External fixation strut

This disclosure generally relates to the field of external fixation. More specifically, the present disclosure relates to external fixation connection columns and other connection rods.

Without limiting the technical scope of the disclosure, the disclosure is described in the context of external fixators and in particular connecting struts and rods. External fixators are commonly used in a variety of surgical procedures-including leg extension and deformity correction. The method has a rigid framework with multiple rings. The rigid framework is provided around the legs and attached to the bone segment using wires and half pins. The wire and half pin are inserted into a part of the bone and connected to the relevant part of the external rigid framework. The opposing rings of the rigid framework are either directly interconnected by threaded or telescopic rods, or interconnected with single-sided or multi-layered hinges. This allows the surgeon to adjust the position of the rings relative to each other in the longitudinal, rotational, horizontal, or angular directions over a long period of time.

For example, in leg extension, the bone is surgically divided into two parts, and wires and halves are inserted into parts of the bone in front of and behind the surgically cut bone to support or extend. It is attached to the ring of a rigid framework that is interconnected by connecting rods. The rigid framework is used to push two bone segments and gradually separate the two bone segments in the longitudinal direction (eg 1 mm / day) over a long period of time. This makes it possible to gradually generate bone in the gap between the bone segments produced by this bone extension method. Once the desired amount of bone length (eg 5-6 cm) is achieved, the external fixator stabilizes in a fixed position and newly generated bone (eg March-June, but the nature of the condition). And depending on the amount of bone length) is left on the bone segment until it is completely calcified.

Similarly, in deformity correction, the bone is surgically divided into two segments, and wires and halves are inserted into parts of the bone in front of and behind the surgically cut bone, a ring of rigid framework. Attached to. The opposing rings of the rigid framework are threaded rods with single or multi-layer hinges and angle extenders used to gradually pull the two bone segments apart over a long period of time. Connect them so that they are one with each other by (angular distractor).

One common fixator is the annular metal structure known as the Ilizarov external fixator. Ilizarov external fixators, when used for bone lengthening or deformity correction, consist of multiple rings or arches. The plurality of rings or arches are provided around the bone and attached to a bone segment surgically separated using wires and half pins. In bone extension, opposing rings are directly interconnected by three or four threaded or telescopic rods. The length of the three or four screwed or telescopic rods is regularly adjusted and allows the bone segments to gradually separate in the longitudinal direction. In angle-varying deformation correction, the opposing rings of the Ilizarov fixator are connected by a pair of hinges that provide the axis of rotation to the bone segment and an angle extender that gradually pulls the bone segment associated with the two rings apart.

Another common external fixator is the Taylor Spatial Frame. This is a six-legged external fixator based on the Stewart platform, but shares many parts and features of the Ilizarov external fixator. The tailor spatial frame consists of two external fixation rings. The two external fixation rings are attached to the bone segment by wires and half pins, and are connected together by six telescopic struts with multi-layer hinges located at both ends. Each strut can be expanded and contracted as needed to bring the two interconnected ring segments closer to or apart from each other. By adjusting the length of the stanchions, 6 axes (extension, medial / lateral rotation, forward / posterior horizontal translation, medial / lateral horizontal translation, anterior / posterior angular translation, And medial / lateral translation in the angular direction), it is possible to operate the bone segment abruptly or stepwise to simultaneously perform bone extension and deformation correction in the angular, translational, and rotational directions. ..

<p> Tailor spatial frames have multiple struts that interconnect with a pair of rings. Wires, half-pins, struts, and other connecting and assembling elements of the frame connect to the ring, which connection is made through an opening defined within the ring. All of these openings, or holes, are provided on the same ring surface and extend through the upper ring surface to the lower ring surface. This creates problems with the installation of wires and half pins, as well as the installation of additional connecting rods and assembly elements, due to the scramble for holes in the fixing ring of the frame, that is, the wires and pins that interfere with the connection of the stanchions to the holes. It ends up.</p><p> Each strut of the tailor spatial frame has a threaded rod, a portion of which the threaded rod is provided inside a hollow shaft, and the hollow shaft has an adjusting nut that fits the threaded rod. The same threaded rod is pushed against the hollow shaft for either rough adjustment (rapid strut length adjustment) or fine adjustment (stepwise strut length adjustment) for the strut length. Be drawn. However, since the length of the threaded rod is finite, using the same threaded rod to make abrupt strut length adjustments, for example, stepwise strut length between bone extension and deformity correction. The total number of threaded rods that can be used to adjust is limited. As a result, it takes time to replace the long column during processing.</p><p> In addition, replacement or removal of struts from the tailor spatial frame during rough adjustment is not possible without the use of external supports or other stabilizing mechanisms that support the other frames. The columns of the tailor-spatial frame need to be connected at the top or bottom of the ring. Such a connection requires the use of a ball joint in the hole of the ring or a universal joint extending from the top or bottom of the ring. However, the tailor spatial frame does not have a fixing mechanism that temporarily fixes the orientation of the universal joint or ball joint. As a result, if one strut is removed from the frame, the frame becomes unstable and breaks.</p><p> Also with universal joints and ball joints of tailor spatial frames, adjusting the strut length is inaccurate and inconvenient. At the tailor-spatial frame joint, each strut can have three degrees of freedom of rotation. This degree of freedom also includes an unintended degree of freedom in shaft rotation. Therefore, as described above, when the strut adjustment nut rotates around the shaft to adjust the strut length, the strut as a whole also rotates around the shaft, so that the screw rod of the strut is the strut. Cannot be translated with respect to the hollow shaft of. In order for the threaded rod to perform the desired translational motion, a second hand or vise must be used to secure the hollow shaft from rotating around the shaft. Without such an inconvenient procedure, the adjustment of the strut length will be inaccurate.</p><p> Both types of joints have yet another challenge. One problem with using ball joints is that there is insufficient spatial clearance for the ball joints to adjust the orientation of the stanchions and rings. The problem with using universal joints is that the length of the universal joint occupies space, thus reducing the functional length of the stanchions. Another challenge is the instability caused by universal joints. Each of the universal joints has at least one hinge connection. In that hinge connection, the pivot pin is usually loosely held by two rotating parts. The two rotating parts are designed to rotate around a long axis defined by a pivot pin. Due to the loose coupling between the rotating parts and the pivot focus, unintended translational motion is unavoidable in the design of the hinge connection, introducing instability in the tailor spatial frame.</p>

