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WO1994006364A1 - Stabilisateur de compensation dynamique - Google Patents

Stabilisateur de compensation dynamique Download PDF

Info

Publication number
WO1994006364A1
WO1994006364A1 PCT/US1993/008639 US9308639W WO9406364A1 WO 1994006364 A1 WO1994006364 A1 WO 1994006364A1 US 9308639 W US9308639 W US 9308639W WO 9406364 A1 WO9406364 A1 WO 9406364A1
Authority
WO
WIPO (PCT)
Prior art keywords
members
stabilizer
screws
manipulator
intraosteal
Prior art date
Application number
PCT/US1993/008639
Other languages
English (en)
Inventor
Jaroslaw Deszczynski
Janusz Karpinski
Waldemar Deszczynski
Original Assignee
Dynastab Limited Partnership
Priority date (The priority date is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the date listed.)
Filing date
Publication date
Application filed by Dynastab Limited Partnership filed Critical Dynastab Limited Partnership
Priority to AU51277/93A priority Critical patent/AU5127793A/en
Publication of WO1994006364A1 publication Critical patent/WO1994006364A1/fr

Links

Classifications

    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods
    • A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements
    • A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws or setting implements for external osteosynthesis, e.g. distractors, contractors
    • A61B17/64—Devices extending alongside the bones to be positioned
    • A61B17/6491—Devices extending alongside the bones to be positioned allowing small-scale motion of bone ends

