US3604414A - Bone setting device - Google Patents

Abstract

An osteosynthesis plate of two-piece construction having a toothed rack system to enable sliding movement of the two pieces in a direction to move the plate pieces in a direction to achieve the greatest approximation of a fractured bone to facilitate joining the fracture in the bone. The plates are secured to the fragments of the bone by screw members and a tool for moving the plates toward each other is provided to facilitate engagement with the plates after they have been attached to the fragments of the fractured bone.

Description

United States Patent [72] lnventor Nicomeda Borges Caracas. Venezuela [21] Appl. No. 756.206

Filed Aug. 29. 1968 Patented Sept. 14, 1971 [54] BONE SETTING DEVICE 1 Claim, 6 Drawing Figs.

[52] US. Cl 128/92 D [51] Int. Cl A61f 5/04 [50] Field of Search 128/83,92,

92 A, 92 D, 92 E, 87. 92 R, 92 ED, 87 R [56] References Cited UNITED STATES PATENTS 2.406.832 9/1946 Hardinge 128/92 D 24346431 l/l948 Pincock...... 128/92 A 3,244,170 4/1966 McElvanny 128/92 1.025,008 4/1912 Miner 128/92 D FOREIGN PATENTS 1.239.266 7/1960 France 128/92 D 1.507.627 11/1967 France 128/92 867,422 7/1949 Germany... 128/92 D 335.797 3/1959 Switzerland 128/92 D Primary Examiner- Richard A. Gaudet Assistant Examiner-.1. B. Mitchell Attorneys-Clarence A. O'Brien and Harvey B. Jacobson ABSTRACT: An osteosynthesis plate of two-piece construction having a toothed rack system to enable sliding movement of the two pieces in a direction to move the plate pieces in a direction to achieve the greatest approximation of a fractured bone to facilitate joining the fracture in the bone. The plates are secured to the fragments of the bone by screw members and a tool for moving the plates toward each other is provided to facilitate engagement with the plates after they have been attached to the fragments of the fractured bone.

PATENTEU SEPI 419m SHEET 1 [IF 2 N/comedes Borges (Rivas) INVIiN'I'OK.

BONE SETTING DEVICE The present invention generally relates to the field of medicine and more particularly to traumatological surgery.

At the present time, osteosynthesis, the repair of fractures by use of extraneous material such as a metal plate, so-called osteosynthesis plates have been used which is in the form of a strip of material of stainless steel or vitallium, which are accepted by the body with the least degree of reaction, are attached by apposition to the fractured bone. Various types or models of such plates have been employed but all of them operate under a single principle, that is, maintaining the fragments of a fractured bone in the closest position to their normal state so they can unite by the formation of a bony callus due the proximity of the fragments. However, this consolidation of the bone is impeded in a great number of cases by the fact that the more the fragments are separated and mobile, the consolidation is retarded and the formation of pseudoarthrosis is stimulated which defect renders the bone incompatible with its normal functioning.

In view of each undesirable results caused by the singlepiece construction of the osteosynthesis plate, the present plate constructed of two pieces enables one piece to be moved in relation to the other by employing interengaging teeth between the two sections or pieces of the plate. Each piece of the plate is located on one of the bone fragments and attached thereto by screws which permit sliding in the direction of approximation, but not in the direction of separation due to the particular configuration of the toothed connection therebetween.

An instrument is provided for sliding the two pieces of the osteosynthesis plate in an approximation direction which includes a pair of parallel arms engaged with a rodlike member having opposite screw threads thereon for moving the arms toward and away from each other. The outer ends of the arms and each piece of the plate have correspondingly shaped projections and orifices receiving the projections to enable movement of the pieces of the plate in an approximation direction.

One of the objects of the present invention is to provide an osteosynthesis plate and an instrument for moving the two pieces thereofin an approximation direction which is effective for the purpose of consolidating the fragments of a fractured bone, relatively easy to use while being dependable and long lastingv These together with other objects and advantages which will become more subsequently apparent reside in the details of construction and operation as more fully hereinafter described and claimed, reference being had to the accompanying drawings forming a part hereof, wherein like numerals refer to like parts throughout, and in which:

FIG. 1 is a perspective view illustrating the osteosynthesis plate and the instrument for moving the two pieces thereof towards approximation illustrating the manner of use thereof;

FIG. 2 is a side elevational view of the assembly of FIG. 1 with the osteosynthesis plate in section;

FIG. 3 is a transverse, sectional view taken substantially upon a plane passing along section line 33, on an enlarged scale, of FIG. 2 illustrating further structural details of the invention;

FIG. 4 is an enlarged fragmental sectional view of the two pieces of the plate illustrating the relationship of the toothed interconnection therebetween;

FIG. 5 is an exploded group perspective view of the twopiece osteosynthesis plate; and

FIG. 6 is a bottom plan view of one piece of the plate.

