Implant delivery device in the treatment of trochanter and subtrochanter fractures

Translation of description of equivalent WO 9833442 A1

Target device for an implant for supply trochanterer and subtrochanteric fractures

D escription

The invention relates to a target device for an implant for supplying trochanterer and subtrochanteric fractures according to the preamble of claim 1.

From EP 0496950 Bl a target device for an implant for supplying trochanterer and subtrochanteric fractures is known which comprises a head which comprises a pin for retaining an insertable into the medullary space Femumagels. Furthermore, this target device comprises a side of the head mounted guide arm, which extends approximately parallel to the Fe urnagel and at least two on proximal oblique bores of Femumagels aligned for a femoral neck screw inclined target bores and at least one of a distal transverse bore of Femumagels aligned for distal locking screw cross target bore for receiving having a drill sleeve. The head is mounted on the guide arm insoluble in the known Ausführungsfor. Furthermore, has the head locking for releasable attachment and a striking face for driving in the Femumagels. The guide arm has a plurality of inclined aiming bores, which include different angles with the aiming arm and are at least partially crossed by the cross target bore. This design allows all target holes can be accommodated in a relatively short section of the target device so that the target device can be carried out correspondingly compact.

A disadvantage of the known construction is another rigid assignment of different target holes. The known target device in particular allows no adjustment of the transverse aiming bores to different distal transverse bores of Femumagels. It must be remembered that modern femoral nails in the distal region having elongated transverse bores, to receive either a static or dynamic locking. For the known target device is not suitable due to the static allocation of target holes each other.

The present invention has for its object to provide a target device of the type mentioned, which described less the transverse aiming bores has more degrees of freedom.

This object is achieved by the characterizing features of claim 1, preferred details of construction are disclosed in the dependent claims.

The construction of the invention is characterized firstly by the fact that it can be executed extremely compact, which for this purpose, at least the distal slanted aiming passage in the aiming arm with the passage of the plate-shaped insert part or the insert plate, in which the transverse aiming bores are formed crosses. The variability of the target device according to the invention is obtained by insert plates with different directions and / or different sized and / or differently spaced Querzielboh- ments are provided. The transverse aiming bores an insert plate may extend to one another either parallel or at an angle.

Particularly advantageous is the embodiment according to claim 2, after which the transverse aiming bores, however, extend parallel to the longitudinal center axis of the insert at a different distance from the latter. It is thus possible to 180 degrees either slightly adjust transverse aiming bores above or slightly below by turning the insert plate, so that when training fertil of elongated transverse bores in the distal region of an associated Femu Agel either a static or dynamic anchoring thereof possible ,

The slanted aiming passages, proximal to corresponding Oblique passages of Femumagels aligned, serve to receive a wrapping and / or drill sleeve. A protective sleeve is always used when the femoral neck stabilization sationselement one femoral neck blade which is hammered into the Schengen kelhalsknochen and not screwed, so as proposed in the prior art.

Preferably, the slanted aiming passages have at least each an asymmetric cross-section over part of its length, in particular at least one side flattened

Circular cross-section, so that a protective sleeve can be placed rotatably. The flattening of the inclined aiming passages is obtained with a specific embodiment, in that a corresponding hole in the aiming arm at least one side by a predetermined length designed to be open and this opening by a planar plate can be closed. The protective sleeve then has a corresponding or complementary shaped outline in the direction transverse to the longitudinal extent. By protective sleeve through the said femoral neck can recover sword into the femoral neck bone.

The measure according to claim 3, after which the Fe urnagel facing face of the insert plate is starting inclined towards roof-like from the longitudinal central axis respectively towards the two narrow longitudinal sides, serve to avoid

Collisions between the set plate and the femur. It must be remembered that the insert plate is longer than the corresponding passage in the aiming arm, so that side of the femur, the insert plate on the guide arm protrudes, in a 90 degree angle deviating relative to the aiming arm. Of the

Angle of the roof-like chamfer relative to the longitudinal center axis of the insert preferably corresponds to the angle between the aiming arm axis and the longitudinal center axis of the passage for the insert plate in the aiming arm.

The measures according to claims 4 and 5 serve for eccentric arrangement of the transverse aiming bores relative to the longitudinal center axis of the insert for immediate recognition of the eccentricity of the transverse aiming bores. The features of claim 7 allow a functionally reliable fixing of insert within the associated passage in the aiming arm.

It goes without saying that the oblique aiming passages 12, 13 may be designed as circular holes or oval holes, so that can be dispensed with the shutter plate 16th In this case, the guide arm 10 would be in one piece forms.

