U.S. patent number 3,604,414 [Application Number 04/756,206] was granted by the patent office on 1971-09-14 for bone setting device.
Invention is credited to Nicomedes Borges.
United States Patent |
3,604,414 |
Borges |
September 14, 1971 |
BONE SETTING DEVICE
Abstract
An osteosynthesis plate of two-piece construction having a
toothed rack system to enable sliding movement of the two pieces in
a direction to move the plate pieces in a direction to achieve the
greatest approximation of a fractured bone to facilitate joining
the fracture in the bone. The plates are secured to the fragments
of the bone by screw members and a tool for moving the plates
toward each other is provided to facilitate engagement with the
plates after they have been attached to the fragments of the
fractured bone.
Inventors: |
Borges; Nicomedes (Caracas,
VE) |
Family
ID: |
25042465 |
Appl.
No.: |
04/756,206 |
Filed: |
August 29, 1968 |
Current U.S.
Class: |
606/105;
606/71 |
Current CPC
Class: |
A61B
17/8019 (20130101); A61B 17/8009 (20130101); A61B
17/8023 (20130101); A61B 17/7225 (20130101) |
Current International
Class: |
A61B
17/68 (20060101); A61B 17/80 (20060101); A61B
17/72 (20060101); A61f 005/04 () |
Field of
Search: |
;128/83,92,92A,92D,92E,87,92R,92ED,87R |
References Cited
[Referenced By]
U.S. Patent Documents
Foreign Patent Documents
|
|
|
|
|
|
|
1,239,266 |
|
Jul 1960 |
|
FR |
|
1,507,627 |
|
Nov 1967 |
|
FR |
|
867,422 |
|
Jul 1949 |
|
DT |
|
335,797 |
|
Mar 1959 |
|
CH |
|
Primary Examiner: Gaudet; Richard A.
Assistant Examiner: Mitchell; J. B.
Claims
What is claimed as new is as follows:
1. A device for setting bone fragments comprising an osteosynthesis
plate constructed of first and second substantially flat elongated
pieces, said first piece having upper and lower surfaces and first
and second ends, the lower surface being adapted to engage the bone
fragments, said second piece overlying the upper surface of said
first piece and being adapted to remain remote from the bone
fragments, means for guiding said pieces and enabling longitudinal
movement of the pieces toward each other into approximation but
preventing movement in the opposite direction after approximation
has been achieved, said means including a longitudinal recess in
said first piece extending over a major portion of the length
thereof and defining flanges slidably receiving substantially the
entire length of said second piece, said means further including a
plurality of teeth in said longitudinal recess and a plurality of
teeth on said second piece, said teeth on said first piece having
two faces, one of said two faces being substantially perpendicular
to the longitudinal axis of said first piece and the other of said
faces being inclined toward said first end, said teeth on said
second piece also having a pair of faces, one of said pair of faces
being substantially perpendicular to the longitudinal axis of said
second piece and the other of said pair of faces being inclined
toward said second end, each of said pieces of said plate including
at least one aperture therein, said recess including a longitudinal
slot therein underlying said aperture in said second piece, a
fastener extending through each of said apertures and adapted to
engage the bone fragments, an opening in each of said pieces, and
means for engaging the openings and moving the two pieces of the
plate into approximation.
Description
The present invention generally relates to the field of medicine
and more particularly to traumatological surgery.
At the present time, osteosynthesis, the repair of fractures by use
of extraneous material such as a metal plate, so-called
osteosynthesis plates have been used which is in the form of a
strip of material of stainless steel or vitallium, which are
accepted by the body with the least degree of reaction, are
attached by apposition to the fractured bone. Various types or
models of such plates have been employed but all of them operate
under a single principle, that is, maintaining the fragments of a
fractured bone in the closest position to their normal state so
they can unite by the formation of a bony callus due the proximity
of the fragments. However, this consolidation of the bone is
impeded in a great number of cases by the fact that the more the
fragments are separated and mobile, the consolidation is retarded
and the formation of pseudoarthrosis is stimulated which defect
renders the bone incompatible with its normal functioning.
In view of each undesirable results caused by the single-piece
construction of the osteosynthesis plate, the present plate
constructed of two pieces enables one piece to be moved in relation
to the other by employing interengaging teeth between the two
sections or pieces of the plate. Each piece of the plate is located
on one of the bone fragments and attached thereto by screws which
permit sliding in the direction of approximation, but not in the
direction of separation due to the particular configuration of the
toothed connection therebetween.
