CA2512074A1 - External fixation apparatus - Google Patents
External fixation apparatus Download PDFInfo
- Publication number
- CA2512074A1 CA2512074A1 CA002512074A CA2512074A CA2512074A1 CA 2512074 A1 CA2512074 A1 CA 2512074A1 CA 002512074 A CA002512074 A CA 002512074A CA 2512074 A CA2512074 A CA 2512074A CA 2512074 A1 CA2512074 A1 CA 2512074A1
- Authority
- CA
- Canada
- Prior art keywords
- pin clamp
- external fixation
- pin
- clamp
- further characterized
- Prior art date
- Legal status (The legal status 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 status listed.)
- Abandoned
Links
Classifications
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6425—Devices extending alongside the bones to be positioned specially adapted to be fitted across a bone joint
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- 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, setting implements or the like
- A61B17/60—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like for external osteosynthesis, e.g. distractors, contractors
- A61B17/64—Devices extending alongside the bones to be positioned
- A61B17/6416—Devices extending alongside the bones to be positioned with non-continuous, e.g. hinged, pin-clamp connecting element
Abstract
Apparatuses for externally fixing and precisely adjusting fractures, such as fractures near the ankle, are disclosed. In one embodiment, an external fixation apparatus includes a first member attachable to a first bone segment through pins, a second member coupled to the first member through a lockable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member, and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to a second bone segment. The pin clamp and the second member may be releasably coupled.
Description
EXTERNAL FIXATION APPARATUS
Related Applications This application claims priority to U.S. Application Serial No. 10/607,010, entitled "External Fixation Apparatus and Method," filed June 26, 2003, which claims the benefit s of U.S. Provisional Application Serial No. 60/439,195, entitled "External Fixation Apparatus and Method," filed January 10, 2003, the entire contents of which are hereby incorporated by reference.
Field of the Invention 1o The invention relates generally to apparatuses and methods of orthopedic external fixation, and, more particularly, to apparatuses and methods for externally fixing and precisely adjusting fractures, such as fractures near the ankle.
Background of the Invention is External fixation of fractures has been practiced extensively, and there exists a number of external fixation devices designed to fix fractures of the ankle.
Generally, these devices attach to the tibia with bone pins, span the fracture, and attach to bones of the foot, the talus and calcaneus, to secure the fracture while it heals. Some of the devices are designed to provide a pivot point in the external fixator adjacent to the natural hinge 2o point of the patient's ankle. It is suggested by some that allowing the external fixator and ankle to pivot at some times during the healing process is advantageous. This view is not held by all, and some of the external fixators are not designed to pivot in this manner, or are designed to be lockable to selectively inhibit any pivoting prior to healing. Some external fixators are also adjustable longitudinally.
However, none of the existing external fixation devices are capable of adjustment and consequent fme adjustment of a fracture reduction lateral or transverse to the longitudinal axis of a fixator once the fixator. has been placed on the bone pins and tightened. Therefore, if any transverse fracture reduction adjustment is needed, the fixator must be loosened, the fracture realigned, and the fixator tightened again.
Prior devices also fail to give significant flexibility in pin placement and orientation in the foot of a patient. It is important that external fixation devices for the anlcle be easier to use, less cumbersome, and more versatile than existing devices, particularly when used in a trauma setting.
to Accordingly, there is a need for apparatuses and methods optimized to enable convenient placement and locking of an external fixator and apparatuses and methods that provide for fme adjustment of fracture reduction without requiring loosening of the external fixator. It would be additionally advantageous to enable manipulation of the external fixator in greater degrees of freedom in order to more effectively and efficiently place fixation elements such as bone pins. Furthermore, it would be advantageous in certain embodiments to provide for rotatable removal and attachment means for multiple fixator configurations. All of these are particularly important in the context of ankle fixators, even though it is possible for concepts, features, and aspects of the invention, and embodiments of it, to be used in the context of other points in the human body.
Related Applications This application claims priority to U.S. Application Serial No. 10/607,010, entitled "External Fixation Apparatus and Method," filed June 26, 2003, which claims the benefit s of U.S. Provisional Application Serial No. 60/439,195, entitled "External Fixation Apparatus and Method," filed January 10, 2003, the entire contents of which are hereby incorporated by reference.
Field of the Invention 1o The invention relates generally to apparatuses and methods of orthopedic external fixation, and, more particularly, to apparatuses and methods for externally fixing and precisely adjusting fractures, such as fractures near the ankle.
Background of the Invention is External fixation of fractures has been practiced extensively, and there exists a number of external fixation devices designed to fix fractures of the ankle.
Generally, these devices attach to the tibia with bone pins, span the fracture, and attach to bones of the foot, the talus and calcaneus, to secure the fracture while it heals. Some of the devices are designed to provide a pivot point in the external fixator adjacent to the natural hinge 2o point of the patient's ankle. It is suggested by some that allowing the external fixator and ankle to pivot at some times during the healing process is advantageous. This view is not held by all, and some of the external fixators are not designed to pivot in this manner, or are designed to be lockable to selectively inhibit any pivoting prior to healing. Some external fixators are also adjustable longitudinally.
However, none of the existing external fixation devices are capable of adjustment and consequent fme adjustment of a fracture reduction lateral or transverse to the longitudinal axis of a fixator once the fixator. has been placed on the bone pins and tightened. Therefore, if any transverse fracture reduction adjustment is needed, the fixator must be loosened, the fracture realigned, and the fixator tightened again.
Prior devices also fail to give significant flexibility in pin placement and orientation in the foot of a patient. It is important that external fixation devices for the anlcle be easier to use, less cumbersome, and more versatile than existing devices, particularly when used in a trauma setting.
to Accordingly, there is a need for apparatuses and methods optimized to enable convenient placement and locking of an external fixator and apparatuses and methods that provide for fme adjustment of fracture reduction without requiring loosening of the external fixator. It would be additionally advantageous to enable manipulation of the external fixator in greater degrees of freedom in order to more effectively and efficiently place fixation elements such as bone pins. Furthermore, it would be advantageous in certain embodiments to provide for rotatable removal and attachment means for multiple fixator configurations. All of these are particularly important in the context of ankle fixators, even though it is possible for concepts, features, and aspects of the invention, and embodiments of it, to be used in the context of other points in the human body.
Summary of the Invention The present invention provides apparatuses and methods for externally fixing and precisely adjusting fractures in or near a joint, such as fractures near the ankle. According to an exemplary embodiment of this invention, an external fixation apparatus includes a first member attachable to a first bone segment through pins, a second member coupled to the first member through a lockable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member, and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to a second bone segment. The first bone segment may be a to tibia and the second bone segment may be a talus or a calcaneus. The second member may include a unitary, bifurcated, or other type of stem. The pin clamp may be symmetrical or asymmetrical.
According to certain exemplary embodiments, translation of first and second ends of a second member relative to the longitudinal axis of the second member is possible in 1s at least two dimensions. In one embodiment, the second member includes a carriage that fits within an upper recess and a lower recess of the second member, the carriage including two threaded holes each for receiving a worm gear, and lceybolts for operating each worm gear such that the carriage may be moved transversely to the longitudinal axis in one dimension within the upper recess and transversely relative to the longitudinal axis 2o in another dimension within the lower recess.
According to one embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes an axle extending through a hole in a first jaw of the pin clamp and a hole in the second end of the second member, an anti-rotation pin inserted through a portion of the second member and into the axle, and a first bolt that passes through openings in first and second jaws of the pin clamp such that tightening of the first bolt interferes with the axle and locks rotation of the pin clamp and the second member.
According to another embodiment of this invention, a loclcable joint coupling a second member and a pin clamp includes a threaded sleeve fixed to the second member s and a core with internal hex driving sockets that is threaded onto the sleeve so that as the core is moved along the sleeve, balls are forced up ramps and into the pin clamp or allowed to move down ramps and away from the pin clamp.