Definitions

  • the invention refers to a dynamic compensating stabilizer for use in functional therapy of bone fractures.
  • fractured bone stabilizers for use in cases of periaiticular and bone shaft fractures. They constitute usually metal structures consisting of tubes, bars, links and intraosteal screws. Some of them are provided with articulated joints used to restore motorial abilities of damaged or injured human skelton joints to facilitate repositioning of fractured bones. Adjustment of the stabilizer's length is accomplished by turning an adjustment screw in an appropriate direction or by appropriately moving links along a bar. Dynamic behavior of such stabilizers is ensured by suitable springs being so arranged as to cause axial movement after loosening a locking screw. In these known stabilizers, it is difficult to determine correctly required pretensioning of such springs as well as to control correct positioning of stabilizer's axis and articulated joint in respect to axes of fractured bone fragments and a human skeleton joint involved.
  • such known stabilizers are constructed as frame structures surrounding a limb injured over its whole circumference or a part thereof. This causes such stabilizers to be rather large in size and heavy. Further, these designs make it difficult to get access to wounds associated with a particular injury or postoperative ones. Frequently used introduction of intraosteal screws, not rarely right through a bone in question, may be associated with a serious risk. Furthermore, their use either requires an operative intervention which is burdensome for a patient or reduction of fractures being done externally based on guess work which makes correct repositioning difficult and worsens the results of treatment.
  • the therapeutic process is based on experience, physical examinations, interviewing a patient and some auxiliary or additional investigations. It is completely impossible to verify correctness of data obtained from interviewing a patient, in particular those referring to intensity of exercises and loading forces.
  • a patient is-unablp tq determine whether actual force loading an injured limb is or is not within the limits recommended by a physician.
  • a stabilizer according to the present invention avoids these disadvantages of the prior art stabilizers by substituting a hydro/pneumatic system for hitherto used length and force adjustment mechanical components such as screws and springs.
  • This system makes it possible, by admission or discharge of . corresponding amount of hydraulic fluid into or from a hydraulic cylinder chamber, to adjust exactly the length of the stabilizer as desired.
  • Expansion of gas in a pneumatic chamber with tensile force being applied to the stabilizer results in stretching a membrane and resilient extension of the stabilizer.
  • a partitioning wall with an appropriately sized orifice provided in the hydraulic chamber offers substantial resistance to hydraulic fluid flow and distributes over a substantial period of time any suddenly increasing loads.
  • pressure gauge or pressure transducer connected to the pneumatic chamber or, preferably, to the hydraulic one associated with an appropriate electronic circuit it is made possibly to precisely control the loads transmitted to a limb in question.
  • the electronic circuit through appropriate signaling (e.g. audible alarm signals) provides a patient involved with reliable information about the load actually applied to the injured limb such as too high or too little load applied to the limb.
  • a memory enables storage of the total number of loads applied to a limb along with total number of external overloadings which may unfavorably influence the course of treatment.
  • a stabilizer according to the present invention has been provided with a remotely controlled manipulator.
  • This manipulator serves to correct any displacements of fractured bone fragments, while allowing monitoring of the displacements on an X-ray monitor situated at some distance from the X-ray unit or behind a lead shield separating it from that unit.
  • the manipulator consists of a base and two or three functional units, each of them being provided with five or six individually, remotely or directly, controllable moving members.
  • a single moving member has a movable part with one degree of freedom and its own hydraulic, electric or pneumatic actuator.
  • the manipulator's gripping devices are coupled to a bone to be manipulated through intraosteal screws and their associated coupling blocks of the stabilizer.
  • the manipulator's base is attached to a special stand or operating table.
  • Fig. 1 shows a schematical top view of the stabilizer in longitudinal section
  • Fig. 2 shows a side view of the stabilizer in longitudinal section
  • Fig. 3 shows a cross-sectional view of the stabilizer of Fig. 1 along line I- I indicated in that figure;
  • Fig. 4 shows one of moving members of the stabilizer in longitudinal section along with its associated elastic tank
  • Fig. 5 shows a schematical side view of the manipulator
  • Fig. 6 shows a schematical top view of the manipulator.
  • the stabilizer consists of linking member 29 formed by a ball journal 1 and an element 10 with a longitudinal slot 20 formed therein.
  • a hydraulic seal 9 e.g. in the form of O-ring
  • the member 10 is slidablv movable inside the member 3 wherein it is stabilized to prevent its rotation by means of pin 8 slidablv engaging the slot 19 and mounted in the member 3.
  • the member 3 incorporates a ball journal 2 being a part of a ball-and-socket articulated joint.
  • a pneumatic chamber 4 provided with a regulating valve 1 1 and separated by means of flexible membrane 6 from hydraulic chamber 5 which is also provided with a regulating valve 12.
  • the membrane 6 is supported on its side facing the chamber 4 by means of rigid perforated baffle 27.
  • a partition wall 7 with an appropriately sized orifice. Admission or discharge of hydraulic fluid through the valve 12 into or from the hydraulic chamber 5 results in lengthening or shortening of the stabilizer respectively. Resistance to flow of hydraulic fluid through the orifice in the partition wall 7 causes efficient vibration damping when the stabilizer is being loaded. As soon as a compressive load has been relieved, gas from the pneumatic chamber 4 expands and flows through perforations or the baffle 27 and enables resilient damping in the direction of stretching. In the pneumatic chamber 4 or. preferably, in the hydraulic one 5.
  • the coupling block 17 consists of a central part 1, preferably in the form of tube, carrying at its end a clamping ring 23 of internal diameter smaller than the outer diameter of the ball journal 1 and locked in place by means of taper screws 15.
  • a clamping ring 23 of internal diameter smaller than the outer diameter of the ball journal 1 and locked in place by means of taper screws 15.
  • recesses preferably in the form of elongated grooves 26, intermeshing with corresponding protrusions on contiguous surfaces of the part 13.
  • the pneumatic chamber 4 with its associated regulating valve 1 1 and perforated baffle 27 of the previously described embodiment has been retained there.
  • a pressure sensing element can be placed either inside or outside the tank 28.
  • the members 3 and 10 are circular in their cross sections, it is necessary to prevent their rotational movement around their longitudinal axis while simultaneously allowing their linear movement in axial direction. This is achieved by providing the member 10 with a longitudinal slot 2.
  • the pin 8 can comprise either a conventional pin or can take the form or a screw or bolt with a nut.
  • Figs. 5 and 6 illustrate a manipulator designed to operate in association with a stabilizer according to the present invention.
  • the manipulator comprises a base 30 (to be attached either to a special stand or operating table) and two or three functional units 31. depending on what kind of fracture is to be treated - a periarticular or bone shaft fracture.
  • Each functional unit 31 consists of five or six members, each of them having a mount for attaching the next one and an actuator, preferably in the form of a hydraulic cylinder 32.
  • an electric or pneumatic one can be used.
  • Each of these members is able to be moved by its associated actuator in a single direction only and can be individually controlled either locally or remotely.
  • the actuators are provided with pressure or force sensing elements.
  • Adjustment of the angle at which the intraosteal screws are inclined in respect to each other is effected by rotating the rings 33 (together with their associated members 13) around the longitudinal axis of the central member 14 and locking them in place by means of screws 34 screwed into corresponding tapped holes in the ring 33.