An instrument is provided for sliding the two pieces of the
osteosynthesis plate in an approximation direction which includes a
pair of parallel arms engaged with a rodlike member having opposite
screw threads thereon for moving the arms toward and away from each
other. The outer ends of the arms and each piece of the plate have
correspondingly shaped projections and orifices receiving the
projections to enable movement of the pieces of the plate in an
approximation direction.
One of the objects of the present invention is to provide an
osteosynthesis plate and an instrument for moving the two pieces
thereof in an approximation direction which is effective for the
purpose of consolidating the fragments of a fractured bone,
relatively easy to use while being dependable and long lasting.
These together with other objects and advantages which will become
more subsequently apparent reside in the details of construction
and operation as more fully hereinafter described and claimed,
reference being had to the accompanying drawings forming a part
hereof, wherein like numerals refer to like parts throughout, and
in which:
FIG. 1 is a perspective view illustrating the osteosynthesis plate
and the instrument for moving the two pieces thereof towards
approximation illustrating the manner of use thereof;
FIG. 2 is a side elevational view of the assembly of FIG. 1 with
the osteosynthesis plate in section;
FIG. 3 is a transverse, sectional view taken substantially upon a
plane passing along section line 3--3, on an enlarged scale, of
FIG. 2 illustrating further structural details of the
invention;
FIG. 4 is an enlarged fragmental sectional view of the two pieces
of the plate illustrating the relationship of the toothed
interconnection therebetween;
FIG. 5 is an exploded group perspective view of the two-piece
osteosynthesis plate; and
FIG. 6 is a bottom plan view of one piece of the plate.
Referring now specifically to the drawings, the osteosynthesis
plate is generally designated by the numeral 10 and the clamp or
instrument for manipulating the two pieces of the plate is
designated by the reference numeraL 12. The plate 10 includes two
pieces, segments or sections generally designated by the numerals
14 and 16 respectively with the segment 14 including an elongated
relatively narrow and thin rectangular body 18 having a pair of
longitudinally spaced and aligned apertures 20 extending
therethrough with the upper ends of each aperture 20 being
countersunk at 22 for receiving screw-type fasteners 24 as
illustrated in FIG. 2. Provided in the upper surface of the body 18
is an elongated recess 26 extending from a point adjacent the inner
orifice 20 to the opposite end thereof with the recess 26 being
defined by a pair of edge flanges 28 and an inner end surface 30.
The bottom of the recess 26 is provided with a plurality of
transversely extending teeth 32 thereon and an elongated slot 34
extends substantially throughout the length of the bottom of the
recess 26.
The piece or segment 16 includes an elongated rectangular body 36
adapted to be received within the recess 26 between the flanges 28
with the body 36 having a pair of countersunk apertures 38
extending therethrough for receiving the screw-threaded fasteners
40 as illustrated in FIG. 1. The lower surface of the body 36 is
provided with a plurality of transversely extending teeth 42
thereon for interengagement with the teeth 32 within the recess 26.
When the section 16 is assembled with the section 14, the teeth 42
and 32 are interengaged and the screw-threaded fasteners 40
extending through the apertures 38 also extend through the slot 34
in the section 14. Centrally of the section 14 intermediate the
apertures 20, a square recess or opening 44 extends therethrough
and a similar square or rectangular opening 46 extends through the
section 16 between the two apertures 38.
The instrument 12 for manipulating the segments 14 and 16 of the
osteosynthesis plate 10 includes a bar of elongated rectangular
configuration with the transverse cross section of the bar also
being rectangular. At one end of the bar 48, there is provided a
laterally extending arm 50 of one-piece construction with the bar
48, with the outer end of the arm 50 including a projection 52 for
reception within the opening 44 in the section 14 of the plate
10.
Slidable on the bar 48 is a sleeve 54 having a recess 56 extending
therethrough closely receiving the bar 48 for sliding movement
thereon. The sleeve 54 is provided with an arm 58 of one-piece
construction therewith which is disposed in parallel coplanar
relation with the arm 50 and terminates in a projection 60 at its
free end for engagement in the opening 46 in the plate segment 16.
The projections 52 and 60 are of a shape and configuration to
closely fit within the openings 44 and 46 respectively so that when
the arm 58 is moved toward the arm 50, the plate segment 16 will be
moved toward the plate segments 14.