According to another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a biasing element and a pushbutton core 1o contacting the biasing element such that when the pushbutton core is depressed the pin clamp may rotate freely.
According to another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a shaft extending transversely from the second end of the second member, the shaft including at least one radial groove, a hole within a 15 first jaw of the pin clamp that receives the shaft, a locator pin of the pin clamp that is received within the at least one radial groove to releasably couple the second member and the pin clamp, and a first bolt that passes through openings in the first jaw and a second jaw of the pin clamp such that tightening of the first bolt interferes with the shaft and loclcs rotation of the pin clamp and the second member.
2o According to certain exemplary embodiments of this invention, a lockable joint coupling a second member and a pin clamp provides for multi-axis rotation between the second member and the pin clamp.
In one embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a sphere suspended from the second end of the second member that is received within interior surfaces of first and second jaws of the pin clamp and at least one bolt that passes through openings in at least one of the first and second jaws of the pin clamp such that tightening of the at least one bolt interferes with the sphere and locks rotation of the pin clamp and the second member.
s In another embodiment of this W vention, a lockable joint coupling a second member and a pin clamp includes a sphere attached to the piii clamp and a compression bolt that extends through holes in the sphere of the pin clamp and the second member so that when the bolt is tightened with a lock nut, the second member is compressed against the sphere thereby locking rotation of the second member and the pin clamp.
1o In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a connector that is held within a sphere-shaped tip of the second member by a retaining cap and a biasing element, the connector having a ball end and a threaded end, a cooperating surface of the pin clamp that receives the sphere-shaped tip of the second member and the threaded end of the connector, and a nut that is is threaded onto the threaded end of the connector to retain the connector within the pin clamp and such that when the nut is tightened the sphere-shaped tip of the second member and the cooperating surface of the pin clamp are locked against one another.
In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a connector held within a sphere-shaped tip of the pin 2o clamp, a cooperating surface of the second member that receives the sphere-shaped tip of the pin clamp and a shaft end of the connector, and a wedge bolt extending through the second member that is tightened by a wedge nut causing a ramp to force a ball end of the connector to be pulled up forcing the sphere-shaped tip of the pin clamp and the cooperating surface of the second member to lock against one another.
___ In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes two stacked washers attached to a spherical portion of the second member, two staclced washers attached to the pin clamp, wherein the two stacked washers of the pin clamp are alternatingly nested with the two stacked washers of the second member, and a bolt extending from the pin clamp and into the spherical portion of the second member such that all of the washers and the spherical portion are pressed together upon tightening of the bolt, thereby locking rotation of the pin clamp and the second member.
According to certain exemplary embodiments of the present invention, a second 1o member may be biased at its second end from the longitudinal axis of the second member up to approximately sixty degrees.
According to certain exemplary embodiments of this invention, an external fixation apparatus includes a first member attachable to a first bone segment through pins, a second member coupled to the first member through a lockable joint, the second is member including a shaft extending transversely from a distal end of the second member with at least one radial groove in the shaft, and a pin clamp attachable to a second bone segment and releasably coupled to and rotatable about the second member. The pin clamp may include a first jaw and a second jaw, the first jaw including a hole that receives the shaft, a locator pin that is received within the at least one radial groove of the shaft to 2o releasably couple the second member and the pin clamp, and a first bolt that passes through openings in the first and second jaws such that tightening of the first bolt interferes with the shaft and locks rotation of the pin clamp and the second member. The locator pin may be configured to allow for pull release or pushbutton release of the second member from the pin clamp. The pin clamp may include second and third bolts that hold the first and second jaws together and attach and clamp pins or wires to the second bone segment, and the first and second jaws may include openings that receive biasing elements and threaded ends of the second and third bolts.
According to certain exemplary embodiments of this invention, an external s fixation system for attaching pins or wires to at least one bone segment includes an external fixation device and a pin clamp. The pin clamp may include a first jaw and a second jaw, biasing elements received within openings in the first and second jaws, first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together, a hole in to the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove, a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp, and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external 1s fixation device. In one embodiment, the external fixation device is a handle such that the pin clamp and handle coupled thereto may be used as a drill guide. In another embodiment, the external fixation device is a fixation component that includes a capture member that receives a pin, bar, or wire. In another embodiment, the external fixation device is a second member with first and second ends that may be translated transversely 2o in at least two dimensions relative to a longitudinal axis of the second member.
Certain exemplary embodiments of this invention also include methods of reducing a fracture.
According to the present invention, there is provided an external fixation apparatus for use with a first bone segment that is a tibia and a second bone segment that is a talus, calcaneus, or both, characterized in that the external fixation apparatus comprises a first member attachable to the first bone segment through pins; a second member coupled to the first member through a loclcable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member; and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to the second bone segment.
According to the present invention, there is also provided an external fixation system for attaching pins or wires to at least one bone segment, characterized in that the system comprises an external fixation device and a pin clamp comprising: a first jaw and a second jaw; biasing elements received within openings in the first and second jaws; first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together; a hole in the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove; a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp; and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external fixation device.
2o Brief Description of the Drawings Figure 1 is a perspective view of an embodiment of an apparatus according to the present invention in use to support the ankle of a patient.
Figure 2 shows the alignment of an embodiment of a pin clamp according to the present invention over the ankle of a patient.
Figure 3 is an exploded perspective view of components of an embodiment of an apparatus according to the present invention.
Figure 4 is a cross-sectional elevation view of an embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 5 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 6 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figures 7A and 7B are elevation views of another embodiment of a coupling 1o between a second member and a pin clamp according to this invention.
Figures 8A and 8B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 9 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
~s Figure 10 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 11 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 12 is a perspective view of an embodiment of a pin clamp according to the 2o present invention.
Figure 13 is a perspective view of an embodiment of a second member according to the present invention configured to create an angular bias from normal between the longitudinal axis of the second member and a pin clamp.
Figure 14 is a perspective view of an embodiment of an apparatus according to the present invention configured to create an angular bias from normal between the longitudinal axis of the external fixation apparatus and a pin clamp of the apparatus.
Figure 15 is a perspective view of an embodiment of a pin clamp according to the s present invention over the anlcle of a patient with two drill sleeves inserted in the pin clamp.
Figure 16 is an elevation view of an embodiment of an external fixation apparatus according to the present invention including the pin clamp of Figure 15 and a second member.
Figure 17 is an exploded, cross-sectional elevation view of the embodiment of the external fixation apparatus shown in Figure 16.
Figure 18 is an exploded elevation view of the pin clamp shown in Figures 15-17.
Figure 19 is an elevation view of another embodiment of a pin clamp with a locator pin according to the present invention.
1s Figure 20 is an elevation view of an embodiment of a handle assembly for use with an embodiment of a pin clamp according to the present invention.
Figure 21 is an elevation view of an embodiment of a fixation component for use with an embodiment of a pin clamp according to this invention.
2o Detailed Description of the Invention Figure 1 shows an external fixation apparatus 100 placed on the lower leg and ankle of a human. External fixation apparatus 100 includes a first member 102 that is attached to a tibia through upper bone pins 104 and 106. As shown in Figure 1, first member 102 includes upper and lower components that cooperate to provide for additional adjustments, but first member 102 may be a single component. A
second member 110, sometimes referred to in practice as a pivot arm or a stem, is coupled to first member 102 through a loclcable joint, preferably a ball joint. A pin clamp 140, sometimes referred to in practice as a pin bloclc, is coupled to second member 110 and to a second s bone segment through lower bone pins 142 and 144. A first lower bone pin 142 may be attached to the talus and a second lower bone pin 144 may be attached to the calcaneus, as shown more clearly in Figure 2. The talus and calcaneus are both bones of the foot and semi-rigidly fixed to one another through tissues of the foot, and therefore may be considered as a unitary bone segment for the purpose of the invention and referred to as a 1o bone segment herein. Similarly, other combinations of the slceletal structure may be considered a bone segment for purposes of the invention. Although pin clamp 140 and bone pins 102, 104, 142, and 144 are designated as "pin" or "pins," other devices capable of fixiizg to skeletal structures, such as, but not limited to, wires, are within the scope of fixation systems and devices available for use with certain exemplary embodiments of the is present invention.
