patent Document 1 Korean Patent Publication No. 2019-0076538
  • Patent Document 2 Japanese Laid-open Patent No. 2021-000454
  • An object of the present invention is to provide a reduction device, which is one of the reduction instruments used in fracture reduction surgery, that wraps a plurality of fractured bones so that the bones can be fused without using a plurality of pins penetrating the bones.
  • the present invention is to provide a reduction device that does not require a separate operation to remove the inserted device after fracture reduction surgery.
  • the present invention provides a reduction mechanism inserted into a body to reduce a crushed fractured bone, comprising: a sheet member surrounding a plurality of fractured bones; first fastening parts respectively provided at both ends of the sheet member; And characterized in that it comprises a second fastening portion coupled to the first fastening portion to connect both ends of the sheet member.
  • the sheet member may be in the form of a mesh consisting of a plurality of cells having different shapes.
  • the first fastening part forms a ring
  • the second fastening part is a cable tie band having a plurality of teeth that can be fastened to the ring
  • the first fastening part and the second fastening part are fastened to the sheet. Both ends of the member can be connected.
  • a distance between both ends of each of the first fastening parts may correspond to a circumferential length of a fractured bone.
  • the sheet member may have a different distance between both ends provided with the first fastening part according to the shape of the fractured bone.
  • the sheet member may have a shape in which a distance between both ends provided with the first fastening part is tapered narrower on one side than on the other side as the thickness of the bone becomes thinner.
  • the present invention in the reduction mechanism for conquering a fractured bone, a sheet member composed of a plurality of cells capable of stretching; A first fastening part provided at one end of the sheet member and having a plurality of convex protrusions protruding convexly; and a second fastening part provided at the other end of the sheet member, wherein a plurality of concave grooves fitted with the convex projections are formed corresponding to the convex projections, and the sheet member has a plurality of fractures in which the convex projections and the concave grooves are combined. Encircling the dog's bone is another characteristic.
  • a plurality of fractured bones inside or outside the body may be surrounded and fixed.
  • it is made of a biodegradable polymer and can be degraded in the body.
  • the present invention helps bone union by wrapping a plurality of comminuted fractured bones in the body at once. Therefore, it is possible to significantly alleviate the patient's pain compared to the conventional pin fixing method, and the patient's convenience can be increased because the body except for the fractured part can be moved. In particular, even when the size is small, such as a finger bone, the fractured bone is wrapped as a whole to be fused, so the bone fusion effect has a greater advantage than before.
  • the present invention can be customized to each individual shape or size in consideration of the shape of the fracture site or the physical characteristics of the patient through 3D printing. Through this, it is possible to improve the fusion effect of the corresponding fracture site.
  • the reduction device of the present invention is biodegradable in the body, the risk of infection from the external skin is low, and it does not require a separate operation to remove the reduction device after reduction surgery, thereby reducing the patient's pain and saving time and money. efficient
  • FIG. 1a and 1b are photographs of a conventional method for treating a fracture using a plurality of pins when a finger bone is fractured.
  • FIG. 2 shows a configuration diagram of a conquering mechanism according to an embodiment of the present invention.
  • 3A and 3B show various embodiments of the sheet member of the present invention.
  • Figures 4a to 4d show an embodiment of application of the reduction mechanism of the present invention to comminuted fractured chicken bones.
  • FIG 5 shows an embodiment of another fastening structure of the conquering mechanism of the present invention.
  • FIG. 6 shows a conquering instrument in the form of the FIG. 5 embodiment of the present invention manufactured in various sizes.
  • FIG. 7a and 7b show a state in which the conquest mechanism of the embodiment of FIG. 5 of the present invention is fastened to a finger.
  • FIG. 2 shows a configuration diagram of a conquering mechanism 1 according to an embodiment of the present invention.
  • the reduction mechanism 1 can reduce by surrounding and fixing a plurality of fractured bones.
  • the reduction device 1 may wrap the fracture site inside or outside the body.
  • the reduction mechanism 1 since the reduction mechanism 1 is composed of a biodegradable material and is degraded in the body, it can be inserted into the body and directly wrap the fractured bone.
  • the reduction mechanism 1 is made of a biodegradable polymer and can be degraded in the body.
  • the conquering device 1 is a biodegradable polymer and may be a natural polymer, a synthetic polymer, or a polymer produced by microorganisms, and may not be limited to the type as long as it is degradable in the body.
