EXTRA MEDULAR INTERNAL BONE FIXATION AND ELONGATION DEVICE WITH DYNAMIC AXIAL STABILIZATION

Abstract

The development of an internal bone lengthening stabilization system with extramedullary localization to generate a dynamic axial stabilization system by the incorporation of tension-locked Kirschner wires and tension-locked cerclage wires is described.

It features as a benefit the performance of bone lengthening, transports or reconstruction without any external fixation element, using the benefits of the pressure Kirschner wires in different planes without going through soft parts such as skin, cells, fascia, muscle, thereby reducing the risk of neurological and vascular injury to these elements.

The present development is based on my previous patent “Canulated locking and fixation assembly for trauma surgery”, which allows the attachment of Kirschner wires, cerclage wires, ender or TENS with tension to internal extramedullary fixation elements such as locked plates or bone fixation rings.

The present development has a central sliding zone of motorized lengthening, being able to use the different motorized systems currently developed for intramedullary nails.

We think its main application will be for femur and tibia, but it can involve any bone if its development is considered useful.

Claims

1. An internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least two plate-like bone fixation elements shaped as a locked plate with bone fixation in the proximal and distal sectors, wherein a double-locking canulated assembly can be used as bone fixation element, which allows bone fixation with tension Kirschner wires and/or tension cerclage wires, featuring an intermediate sliding zone with tubular or semi-tubular (telescopic) shape, which is actuated by motorized means with systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

2. An internal extramedullary bone lengthening (bone transport) device with dynamic axial stabilization comprising at least two bone fixation elements. The firsts bone fixation element is a locked plate-like system with bone fixation in the proximal and distal sectors, which allows the use a double-locking canulated assembly as a form of bone fixation which, in turn, allows for bone fixation by tension Kirschner wires and/or tension cerclage wires. This locked plate has a second bone anchoring element in the central sliding area, with a tubular or semi-tubular shape, which is actuated in a telescoping motorized way by a motor placed on the fixed part of the plate, which can be at the proximal or distal end thereof, being actuated by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

3. An internal extramedullary bone lengthening (bone transport) device with dynamic axial stabilization comprising at least two bone fixation elements. The firsts bone fixation element is a locked plate-like system with bone fixation in the proximal and distal sectors, which allows the use a double-locking canulated assembly as a form of bone fixation which, in turn, allows for bone fixation by tension Kirschner wires and/or tension cerclage wires. This locked plate has a second bone anchoring element in the central sliding area, which moves through a chamber guided by a central threaded rod that passes therethrough and that rotates in a motorized way by a motor placed on the fixed part of the plate, which can be at the proximal or distal end thereof, being actuated by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails. The central sliding portion with bone fixation further comprises side wings that slide through the intermediate part of the plate and prevent this central element from rotating while sliding down the threaded rod.

4. An internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least two bone fixation elements. The bone fixation elements are two locked plate-like systems with bone fixation in the proximal and distal sectors, which allows the use a double-locking canulated assembly as a form of bone fixation which, in turn, allows for bone fixation by tension Kirschner wires and/or tension cerclage wires. This locked plate, consisting of two proximal and distal elements, is joined in the intermediate zone by a central sliding zone, advancing into a chamber guided by a threaded central rod passing through it and rotating by motorized means one of the two bone fixation elements, the motor is located on the other plate element, which can be at the proximal or distal end thereof actuating by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

5. An internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least two bone fixation elements. The bone fixation elements are two ring-shaped periosseous systems that extend the entire bone circumference with bone fixation in the proximal and distal sectors, which allows the use a double-locking canulated assembly as a form of bone fixation which, in turn, allows for bone fixation by tension Kirschner wires and/or tension cerclage wires. These locked rings, consisting of two proximal and distal elements, is joined in the intermediate zone by a central sliding zone, advancing into a chamber telescopically guided by a threaded central rod passing through it and rotating by motorized means one of the two bone fixation elements, the motor is located on the other element circumferential to the bone, which can be at the proximal or distal end thereof actuating by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

6. An internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least two plate-like bone fixation elements shaped as a locked plate with bone fixation in the proximal and distal sectors, wherein a double-locking canulated assembly can be used as bone fixation element, which allows bone fixation with tension Kirschner wires and/or tension cerclage wires, which also allows the locked application of intramedullary fixation elements such as ender or TENS. It features an intermediate sliding zone of tubular or semi-tubular shape that is actuated in a motorized way by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

7. An internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least four plate-like bone fixation elements shaped as a double-locked plate with bone fixation in the proximal and distal sectors, wherein a double-locking canulated assembly can be used as bone fixation element, which allows bone fixation with tension Kirschner wires and/or tension cerclage wires, which also supports the joining between the 2 plates by these bone fixation elements. It features an intermediate sliding zone of tubular or semi-tubular shape that is actuated in a motorized way in one of the 2 plates by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

8. An internal extramedullary bone lengthening device for bone transport with dynamic axial stabilization comprising at least three plate-like bone fixation elements shaped as a double-locked plate with bone fixation in the proximal and distal sectors, wherein a double-locking canulated assembly can be used as bone fixation element, which allows bone fixation with tension Kirschner wires and/or tension cerclage wires, which also supports the joining between the 2 plates by these bone fixation elements. It features an intermediate bone stabilization and sliding zone of tubular or semi-tubular shape in one of the plates that is actuated in a motorized way by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails. The other plate has no sliding element, it is fixed.