<p> Various examples of improved external fixation struts are included in the present disclosure. In one embodiment, the external fixator is a strut housing having axial holes defined to penetrate, a first ball joint that joins the end of the strut housing, and the axial direction. It has an adjustable sleeve that is slidable inside the hole. The adjusting sleeve and the strut housing are joined so as to be releasable by a connector. The external fixation strut further has an elongated member threaded on the outside, a second ball joint that connects to the end of the elongated member threaded on the outside, and an adjustment mechanism having a rotating element. .. The rotating element has an internally threaded hole defined to penetrate. The elongated member threaded on the outside is provided so as to penetrate the hole threaded on the inside. The threads on the outside of the elongated member and the threads on the inside of the hole match each other, so that the rotating element rotates, causing the translational motion of the elongated member. The adjusting mechanism is rotatably coupled to the end of the adjusting sleeve. The adjustment mechanism can operate to rotate, but does not translate with respect to the adjustment sleeve.</p><p> Further, in the present disclosure, a method in which a first fixing ring and a second fixing ring are interconnected by a support column, the support column is adjusted to the length of the support column in the pretreatment, and the desired support column length is obtained during the treatment. Also included are various examples of. Each of the rings has a plurality of openings defined on the outer or inner surface of the ring. In one embodiment, the method comprises the procedure of providing a first portion of a strut having a first ball joint that joins an end of the strut housing. The strut housing has a shaft hole defined to penetrate the strut housing, and the first ball joint has a first ball strut. The method further comprises a procedure for providing a second portion of the strut. The second portion has a second ball joint that connects to the end of a threaded elongated member. The threaded elongated member is coupled to the adjusting mechanism so that it can be screwed. The adjusting mechanism is rotatably coupled to the end of the adjusting sleeve. The adjusting mechanism can operate to rotate, but does not translate with respect to the adjusting sleeve. The second ball joint has a second ball fastener. The method further comprises a procedure in which the adjusting sleeve is slidably provided inside the shaft hole of the strut housing. The method comprises connecting the ball strut of the first ball joint to the first opening of the first ring, and connecting the ball strut of the second ball joint to the second opening of the second ring. Have a procedure to connect. Other procedures included in the disclosed embodiments of the method include a procedure in which the adjustment sleeve is positioned relative to the strut housing to reach the strut length in the pretreatment, and can be released. As such, the procedure for connecting the adjusting sleeve to the support column housing is included.</p>

<figref num="1">It is a perspective view of one Example of the external fixation column of this disclosure.</figref><figref num="2">It is an enlarged view of the external fixation column of FIG.</figref><figref num="3A">It is sectional drawing of one Example of the external fixation column of this disclosure.</figref><figref num="3B">It is sectional drawing of another embodiment of the external fixation column of this disclosure.</figref><figref num="3C">It is sectional drawing of the specific part of the external fixation column of FIG. 3B.</figref><figref num="4A">It is a perspective view of the Example of the external fixation column of this disclosure.</figref><figref num="4B">It is a perspective view of a part of the external fixation strut illustrated in FIG. 4A.</figref><figref num="5">AD is a perspective view or a perspective view of an embodiment of the external fixation strut of the present disclosure.</figref><figref num="6A">It is a perspective sectional view of the ball joint which can be fixed by the separated ball joint cage.</figref><figref num="6B">It is a perspective sectional view of the ball joint of FIG. 6A.</figref><figref num="6C">It is a perspective sectional view of another ball joint which can be fixed by a separated ball joint cage.</figref><figref num="7">It is a perspective view of the ball joint which can be fixed by a screw type ball joint cage cup.</figref><figref num="8">It is a perspective view of a ball joint which can be fixed by a separated ball.</figref><figref num="9">It is an exploded view of the ball joint which can be fixed by a set screw.</figref><figref num="10">It is a side view of one Example of the external fixation column of the present disclosure attached to the outer surface of the external fixator.</figref><figref num="11">It is a side view of one Example of the six external fixation columns of the present disclosure attached to the outer surface of the external fixator.</figref>

For a more complete understanding of the features and advantages of the present disclosure, reference is made to the detailed description of the invention along with the accompanying drawings.

Although the fabrication and use of the various embodiments of the present disclosure are detailed below, the present disclosure provides many applicable invention concepts, which are feasible in a wide range of specific situations. Please keep in mind. The specific examples disclosed herein are merely examples of specific methods for making and utilizing the present disclosure, and do not limit the technical scope of the present disclosure.

The present disclosure provides external fixation struts with ball joints. The ball joint may be attached to the inner or outer surface of the fixing ring and housing. The fixing ring and housing allow the length to be adjusted independently, both rapidly and stepwise. The external fixation strut has a first ball joint having a first ball fastener. The first ball joint is at least partially surrounded by a first ball cage. The first ball fastener is attached to an opening in the outer or inner surface of the external fixation ring or other external support. The external fixation strut is a strut housing having a shaft hole extending longitudinally from the ball cage, an adjustment sleeve that fits slidably inside the shaft hole of the strut housing, and the adjustment. It has a sleeve fastener provided to fix the sleeve to the strut housing. The adjustment sleeve roughly adjusts an adjustment mechanism provided at one end of the adjustment sleeve and connected to a screw-type elongated member so as to be screwed, and a sudden longitudinal movement with respect to the support column housing. The adjusting mechanism gradually adjusts the second ball joint connected to the screw-type elongated member and the screw-type elongated member in the longitudinal direction. The second ball joint has a second ball fastener extending from the second ball member. At least a part of the second ball member is surrounded by a second ball cage. The second ball fastener is attached to an opening in the outer or inner surface of the external fixation ring or other external support.