Landscapes

  • Health & Medical Sciences (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Surgery (AREA)
  • Biomedical Technology (AREA)
  • Engineering & Computer Science (AREA)
  • Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Medical Informatics (AREA)
  • Molecular Biology (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Orthopedics, Nursing, And Contraception (AREA)

Abstract

L'invention concerne un stabilisateur de compensation dynamique utilisé dans le traitement des fractures. Des systèmes hydraulique (5) et pneumatique (4) sont utilisés pour ajuster la longueur du stabilisateur, ce qui permet de commander le chargement dynamique de l'ostéosynthèse et de rééducation. Un bloc d'accouplement divisé (17) modifie l'inclinaison des vis intraosseuses. Un manipulateur (30, 31, 32) permettant d'effectuer des fonctions dans tous les plans est également décrit.
PCT/US1993/008639 1992-09-15 1993-09-15 Stabilisateur de compensation dynamique WO1994006364A1 (fr)

Priority Applications (1)

Application Number Priority Date Filing Date Title
AU51277/93A AU5127793A (en) 1992-09-15 1993-09-15 Dynamic compensating stabilizer

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
PLP.295943 1992-09-15
PL29594392A PL169633B1 (pl) 1992-09-15 1992-09-15 Dynamiczny stabilizator kompensacyjny PL

Publications (1)

Publication Number Publication Date
WO1994006364A1 true WO1994006364A1 (fr) 1994-03-31

Family

ID=20058497

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1993/008639 WO1994006364A1 (fr) 1992-09-15 1993-09-15 Stabilisateur de compensation dynamique

Country Status (3)

Country Link
AU (1) AU5127793A (fr)
PL (1) PL169633B1 (fr)
WO (1) WO1994006364A1 (fr)

Cited By (26)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2726757A1 (fr) * 1994-11-16 1996-05-15 Soubeiran Arnaud Andre Dispositif implantable chirurgicalement a geometrie modifiable par chauffage et applications
EP0807419A3 (fr) * 1996-05-15 1998-04-08 ORTHOFIX S.r.l. Fixateur externe compacte
EP0820731A3 (fr) * 1996-07-22 1998-07-15 Fred Zacouto Implant squelettique
EP0953317A1 (fr) * 1998-04-30 1999-11-03 Fred Zacouto Implant squelettique
WO2002078554A1 (fr) * 2001-03-28 2002-10-10 Imperial College Innovations Ltd. Régulateur de charge d'une articulation mobile, fixé sur l'os
US6835207B2 (en) 1996-07-22 2004-12-28 Fred Zacouto Skeletal implant
US7611540B2 (en) 2007-05-01 2009-11-03 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US8523948B2 (en) 2009-10-20 2013-09-03 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US8597362B2 (en) 2009-08-27 2013-12-03 Cotera, Inc. Method and apparatus for force redistribution in articular joints
US8679178B2 (en) 2009-10-20 2014-03-25 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having two deflecting members and compliance member
US8845724B2 (en) 2009-08-27 2014-09-30 Cotera, Inc. Method and apparatus for altering biomechanics of the articular joints
US8894714B2 (en) 2007-05-01 2014-11-25 Moximed, Inc. Unlinked implantable knee unloading device
US9005298B2 (en) 2007-05-01 2015-04-14 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems
US9044270B2 (en) 2011-03-29 2015-06-02 Moximed, Inc. Apparatus for controlling a load on a hip joint
US9168065B2 (en) 2008-04-30 2015-10-27 Moximed, Inc. Ball and socket assembly
US9398957B2 (en) 2007-05-01 2016-07-26 Moximed, Inc. Femoral and tibial bases
US9468466B1 (en) 2012-08-24 2016-10-18 Cotera, Inc. Method and apparatus for altering biomechanics of the spine
CN106413604A (zh) * 2014-03-12 2017-02-15 奥索斯平有限公司 预加载的医疗柱
US9655648B2 (en) 2007-05-01 2017-05-23 Moximed, Inc. Femoral and tibial base components
US9668868B2 (en) 2009-08-27 2017-06-06 Cotera, Inc. Apparatus and methods for treatment of patellofemoral conditions
US9861408B2 (en) 2009-08-27 2018-01-09 The Foundry, Llc Method and apparatus for treating canine cruciate ligament disease
US9907645B2 (en) 2007-05-01 2018-03-06 Moximed, Inc. Adjustable absorber designs for implantable device
CN108236491A (zh) * 2016-12-24 2018-07-03 王培林 一种骨块间轴向加压力可调的骨折外固定架
US10327816B2 (en) 2007-05-01 2019-06-25 Moximed, Inc. Adjustable absorber designs for implantable device
US10349980B2 (en) 2009-08-27 2019-07-16 The Foundry, Llc Method and apparatus for altering biomechanics of the shoulder
US10383736B2 (en) 2007-05-01 2019-08-20 Moximed, Inc. Femoral and tibial base components

Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4502473A (en) * 1981-08-06 1985-03-05 National Research Development Corp. Apparatus for external fixation of bone fractures
US5026372A (en) * 1987-11-05 1991-06-25 Robert Sturtzkopf Fixation device for the external adjusting of bone fragments

Patent Citations (2)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US4502473A (en) * 1981-08-06 1985-03-05 National Research Development Corp. Apparatus for external fixation of bone fractures
US5026372A (en) * 1987-11-05 1991-06-25 Robert Sturtzkopf Fixation device for the external adjusting of bone fragments

Cited By (55)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
FR2726757A1 (fr) * 1994-11-16 1996-05-15 Soubeiran Arnaud Andre Dispositif implantable chirurgicalement a geometrie modifiable par chauffage et applications
EP0807419A3 (fr) * 1996-05-15 1998-04-08 ORTHOFIX S.r.l. Fixateur externe compacte
EP0820731A3 (fr) * 1996-07-22 1998-07-15 Fred Zacouto Implant squelettique
AU732244B2 (en) * 1996-07-22 2001-04-12 Fred Zacouto Skeletal implant
US6835207B2 (en) 1996-07-22 2004-12-28 Fred Zacouto Skeletal implant
EP0953317A1 (fr) * 1998-04-30 1999-11-03 Fred Zacouto Implant squelettique
FR2778085A1 (fr) * 1998-04-30 1999-11-05 Fred Zacouto Implant squelettique
US9610103B2 (en) 2001-03-28 2017-04-04 Moximed, Inc. Bone fixated, articulated joint load control device
WO2002078554A1 (fr) * 2001-03-28 2002-10-10 Imperial College Innovations Ltd. Régulateur de charge d'une articulation mobile, fixé sur l'os
AU2002234756B2 (en) * 2001-03-28 2006-04-27 Moximed, Inc. Bone fixated, articulated joint load control device
US9943336B2 (en) 2001-03-28 2018-04-17 Moximed, Inc. Bone fixated, articulated joint load control device
US10022154B2 (en) 2007-05-01 2018-07-17 Moximed, Inc. Femoral and tibial base components
US9125746B2 (en) 2007-05-01 2015-09-08 Moximed, Inc. Methods of implanting extra-articular implantable mechanical energy absorbing systems
US11389298B2 (en) 2007-05-01 2022-07-19 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems
US8894714B2 (en) 2007-05-01 2014-11-25 Moximed, Inc. Unlinked implantable knee unloading device
US9005298B2 (en) 2007-05-01 2015-04-14 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems
US10736746B2 (en) 2007-05-01 2020-08-11 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems
US10639161B2 (en) 2007-05-01 2020-05-05 Moximed, Inc. Extra-articular implantable load sharing systems
US10383736B2 (en) 2007-05-01 2019-08-20 Moximed, Inc. Femoral and tibial base components
US9700419B2 (en) 2007-05-01 2017-07-11 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US9814579B2 (en) 2007-05-01 2017-11-14 Moximed, Inc. Unlinked implantable knee unloading device
US9907645B2 (en) 2007-05-01 2018-03-06 Moximed, Inc. Adjustable absorber designs for implantable device
US10327816B2 (en) 2007-05-01 2019-06-25 Moximed, Inc. Adjustable absorber designs for implantable device
US9398957B2 (en) 2007-05-01 2016-07-26 Moximed, Inc. Femoral and tibial bases
US10070964B2 (en) 2007-05-01 2018-09-11 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US7611540B2 (en) 2007-05-01 2009-11-03 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems and implantation method