Description

BRIEF DESCRIPTION OF THE DRAWINGS

[0030] For greater clarity and understanding of the object of this invention, it has been illustrated in several figures, in which it has been represented in one of the preferred embodiments, all by way of example, wherein:

[0031] FIGS. 1 and 2 are perspective views of a locked plate-like embodiment for both femur and tibia, which, in the lengthening segment, can use any of the lengthening forms currently developed for intramedullary nails.

[0032] FIGS. 3 and 4 show a perspective view of a portion of the canulated double-locking and fixation assembly for plate-to-bone stabilization with locked Kirschner wires (system protected under patent, U.S. patent application Ser. No. 17/006,098. Priority date. Aug. 30, 2019. Not published).

[0033] FIG. 5.1 shows a perspective view of a locked plate for extramedullary stabilization-lengthening that allows bone transport of a bullet fragment, similar to Orthofix type extramedullary systems but internal, wherein the magnetic or electric motor allows the rotation of a threaded rod and this allows to lower the intermediate fixation system for bone transport, this system could be developed to allow rotation in both directions generating bone distraction or compression.

[0034] FIG. 5.2 shows a perspective view of a locked plate for extramedullary stabilization-lengthening that allows bone lengthening, similar to Ortofix type extramedullary systems but internal, wherein the magnetic or electric motor allows the rotation of a threaded rod and this allows to lower the distal fixation system for bone lengthening, this system could be developed to allow rotation in both directions generating bone distraction or compression.

[0035] FIG. 6.1, 6.2, 6.3 shows a perspective view of an internal extramedullary lengthening stabilization system circular to the bone with tension Kirschner wires (internal Ilizarov).

[0036] FIG. 7 shows a perspective view of an extramedullary internal lengthening stabilization system, wherein the stabilization system is a mixed extra and intramedullary system.

[0037] FIGS. 8.1, 8.2, 8.3 show a perspective view of an internal extramedullary lengthening stabilization system, wherein the bone stabilization system is a double plate with interconnection therebetween by tension Kirschner wires and/or cerclage wires.

[0038] FIGS. 9.1, 9.2 show a perspective view of the double block head with its central cannulated system and the slits that close when threading and of the double block head attached to the cannulated screwdriver.

[0039] FIG. 10 show a perspective view of a double block head with Kirschner going through its cannulated system and cannulated screwdriver

[0040] FIGS. 11.1, 11.2 show a perspective view of a Kirschner Nail locked to plate by a double locking cannulated head.

[0041] FIGS. 12.1, 12.2 show perspective views of a Cerclage wire locked to the plate by the double-locking cannulated.

[0042] FIGS. 13.1, 13.2 how a perspective view of a locked plate integrating locked screws and locked Kirschner hybrid bone anchoring systems and of a locked plate with association of locked and locked Kirschner screws showing the cannulated Kirschner locking screwdriver.

DETAILED DESCRIPTION OF THE INVENTION

[0043] Referring to FIGS. 1, 2, 5, 6, 7 and 8, they show that the invention consists of a new internal extramedullary bone stabilization-lengthening system with dynamic axial stability. This system allows the development of lengthening systems in bones which nowadays, because of their size or shape, do not allow intramedullary internal lengthening systems, being able to determine a relative stability of the locked system, thanks to bone stabilization with tension-locked Kirschner wires and/or locked cerclage cables or wires protected by a previous patent (U.S. patent application Ser. No. 17/006,098. Priority date. Aug. 30, 2019. Not published). As seen in FIGS. 3 and 4 and Photos 1, 2, 3 and 4.

[0044] According to FIGS. 1 and 2, the invention as a whole consists of at least two locked plate-like bone fixation elements, which allow double-locking canulated systems for the attachment of tension Kirschner wires to the bone, as shown in FIGS. 3 and 4 and photos 1, 2, 3 and 4. These two bone fixation elements (a and b) are attached in the intermediate zone by a (telescopic c) tubular or semi-tubular sliding system that can be motorized by currently used systems in intramedullary (magnetic, electro or electro-magnetic) nails allowing bone lengthening.