Further features and advantages of erfindungsge ate target device will be explained in more detail using an exemplary embodiment which is illustrated in the accompanying drawing atic cal. Shown are:

Figure 1 shows a part, namely the distal part of an aiming arm according to the invention in a schematic side elevational looks;

Figures 2a and 2b, a first embodiment of an inventive insert, here eccentric plate, in side view, end view and perspective

View;

Figure 3 shows the distal portion of the aiming arm in plan view from lateral illustrated in Figure 1;

4 shows a second embodiment of an inventively embodied aiming arm in a schematic side view;

Figure 5 the aiming arm as Figure 4 in plan view from the lateral direction;

Figure 6 the aiming arm as in Figures 4 and 5 in a perspective view; characters

8-10, a second embodiment of an inventive insert, namely eccentric

Plate in flat-sided view, perspective view, cross-sectionally along line AA and end view.

In the figures 1 and 3, the distal portion of an aiming arm 10 is shown in side and front view, which is detachably connected in the proximal region with a head. On this head, a femoral nail is connected. In the aforementioned head and the connection to a femoral nail is itself described known measures, so an explanation is omitted here. It should be noted, however, that the detachable connection between the head and the aiming arm is advantageous in that both parts can be made of different materials, for. Example, the plastic head. X Technically appropriate this construction and two-piece design

Advantages. The Röntengenbild is not disturbed by the guide arm is made of plastic. The fixing of the aiming arm 10 on the mentioned head is such that the longitudinal axis 11 of the aiming arm extends approximately parallel to a head-mount spring murnagel.

In aiming arm 10 first aiming passages 12, 13 are formed which include different angles with the aiming arm 11 of preferably 125 degrees, 130 degrees or 135 degrees. It is also an angle of 140 degrees is conceivable. In this case, two slanted aiming passages 12, 13 are provided. It is also conceivable to provide more than two inclined aiming passages. This slanted aiming passages serve to receive a protective sleeve for wrapping a contoured cross-section neck stabilization element not shown here, in particular femoral-neck blade with double-T cross-sectional profile, star profile, T-profile or the like. The respective slanted aiming passage according to the orientation of the proximal oblique passage in selected according to anatomical Fe murnagel selected. Both slanted aiming passages 12 and 13 have at least a portion of its length (see especially Figure 6) each have an asymmetric, namely flattened on one side of a circular cross-section for the rotationally fixed placement of said protective sleeve, the outer contour of the mentioned

Cross section of the aiming passages 12 and 13 corresponds. The flattening of the inclined aiming passages 12, 13 is obtained in that a corresponding hole in the aiming arm 10 is set so that this at least one, the left in Figure 3 side over a predetermined length (see Figure 6) designed to be open and this opening 14, 15 is closed by a planar plate 16th The plate 16 is fixed by screws 17 on the guide arm 10, within a corresponding recess 18th The fixation within the recess 18 is such that the plate 16 on the outside flush with the Target Arm 10th

The guide arm 9 further has a second passage 19 which is also inclined in accordance with Figure 1 obliquely to the longitudinal axis aiming arm 11, namely opposite to the inclination of the first

Slanted aiming passages 12 and 13. The passage 19 is arranged so that it crosses the distal slanted aiming passage 13 or tapping interspersed. The helical passage 19 serves for receiving a plate-shaped insert member or an insertion plate 20, extending parallel to the longitudinal axis of the insert plate 20 extending transverse aiming bores 21, 22 comprises, which are directed in the mounted state of the insert plate 20 to distal transverse bores of Femumagels not shown here. In general, each femur pin has two distal cross bores, modern Femoral Nail elongated transverse bores so that the

Femoral Nail can be fixed either statically or dynamically in the femur. With static fixing the bone screw at the proximal end of the elongated transverse holes are, while they are in contact with dynamic fixation at the distal end of said elongated hole transverse bores. To an appropriate placement of the

to allow bone screws, the transverse aiming bores 21, 22 relative to longitudinal center axis 23 of insert 20 are at different distances from the longitudinal center axis of the 23rd By turning the insert plate 20 by 180 degrees thus be the Transverse aiming bores 21, 22 move from bottom to top and vice versa. The different distances of the longitudinal axes of the transverse aiming bores 21, 22 of the longitudinal center axis 23 of insert 20 are shown in Figure 2a with the distance arrows 24, 25th The insert plate of this type can therefore also as

Eccentric disk are referred to as the transverse aiming bores 21, 22 are arranged relative to the long center axis 23 eccentric.