FIG. 1 is a perspective view of an embodiment of the external fixator of the present disclosure used for the external fixator. The external fixation support 10 has a first ball joint cage 12, and at least a part of the first ball joint cage 12 is surrounded by a first ball member 14, and the first ball member 14 is a first ball fastener 16. The first ball fastener 16 secures the first ball member 14 of the first ball joint cage 12 to an external fixation ring or other fixation support (not shown). It is possible to operate to be received within the opening of the external fixation ring or other fixation support (not shown).

The telescopic strut housing 18 has an opening (not shown) that extends from the first ball joint cage 12 and extends longitudinally from the first ball joint cage 12. The first ball joint cage 12 allows the stretchable strut housing 18 to be angled and rotated with respect to the first ball member 14. The stretchable strut housing 18 has a stretchable housing adjustment opening 20. The adjustable sleeve 22 is provided so as to be slidable in a shaft hole (not shown) of the telescopic strut housing 18. Since the adjusting sleeve 22 is provided so as to be slidable inside the hole of the shaft, it is possible to quickly perform rough adjustment of the distance between the ends of the external fixation support column 10. The adjustable sleeve 22 has a sleeve fastener 24, and the sleeve fastener 24 is provided so as to penetrate the expandable housing adjusting opening 20, so that the adjustable sleeve 22 is fixed to the expandable strut housing 18. Will be done. In some embodiments, the adjustment opening 20 may have preset holes for abruptly moving the adjustment sleeve 22 in the longitudinal direction by a preset amount (eg, 5 mm) with respect to the strut housing. In these embodiments, the sleeve fastener 24 may be provided to have a neck portion that corresponds to the shape of a preset hole for positive mechanical interference. As such, the coarse adjustment of the strut length does not include the translation of the elongated member 28 with respect to the adjustment sleeve 22, and the overall length of the elongated member 28 is held so as to make a stepwise adjustment of the strut length, as described below. Will be done.

The adjusting mechanism 26 is rotatably coupled to the end of the adjusting sleeve 22 and screwed to the elongated threaded member 28. Therefore, the adjusting mechanism 26 can operate so as to rotate with respect to the adjusting sleeve 22 but not translate. The adjusting mechanism 26 generally has a rotating element with internally defined threaded holes. The screw-type elongated member 28 is provided so as to penetrate the screw-type hole. The threads of the threaded holes and the threads of the elongated threaded members coincide with each other. As a result, the rotation of the rotating element causes the elongated member 28 to translate in the longitudinal direction.

In the embodiment illustrated in FIG. 1, the adjustment mechanism 26 has a thumbwheel provided in a groove portion (not shown) defined at the upper end of the adjustment sleeve 22. The thumbwheel of the adjustment mechanism 26 translates the elongated threaded member 28 stepwise and rotates stepwise to adjust the overall length between the ends of the external fixator 10 stepwise. The adjustment sleeve 22 has a slot 23. Through the slot 23, the longitudinal position of the end of the threaded elongated member 28 with respect to the adjustment sleeve 22 can be observed. Therefore, the amount of adjustment in the longitudinal direction can be determined. Although not shown in FIG. 1, in some embodiments, the adjustment mechanism 26 incorporates a fixation mechanism known to those of skill in the art to limit the rotation of the thumbwheel to one or two dimensions. Please note that the doctor or patient may not accidentally adjust the strut length. In one typical embodiment, the adjusting mechanism 26 may have a ratchet-based fixing mechanism that is removable by pressing a button or lever.

The threaded elongated member 28 has a second ball joint 30, the ball joint 30 has a second ball joint cage 32, and the second ball joint cage 32 at least partially surrounds the second ball member 34. The second ball member 34 has a second ball clasp 36, which is provided in an external fixation ring or an opening in another external support (not shown). It can be operated so that it can be received. Like the first and second ball fasteners, the first and second ball members also operate to connect to the first and second ball members in order to secure the ball or ball fastener in the desired position. It is readily apparent to those skilled in the art that they may have one or more additional slots 40 or nuts (not shown) that can. Slot 40 may use any type of head fastener known to those of skill in the art-eg slot, phillips, hexagonal, socket, high torque, or other fasteners / heads.

FIG. 2 is an enlarged view of an embodiment of the external fixator of the present disclosure used for the external fixator. The external fixation strut 10 has a first ball joint cage 12 that at least partially surrounds the first ball member 14. The first ball member 14 penetrates a ball opening 38 having a size suitable for the first ball member 14. The first ball fastener 16 can operate to secure the first ball member 14 to an external fixation ring or other external support (not shown). The first ball joint cage 12 enables the angle and rotation of the external fixation support 10 to be aligned with respect to the first ball member 14.

The telescopic strut housing 18 has a shaft hole that extends from the first ball joint cage 12 and extends longitudinally from the first ball joint cage 12 to the opening 42 that serves as an axial hole. The stretchable strut housing 18 has a stretchable housing adjusting opening 20 defined in the wall of the strut housing 18. The adjustment sleeve 22 is provided in the shaft hole of the telescopic support housing 18 through the opening 42 which is the hole of the shaft. The adjustable sleeve 22 is slidable inside a shaft hole (not shown), which allows for quick rough adjustment of the length between the ends of the connecting rod 10. The adjustment sleeve 22 has a sleeve fastener 24. The sleeve fastener 24 is inserted through the centrally defined opening 44 of the sleeve fastener washer 46 and through the telescopic housing adjustable opening 20, the sleeve fastener within the adjustable sleeve 22. Inserted into opening 48. In the embodiment illustrated in FIG. 2, the sleeve fastener opening is a threaded hole in the sleeve radial direction defined within the end of the adjustment sleeve. The sleeve fastener washer 46 may have different configurations that offer different design advantages. In some embodiments, the sleeve fastener washer 46 may have a smooth inner surface (not shown). In yet another embodiment, the sleeve fastener washer 46 has a serrated portion (not shown), the serrated portion engaging with the serrated portion of the stretchable strut housing 18 to more reliably support the strut housing. Connect with 18.