Referring now specifically to the drawings, the osteosynthesis plate is generally designated by the numeral 10 and the clamp or instrument for manipulating the two pieces of the plate is designated by the reference numeral. 12. The plate 10 includes two pieces, segments or sections generally designated by the numerals I4 and 16 respectively with thesegment 14 including an elongated relatively narrow and thinrectangular body 18 having a pair of longitudinally spaced and aligned apertures 20 extending therethrough with the upper ends of each aperture 20 being countersunk at 22 for receivingscrewtype fasteners 24 as illustrated in FIG. 2. Provided in the upper surface of thebody 18 is anelongated recess 26 extending from a point adjacent the inner orifice 20 to the opposite end thereof with therecess 26 being defined by a pair ofedge flanges 28 and aninner end surface 30. The bottom of therecess 26 is provided with a plurality of transversely extendingteeth 32 thereon and anelongated slot 34 extends substantially throughout the length of the bottom of therecess 26.

The piece orsegment 16 includes an elongatedrectangular body 36 adapted to be received within therecess 26 between theflanges 28 with thebody 36 having a pair ofcountersunk apertures 38 extending'therethrough for receiving thescrewthreaded fasteners 40 as illustrated in FIG. 1. The lower surface of thebody 36 is provided with a plurality of transversely extendingteeth 42 thereon for interengagement with theteeth 32 within therecess 26. When thesection 16 is assembled with thesection 14, theteeth 42 and 32 are interengaged and the screw-threadedfasteners 40 extending through theapertures 38 also extend through theslot 34 in thesection 14. Centrally of thesection 14 intermediate the apertures 20, a square recess or opening 44 extends therethrough and a similar square orrectangular opening 46 extends through thesection 16 between the twoapertures 38.

Theinstrument 12 for manipulating thesegments 14 and 16 of the osteosynthesis plate 10 includes a bar of elongated rectangular configuration with the transverse cross section of the bar also being rectangular. At one end of thebar 48, there is provided a laterally extendingarm 50 of one-piece construction with thebar 48, with the outer end of thearm 50 including aprojection 52 for reception within the opening 44 in thesection 14 of the plate 10.

Slidable on thebar 48 is asleeve 54 having arecess 56 extending therethrough closely receiving thebar 48 for sliding movement thereon. Thesleeve 54 is provided with anarm 58 of one-piece construction therewith which is disposed in parallel coplanar relation with thearm 50 and terminates in aprojection 60 at its free end for engagement in theopening 46 in theplate segment 16. Theprojections 52 and 60 are of a shape and configuration to closely fit within theopenings 44 and 46 respectively so that when thearm 58 is moved toward thearm 50, theplate segment 16 will be moved toward theplate segments 14.

The end of thebar 48 having thearm 50 thereon is also provided with a laterally projecting sleeve orbearing block 62 journaling anelongated rod 64 therein. Therod 64 has the major portion thereof externally threaded at 66 for threaded engagement with a laterally extending internally threaded sleeve orboss 68 formed unitarily with thesleeve 64 in alignment with thebearing block 62. Fixedly mounted on therod 64 is a pair ofabutment members 70 and 72 which are disposed on opposite sides of thebearing block 62 and engage thebearing block 62 withwashers 74 therebetween if desired so that when therod 64 is rotated, themembers 70 and 72 will prevent axial movement thereof thereby causing theboss 68 and thesleeve 54 as well as thearm 58 to move longitudinally on thebar 48 when therod 64 is rotated.

The end of therod 64 which extends beyond the sleeve orabutment member 70 is formed with apolygonal end 76 for the reception ofa suitable wrench orhandle 78 which includes a ratchet mechanism within a housing 80 so that thehandle 78 may be ratcheted to cause rotation of the threadedrod 64 in a selected rotational direction.