To avoid too far insertion of the insert plate 20 in the inclined passage 19 of the aiming arm 10 from the lateral side, the insert plate 20 has at its lateral end face an outwardly projecting collar 26 on. This collar 26 serves forth on the lateral side of the aiming arm 10 during insertion of the insert plate 20 in the passage 19 of the target low-10 from laterally as a stop.

After installation of the insert plate 20, only the proximal oblique passage 12 is open. In the event that the distal slanted aiming passage 13 to be used, the insertion must be plate 20 removed.

The advantage of the insert plate 20 is that in this one, two, three or more transverse aiming bores parallel or at an angle to each other can be formed. It is also possible to provide insert plates with transverse aiming bores of different diameters are available. Also insert plates can be provided with transverse aiming bores are available, which have a different distance from the longitudinal center axis 23 of insert 20th The variability of the construction described is thus significantly improved compared to the rigid embodiment according to the initially mentioned prior art.

The insert plate 20 is fixed to 27 in the embodiment according to FIGS 1 to 3 by means of clamping screws 16 screwed in corresponding threaded bores of the plate. The inclined aiming passages 12 and 13 are also associated with clamping screws to suit the screws 27, as can be seen in particular in FIG. 1 The average in Figure 1 clamp screw 27 has a dual function in so far. It serves firstly to clamp the insert plate 20 and the other to clamp an inserted into the distal slanted aiming passage 13 in sleeve.

The embodiment of Figures 4 to 6 essentially corresponds to that of Figures 1 to 3, wherein Figure 6 very beautiful leaves 12 and 13 recognize the longitudinal openings of the slanted aiming passages which are then closable by said plate 16th Also let the 4 to 6, the proximal end of the aiming arm 10 seen with a device 28 for connecting the above-mentioned head. Figure 6 can further good mutual intersection between the passage 19 on the one hand and distal slanted aiming passage 13 recognize.

In the embodiment of Figures 4 to 6, the longitudinal edges of the passage 19 are rounded. Of course, then the insert plate must have 20 correspondingly rounded or chamfer oriented longitudinal edges.

That of the embodiment of Figures 4 to 6 associated insert plate is shown in Figures 7 through 10th She in turn, the reference numeral 20. The transverse aiming bores are marked with the reference numbers 21, 22nd The longitudinal center axis of the insert 20 is also indicated in Figure 8 and 10 by reference numeral 23rd The transverse aiming bores 21, 22 are relatively different distances to the longitudinal center axis 23 of insert 20 from the longitudinal center axis 23rd The corresponding distance arrows are also provided here with the reference numbers 24 and 25th

The the femoral nail facing end face 29 of the insert plate 20 is at the dargestellen in Figures 7 to 10 embodiment, starting from the longitudinal center axis 23 roof-like inclined respectively towards the two narrow longitudinal sides 30 toward, in the direction laterally. This collision of the inner end with the patient can be avoided despite oblique use of insert 29th accordingly, the angle of the roof-like bevel relative to the longitudinal center axis 23 corresponds approximately to the angle of the longitudinal center axis of the passage 19 relative to the longitudinal axis 11 of the aiming arm 10th

The insert plate 20 has in the 7 to 10 illustrated embodiment also a starting from the the femur pin end facing 29 to the femoral nail remote toward end face 31 toward extending incision or longitudinal slot 32 which extends in the direction long central axis 23 extends over about 2/3 and that the total length of the insert plate 20. This longitudinal slot corresponds at

Inserting the insert plate 20 in the aiming arm passageway 19 located extending therethrough guide pins 34. These are parallel to the longitudinal axis of the passageway 19 at a distance one behind the other in the insertion direction or in the direction. Hold the insert plate clearance in the passage and facilitate the insertion and removal of the insert plate without the risk of jamming during insertion and removal thereof.

On lateral end the insert plate 20 here two flat sides with Griffnuten 33 or the like. Handholds or handle support is at least one, provided that facilitate the handling. The fixing of the insert plate 20 in the passage 19 by the aforementioned clamping screws 27th

All features disclosed in the application documents are claimed as essential to the invention insofar as they individually or in combination, over the prior art are new.

Bezu gszei che nl i ste

5 10 aiming arm

11 aiming arm longitudinal axis

12 slanted aiming passage

13 slanted aiming passage

14 opening 10 opening 15

16 plate

17 screws

18 recess

19 oblique passage 15 20 insert plate

21 cross target bore

22 cross target bore

23 long central axis

24 spacing arrow 20 25 distance arrow

26 peripheral collar

27 clamping screw

28 head-connecting device 29 front side

25 30 longitudinal side (narrow)

31 front side

32 longitudinal slot

33 Griffnuten

34 guide pins 30