US10010421B2 (en) 2007-05-01 2018-07-03 Moximed, Inc. Extra-articular implantable mechanical energy absorbing systems
US9655648B2 (en) 2007-05-01 2017-05-23 Moximed, Inc. Femoral and tibial base components
US9168065B2 (en) 2008-04-30 2015-10-27 Moximed, Inc. Ball and socket assembly
US10363139B2 (en) 2008-04-30 2019-07-30 Moximed, Inc. Ball and socket assembly
US9278004B2 (en) 2009-08-27 2016-03-08 Cotera, Inc. Method and apparatus for altering biomechanics of the articular joints
US8845724B2 (en) 2009-08-27 2014-09-30 Cotera, Inc. Method and apparatus for altering biomechanics of the articular joints
US11730519B2 (en) 2009-08-27 2023-08-22 The Foundry, Llc Method and apparatus for force redistribution in articular joints
US9861408B2 (en) 2009-08-27 2018-01-09 The Foundry, Llc Method and apparatus for treating canine cruciate ligament disease
US9668868B2 (en) 2009-08-27 2017-06-06 Cotera, Inc. Apparatus and methods for treatment of patellofemoral conditions
US9931136B2 (en) 2009-08-27 2018-04-03 The Foundry, Llc Method and apparatus for altering biomechanics of articular joints
US9114016B2 (en) 2009-08-27 2015-08-25 Cotera, Inc. Method and apparatus for altering biomechanics of the articular joints
US11517360B2 (en) 2009-08-27 2022-12-06 The Foundry, Llc Method and apparatus for treating canine cruciate ligament disease
US8597362B2 (en) 2009-08-27 2013-12-03 Cotera, Inc. Method and apparatus for force redistribution in articular joints
US10695094B2 (en) 2009-08-27 2020-06-30 The Foundry, Llc Method and apparatus for altering biomechanics of articular joints
US9795410B2 (en) 2009-08-27 2017-10-24 Cotera, Inc. Method and apparatus for force redistribution in articular joints
US10349980B2 (en) 2009-08-27 2019-07-16 The Foundry, Llc Method and apparatus for altering biomechanics of the shoulder
US8679178B2 (en) 2009-10-20 2014-03-25 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having two deflecting members and compliance member
US9034049B2 (en) 2009-10-20 2015-05-19 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US8523948B2 (en) 2009-10-20 2013-09-03 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US9060867B2 (en) 2009-10-20 2015-06-23 Moximed, Inc. Extra-articular implantable mechanical energy absorbing assemblies having a tension member, and methods
US9044270B2 (en) 2011-03-29 2015-06-02 Moximed, Inc. Apparatus for controlling a load on a hip joint
US10898237B2 (en) 2012-08-24 2021-01-26 The Foundry, Llc Method and apparatus for altering biomechanics of the spine
US9468466B1 (en) 2012-08-24 2016-10-18 Cotera, Inc. Method and apparatus for altering biomechanics of the spine
CN106413604A (zh) * 2014-03-12 2017-02-15 奥索斯平有限公司 预加载的医疗柱
US9949758B2 (en) 2014-03-12 2018-04-24 Orthospin Ltd. Preloaded medical struts
EP3110353A4 (fr) * 2014-03-12 2018-01-03 Orthospin Ltd. Entretoises médicales préchargées
US11241256B2 (en) 2015-10-15 2022-02-08 The Foundry, Llc Method and apparatus for altering biomechanics of the shoulder
CN108236491B (zh) * 2016-12-24 2021-07-13 王培林 一种骨块间轴向加压力可调的骨折外固定架
CN108236491A (zh) * 2016-12-24 2018-07-03 王培林 一种骨块间轴向加压力可调的骨折外固定架

Also Published As

Publication number Publication date
AU5127793A (en) 1994-04-12
PL169633B1 (pl) 1996-08-30
PL295943A1 (en) 1994-03-21

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