Figure 2 illustrates the typical placement of pin clamp 140 on the anatomy of a patient. As noted above, first lower bone pin 142 is attached to the talus and second lower bone pin 144 is attached to the calcaneus. As shown in Figure 2, pin clamp 140 is symmetrical. However, pin clamp 140 may be asymmetrical, such as, for example, pin 2o clamp 340 shown in Figure 15. Pin clamp 140 may be pivoted about the second member 110, as further described below, and used interchangeably from either the left or the right side of the leg of a patient. As shown in Figure 2, first lower bone pin 142 is closer to an axle 112 that goes through the center of pin clamp 140 than is second lower bone pin 144.
Figure 3 is an exploded perspective view of components of an embodiment of an external fixation apparatus according to the present invention, including second member 110 and pin clamp 140. Opposite ends 116 and 118 of second member 110 may be translated transversely relative to the longitudinal axis of the second member through use s of a carriage 130. Carriage 130 fits within recesses in an upper portion 120 and a lower portion 122 of second member 110. The recesses in portions 120 and 122 of second member 110 are larger than the parts of carriage 130 that fit within the recesses.
Therefore, carriage 130 is allowed to move within the recesses laterally along the longitudinal axis of second member 110. A worm gear 132A engages a threaded hole 134A in the upper portion of carriage 130. The length of worm gear 132A fits within the recess in upper portion 120 of second member 110. A keybolt or lceybolts 136 may be mated to either or both ends of worm gear 132A to enable worm gear 132A to be operated with an internal hex driver. Operation of worm gear 132A moves carriage 130 laterally between the extents to which carriage 130 is allowed to move within the recess in upper Is portion 120 of second member 110. More specifically, turning of worm gear 132A within hole 134A will move end 118 either medially or laterally relative to the longitudinal axis of second member 110 and end 116, depending on the direction in which worm gear 132A
is turned. Similarly, Figure 3 shows another worm gear 132B engaged with another threaded hole 134B in the lower portion of carriage 130 such that lceybolts 138 may be operated with an internal hex driver. Turning of worm gear 132B within hole 134B will move end 116 either posterior or anterior relative to the longitudinal axis of second member 110 and end 118, depending on the direction in which worm gear 132B is turned.
In certain other exemplary embodiments of the transverse movement feature, finely controlled movement, such as with the two worm gears, may or may not be incorporated. For example, in some embodiments opposite ends of second member would be moveable as a result of a releasable connection within second member 110. The releasable connection could be unloclced, the transverse movement accomplished, and then the connection loclced to hold the desired movement. Locking could be s accomplished through use of a setscrew. Other apparatuses that would provide finely controlled movement may be used as well. A single worm gear could be used to provide fme adjustment only in the most advantageous dimension. Automated adjustments using mechanical, electrical, thermal, and/or computer-controlled signals or actuators could also be employed. Any apparatus providing for adjustment substantially transverse to the longitudinal axis of the second member 110 is contemplated by certain exemplary embodiments of this invention.
Returning to Figure 3, pin clamp 140 is coupled to second member 110 through axle 112. Pin clamp 140 includes a first jaw 146 and a second jaw 148. First jaw 146 has a hole 150 through which axle 112 is inserted, and pin clamp 140 is able to rotate about 1s axle 112. Axle 112 is coupled to second member 110 through a hole 124 in second member 110. Axle .112 may be fixed to second member 110 by inserting an anti-rotation pin 126 through a portion of second member 110 and into axle 112.
Alternatively, axle 112 could be fixed to second member 110 with an adhesive, by welding, by compression fit, by being formed integrally with second member 110, or by any other method adequate 2o to form a structurally sufficient connection. Axle 112 may also include an alignment hole 114 through which a pin or wire may be placed into the bone. Such alignment may be useful to approximate a desired center of rotation of pin clamp 140. For example, a wire may be placed through alignment hole 114 and into the talus to approximate the pivot axis of a patient's ankle. Second member 110 may also include a notch 128 to provide for additional rotational freedom of pin clamp 140. Notch 128 effectively gives pin clamp 140 a greater range of motion without significantly reducing the strength of second member 110.
First jaw 146 and the second jaw 148 are held together by clamp bolts 152.
Clamp s bolts 152 may serve to both hold the jaws together, and to attach and clamp bone pins 142 and 144 to a bone segment (see Figure 1). Bone pins may be clamped in any of the four holes defined by the eight depressions 154, as shoml in Figure 3. Clamp bolts 152 may be urged by biasing elements, such as springs 156, such that first jaw 146 and second jaw 148 tend to push together to stay loosely secured to bone pins prior to tightening clamp to bolts 152. A lock bolt 158 may be provided to lock the rotation between second member 110 and pin clamp 140. Lock bolt 158 passes through holes in second jaw 148 and first jaw 146 such that by sufficiently tightening lock bolt 158, the distal end of the bolt interferes with axle 112 and locks rotation between second member 110 and pin clamp 140. As shown in Fig. 3, the threaded hole with which loclc bolt 158 engages is in first ~s jaw 146.
Certain additional exemplary embodiments of coupling between a second member and a pin clamp according to the present invention are shown in Figures 4-11.
Figures 4-6 illustrate configurations useful in locking single axis rotation between a second member and a pin clamp, while Figures 7-11 show locking of multi-axis rotation between a second 2o member and a pin clamp. The apparatuses of Figures 2, 4, 7, and 9-11 illustrate a second member with a unitary stem to which the pin clamp attaches. The apparatuses of Figures 5, 6, and 8 show a second member with a bifurcated stem to which the pin clamp attaches (i.e., two separate appendages of the stem extend to and connect with the pin clamp). As understood by those skilled in the art, the locking mechanisms of the two types of stems may be interchangeable, and merely because a locking mechanism of one type is shown with a stem of a particular type, that does not preclude use with a stem of another type.
Figure 4 is a cross-sectional elevation view of an embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 4 shows a single-ramp locking axle 160 useful in loclcing the coupling between second member 110 and pin clamp 140. Single-ramp locking axle 160 may include an alignment hole 162 for aiding with the placement of the apparatus as described above. Single-ramp locking axle 160 has a threaded sleeve 164 and a core 166 with internal hex driving sockets 168. Core 166 is threaded into sleeve 164, and sleeve 164 is fixed to second member 110.
By 1o turning core 166, the core moves along sleeve 164, and balls 170 are forced up or allowed to move down ramps 172 and into or away from pin clamp 140. Balls 170 may therefore be used to loclc and unlock movement between second member 110 and pin block 140.
Balls 170 and surfaces of pin clamp 140 and ramps 172 may be coated or manufactured such that higher coefficients of friction are generated to enhance the loclcing. Ramps 172 may be discrete ramps holding a single ball 170, or may be substantially continuous about the exterior of core 166. For example, the surface of core 166 may be a conical shape providing for ramps all around the core.
Figure 5 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 5 2o illustrates a double-ramp locking axle 180 that is similar in function to single-ramp locking axle 160 shown in Figure 4, but may be tightened by advancing a core 186 in either direction relative to a threaded sleeve 184. Aligmnent hole 182, internal hex driving sockets 188, balls 190, and ramps 192 are also included. Double-ramp locking axle 180 is shown in use with a bifurcated second member 110A and pin clamp 140.
