JP-7855822-B2 - A device for treating fractures

Inventors

• プラゲル、ロナルド
• ブーレン、ヴォルカー

Assignees

• アイ．ティー．エス． ゲーエムベーハー

Dates

Publication Date

20260511

Application Date

20221107

Claims (20)

1. A device for treating a fracture is provided, comprising a nail that can be introduced into the intramedullary canal of a bone , wherein the nail has a hole that is generally aligned transversely with respect to the longitudinal axis of the nail, wherein a connecting device is provided that can be introduced into the hole so as to be able to move within the hole along a transverse axis in an outward and inward direction opposite to the outward direction, wherein the connecting device can be fixed in the correct position at the end of a bone portion , and an adjustable device is provided that can be fixed in the correct position at various positions relative to the nail, wherein the adjustable device has a first restraining surface that restricts the outward movement of the connecting device when the connecting device and the adjustable device are positioned on the nail, wherein the outward end position to which the connecting device can move outward relative to the nail can be changed by changing the position of the adjustable device relative to the nail , wherein the first restraining surface is formed by a plurality of restraining surfaces acting simultaneously .
2. The apparatus according to claim 1, wherein the nail can be introduced into the intramedullary canal of the femoral shaft axis.
3. The apparatus according to claim 1, wherein the connecting device is a bone screw.
4. The apparatus according to claim 1, wherein the fracture is a fracture of the proximal femur or a fracture of the femoral neck.
5. The apparatus according to claim 1, wherein the end portion of the bone is the femoral head.
6. The apparatus according to claim 1, wherein the connecting device can be fixed in the correct location using screw threads provided on the connecting device.
7. The apparatus according to claim 1, wherein the adjustment device can be fixed in the correct position at various positions relative to the nail using threads within the adjustment device and within the nail.
8. The apparatus according to claim 1, wherein the first stopping surface is formed at least partially by a shoulder or collar within the region of the outer end of the adjustment device.
9. The apparatus according to claim 8, wherein the collar is an adjustment screw collar.
10. The apparatus according to any one of claims 1, 8, or 9, wherein the first stopping surface is at least partially formed by a portion of the threads of the adjustment device, and the adjustment device can be secured in the correct position relative to the nail using the threads.
11. The apparatus according to any one of claims 1, 8, or 9, wherein the first stopping surface is at least partially formed by a portion of the threads of the connecting device, and the connecting device can be secured in the correct position at the end within the bone portion using the threads.
12. The apparatus according to any one of claims 1 , 8, or 9 , wherein the adjustment device is connected to the nail by a screw thread, and a screw lock that increases friction in the screw thread is provided to prevent the adjustment device from loosening.
13. The apparatus according to claim 12, wherein the screw lock is a piece of plastic.
14. The apparatus according to any one of claims 1, 8, or 9, wherein the adjustment device can be screwed onto the nail only to a predetermined position, and the fact that the adjustment device can be screwed onto the nail only to a predetermined position is structurally implemented using a wrench that, starting from the predetermined position of the adjustment device, no longer generates any contact with the corresponding mating member of the adjustment device.
15. The apparatus according to claim 14, wherein the mating member is a hexagonal socket and the wrench is a hexagonal wrench.
16. The apparatus according to claim 1, wherein the adjustment device has a second stop surface that restricts the inward movement of the connecting device when the connecting device and the adjustment device are positioned on the nail.
17. The apparatus according to claim 1 or 16 , wherein the position of the adjustment device with respect to the nail can be changed along the adjustment direction.
18. The apparatus according to claim 17, wherein the position of the adjustment device with respect to the nail can be changed along a straight line.
19. The apparatus according to claim 17, wherein the first stop surface and the second stop surface are aligned at different angles with respect to the adjustment direction, and as a result, when the position of the adjustment device relative to the nail is changed, the outer end position can be changed to a greater extent than the inner end position.
20. The apparatus according to any one of claims 1 , 8, or 9 , wherein the position of the adjustment device with respect to the nail can be changed along the adjustment direction, where the adjustment direction is aligned at an angle of 0.1° to 15 ° with respect to the transverse direction.

Description

The present invention provides a device for treating fractures, particularly fractures of the proximal femur, such as fractures of the femoral neck, comprising a nail that can be introduced, for example, into the intramedullary canal of a bone, particularly into the intramedullary canal of the femoral shaft axis, wherein the nail has a hole that is generally aligned transversely with respect to the longitudinal axis of the nail, and the connecting device can be introduced into the hole so that it can move along the transverse axis within the hole, past both sides of the hole and oriented laterally and medially in the opposite direction to the laterally direction, wherein the connecting device can be fixed in the correct position at the end of a bone portion, particularly at the femoral head, particularly using threads provided on the connecting device. The present invention further relates to a method for treating a femoral neck fracture, wherein a nail is introduced into the intramedullary canal of the femoral shaft axis, a connecting device is then introduced into the nail, and the connecting device is fixed in the correct position within the femoral head. Based on prior art, the types of devices and methods mentioned at the beginning are known, particularly for treating femoral neck fractures. Therefore, a certain degree of mobility between the femoral head and the femoral shaft axis is crucial for rapid healing. For this reason, for example, a device known from reference US 8,172,841 B2 allows for a certain degree of mobility of the connecting device relative to the nail. According to the aforementioned reference, this mobility is achieved using a grab screw positioned distally on the nail, which slides within a groove in the connecting device. However, it has been proven that this type of device cannot achieve optimal healing for all patients. This is addressed by the present invention. The object of the present invention is to specify the type of device mentioned at the beginning that can be better adapted to the individual patient's needs. Furthermore, this type of method is specified. According to the present invention, a first object is provided: an adjustment device that can be fixed in the correct position on the nail at various positions, particularly using threads within the adjustment device and within the nail, wherein the adjustment device has a first stop surface that restricts the outward movement of the connecting device when the connecting device and the adjustment device are positioned on the nail, and as a result, the outer end position to which the connecting device can move outward relative to the nail can be changed by changing the position of the adjustment device on the nail. In the course of this invention, it was discovered that the same mobility of the connecting device relative to the nail, or transverse play between the connecting device and the nail, is not equally beneficial for all patients, and that the connecting device being movable to varying degrees relative to the nail may be advantageous depending on patient-specific parameters, particularly, for example, height, weight, bone density, fracture type, and similar factors. According to this invention, this adaptability of mobility or play, which promotes healing, can be achieved in a structurally particularly simple manner by an adjustable device that can be fixed in the correct position at various positions relative to the nail, the adjustable device restricting the outward mobility of the connecting device within the shape fit via a first stopping surface. Typically, the connecting device may be connected to the femoral head using threads provided at its ends, and for this purpose, it is usually embodied as a bone screw. However, the connecting device may be embodied in any other suitable manner to enable connection to a bony portion, such as the femoral head. Furthermore, it will be understood that the device according to the present invention may also be used to treat fractures other than those of the femoral neck, particularly fractures in the proximal femur region. Typically, the transverse axis is roughly perpendicular to the longitudinal axis of the nail, at the angle typically taken by the axis of the femoral neck relative to the axis of the femoral shaft, for example, between 110° and 140°. Preferably, the adjustment device can be screwed into the nail, specifically preferably distal to the connecting device, and, for example, preferably at a slight angle to the transverse axis. Therefore, the play of the connecting device relative to the nail can be easily changed by altering the screwing depth of the adjustment device, which is typically embodied as an adjustment screw. The first stopping surface may be formed by a single surface only. However, it may be provided that the first stopping surface is formed by multiple stopping surfaces that act simultaneously and, in a particularly effective manner, restrict