The adjusting mechanism 26 is rotatably coupled to the end of the adjusting sleeve 22 and screwed to the elongated threaded member 28. The adjusting mechanism 26 adjusts the elongated member 28 of the screw type in the longitudinal direction to gradually adjust the total length between the ends of the connecting rod 10. The adjustment sleeve 22 has a slot 23. Through the slot 23, the longitudinal position of the end of the threaded elongated member 28 with respect to the adjustment sleeve 22 can be observed. Therefore, the amount of adjustment in the longitudinal direction can be determined.

The threaded elongated member 28 has a second ball joint 30. The second ball joint 30 has a second ball cage 32 provided to fit the second ball member 34. The second ball member 34 fits into the ball opening 50 of the second ball cage 32. The ball opening 50 is sized to fit the second ball member 34. The second ball fastener 36 can operate to be received within an opening (not shown) of an external fixation ring or other external support (not shown). The second ball joint cage 32 allows the angle and rotation of the external fixation column 10 to be aligned with respect to the second ball member 34. The first and second ball fasteners as well as the first and second ball members also have one or more additional slots 40 or nuts (not shown), of which one or more additional slots 40 or nuts are the first. Those skilled in the art will immediately understand that by operably connecting to the first and second ball fasteners as well as the first and second ball members, the fastener or ball can be fixed in the desired position. Slot 40 can also be used with any type of fastener known to those skilled in the art-eg slot, phillips, hexagonal, socket, high torque-tip fasteners, or other fasteners / heads. good.

FIG. 3A is a cross-sectional view of an embodiment of the external fixator of the present disclosure used in the external fixator. The external fixation support 10 has a first ball joint cage 12 for accommodating the first ball member 14. The first ball member 14 penetrates the first ball opening 38. The first ball opening 38 is sized to fit the first ball member 14. The first ball fastener 16 acts to catch the first ball member 14 within an opening (not shown) of an external fixation ring or other fixation support (not shown). It can be fixed to an external fixation ring or other fixation support (not shown). The first ball joint cage 12 enables the angle and rotation of the external fixation support 10 to be aligned with respect to the first ball member 14.

The telescopic support housing 18 has an opening extending from the first ball joint cage 12 and extending in the longitudinal direction from the first ball joint cage 12 to the opening 42 which is a hole of the shaft. The stretchable strut housing 18 has an adjustable opening 20 of the stretchable strut defined within the wall of the telescopic strut housing 18. The adjusting sleeve 22 penetrates the opening 42, which is a hole in the shaft, and is provided in the hole 58 in the shaft of the telescopic support housing 18. The adjustment sleeve 22 is slidable inside the shaft hole 58 to allow for quick rough adjustment of the end-to-end length of the connecting rod 10. The adjustment sleeve 22 has a sleeve fastener 24. The sleeve fastener 24 penetrates the opening 44 of the sleeve fastener washer 46 and the telescopic housing adjustment opening (not shown) and is defined within the end of the adjustment sleeve 22 with the radius of the adjustment sleeve. It is provided so as to enter the screw-type hole in the direction. In some embodiments, the sleeve fastener 24 and the sleeve fastener washer 46 are connected together.

The adjustment mechanism 26 is rotatably coupled to the end of the adjustment sleeve 22 and is connected to a threaded elongated member 28 so that it can be screwed through the adjustment mechanism opening 60. The adjusting mechanism 26 adjusts the elongated member 28 of the screw type in the longitudinal direction to gradually adjust the total length between the ends of the connecting rod 10. The adjustment sleeve 22 has a slot 23. Through the slot 23, the longitudinal position of the end 29 of the threaded elongated member 28 with respect to the adjustment sleeve 22 can be observed. Therefore, the amount of adjustment in the longitudinal direction can be determined.

The threaded elongated member 28 has a second ball joint 30. The second ball joint 30 has a second ball joint cage 32 provided to fit the second ball member 34. The second ball member 34 penetrates the second ball joint opening 50. The second ball joint opening 50 is sized to fit the second ball member 34. The second ball fastener 36 secures the second ball member 34 to an external fixation ring or other external support (not shown). The second ball joint cage 32 allows the angle and rotation of the external fixation strut to be aligned with respect to the second ball member 34.

FIG. 3B is a cross-sectional view of another embodiment of the external fixator of the present disclosure used in the external fixator. This embodiment is similar to that of FIG. 3A, except that the adjustment mechanism 26 has been replaced by a gear-based adjustment mechanism 100. As illustrated in FIG. 3C, which is a perspective view of a particular portion of the embodiment illustrated in FIG. 3B, the gear-based adjustment mechanism 100 is provided orthogonal to the threaded elongated member 28. It has a worm gear 102, and a connecting gear 104 that connects the worm gear 102 with a screw-type elongated member 28. The connecting gear 104 has a central opening and teeth 106 defined to penetrate the connecting gear 104. The central opening of the connecting gear 104 allows a portion of the threaded elongated member 28 to penetrate, while the teeth 106 of the connecting gear 104 engage with the screw of the worm gear 104 to engage with the worm gear 102. Screw-type elongated members 28 are joined. Therefore, the longitudinal adjustment of the screw-type elongated member 28 is realized by the rotation of the worm gear 104.