The end of the bar 48 having the arm 50 thereon is also provided
with a laterally projecting sleeve or bearing block 62 journaling
an elongated rod 64 therein. The rod 64 has the major portion
thereof externally threaded at 66 for threaded engagement with a
laterally extending internally threaded sleeve or boss 68 formed
unitarily with the sleeve 64 in alignment with the bearing block
62. Fixedly mounted on the rod 64 is a pair of abutment members 70
and 72 which are disposed on opposite sides of the bearing block 62
and engage the bearing block 62 with washers 74 therebetween if
desired so that when the rod 64 is rotated, the members 70 and 72
will prevent axial movement thereof thereby causing the boss 68 and
the sleeve 54 as well as the arm 58 to move longitudinally on the
bar 48 when the rod 64 is rotated.
The end of the rod 64 which extends beyond the sleeve or abutment
member 70 is formed with a polygonal end 76 for the reception of a
suitable wrench or handle 78 which includes a ratchet mechanism
within a housing 80 so that the handle 78 may be ratcheted to cause
rotation of the threaded rod 64 in a selected rotational
direction.
In utilizing the invention, the fracture site such as in the
forearm 82 is opened surgically as at 84 in the usual manner to
expose the fracture 86 between fragments or segments 88 and 90 of
the bone. Once the fracture has been reduced, section 14 is placed
on the end of one of the fragments such as fragment 90 of the bone
and is temporarily held in place by a bone clamp while it is
attached to the bone fragment with two screws 24 as illustrated in
FIG. 2 so that the end thereof having the slot 34 therein extends
beyond the fracture 86 into overlying relation to the bone fragment
88. Piece or segment 16 is then put in place within the recess 26
with the screws 40 being inserted through the apertures 38 and the
slot 34 but not tightened completely to enable sliding movement of
the segment 16 in a direction to bring the bone fragments 88 and 90
into contacting engagement with each other or into close
approximation. As soon as the piece 16 has been attached in the
manner illustrated, movement in a direction to increase the
distance between the ends of the bone fragments 88 and 90 is
precluded by the teeth 32 and 42. This is assured inasmuch as all
of the teeth 32 on the segment 18 have a surface 92 in
perpendicular relation to the longitudinal axis of the segment 18
and facing the end surface 30 of the recess 26 with the apex of
each tooth defining the upper limit of the vertical surface 92 and
the upper limit of an inclined surface 94 thus defining a tooth
which will enable movement of the plate 36 in a direction toward
the apertures 20 and preclude movement in the opposite direction.
As illustrated in FIG. 4, the teeth 42 in the segment 16 are
oppositely oriented so that the teeth 32 and 42, in effect form a
one-way ratcheting engagement between the segments of the plate. In
this condition such as illustrated in FIGS. 1 and 2, the instrument
or tool 12 is applied and by operating the ratchet handle 48, the
fracture 86 may be substantially closed by bringing the ends of the
bone fragments 88 and 90 into contact with each other or into
substantially approximation of each other to facilitate the
consolidation or uniting thereof. During this procedure, the
surgical incision 84 may be kept open by employing conventional
instruments 96 for this purpose and conventional bone clamps may be
employed for alignment of the bone fragments and bringing the bone
fragments 88 and 90 into closer approximation before installation
of the osteosynthesis plate. After installation of the plate and
operation of the instrument 12 to position the bone fragments 88
and 90 in the optimum position, the screws 40 are tightened into a
final condition thus securing the plate in position after which the
surgical incision 84 is closed in the usual manner.
The osteosynthesis plate will be provided in different lengths and
sizes with suitable indicia provided for indicating the size. The
indicia may be in the form of matching numerals on the upper
surface of the segments 14 and 16 respectively. The plate and the
clamp may be readily rendered aseptic and are constructed of
conventional materials employed for surgical instruments and the
number, shape and size of teeth may be varied to vary the
increments of movement of the segments of the plate in relation to
each other in order to enable accurate and positive approximation
of the end of the bone fragments defining the line of fracture to
facilitate the consolidation or knitting of the surfaces defining
the fracture.
The foregoing is considered as illustrative only of the principles
of the invention. Further since numerous modifications and changes
will readily occur to those skilled in the art, it is not desired
to limit the invention to the exact construction and operation
shown and described, and accordingly all suitable modifications and
equivalents may be resorted to, falling within the scope of the
invention as claimed.
* * * * *