  • the reduction device 1 does not require a separate procedure to remove the reduction device 1 since the bone is reduced or biodegraded after being inserted into the body during the reduction procedure.
  • the reduction mechanism 1 since the reduction mechanism 1 directly wraps and fixes the fractured bone, it is possible to minimize the movement of bone fragments and apply hydraulic pressure, rather than fixing them outside the body.
  • the seat member 10, the first fastening part 30, and the second fastening part 50 included in the reduction mechanism 1 may all be made of biodegradable materials.
  • the conquering device 1 may be manufactured by a 3D printing technique, and may be manufactured in a shape or size customized to an individual user through the 3D printing technique.
  • the conquering mechanism 1 may include a seat member 10 , a first fastening part 30 and a second fastening part 50 .
  • the sheet member 10 is extensible and can surround a plurality of fractured bones.
  • the sheet member 10 is manufactured in the form of a sheet having a large area, and may cover a cylindrical bone having a predetermined length. A length between both ends of the sheet member 10 may be a length corresponding to a minimum bone circumference.
  • the sheet member 10 may have a rectangular sheet shape, but the shape is not limited as long as it can wrap bones.
  • the seat member 10 may be made of an elastic material, and is slightly stretched in the process of covering the fractured bone, and then contracted again when the first fastening part 30 and the second fastening part 50 are combined to fix the bone. can make it
  • the sheet member 10 may be a single sheet without holes, or may have a mesh shape composed of a plurality of cells 100 with a central portion pierced.
  • the cell 100 may be formed by crossing or twisting the biodegradable materials constituting the sheet member 10 at a specific location.
  • the cell 100 may have a shape such as a rectangle or a circle with a central portion penetrated, but is not limited to its shape or size, and may be manufactured in various ways according to the patient's individual characteristics or the tissue characteristics of the fractured part. Since the sheet member 10 is manufactured in a mesh shape in which a plurality of cells 100 are formed, it can be more easily stretched or contracted when both ends of the sheet member 10 are coupled.
  • the cell 100 may constitute the sheet member 10 using only a single shape, or may constitute a single sheet member 10 by combining various shapes. It will be described later in detail with reference to FIG. 3B.
  • the sheet member 10 may be provided with first fastening parts 30 at both ends, respectively.
  • the distance between both ends of the sheet member 10, that is, the distance between the first fastening parts 30 may correspond to the circumferential length of the fractured bone. Accordingly, the distance between both ends of the sheet member 10 provided with the first coupling part 30 may be different according to the type of fractured bone, the thickness of the user's bone, or the shape of the fractured bone. This is because the conquering device 1 of the present invention can be manufactured through 3D printing to suit individual situations.
  • the first fastening parts 30 may be provided at both ends of the sheet member 10, respectively, and may form a ring as shown in FIG. 2.
  • the second fastening part 50 may be separated from the sheet member 10 , and a plurality of teeth 501 may be formed to be fastened to the ring of the first fastening part 30 .
  • the second fastening part 50 may be a cable tie band.
  • the ring of the first fastening part 30 may be coupled to the tooth 501 of the second fastening part 50, and once coupled, the first fastening part 30 is the tooth of the second fastening part 50 ( 501) may not be separated.
  • the first fastening part 30 attaches the second fastening part 50 to the ring of the first fastening part 30 after the first fastening part 30 at both ends approaches while the sheet member 10 surrounds the fractured bone. ) By being inserted, it can be coupled to the teeth (501). As a result, as the two first fastening parts 30 and the second fastening parts 50 provided at both ends of the sheet member 10 are fastened, the sheet member 10 can surround and fix the fractured bone.
  • FIG. 3A and 3B show various embodiments of the sheet member 10 of the present invention. More specifically, FIG. 3A shows a sheet member 10 having a rectangular shape with one side and the other side having different lengths.
  • the reduction mechanism 1 of the present invention can be manufactured by 3D printing, so that the type of fractured bone, the thickness of the user's bone, or the shape of the fractured bone can be considered and tailored to it during initial design. Thus, the distance between both ends of the sheet member 10 provided with the first fastening portion 30 may be different rather than constant.
  • FIG. 3A shows the sheet member 10 applied to, for example, a finger bone when the thickness of a bone extended in the longitudinal direction gradually decreases.
  • the length A of the left side of the sheet member 10 is shorter than the length B of the right side.
  • the sheet member 10 has a shape in which the distance between both ends at which the first fastening portion 30 is provided becomes gradually tapered toward the left side (A) rather than the right side (B) as the thickness of the finger bone becomes thinner.