It should be noted that the adjustment mechanism suitable for the embodiment of the present disclosure is not limited to the adjustment mechanism based on the thumb wheel and the adjustment mechanism based on the gear described above. Any regulatory mechanism known in the art may be incorporated into the embodiments disclosed herein. Electrical connections may be incorporated into any of the above embodiments, for example, to adjust the stanchions with an automatic wrench as disclosed in US Patent Provision 61/029483.

In embodiments where an electric wrench is used to adjust the stanchions, the adjuster may have a rotary shaft encoder or other feedback sensor that counts the number of turns of the rotary shaft of the regulator. The regulator may further have a magnetic feedback sensor that interacts with a magnetic ring transmitter provided in the adjusting mechanism of the external fixation column. The magnetic feedback sensor counts the number of turns of the adjustment mechanism of the external fixation support.

Some typical embodiments may have a digital ruler or feedback sensor that determines the overall length and / or amount of length adjustment of the external fixator. To determine resistance during external fixation struts adjustment, some typical embodiments provide feedback torque measurement sensors for monitoring resistance during external fixation struts adjustment and providing rotational profiles. You may have it.

In addition to or in place of the display, an electrical sensor that generates a signal when a specific target adjustment is achieved may be provided. The display may be mechanically operated by conventional methods-eg, axially movable pins, swivel bars, and the like. In addition to or instead, an electrical sensor that is generated when a specific target adjustment is achieved may be used in a conventional manner. The signal from the electronic sensor is evaluated by electronic circuits in a known manner in order to initiate a conventional audio or optical device when the target torque is achieved.

FIG. 4A is a perspective view of an embodiment of the external fixation column of the present disclosure. The external fixation support 10 has a first ball joint cage 12 for accommodating the first ball member 14. The first ball member 14 has a first ball fastener 16. The first ball fastener 16 may act to penetrate the first ball joint cage 12 and secure the first ball member 14 to an external fixation ring or other external support (not shown). it can. The first ball joint cage 12 allows the external fixator to be angled (rotated) in directions X1, Y1, and Z1 in three orthogonal planes with respect to the first ball member 14. .. These movements allow the first ball joint cage 12 to be fixed at various angles to the external fixation ring or other external support (not shown).

The stretchable strut housing 18 has an opening (not shown) that extends longitudinally from the first ball joint cage 12 and extends longitudinally from the first ball joint cage 12. The stretchable strut housing 18 has a stretchable housing adjustment opening 20. The adjustable sleeve 22 is provided in a shaft hole (not shown) of the telescopic strut housing 18. The movement of the adjustment sleeve 22 within the shaft hole of the telescopic strut housing 18 allows adjustment to the distance "B". By adjusting in this way, the rough adjustment of the end-to-end length "A" of the external fixation support column 10 is quickly performed.

The adjustment sleeve 22 has a sleeve fastener 24. The sleeve fastener 24 is provided so as to pass through the sleeve fastener washer 46 and the expandable housing adjusting opening 20, thereby fixing the adjustable sleeve 22 to the expandable strut housing 18. The telescopic housing adjustment opening 20 also allows for positioning and reference of the adjustment sleeve 22 and / or the threaded elongated member 28 so that the external fixation column 10 has an end-to-end length of "A". It also functions as a window to help adjust.

The adjusting mechanism 26 is rotatably coupled to the end of the adjusting sleeve 22 and screwed to the elongated threaded member 28. The adjusting mechanism 26 may rotate to engage the threaded elongated member 28. By engaging in this way, the distance "C" is adjusted in the longitudinal direction, and the length between the ends of the external fixation support 10 "A" is adjusted stepwise. The adjustment sleeve 22 has a slot 23. Through the slot 23, the longitudinal position of the end 29 of the threaded elongated member 28 with respect to the adjustment sleeve 22 can be observed. In this way, the amount of adjustment in the longitudinal direction can be determined.

The threaded elongated member 28 has a second ball joint 30 with a second ball joint cage 32 provided to fit the second ball member 34. The second ball member 34 has a second ball fastener 36. The second ball fastener 36 may act to penetrate the second ball joint cage 32 and secure the second ball joint 30 to an external fixation ring or other external support (not shown). It is possible.

The second ball joint cage 32 can rotate in directions X2, Y2, and Z2 with respect to the second ball member 34 in three orthogonal planes. This movement allows the second ball joint cage 32 to be fixed at various angles to the external fixation ring or other external support (not shown). The first ball joint cage 12 of the external fixation support may be oriented at the same angle, position, or surface with respect to the second ball joint cage 32, but must be oriented at the same angle, position, or surface. Keep in mind that you don't have to.

The scale 74 is defined within the adjustable sleeve 22 and the telescopic strut housing 18 or is formed on the adjustable sleeve 22 and the telescopic strut housing 18. The scale 74 is provided adjacent to slot 23 and the telescopic housing adjustment opening 20 and is a discrete increment (eg,) indicating the distance between the first ball joint cage 12 and the second ball joint 30. Adjusted to 1mm increments). This discrete increment corresponds to the end-to-end length "A" of the external fixation strut 10.

The scale 74 indicates the length of the external fixation strut 10 as a relative length rather than a predetermined specific length. The scale 74 need not be based on a conventional measurement system and does not need to indicate the effective length of the column. For example, the scale may indicate the ratio of the total length of the bar, or the daily increment when translation occurs over a long period of time. Referencing an intermediate position can be useful in setting the bottom member in a predetermined "intermediate" position.