Figure 6 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. A
pushbutton locking axle 200 is shown in Figure 6. Pushbutton locking axle 200 includes an alignment hole 202. A biasing element 204 is used to lceep pushbutton loclcing axle 200 in a locked configuration unless a pushbutton core 206 is pushed toward biasing element 204. Pushbutton locking axle 200 is shown in use with a bifurcated second member 1 l0A
and pin clamp 140.
Figures 7-11 illustrate configurations useful in loclcing multi-axis rotation between a second member and a pin clamp according to this invention. Mufti-axis rotation is 1o sometimes useful in giving a user of ceutain exemplary embodiments of an external fixation apparatus according to this invention flexibility in placement of bone pins or other bone connection devices. Mufti-axis rotation may also be useful to adjust fracture reduction. All sphere, ball, spacer, and plate surfaces, and the surfaces that mate therewith may be coated or manufactured such that higher coefficients of friction are generated to enhance the locking described in conjunction with Figures 7-11.
Figures 7A and 7B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figures 7A and 7B show a sphere 210 suspended from a unitary second member 110B. A pin clamp 140B has interior surfaces that fit around sphere 210 and press against sphere 210 when 2o bolts 212 are tightened. The tightening of bolts 212 therefore may be used to lock pin clamp 140B to both lower bone pins 142 and 144 and sphere 210. Additionally, a sphere loclcing bolt 214 may be used to lock pin clamp 140B to sphere 210 by tightening sphere locking bolt 214 into contact with sphere 210 through a threaded hole in pin clamp 140B.
Figures 8A and 8B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figures 8A and 8B illustrate a compressing, bifurcated second member 110C designed to have its bifurcated appendages pulled together by a compression bolt 220 or a similar connector.
s The appendages may be pulled into spacers 222 that bear on sphere 224 and loclc relative movement between bridging pin clamp 140C and compressing, bifurcated second member 1 l OC. Bolts 226 may be used to attach and loclc the bridging pin clamp 140C
onto lower bone pins. Sphere 224 and spacers 222 include cutouts 228 to enable rotation of the bridging pin clamp 140C about the axis perpendicular to the plane in which Figure. 8A is 1o drawn. Ball loclc nut 230 may also be used.
Figure 9 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 9 shows a sphere-tipped second member 110D coupled to a nested pin clamp 140D. The nested pin clamp 140D may be bolted to the end of a connector 240 that allows multi-axis rotation 15 between nested pin clamp 140D and sphere-tipped second member 110D. As shown, connector 240 is held in place in sphere-tipped second member 110D by a retaining cap 242 and a spring 244. Connector 240 may therefore rotate about three axes within a useful range. Nested pin clamp 140D fits over the threaded end of connector 240 and is retained by a nut 246. When nut 246 is tightened, the cooperating spherical surfaces of 2o nested pin clamp 140D and sphere-tipped second member 110D are loclced against one another. Bolts 248 may be tightened to compress the top and bottom portions of pin clamp 140D and thereby attach lower bone pins 142 and 144.
Figure 10 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 10 shows a sphere-indented second member 110E engaging a sphere-tipped pin clamp 140E
including hollowed sphere 250. Tightening a wedge nut 252 on a wedge bolt 254 causes a ramp 256 to force a loclc ball 258 to be pulled up to force the spherical surfaces of the sphere-shaped tip of the pin clamp and the cooperating surfaces of sphere-indented second s member 110E to lock against one another. Ramp 256 may be an incline resulting from a comically shaped bolt at any rotational orientation or may be inclined on only the operative side that bears against the shaft of lock ball 258.
Figure 11 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 11 shows a 1o stacked washer second member 110F engaging a staclced washer pin clamp 140F. Out of the plane of Figure 11, stem stacked washers 260 and 262 are fixed to and a part of the stacked washer second member 110F. Stem stacked washers 260 and 262 and the spherical surface of stacked washer second member 110F nest among the block staclced washers 264 and 266. Consequently, stacked washer second member 110F is able to is move about tluee axes relative to the stacked washer pin clamp 140F. When washer-locking bolt 268 is tightened, washers 260, 262, 264, and 266, and the spherical surface of the stacked washer second member 110F are pressed together and friction on the various surfaces locks movement of the second member and pin clamp.
Figure 12 is a perspective view of another embodiment of a pin clamp according to 2o the present invention. Unitary body pin clamp 1406 may be coupled to either a bifurcated second member (e.g., see Figure 5), or a unitary second member (e.g., see Figure 4). Additionally, unitary body pin clamp 1406 may be asymmetrical as depicted, or symmetrical with a pin hole 270 configuration similar to that of pin block 140, as shown in Figure 3. Clamps 272 may be urged by clamp bolts 274 against bone pins in pin holes 270 to attach bone pins to unitary body pin clamp 1406. Pin clamp 1406 includes a hole 276 for accepting an axle such as axle 112 shown in Figure 3. A lock bolt 278 may be used to engage an axle and loclc pin clamp 1406 relative to the axle. Each of bolts 274 and 278 is held in pin clamp 1406 by a bolt spring 280 and a block retainer 282.
s Figure 13 is a perspective view of an embodiment of a second member according to the present invention configured to create an angular bias from normal between the longitudinal axis of the second member and a pin clamp. Figure 13 shows a biased second member 110H that is biased at its distal end 290 from the member's longitudinal axis by approximately 26 degrees. This bias is useful because it approximates the typical 1o bias from horizontal defined by a line between the locations in the talus and calcaneus where bone pins are typically placed. Therefore, by biasing second member 110H, the fullest range of rotational adjustment in either direction is left for an attached pin clamp.
Such a bias makes the need for a notch, such as notch 128 shown in Figure 3, to provide for additional rotational freedom of the pin clamp less 'necessary. Figure 14 is a 1s perspective view of an embodiment of an apparatus according to he present invention configured to create an angular bias from normal between the longitudinal axis of the external fixation apparatus and a pin clamp of the apparatus. Biased second member 110H may be used with a bifurcated or unitary appendage extending from a second member to a pin clamp. The bias may be advantageous if different than 26 degrees. For 2o example, biases in the range of 1 degree to 60 degrees may be useful in certain exemplary embodiments according to the present invention.
Figure 15-18 show another embodiment of an external fixation apparatus according to the present invention. Figure 15 shows an embodiment of a pin clamp according to this invention over the ankle of a patient with two drill sleeves inserted in the pin clamp. Figure 16 shows an elevation view of an embodiment of an external fixation apparatus according to this invention, including the pin clamp of Figure 15 and a second member. Figure 17 shows an exploded cross-sectional elevation view of the embodiment of the external fixation apparatus shown in Figure 16. Figure 18 shows an exploded s elevation view of the pin clamp of Figures 15-17.
Referring now to Figures 15-18 and more specifically to Figures 16-18, this embodiment of an external fixation apparatus provides for releasable engagement of a second member 310 and a pin clamp 340. Pin clamp 340 may be pivoted about the second member 310 and used interchangeably from either the left or the right side of the leg of a patient. Second member 310 may be of a number of configurations, such as unilateral, bar connector, handle, or ring connector. As shown in Figures 16 and 17, second member 310 includes a unitary stem. Pin clamp 340 and second member 310 are designed such that pin clamp 340 can easily snap onto and be removed from second member 310 using a locator pin 360 in pin clamp 340 as fuxther described below.
~s Second member 310 includes ends 316 and 318. At end 316 is a ball joint for coimection with a first member (not shown) such as first member 102 described above in conjunction with Figure 1. Second member 310 may be similar to second member 110 in that second member 310 may include a mechanism by which ends 316 and 318 of second member 310 may translate transversely relative to the longitudinal axis of second member 310 in one or more dimensions. For example, second member 310 may include a carriage 130 with worm gears 132A and 132B, threaded holes 134A and 134B, and lceybolts and 138 to provide for translation of ends 316 and 318 relative to the longitudinal axis of the second member as described above in conjunction with second member 110.