  • the shape of the sheet member 10 is determined according to the shape of the bone, it may be variously tapered in one direction, a fan shape, and the like, as shown in FIG. 3A.
  • FIG. 3B shows one of the sheet members 10 made of cells 100 of various shapes.
  • the upper cell a 100a and the lower cell b 100b have different shapes.
  • Cell a (100a) at the top of FIG. 3B is formed vertically and parallel with a plurality of straight lines forming regular intervals, while cell b (100b) at the bottom is a sheet member in which a plurality of straight lines intersect each other to create a diamond shape. (10) is in the form of a mesh.
  • one sheet member 10 may be composed of a plurality of cells 100 having different shapes, and the shapes or sizes of the cells 100 may be set in various ways during the design process for 3D printing.
  • the cell 100 has different tension applied when stretched, degree of stretch, and area surrounding a plurality of bones according to each shape or size. Therefore, the shape and size of the cell 100 suitable for the type of bone or location of fracture may be applied to enhance the fusion effect.
  • cell a (100a) is more densely formed than cell b (100b) and thus has strong stretchability, but may have weak elasticity. Since the seat member 10 composed of only the cells a 100a has weak elasticity and strong fixation force to bones, a user may feel uncomfortable.
  • the sheet member 10 composed of only the cell b 100b has a relatively weak fixing force to the bone due to its high elasticity, and thus the fusion effect may be reduced. Therefore, by configuring the cell a 100a and the cell b 100b in one sheet member 10, it is possible to reduce the user's discomfort while having an appropriate fusion effect.
  • Figures 4a to 4d show an embodiment of applying the reduction mechanism 1 of the present invention to comminuted fractured chicken bones.
  • Figure 4a is a photograph of a crushed fractured chicken bone, in the case of a crushed fracture, bone fragments of various sizes, large and small, are produced as shown in Figure 4a.
  • the first fastening part 30 of FIG. 4B has a ring shape
  • the second fastening part 50 has a cable tie band shape in which a plurality of teeth 501 are formed. It can be fastened while engaging with the teeth 501 of the part 50.
  • the number of second fastening parts 50 used corresponds to the number of rings of the first fastening parts 30 provided at one end of the sheet member 10 .
  • the horizontal and vertical lengths of the sheet member 10 may be determined according to the circumference (thickness) of the fractured bone and the length of the fractured area.
  • FIG. 4C is a state in which the first fastening parts 30 at both ends of the sheet member 10 come into contact with each other and the sheet member 10 completely covers the bone fragments.
  • FIG. 4B the positions of the first fastening parts 30 at both ends are different from each other in one second fastening part 50, but in FIG. 4C, the seat member 10 completely surrounds the bone fragments and the second fastening It can be seen that the parts 50 converge to one position.
  • Figure 4d shows the bone fragments wrapped around the sheet member 10, the opposite view of Figure 4c. It can be confirmed that the bone is wrapped at 360 degrees through the seat member 10 .
  • the conquering mechanism 3 of FIG. 5 shows an embodiment of another fastening structure of the conquering mechanism 3 of the present invention. Similar to the conquering mechanism 1 of FIG. 2 described above, the conquering mechanism 3 of FIG. 5 includes a sheet member 10 composed of a plurality of stretchable cells, a first fastening part 30, and a second fastening part 50. Including, when the first fastening part 30 and the second fastening part 50 are coupled, the seat member 10 can surround a plurality of bones and fuse the bones in the body.
  • the first fastening part 30 is provided at one end of the sheet member 10, and a plurality of convex protrusions 70 protruding convexly may be formed.
  • the second fastening part 50 is not separated from the sheet member 10 and is provided at the other end of the sheet member 10, and the convex protrusion 70 and the concave groove 90 fitted to the convex protrusion 70 Correspondingly, a plurality may be formed. Accordingly, the sheet member 10 may enclose a plurality of fractured bones by combining the convex protrusions 70 and the grooves 90 provided at both ends thereof.
  • the sheet member 10 may be formed in a tapering shape in which one side of the sheet member 10 is shorter than the other side in consideration of the thickness of the bone when the bones in the longitudinal direction gradually become thinner.
  • the length C of the left side of the sheet member 10 is shorter than the length D of the right side.
  • the reduction mechanism 3 is entirely made of a biodegradable polymer and can be degraded in the body.
  • Fig. 6 shows a reduction mechanism 3 of the Fig. 5 embodiment of the present invention fabricated in various sizes. As described above, since the reduction mechanism 3 is manufactured by 3D printing, the size may be different depending on the circumference of a bone or a fracture site.
  • FIG. 7a and 7b show a state in which the conquering mechanism 3 of the embodiment of FIG. 5 of the present invention is fastened to a finger.
  • the reduction mechanism 3 may surround and fix a plurality of bones fractured inside or outside the body.