In some embodiments, the axial rotation X of the external fixation column with respect to the first ball 14 and the second ball 34.₁And X₂Keep in mind that it may be desirable to limit. For example, as described above, the adjustment of the strut length is realized by the rotation of the adjusting mechanism 26 with respect to the screw type elongated member 28 which cannot rotate in the axial direction. If the threaded elongated member 28 is free to rotate around its long axis, it is not possible to make the desired strut adjustment exactly. Axial rotation of the external fixation strut with respect to the first ball member 14 and the second ball member 34 to ensure precise strut length adjustment X₁And X₂It is desirable to limit. FIG. 4B is a perspective view of a part of the external fixation support. The external fixation strut illustrated in FIG. 4B has two degrees of freedom of rotation (Y) with respect to the first ball member 14 and the second ball member 34.₂And Z₂) Only. The second ball joint cage 32 of FIG. 4B has a pair of holes (not shown) defined to penetrate the inside of the second ball joint cage 32 at opposite peripheral portions. The pair of holes can operate to receive the pair of pins 110. The pair of pins 110 extend so as to partially enter the radial groove 112 defined within the second ball member 34. The pair of pins 110 thus allows the external fixator to rotate around a first axis defined by the pins 110 and a second axis orthogonal to the plane defined by the groove 112. However, the pair of pins 110 prevent the external fixator from rotating around a third axis that is orthogonal to the first and second axes. Although not shown in FIG. 4B, the first ball joint cage and the first ball member 14 are similar to include a pair of pins 110 that limit the axial rotation of the external fixator with respect to the first ball member 14. Take a similar configuration. In some embodiments, one pin 110, rather than a pair of pins 110, is sufficient to eliminate the unintended third degree of freedom of rotation.

FIG. 5A is a partial perspective view of an embodiment of the external fixation column of the present disclosure. The second ball joint 30 has a second ball joint cage 32 provided to fit the second ball member 34. The second ball member 34 penetrates the second ball joint opening 50 having a size suitable for the second ball member 34. The second ball joint cage 32 has a second ball joint cage fastener 36. The second ball joint cage fastener 36 is inserted through the external fixation ring 54 or the threaded opening 52 on the outer surface of the other second external support to provide the second ball joint 30. It can be operated to fix to the outer surface of the external fixation ring 54 or other second external support. Not only the second ball member 34 but also the second ball fastener 36 is connected to the second ball fastener 36 as well as the second ball member 34 in order to fix the fastener or the ball in a desired position. It may have one or more additional slots 40 or nuts (not shown) that can operate. Slot 40 may use any type of head fastener known to those of skill in the art-eg slot, phillips, hexagonal, socket, high torque, or other fasteners / heads.

The configuration of the second ball fastener 36 accepts the various design openings of the external fixation ring 54 and improves the ease of connecting the second ball fastener 36 to the external fixation ring 54. It may change.

FIG. 5B is a cross-sectional view of a part of another embodiment of the external fixation strut of the present disclosure. In this embodiment, the second ball fastener 36 has a smooth outer surface. The second ball fastener 36 is received in the opening 53 having a smooth inner surface and is substantially fixed in place by the set screw 55 inserted into the opening 57 of the external fixation ring 54. Can work like this. The opening 53 is positioned at an angle substantially corresponding to the shape of the tip portion forming the angle of the set screw 31. This increases the contact area between the second ball fastener 36 and the set screw 55.

By applying a dynamic load to the contact surface between the second ball fastener 36 and the set screw 55, the contact surface is deformed and finally the second ball fastener 36 is loosened. Therefore, the second ball fastener 36 may be configured to have an internally defined groove in order to allow optimum holding and adaptation of the contact surface to dynamic loads.

FIG. 5C is a cross-sectional view of a part of another embodiment of the external fixation strut of the present disclosure. In this embodiment, the second ball fastener 36 has a smooth outer surface and has a groove 37 around it. FIG. 5D is a cross-sectional view of a part of still another embodiment of the external fixation strut of the present disclosure. In this embodiment, the second ball fastener 36 has a smooth outer surface and has a cone tip 39 and a groove 37 around it. The second ball fastener 36 is received in the opening 53 having a smooth inner surface and is substantially fixed in place by the set screw 55 inserted into the opening 57 of the external fixation ring 54. Can work like this. The cone tip 39 increases the contact area of the inner surface between the second ball fastener 36 and the opening 53 to better guide the insertion of the second ball fastener 36 and improve stability. Allows you to. In addition, having the cone tip 39 increases the effective length of the second ball fastener 36 and further improves the stability of the second ball fastener 36 within the opening 53. Although not shown in FIG. 5A-5D, the first ball joint 35 and the first ball member 14 may have a configuration similar to that described in FIG. 5A-5D.

6A and 6B are perspective views and cross-sectional views of a ball joint that can be fixed by separate ball joint cages, respectively. The ball joint 30 has a separate ball joint cage 32 provided to receive the ball 34. The separated ball joint cage 32 is divided into an upper portion 32a and a lower portion 32b. The upper portion 32a and the lower portion 32b substantially seal the ball 34. The upper portion 32a has a hole 54a and a hole 54b defined so as to penetrate the upper portion 32a. The lower portion 32b is capable of receiving a fastener 56a and a fastener 56b that can be inserted through the hole 54a and the hole 54b and has a corresponding threaded opening defined within the lower portion 32b. Has a part (not shown). The fasteners 56a and 56b fix the ball 34 inside a separate ball joint cage 32a and limit the movement of the ball 34. The ball 34 penetrates a ball joint opening 50 having a size suitable for the ball 34. The ball fastener 36 can act to secure the ball 34 to an external fixation ring or other external support (not shown). The separate ball joint cage 32a connects to a threaded elongated member 28 and allows the angle and rotation alignment of the external fixator (not shown) with respect to the ball 34.