At end 318 is a single prong that comprises a unitary stem. A shaft 320 extends from end 318, as shown in Figure 17, transverse to the longitudinal axis of second member 310. Shaft 320 includes at least one radial groove 322. Shaft 320 may include an alignment hole 314 through which a pin or wire may be placed into the bone.
Such s alignment may be useful to approximate a desired center of rotation of pin clamp 340.
For example, a wire may be placed through alig~unent hole 314 and into the talus to approximate the pivot axis of a patient's anlcle.
Pin clamp 340 includes a first jaw 346 and a second jaw 348. First jaw 346 has a hole 350 into which shaft 320 of second member 310 may be inserted. Once shaft 320 is 1o inserted within hole 350, first jaw 346 may rotate about shaft 320, and thus, when the first and second jaws are coupled together, pin clamp 340 may rotate about shaft 320. First jaw 346 and second jaw 348 are held together by clamp bolts 352. Clamp bolts 352 may serve to both hold the jaws together and to attach and clamp bone pins (not shown) to a bone segment (e.g., see Figure 1). Bone pins may be clamped in any of the three openings 1s defined by the six depressions 354, as shown in Figures 16 and 18. Clamp bolts 352 may be urged by biasing elements, such as springs 356, such that first jaw 346 and second jaw 348 tend to push together to stay loosely secured to bone pins prior to tightening clamp bolts 352. A lock bolt 358 may be provided to lock the rotation between second member 310 and pin clamp 340. Lock bolt 358 passes through holes in second jaw 348 and first 2o jaw 346 such that by sufficiently tightening lock bolt 358, the distal end of lock bolt 358 interferes with shaft 322 of second member 310 and locks rotation between second member 310 and pin clamp 340. As shown in Figure 18, the threaded hole with which lock bolt 358 engages is in first jaw 346.
First jaw 346 includes a stepped hole 362 that retains a biasing element, such as a spring 364, and locator pin 360. When shaft 320 of second member 310 is fully inserted within hole 350 of pin clamp 340, radial groove 322 receives locator pin 360, engaging second member 310 and first jaw 346 of pin clamp 340 while still allowing rotation of pin clamp 340 about shaft 320. To release engagement between second member 310 and pin clamp 340, locator pin 360 is pulled and shaft 320 of second member 310 may easily be removed from hole 350 of first jaw 346.
Figure 19 shows another exemplary embodiment of a pin clamp with a locator pin according to this invention. Pin clamp 340B is the same as pin clamp 340 shown in 1o Figures 15-18 except that the location and configuration of the locator pin assembly has changed. As shown in Figure 19, locator pin 360B is a pushbutton release mechanism rather than a pull release mechanism. Locator pin 360B and spring 364 are received within a stepped hole 366 in first jaw 346. The proximal tip of locator pin 360B is "pinned" to a button 368 in first jaw 346 in such a way that if you push button 368, locator pin 360B is translated up and out of a mating groove in a hinge shaft (not shown, but an example is shaft 320 with radial groove 322 shown in Figures 16 and 17) allowing removal of pin clamp 340 from a device with which it was engaged. Spring 364 biases locator pin 360B toward the center of hole 366. As pin clamp 340 is being engaged with shaft 320 with radial groove 322, locator pin 360B is forced up, compressing spring 364.
2o The tip of locator pin 360B slides along shaft 320 and then snaps into groove 322 on shaft 320, engaging shaft 320 and pin clamp 340: Pushing button 368 allows for shaft 320 and pin clamp 340 to separated from one another.
The embodiments shown and described in Figures 15-19 provide for quick and easy reconfiguration of a pin clamp for use with either left or right limb applications, eliminating the need for pin clamps specific to each limb. Additionally, these embodiments allow for quick attachment and removal of second members or stems and pin clamps of external fixation systems. Furthermore, a modular design is provided whereby a pin clamp or second member according to these embodiments may be provided s separately from each other and each may be connected with other components, elements, or devices of a fixation system that are similarly designed. For example, the handle assembly shown in Figure 20 may engage a pin clamp, such as pin clamp 340 or 340B, to form a drill guide for use by a surgeon. A shaft 384 with a radial groove 386 extends from one end of a handle 382, as shown in Figure 20. Shaft 384 may be inserted into a 1o hole of a pin clamp and the locator pin of the pin clamp is received within radial groove 386 to engage the handle assembly and the pin clamp. Shaft 384 may also include a key 388 that may engages an opening with a corresponding shape in a pin clamp to assist in aligning the pin clamp with the long axis of handle 382. The engaged handle assembly and pin clamp act as a drill guide, with openings in the pin clamp being able to receive a ~s drill, drill bit, depth gauge, or tissue sleeve used to assist a surgeon in placing a pin, wire, or similar fixation element into a patient's bone.
In another example, Figure 21 shows a capture member .390 for receiving- a bar 392 of an external fixation system coupled to a shaft 394 with a radial groove 396, shaft 394 being designed for engagement with an embodiment of a pin clamp, such as pin 20 clamp 340 or 340B, according to this invention. Capture members, such as capture member 390, for use in external fixation systems are described in detail in U.S.
Application No. 10/067,052, filed February 4, 2002, entitled "External Fixation System,"
and International Application No. PCT/L1S03/02712, filed January 30, 2003, entitled "External Fixation System," the entire contents of each of which are hereby incorporated by reference. For example, as shown in Figure 21, an end 398 of shaft 394 may include a generally spherical planetary member having inner and outer surfaces and an aperture adapted to receive a connector, while capture member 390 includes a cooperating surface adapted to receive and correspond generally in shape with the outer surface of the s planetary member and an aperture adapted to receive a connector. It should be understood that end 398 of shaft 394 may be formed to mate with capture member according to any of the principles disclosed in the above-referenced, incorporated-by-reference patent applications.
In addition to allowing for a pin clamp to be connected to additional external 1o fixation devices, the embodiments shown in Figures 15-19 also allow a second member according to this invention to be connected to various pin clamp configurations, including future versions of pin clamps or custom pin clamps that may be used in an external fixation apparatus or system. Using the connection mechanism shown in these embodiments provides flexibility not afforded by apparatuses where the second member ~s and at least a portion of the pin clamp are permanently affixed or connected to each other.
Certain exemplary embodiments of this invention include methods of reducing a fracture. Certain exemplary embodiments of apparatuses according to this invention offer the unique ability to precisely adjust and thereby precisely reduce a fracture after all of the bone pins are placed and the apparatus is tightened onto the pins. An exemplary 2o embodiment includes fixing a first member to one side of a bone fracture and fixing a second member to a second side of a bone fracture to approximately accomplish reduction of the fracture. Subsequently, adjustments of the members may be performed to precisely reduce the fracture. For example, referring to Figure 3, lceybolts 136 and 138 may be operated to adjust a fracture transversely relative to the longitudinal axis of the second member. All of the adjustments described in association with certain exemplary embodiments of apparatuses of this invention may also be accomplished under certain exemplary embodiments of methods according to this invention. Such adjustments are advantageous because loosening of the main couplings within the device may cause s additional fracture misalignment, leading to still further adjustment requirements.
In an exemplary embodiment according to a method of this invention, fixing a first member to one side of a bone fracture is accomplished. Then, the unique adjustment features of certain exemplary embodiments of this invention may be employed to make an advantageous position and orientation alignment of bone pins to a suitable location on the to other side of the fracture. Specifically, the multi-axis adjustments available between the first member and the second member and the multi-axis adjustments between the second member and the pin clamp may be used to make an advantageous position and orientation alignment of bone pins. Further, adjustments of the members may be performed to precisely reduce the fracture as noted above.