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

Abstract

L'invention concerne un mécanisme de réduction qui est inséré dans le corps pour réduire les os comminués, le mécanisme de réduction étant caractérisé en ce qu'il comprend : un élément de feuille qui est étirable et entoure une pluralité de morceaux d'os fracturé; des premières parties de fixation disposées, respectivement, aux deux extrémités de l'élément de feuille; et une seconde partie de fixation couplée aux premières parties de fixation, reliant ainsi les deux extrémités de l'élément de feuille. En conséquence, le mécanisme de réduction améliore l'union osseuse et peut améliorer le confort du patient.
PCT/KR2022/016341 2021-10-26 2022-10-25 Mécanisme de réduction utilisé pour la réduction de fracture comminutive Ceased WO2023075358A1 (fr)

Applications Claiming Priority (4)

Application Number Priority Date Filing Date Title
KR10-2021-0143888 2021-10-26
KR20210143888 2021-10-26
KR10-2022-0043604 2022-04-07
KR1020220043604A KR102801546B1 (ko) 2021-10-26 2022-04-07 분쇄 골절 정복에 사용되는 정복 기구

Publications (1)

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WO2023075358A1 true WO2023075358A1 (fr) 2023-05-04

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PCT/KR2022/016341 Ceased WO2023075358A1 (fr) 2021-10-26 2022-10-25 Mécanisme de réduction utilisé pour la réduction de fracture comminutive

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Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998007384A1 (fr) * 1996-08-19 1998-02-26 Macropore, Inc. Barriere a membrane flexible non repliable, resorbable et macroporeuse pour la reparation et le regeneration du squelette
CN202105009U (zh) * 2011-06-10 2012-01-11 中国人民解放军第四军医大学 一种用于四肢长骨粉碎性骨折后骨折吻合端碎骨片固定的装置
WO2014110471A1 (fr) * 2013-01-12 2014-07-17 Houff Louis Dispositif et procédé de fixation de sternum
US20190290436A1 (en) * 2017-09-11 2019-09-26 DePuy Synthes Products, Inc. Patient-specific mandible graft cage
CN211484846U (zh) * 2019-11-26 2020-09-15 云南省第三人民医院 一种骨科外固定支架保护套
KR20200111920A (ko) * 2019-03-20 2020-10-05 (주)포스메디칼 의료용 열가소성 깁스

Patent Citations (6)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1998007384A1 (fr) * 1996-08-19 1998-02-26 Macropore, Inc. Barriere a membrane flexible non repliable, resorbable et macroporeuse pour la reparation et le regeneration du squelette
CN202105009U (zh) * 2011-06-10 2012-01-11 中国人民解放军第四军医大学 一种用于四肢长骨粉碎性骨折后骨折吻合端碎骨片固定的装置
WO2014110471A1 (fr) * 2013-01-12 2014-07-17 Houff Louis Dispositif et procédé de fixation de sternum
US20190290436A1 (en) * 2017-09-11 2019-09-26 DePuy Synthes Products, Inc. Patient-specific mandible graft cage
KR20200111920A (ko) * 2019-03-20 2020-10-05 (주)포스메디칼 의료용 열가소성 깁스
CN211484846U (zh) * 2019-11-26 2020-09-15 云南省第三人民医院 一种骨科外固定支架保护套

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