FIG. 6C illustrates another embodiment of a ball joint that can be secured by a partially separated ball joint cage. The ball joint 30 has a partially separated ball joint cage 32 provided to fit the ball 34. The partially separated ball joint cage 32 has a gap 120 defined to penetrate the separated ball joint cage 32. The gap 120 partially divides the ball joint cage 32 into a first split portion 122 and a second split portion 124. The first split portion 122 has a hole 54a defined to penetrate the first split portion 122. The second split portion 124 has a threaded opening (not shown) that can act to receive a fastener 56a inserted through the hole 54a. The ball 34 has a ball joint opening 50 that is sized to fit the ball 34. The fastener 54a secures the ball 34 inside a partially separated ball joint cage 32 and limits the movement of the ball 34.

FIG. 7 is a perspective view of a ball joint that can be fixed by a screw-type ball joint cap. The threaded ball joint 30 has a ball cage, which has a first threaded portion 32a and a threaded fixing member 32b capable of operating to engage the surface of the threaded ball member 34. .. The threaded ball joint cages 32a and 32b can be joined to hold the ball 34 inside. The movement of the screw-type ball 34 can be restricted by matching the first screw-type portion 32a with the screw-fastening portion of the screw-type fixing member 32b. The ball 34 penetrates a threaded ball joint opening 50 having a size suitable for the threaded ball 34. The threaded ball fastener 36 can secure the threaded ball 34 to an external fixation ring or other external support (not shown). The threaded ball joint cage 32 connects to a threaded elongated member 28 and allows the angle and rotation of the external fixator (not shown) to align with the ball 34.

FIG. 8 is a perspective view of a ball joint that can be fixed by separated balls. In FIG. 8, the split ball joint 30 has a ball joint cage 32 provided to fit the split ball 34. The split ball 34 has an opening 58 defined to penetrate the split ball 34. The opening 58 allows the separate ball fasteners 36 to be inserted so as to penetrate the separate balls 34. The separated ball fastener 36 has a threaded end and a smooth middle portion, whereby the intermediate portion widens the opening 58 when the separated ball fastener 36 is inserted through the opening 58. .. The expanding force acting on the wall of the opening 58 secures the ball 34 and the cage 32 in desired positions by frictional forces. The threaded end of the threaded ball fastener 36 can secure the separated ball 34 to an external fixation ring or other external support (not shown). The separate ball joint cage 32 connects to a threaded elongated member 28 and allows the angle and rotation of the external fixation column to be aligned with the ball 34.

FIG. 9 is a perspective view of a ball joint that can be fixed by a set screw. In FIG. 9, the ball joint cage 32 is a set screw 116 inserted so as to penetrate the threaded radial hole 114 defined to penetrate the ball joint cage 32 and the threaded radial hole 114. Has. The tip of the set screw 116 applies a frictional force to the second ball member 34 to fix the second ball member 34 in one orientation. In some embodiments, the ball joint cage 32 may be provided to receive an additional set screw 116 in order to increase the total frictional force on the second ball member 34.

FIG. 10 is a cross-sectional view of an embodiment of the external fixation column of the present disclosure attached to the external fixator. The external fixation support column 10 is connected between the first external fixation ring 80 and the second external fixation ring 82. For simplicity, FIG. 10 illustrates a single external fixation strut 10 provided between the first external fixation ring 80 and the second external fixation ring 82. A large number of external fixation columns 10 (eg, 4, 6, or 8) may be attached at various positions around the external fixation ring, and the angle of the external fixation columns 10 with respect to the first external fixation ring 80. Those skilled in the art will immediately understand that the external fixation strut 10 may change and the length of the external fixation strut 10 may be changed and adjusted.

The first ball joint cage 12 is fixed to the external fixation ring 80 or other external support. The external fixation support 10 has a first ball joint cage 12 for accommodating the first ball member 14. The first ball member 14 has a first ball fastener 16, and the first ball fastener 16 penetrates an opening (not shown) in the first external fixation ring 80 to form a first ball member. 14 is fixed to the external fixation ring 80 or other external support. The first ball joint cage 12 enables the angle and rotation of the external fixation strut to be aligned with respect to the first ball member 14. This movement allows the first ball joint cage 12 to be fixed at various angles to the external fixation ring 80 or other external support.

The telescopic strut housing 18 has an opening (not shown) that extends from the first ball joint cage 12 and extends from the first ball joint cage 12. The stretchable strut housing 18 has a stretchable housing adjusting opening 20 defined so as to penetrate the stretchable strut housing 18. The adjustable sleeve 22 is provided in a shaft hole (not shown) of the telescopic strut housing 18. Since the adjustment sleeve 22 is slidable inside the hole (not shown), it is possible to quickly perform rough adjustment of the end-to-end length "A" of the external fixation support column 10. The movement of the adjustment sleeve 22 in the shaft hole (not shown) of the telescopic strut housing 18 can change the distance and thereby the inter-end length of the external fixation strut 10. to enable.

The adjustable sleeve 22 has a sleeve fastener 24 provided to penetrate the telescopic adjustable opening 20, which secures the adjustable sleeve 22 to the telescopic strut housing 18. The telescopic housing adjustment opening 20 also assists in adjusting the end-to-end length of the external fixator 10 by allowing positioning and reference of the adjustment sleeve 22 and / or the threaded elongated member 28. It also functions as a window that enables. The scale 74 indicates the length of the external fixation strut 10 as a relative length rather than a predetermined specific length. The scale 74 need not be based on a conventional measurement system and does not need to indicate the effective length of the column. For example, the scale may indicate the ratio of the total length of the bar, or the daily increment when translation occurs over a long period of time. Referencing an intermediate position can be useful in setting the bottom member in a predetermined "intermediate" position.