~s In another exemplary embodiment, lower bone pins may be placed prior to the placement of any upper bone pins and without the first or second members being attached to the pin clamp. According to one embodiment, lower bone pins may be placed within a pin clamp that releasably connects to a second member and affixed to the bone fracture.
Subsequently, a second member may be connected to the pin clamp, followed by a first 2o member with which the upper bone pins are then placed into the bone. This provides added flexibility to a user because the lower bone pins may be placed without the cumbersome first or second members of the external fixation apparatus being attached to the pin clamp, and greater degrees of freedom of the pin clamp are available for optimal placement of the lower bone pins.
The foregoing description of the exemplary embodiments of the invention has been presented only for the purposes of illustration and description and is not intended to be exhaustive or to limit the invention to the precise forms disclosed. Many modifications and variations are possible in light of the above teaching. The embodiments were chosen and described in order to explain the principles of the invention and their practical application so as to enable others skilled in the art to utilize the invention and various embodiments and with various modifications as are suited to the particular use contemplated. Alternative embodiments will become apparent to those skilled in the art to which the present invention pertains without departing from its spirit and scope.
According to certain exemplary embodiments, translation of first and second ends of a second member relative to the longitudinal axis of the second member is possible in 1s at least two dimensions. In one embodiment, the second member includes a carriage that fits within an upper recess and a lower recess of the second member, the carriage including two threaded holes each for receiving a worm gear, and lceybolts for operating each worm gear such that the carriage may be moved transversely to the longitudinal axis in one dimension within the upper recess and transversely relative to the longitudinal axis 2o in another dimension within the lower recess.
According to one embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes an axle extending through a hole in a first jaw of the pin clamp and a hole in the second end of the second member, an anti-rotation pin inserted through a portion of the second member and into the axle, and a first bolt that passes through openings in first and second jaws of the pin clamp such that tightening of the first bolt interferes with the axle and locks rotation of the pin clamp and the second member.
According to another embodiment of this invention, a loclcable joint coupling a second member and a pin clamp includes a threaded sleeve fixed to the second member s and a core with internal hex driving sockets that is threaded onto the sleeve so that as the core is moved along the sleeve, balls are forced up ramps and into the pin clamp or allowed to move down ramps and away from the pin clamp.
According to another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a biasing element and a pushbutton core 1o contacting the biasing element such that when the pushbutton core is depressed the pin clamp may rotate freely.
According to another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a shaft extending transversely from the second end of the second member, the shaft including at least one radial groove, a hole within a 15 first jaw of the pin clamp that receives the shaft, a locator pin of the pin clamp that is received within the at least one radial groove to releasably couple the second member and the pin clamp, and a first bolt that passes through openings in the first jaw and a second jaw of the pin clamp such that tightening of the first bolt interferes with the shaft and loclcs rotation of the pin clamp and the second member.
2o According to certain exemplary embodiments of this invention, a lockable joint coupling a second member and a pin clamp provides for multi-axis rotation between the second member and the pin clamp.
In one embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a sphere suspended from the second end of the second member that is received within interior surfaces of first and second jaws of the pin clamp and at least one bolt that passes through openings in at least one of the first and second jaws of the pin clamp such that tightening of the at least one bolt interferes with the sphere and locks rotation of the pin clamp and the second member.
s In another embodiment of this W vention, a lockable joint coupling a second member and a pin clamp includes a sphere attached to the piii clamp and a compression bolt that extends through holes in the sphere of the pin clamp and the second member so that when the bolt is tightened with a lock nut, the second member is compressed against the sphere thereby locking rotation of the second member and the pin clamp.
1o In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a connector that is held within a sphere-shaped tip of the second member by a retaining cap and a biasing element, the connector having a ball end and a threaded end, a cooperating surface of the pin clamp that receives the sphere-shaped tip of the second member and the threaded end of the connector, and a nut that is is threaded onto the threaded end of the connector to retain the connector within the pin clamp and such that when the nut is tightened the sphere-shaped tip of the second member and the cooperating surface of the pin clamp are locked against one another.
In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes a connector held within a sphere-shaped tip of the pin 2o clamp, a cooperating surface of the second member that receives the sphere-shaped tip of the pin clamp and a shaft end of the connector, and a wedge bolt extending through the second member that is tightened by a wedge nut causing a ramp to force a ball end of the connector to be pulled up forcing the sphere-shaped tip of the pin clamp and the cooperating surface of the second member to lock against one another.
___ In another embodiment of this invention, a lockable joint coupling a second member and a pin clamp includes two stacked washers attached to a spherical portion of the second member, two staclced washers attached to the pin clamp, wherein the two stacked washers of the pin clamp are alternatingly nested with the two stacked washers of the second member, and a bolt extending from the pin clamp and into the spherical portion of the second member such that all of the washers and the spherical portion are pressed together upon tightening of the bolt, thereby locking rotation of the pin clamp and the second member.
According to certain exemplary embodiments of the present invention, a second 1o member may be biased at its second end from the longitudinal axis of the second member up to approximately sixty degrees.
According to certain exemplary embodiments of this invention, an external fixation apparatus includes a first member attachable to a first bone segment through pins, a second member coupled to the first member through a lockable joint, the second is member including a shaft extending transversely from a distal end of the second member with at least one radial groove in the shaft, and a pin clamp attachable to a second bone segment and releasably coupled to and rotatable about the second member. The pin clamp may include a first jaw and a second jaw, the first jaw including a hole that receives the shaft, a locator pin that is received within the at least one radial groove of the shaft to 2o releasably couple the second member and the pin clamp, and a first bolt that passes through openings in the first and second jaws such that tightening of the first bolt interferes with the shaft and locks rotation of the pin clamp and the second member. The locator pin may be configured to allow for pull release or pushbutton release of the second member from the pin clamp. The pin clamp may include second and third bolts that hold the first and second jaws together and attach and clamp pins or wires to the second bone segment, and the first and second jaws may include openings that receive biasing elements and threaded ends of the second and third bolts.
According to certain exemplary embodiments of this invention, an external s fixation system for attaching pins or wires to at least one bone segment includes an external fixation device and a pin clamp. The pin clamp may include a first jaw and a second jaw, biasing elements received within openings in the first and second jaws, first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together, a hole in to the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove, a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp, and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external 1s fixation device. In one embodiment, the external fixation device is a handle such that the pin clamp and handle coupled thereto may be used as a drill guide. In another embodiment, the external fixation device is a fixation component that includes a capture member that receives a pin, bar, or wire. In another embodiment, the external fixation device is a second member with first and second ends that may be translated transversely 2o in at least two dimensions relative to a longitudinal axis of the second member.
Certain exemplary embodiments of this invention also include methods of reducing a fracture.
According to the present invention, there is provided an external fixation apparatus for use with a first bone segment that is a tibia and a second bone segment that is a talus, calcaneus, or both, characterized in that the external fixation apparatus comprises a first member attachable to the first bone segment through pins; a second member coupled to the first member through a loclcable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member; and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to the second bone segment.
According to the present invention, there is also provided an external fixation system for attaching pins or wires to at least one bone segment, characterized in that the system comprises an external fixation device and a pin clamp comprising: a first jaw and a second jaw; biasing elements received within openings in the first and second jaws; first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together; a hole in the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove; a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp; and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external fixation device.
2o Brief Description of the Drawings Figure 1 is a perspective view of an embodiment of an apparatus according to the present invention in use to support the ankle of a patient.
Figure 2 shows the alignment of an embodiment of a pin clamp according to the present invention over the ankle of a patient.
Figure 3 is an exploded perspective view of components of an embodiment of an apparatus according to the present invention.