In utilizing the invention, the fracture site such as in theforearm 82 is opened surgically as at 84 in the usual manner to expose thefracture 86 between fragments orsegments 88 and 90 of the bone. Once the fracture has been reduced,section 14 is placed on the end of one of the fragments such asfragment 90 of the bone and is temporarily held in place by a bone clamp while it is attached to the bone fragment with twoscrews 24 as illustrated in FIG. 2 so that the end thereof having theslot 34 therein extends beyond thefracture 86 into overlying relation to thebone fragment 88. Piece orsegment 16 is then put in place within therecess 26 with thescrews 40 being inserted through theapertures 38 and theslot 34 but not tightened completely to enable sliding movement of thesegment 16 in a direction to bring thebone fragments 88 and 90 into contacting engagement with each other or into close approximation. As soon as thepiece 16 has been attached in the manner illustrated, movement in a direction to increase the distance between the ends of thebone fragments 88 and 90 is precluded by theteeth 32 and 42. This is assured inasmuch as all of theteeth 32 on thesegment 18 have asurface 92 in perpendicular relation to the longitudinal axis of thesegment 18 and facing theend surface 30 of therecess 26 with the apex of each tooth defining the upper limit of thevertical surface 92 and the upper limit of aninclined surface 94 thus defining a tooth which will enable movement of theplate 36 in a direction toward the apertures and preclude movement in the opposite direction. As illustrated in FIG. 4, theteeth 42 in thesegment 16 are oppositely oriented so that theteeth 32 and 42, in effect form a one-way ratcheting engagement between the segments of the plate. In this condition such as illustrated in FIGS. 1 and 2, the instrument ortool 12 is applied and by operating theratchet handle 48, thefracture 86 may be substantially closed by bringing the ends of thebone fragments 88 and 90 into contact with each other or into substantially approximation of each other to facilitate the consolidation or uniting thereof. During this procedure, thesurgical incision 84 may be kept open by employingconventional instruments 96 for this purpose and conventional bone clamps may be employed for alignment of the bone fragments and bringing thebone fragments 88 and 90 into closer approximation before installation of the osteosynthesis plate. After installation of the plate and operation of theinstrument 12 to position thebone fragments 88 and 90 in the optimum position, thescrews 40 are tightened into a final condition thus securing the plate in position after which thesurgical incision 84 is closed in the usual manner.

The osteosynthesis plate will be provided in different lengths and sizes with suitable indicia provided for indicating the size. The indicia may be in the form of matching numerals on the upper surface of thesegments 14 and 16 respectively. The plate and the clamp may be readily rendered aseptic and are constructed of conventional materials employed for surgical instruments and the number, shape and size of teeth may be varied to vary the increments of movement of the segments of the plate in relation to each other in order to enable accurate and positive approximation of the end of the bone fragments defining the line of fracture to facilitate the consolidation or knitting of the surfaces defining the fracture.

The foregoing is considered as illustrative only of the principles of the invention. Further since numerous modifications and changes will readily occur to those skilled in the art, it is not desired to limit the invention to the exact construction and operation shown and described, and accordingly all suitable modifications and equivalents may be resorted to, falling within the scope of the invention as claimed.

What is claimed as new is as follows:

1. A device for setting bone fragments comprising an osteosynthesis plate constructed of first and second substantially flat elongated pieces, said first piece having upper and lower surfaces and first and second ends, the lower surface being adapted to engage the bone fragments, said second piece overlying the upper surface of said first piece and being adapted to remain remote from the bone fragments, means for guiding said pieces and enabling longitudinal movement of the pieces toward each other into approximation but preventing movement in the opposite direction after approximation has been achieved, said means including a longitudinal recess in said first piece extending over a major portion of the length thereof and defining flanges slidably receiving substantially the entire length of said second piece, said means further including a plurality of teeth in said longitudinal recess and a plurality of teeth on said second piece, said teeth on said first piece having two faces, one of said two faces being substantially perpendicular to the longitudinal axis of said first piece and the other of said faces being inclined toward said first end, said teeth on said second piece also having a pair of faces, one of said pair of faces being substantially perpendicular to the longitudinal axis of said second piece and the other of said pair of faces being inclined toward said second end, each of said pieces of said plate including at least one aperture therein, said recess including a longitudinal slot therein underlying said aperture in said second piece, a fastener extending through each of said apertures and adapted to engage the bone fragments, an opening in each of said pieces, and means for engaging the openings and moving the two pieces of the plate into approximation.

Claims (1)

1. A device for setting bone fragments comprising an osteosynthesis plate constructed of first and second substantially flat elongated pieces, said first piece having upper and lower surfaces and first and second ends, the lower surface being adapted to engage the bone fragments, said second piece overlying the upper surface of said first piece and being adapted to remain remote from the bone fragments, means for guiding said pieces and enabling longitudinal movement of the pieces toward each other into approximation but preventing movement in the opposite direction after approximation has been achieved, said means including a longitudinal recess in said first piece extending over a major portion of the length thereof and defining flanges slidably receiving substantially the entire length of said second piece, said means further including a plurality of teeth in said longitudinal recess and a plurality of teeth on said second piece, said teeth on said first piece having two faces, one of said two faces being substantially perpendicular to the longitudinal axis of said first piece and the other of said faces being inclined toward said first end, said teeth on said second piece also having a pair of faces, one of said pair of faces being substantially perpendicular to the longitudinal axis of said second piece and the other of said pair of faces being inclined toward said second end, each of said pieces of said plate including at least one aperture therein, said recess including a longitudinal slot therein underlying said aperture in said second piece, a fastener extending through each of said apertures and adapted to engage the bone fragments, an opening in each of said pieces, and means for engaging the openings and moving the two pieces of the plate into approximation.

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