The adjusting mechanism 26 is rotatably coupled to the end of the adjusting sleeve 22 and screwed to the elongated threaded member 28. The adjusting mechanism 26 may rotate so as to engage with the screw of the threaded elongated member 28, thereby stepwise adjusting the end-to-end length "A" of the external fixator 10 in the longitudinal direction. .. The threaded elongated member 28 has a second ball joint 30 with a second ball joint cage 32 provided to fit the second ball member 34. The second ball member 34 has a second ball fastener 36. The second ball fastener 36 penetrates an opening (not shown) in the second external fixation ring 80 to secure the second ball joint 30 to the external fixation ring 82 or other external support. ..

The second ball joint cage 32 allows the angle and rotation of the external fixation column 10 to be aligned with respect to the second ball member 34. This movement allows the second ball joint cage 32 to be fixed at various angles to the second external fixation ring 82 or other second external support.

FIG. 11 is a perspective view of an embodiment of an external fixator having six connecting rods for fixing a bone segment. The external fixator has a first external fixation ring 80 and a second external fixation ring 82 that surround the bone (not shown). The first external fixation ring 80 and the second external fixation ring 82 are connected by six external fixation columns 10a-1of. Each external fixation strut (10a, 10b, 10c, 10d, 10e, 10f) has a ball joint (not shown) with a first joint that houses a first ball (not shown). The first ball (not shown) has a first ball clasp (not shown), and the first ball clasp penetrates a slot (not shown) and a screw in the external fixation ring 80. Enter the expression opening.

Due to the presence of multiple external fixation struts, it is necessary to be able to uniquely identify each strut, which allows tracking and implementation of strut length adjustments for each strut. Information indicators may be mounted on or embedded within the stanchions to identify the stanchions. In some embodiments, the information indicator may be a physical classifier-eg, a code name, paper, or label, color, or serial number corresponding to the relevant information. In some embodiments, the information indicator may include the type of strut, maximum or minimum strut length, strut number, and the like. In some embodiments, the information indicator may be an electronic classifier. One common identification method includes a radio frequency (RF) sensor that wirelessly interacts with a radio frequency transmitter (RFID) provided in the external fixation strut adjustment mechanism. Other strut number classifiers may include a barcode reader. The barcode reader counts the specific number of grooves on the external fixator adjustment mechanism or interacts with magnetic debris provided in the external fixator adjustment mechanism. In another embodiment, the strut number identifier includes a sensor that receives information from a touch memory button provided on the adjustment mechanism of the external fixation strut. Another embodiment of the invention manually assigns a number of struts to allow the device to engage the adjustment mechanism and to rotate the adjustment mechanism at the desired number of turns. In other embodiments, the information indicator may be any kind of device suitable for representing information, or a combination of indicators discussed herein.

The telescopic strut housing (not shown) extends from the joint with the first joint (not shown) to the adjustment sleeve and from the threaded elongated member (not shown) to the second ball. Exists. The second ball (not shown) has a second ball fastener (not shown) that penetrates into the external fixation ring or other threaded opening of the external device 82.

The methods of the present disclosure may be performed by an object-eg, a human or other vertebrate. One or more bones to be fixed (of the object) may be selected. Any suitable bone (s) -for example, at least a pair of long bones and / or at least a pair of bones connected via anatomical joints-may be selected. Typical bones include leg bones (femoral bones, tibia, and excretory bones), arm bones (humeral bones, radius, and ulnar bones), foot bones (heel bones, talar bones, metatarsal bones, and finger bones). Includes wrist / hand bones (carpal bones, middle hand bones, and finger bones) and the like. In a typical embodiment, one or more bones may be selected, including at least one long bone.

External fixators may be constructed along and around at least some of the selected bones. The external fixator has a plurality of rings that are fixed in appropriate positions to each other by a large number of external fixation struts.

External fixators may be connected to selected bones. Connections may be made at any suitable time-eg, before, during, and / or after construction of the external fixator. The external fixator may be assembled and then connected to the bone. Alternatively, individual external fixator members or external fixator subassemblies may be connected to the bone before the external fixator is fully assembled. The connection of the external fixator to the bone is such that the connector-eg, wire, pin, screw, and / or rod-is installed, especially through the skin and through the selected bone, into the selected bone. Installation and / or installation around selected bones may be included.

While the external fixator is reconstructed, the external fixator connects to one or more selected bones. Reconstruction may include adjusting the length, angle, position, and / or connection position of one or more external fixator parts-especially external fixators. In some embodiments, the reconstruction may have one or more (or all) external fixator stretches. In some embodiments, the reconstruction may have a procedure of replacing one or more external fixators with different rods (s). Different connecting rods may differ in size, swivelability, adjustment function, shape, and the like.

The external fixator may be reinforced to aid in reconstruction. Reinforcement of the external fixator can strengthen and / or stabilize the external fixator. This causes little unintended change to the external fixator due to the weakening and modification of the external fixator during reconstruction. Reinforcement may be performed by fixing at least one reinforcing material to the external support. In some examples, the reinforcement may be provided to be fastened by the external fixator member before it is completely fixed to the external fixator member. For example, the stiffener may have one or more external fixator engagement elements that are biased to engage so as to sandwich one or more external fixator members. In any case, each engaging element may be fixed in an appropriate position on the member of the external fixator, either manually or by user control by a device. Further, the relative spatial arrangement and angle setting of the engaging element may be fixed by the same (s) user control or separate user control for fixing the engaging element to the frame member.

In some examples, the stiffener may have one or more movable joints, and the stiffener is installed so as to engage an external fixator member with one or more joints in a movable state. May be done. The movable joint may be adjusted in a locked (fixed) state. Alternatively, or in addition, one or more movable joints may be locked before or during the installation of the reinforcement on the frame, and one or more other movable joints external fixators the reinforcement. It may be locked after being installed in.

The stiffener may be removed after the frame is reconstructed. Thus, the stiffener may be removed by a frame that is installed with the frame (and connecting rod) that secures the bone and is reconstructed while retaining the bone. Thus, the stiffener may be present on the external fixator for only one period of time during which the external fixator is fixing the bone.