Figure 4 is a cross-sectional elevation view of an embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 5 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 6 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figures 7A and 7B are elevation views of another embodiment of a coupling 1o between a second member and a pin clamp according to this invention.
Figures 8A and 8B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 9 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
~s Figure 10 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 11 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention.
Figure 12 is a perspective view of an embodiment of a pin clamp according to the 2o present invention.
Figure 13 is a perspective view of an embodiment of a second member according to the present invention configured to create an angular bias from normal between the longitudinal axis of the second member and a pin clamp.
Figure 14 is a perspective view of an embodiment of an apparatus according to the present invention configured to create an angular bias from normal between the longitudinal axis of the external fixation apparatus and a pin clamp of the apparatus.
Figure 15 is a perspective view of an embodiment of a pin clamp according to the s present invention over the anlcle of a patient with two drill sleeves inserted in the pin clamp.
Figure 16 is an elevation view of an embodiment of an external fixation apparatus according to the present invention including the pin clamp of Figure 15 and a second member.
Figure 17 is an exploded, cross-sectional elevation view of the embodiment of the external fixation apparatus shown in Figure 16.
Figure 18 is an exploded elevation view of the pin clamp shown in Figures 15-17.
Figure 19 is an elevation view of another embodiment of a pin clamp with a locator pin according to the present invention.
1s Figure 20 is an elevation view of an embodiment of a handle assembly for use with an embodiment of a pin clamp according to the present invention.
Figure 21 is an elevation view of an embodiment of a fixation component for use with an embodiment of a pin clamp according to this invention.
2o Detailed Description of the Invention Figure 1 shows an external fixation apparatus 100 placed on the lower leg and ankle of a human. External fixation apparatus 100 includes a first member 102 that is attached to a tibia through upper bone pins 104 and 106. As shown in Figure 1, first member 102 includes upper and lower components that cooperate to provide for additional adjustments, but first member 102 may be a single component. A
second member 110, sometimes referred to in practice as a pivot arm or a stem, is coupled to first member 102 through a loclcable joint, preferably a ball joint. A pin clamp 140, sometimes referred to in practice as a pin bloclc, is coupled to second member 110 and to a second s bone segment through lower bone pins 142 and 144. A first lower bone pin 142 may be attached to the talus and a second lower bone pin 144 may be attached to the calcaneus, as shown more clearly in Figure 2. The talus and calcaneus are both bones of the foot and semi-rigidly fixed to one another through tissues of the foot, and therefore may be considered as a unitary bone segment for the purpose of the invention and referred to as a 1o bone segment herein. Similarly, other combinations of the slceletal structure may be considered a bone segment for purposes of the invention. Although pin clamp 140 and bone pins 102, 104, 142, and 144 are designated as "pin" or "pins," other devices capable of fixiizg to skeletal structures, such as, but not limited to, wires, are within the scope of fixation systems and devices available for use with certain exemplary embodiments of the is present invention.
Figure 2 illustrates the typical placement of pin clamp 140 on the anatomy of a patient. As noted above, first lower bone pin 142 is attached to the talus and second lower bone pin 144 is attached to the calcaneus. As shown in Figure 2, pin clamp 140 is symmetrical. However, pin clamp 140 may be asymmetrical, such as, for example, pin 2o clamp 340 shown in Figure 15. Pin clamp 140 may be pivoted about the second member 110, as further described below, and used interchangeably from either the left or the right side of the leg of a patient. As shown in Figure 2, first lower bone pin 142 is closer to an axle 112 that goes through the center of pin clamp 140 than is second lower bone pin 144.
Figure 3 is an exploded perspective view of components of an embodiment of an external fixation apparatus according to the present invention, including second member 110 and pin clamp 140. Opposite ends 116 and 118 of second member 110 may be translated transversely relative to the longitudinal axis of the second member through use s of a carriage 130. Carriage 130 fits within recesses in an upper portion 120 and a lower portion 122 of second member 110. The recesses in portions 120 and 122 of second member 110 are larger than the parts of carriage 130 that fit within the recesses.
Therefore, carriage 130 is allowed to move within the recesses laterally along the longitudinal axis of second member 110. A worm gear 132A engages a threaded hole 134A in the upper portion of carriage 130. The length of worm gear 132A fits within the recess in upper portion 120 of second member 110. A keybolt or lceybolts 136 may be mated to either or both ends of worm gear 132A to enable worm gear 132A to be operated with an internal hex driver. Operation of worm gear 132A moves carriage 130 laterally between the extents to which carriage 130 is allowed to move within the recess in upper Is portion 120 of second member 110. More specifically, turning of worm gear 132A within hole 134A will move end 118 either medially or laterally relative to the longitudinal axis of second member 110 and end 116, depending on the direction in which worm gear 132A
is turned. Similarly, Figure 3 shows another worm gear 132B engaged with another threaded hole 134B in the lower portion of carriage 130 such that lceybolts 138 may be operated with an internal hex driver. Turning of worm gear 132B within hole 134B will move end 116 either posterior or anterior relative to the longitudinal axis of second member 110 and end 118, depending on the direction in which worm gear 132B is turned.
In certain other exemplary embodiments of the transverse movement feature, finely controlled movement, such as with the two worm gears, may or may not be incorporated. For example, in some embodiments opposite ends of second member would be moveable as a result of a releasable connection within second member 110. The releasable connection could be unloclced, the transverse movement accomplished, and then the connection loclced to hold the desired movement. Locking could be s accomplished through use of a setscrew. Other apparatuses that would provide finely controlled movement may be used as well. A single worm gear could be used to provide fme adjustment only in the most advantageous dimension. Automated adjustments using mechanical, electrical, thermal, and/or computer-controlled signals or actuators could also be employed. Any apparatus providing for adjustment substantially transverse to the longitudinal axis of the second member 110 is contemplated by certain exemplary embodiments of this invention.
Returning to Figure 3, pin clamp 140 is coupled to second member 110 through axle 112. Pin clamp 140 includes a first jaw 146 and a second jaw 148. First jaw 146 has a hole 150 through which axle 112 is inserted, and pin clamp 140 is able to rotate about 1s axle 112. Axle 112 is coupled to second member 110 through a hole 124 in second member 110. Axle .112 may be fixed to second member 110 by inserting an anti-rotation pin 126 through a portion of second member 110 and into axle 112.
Alternatively, axle 112 could be fixed to second member 110 with an adhesive, by welding, by compression fit, by being formed integrally with second member 110, or by any other method adequate 2o to form a structurally sufficient connection. Axle 112 may also include an alignment hole 114 through which a pin or wire may be placed into the bone. Such alignment may be useful to approximate a desired center of rotation of pin clamp 140. For example, a wire may be placed through alignment hole 114 and into the talus to approximate the pivot axis of a patient's ankle. Second member 110 may also include a notch 128 to provide for additional rotational freedom of pin clamp 140. Notch 128 effectively gives pin clamp 140 a greater range of motion without significantly reducing the strength of second member 110.
First jaw 146 and the second jaw 148 are held together by clamp bolts 152.
Clamp s bolts 152 may serve to both hold the jaws together, and to attach and clamp bone pins 142 and 144 to a bone segment (see Figure 1). Bone pins may be clamped in any of the four holes defined by the eight depressions 154, as shoml in Figure 3. Clamp bolts 152 may be urged by biasing elements, such as springs 156, such that first jaw 146 and second jaw 148 tend to push together to stay loosely secured to bone pins prior to tightening clamp to bolts 152. A lock bolt 158 may be provided to lock the rotation between second member 110 and pin clamp 140. Lock bolt 158 passes through holes in second jaw 148 and first jaw 146 such that by sufficiently tightening lock bolt 158, the distal end of the bolt interferes with axle 112 and locks rotation between second member 110 and pin clamp 140. As shown in Fig. 3, the threaded hole with which loclc bolt 158 engages is in first ~s jaw 146.