[0045] According to FIG. 5.1, the development of a locked plate (a) is shown, with bone fixation elements in its proximal and distal portions for both locked screws that can be of variable angle as well as supporting the double-locking canulated assembly to lock tension Kirschner wires or cerclage wires (mixed bone fixation systems as shown in photos 5.1 and 5.2), featuring a central sliding space in the middle of the plate where there is a bone fixation area that supports locked Kirschner wires (b) and cerclage wires having a central threaded bore (c) which slides on a threaded rod (d), which acts in a closed chamber (e). This sliding element with bone attachment zones has two side wings (f) that slide inside the plate to prevent it from rotating while sliding down the threaded rod.

[0046] At one end, the threaded rod has a motorized rotation system (g) that can be electric, magnetic or electromagnetic as current motorized systems of intramedullary nails.

[0047] According to FIG. 5.2, a perspective view of an internal extramedullary bone lengthening device with dynamic axial stabilization comprising at least two bone fixation elements is shown. The bone fixation elements are two locked plate-like systems with bone fixation in the proximal (a) and distal (b) sectors, which allows the use a double-locking canulated assembly as a form of bone fixation which, in turn, allows for bone fixation by tension Kirschner wires and/or tension cerclage wires. This locked plate, consisting of two proximal and distal elements, is joined in the intermediate zone by a central sliding zone (c), advancing into a chamber guided by a threaded central rod (d) passing through it and rotating by motorized means one of the two bone fixation elements, the motor is located on the other plate element (e), which can be at the proximal or distal end thereof actuating by systems that can be electric, magnetic or electromagnetic, such as those used in intramedullary internal lengthening with motorized nails.

[0048] According to FIG. 6, the development of a stabilization system consisting of at least two closed circular periosseous elements (a) to maintain the tensile stress of Kirschner wires is shown.

[0049] These closed ring-like elements can be generated by joining three elements (b, c and d) as shown in the figure for proximal tibia, at one of these three elements is attached the sliding system (e), which is continued with the distal fixation element.

[0050] These closed ring-shaped elements allow the use of locked screws which can be of a variable angle and also allow the use of the double-locking assembly for tension Kirschner wires, these bone fixation systems are attached by a sliding system similar to those developed for intramedullary lengthening but arranged in an extramedullary form, as shown in the figure, allowing internal bone lengthening, with locked extramedullary systems of dynamic axial stabilization.

[0051] According to FIG. 7, a perspective view of an extramedullary internal fixation and lengthening system consisting of 2 locked plate-like bone fixation elements (a and b) is shown, which allow the use of a double-locking canulated element for attaching intramedullary elements such as TENS or Ender nails (c) and bone fixation elements, such as tension Kirschner wires, tension cerclage wires and locked screws that may or may not be of a variable angle.

[0052] These two locked plate-like elements are joined in their central portion by a tubular or semi-tubular (telescopic d) sliding zone motorized by current systems used for current intramedullary nails.

[0053] According to FIG. 8.1, a perspective view of an internal locked extramedullary lengthening system which allows the use of tension Kirschner wires and/or cerclage wires joining both plates (a) is shown.

[0054] This specific development model for distal femur shows an external slide plate (b) with proximal and distal anchoring and a slide system similar to those already analyzed, and an internal plate (c) of helical arrangement wherein its proximal and distal portions also present attachment elements to locked bone, which allows the use of tension Kirschner wires, locked screws that can be of a variable angle and tension cerclage wires. Both plates can be joined in the distal portion using tension Kirschner wires (a), thereby closing a lengthening circuit. The two plates locked by tension-locked cerclage can be joined in the proximal portion, as shown in figure (d).

[0055] The sliding motor goes on the lateral straight plate (e), the helical plate presenting a sliding system that accompanies the lengthening guided by the lateral plate (f)

[0056] According to FIG. 8.2, a perspective view of an internal locked extramedullary lengthening system for anterograde bone transport is shown, wherein the lateral locked plate (a) is a continuous plate that allows the use of both proximal and distal locked bone anchoring elements for both locked Kirschner wires (b) and locked screws that can be of a variable angle, which features a sliding element (c) in its central sector that also features bone anchoring elements for the bullet fragment (d). This central element is slid by actuating the motor located in the proximal sector of the locked plate as shown in the figure. In this case of bone transport, the helical locked plate can be continuous (e), without having a central sliding element, featuring proximal and distal locking holes that allow the use of both locked screws that can be of variable angle and locked Kirschner wires that allow attachment with the side plate by tension.

[0057] According to FIG. 8.3, a lateral locked plate (a) is shown, with characteristics similar to the plate shown in FIG. 8.2, which is also associated with an internal helical locked plate (b), with the same characteristics as described above, but in this case the bone transport is retrograde, by positioning the motor (c) in the distal sector of the lateral straight plate.