Certain additional exemplary embodiments of coupling between a second member and a pin clamp according to the present invention are shown in Figures 4-11.
Figures 4-6 illustrate configurations useful in locking single axis rotation between a second member and a pin clamp, while Figures 7-11 show locking of multi-axis rotation between a second 2o member and a pin clamp. The apparatuses of Figures 2, 4, 7, and 9-11 illustrate a second member with a unitary stem to which the pin clamp attaches. The apparatuses of Figures 5, 6, and 8 show a second member with a bifurcated stem to which the pin clamp attaches (i.e., two separate appendages of the stem extend to and connect with the pin clamp). As understood by those skilled in the art, the locking mechanisms of the two types of stems may be interchangeable, and merely because a locking mechanism of one type is shown with a stem of a particular type, that does not preclude use with a stem of another type.
Figure 4 is a cross-sectional elevation view of an embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 4 shows a single-ramp locking axle 160 useful in loclcing the coupling between second member 110 and pin clamp 140. Single-ramp locking axle 160 may include an alignment hole 162 for aiding with the placement of the apparatus as described above. Single-ramp locking axle 160 has a threaded sleeve 164 and a core 166 with internal hex driving sockets 168. Core 166 is threaded into sleeve 164, and sleeve 164 is fixed to second member 110.
By 1o turning core 166, the core moves along sleeve 164, and balls 170 are forced up or allowed to move down ramps 172 and into or away from pin clamp 140. Balls 170 may therefore be used to loclc and unlock movement between second member 110 and pin block 140.
Balls 170 and surfaces of pin clamp 140 and ramps 172 may be coated or manufactured such that higher coefficients of friction are generated to enhance the loclcing. Ramps 172 may be discrete ramps holding a single ball 170, or may be substantially continuous about the exterior of core 166. For example, the surface of core 166 may be a conical shape providing for ramps all around the core.
Figure 5 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 5 2o illustrates a double-ramp locking axle 180 that is similar in function to single-ramp locking axle 160 shown in Figure 4, but may be tightened by advancing a core 186 in either direction relative to a threaded sleeve 184. Aligmnent hole 182, internal hex driving sockets 188, balls 190, and ramps 192 are also included. Double-ramp locking axle 180 is shown in use with a bifurcated second member 110A and pin clamp 140.
Figure 6 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. A
pushbutton locking axle 200 is shown in Figure 6. Pushbutton locking axle 200 includes an alignment hole 202. A biasing element 204 is used to lceep pushbutton loclcing axle 200 in a locked configuration unless a pushbutton core 206 is pushed toward biasing element 204. Pushbutton locking axle 200 is shown in use with a bifurcated second member 1 l0A
and pin clamp 140.
Figures 7-11 illustrate configurations useful in loclcing multi-axis rotation between a second member and a pin clamp according to this invention. Mufti-axis rotation is 1o sometimes useful in giving a user of ceutain exemplary embodiments of an external fixation apparatus according to this invention flexibility in placement of bone pins or other bone connection devices. Mufti-axis rotation may also be useful to adjust fracture reduction. All sphere, ball, spacer, and plate surfaces, and the surfaces that mate therewith may be coated or manufactured such that higher coefficients of friction are generated to enhance the locking described in conjunction with Figures 7-11.
Figures 7A and 7B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figures 7A and 7B show a sphere 210 suspended from a unitary second member 110B. A pin clamp 140B has interior surfaces that fit around sphere 210 and press against sphere 210 when 2o bolts 212 are tightened. The tightening of bolts 212 therefore may be used to lock pin clamp 140B to both lower bone pins 142 and 144 and sphere 210. Additionally, a sphere loclcing bolt 214 may be used to lock pin clamp 140B to sphere 210 by tightening sphere locking bolt 214 into contact with sphere 210 through a threaded hole in pin clamp 140B.
Figures 8A and 8B are elevation views of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figures 8A and 8B illustrate a compressing, bifurcated second member 110C designed to have its bifurcated appendages pulled together by a compression bolt 220 or a similar connector.
s The appendages may be pulled into spacers 222 that bear on sphere 224 and loclc relative movement between bridging pin clamp 140C and compressing, bifurcated second member 1 l OC. Bolts 226 may be used to attach and loclc the bridging pin clamp 140C
onto lower bone pins. Sphere 224 and spacers 222 include cutouts 228 to enable rotation of the bridging pin clamp 140C about the axis perpendicular to the plane in which Figure. 8A is 1o drawn. Ball loclc nut 230 may also be used.
Figure 9 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 9 shows a sphere-tipped second member 110D coupled to a nested pin clamp 140D. The nested pin clamp 140D may be bolted to the end of a connector 240 that allows multi-axis rotation 15 between nested pin clamp 140D and sphere-tipped second member 110D. As shown, connector 240 is held in place in sphere-tipped second member 110D by a retaining cap 242 and a spring 244. Connector 240 may therefore rotate about three axes within a useful range. Nested pin clamp 140D fits over the threaded end of connector 240 and is retained by a nut 246. When nut 246 is tightened, the cooperating spherical surfaces of 2o nested pin clamp 140D and sphere-tipped second member 110D are loclced against one another. Bolts 248 may be tightened to compress the top and bottom portions of pin clamp 140D and thereby attach lower bone pins 142 and 144.
Figure 10 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 10 shows a sphere-indented second member 110E engaging a sphere-tipped pin clamp 140E
including hollowed sphere 250. Tightening a wedge nut 252 on a wedge bolt 254 causes a ramp 256 to force a loclc ball 258 to be pulled up to force the spherical surfaces of the sphere-shaped tip of the pin clamp and the cooperating surfaces of sphere-indented second s member 110E to lock against one another. Ramp 256 may be an incline resulting from a comically shaped bolt at any rotational orientation or may be inclined on only the operative side that bears against the shaft of lock ball 258.
Figure 11 is a cross-sectional elevation view of another embodiment of a coupling between a second member and a pin clamp according to this invention. Figure 11 shows a 1o stacked washer second member 110F engaging a staclced washer pin clamp 140F. Out of the plane of Figure 11, stem stacked washers 260 and 262 are fixed to and a part of the stacked washer second member 110F. Stem stacked washers 260 and 262 and the spherical surface of stacked washer second member 110F nest among the block staclced washers 264 and 266. Consequently, stacked washer second member 110F is able to is move about tluee axes relative to the stacked washer pin clamp 140F. When washer-locking bolt 268 is tightened, washers 260, 262, 264, and 266, and the spherical surface of the stacked washer second member 110F are pressed together and friction on the various surfaces locks movement of the second member and pin clamp.
Figure 12 is a perspective view of another embodiment of a pin clamp according to 2o the present invention. Unitary body pin clamp 1406 may be coupled to either a bifurcated second member (e.g., see Figure 5), or a unitary second member (e.g., see Figure 4). Additionally, unitary body pin clamp 1406 may be asymmetrical as depicted, or symmetrical with a pin hole 270 configuration similar to that of pin block 140, as shown in Figure 3. Clamps 272 may be urged by clamp bolts 274 against bone pins in pin holes 270 to attach bone pins to unitary body pin clamp 1406. Pin clamp 1406 includes a hole 276 for accepting an axle such as axle 112 shown in Figure 3. A lock bolt 278 may be used to engage an axle and loclc pin clamp 1406 relative to the axle. Each of bolts 274 and 278 is held in pin clamp 1406 by a bolt spring 280 and a block retainer 282.
s Figure 13 is a perspective view of an embodiment of a second member according to the present invention configured to create an angular bias from normal between the longitudinal axis of the second member and a pin clamp. Figure 13 shows a biased second member 110H that is biased at its distal end 290 from the member's longitudinal axis by approximately 26 degrees. This bias is useful because it approximates the typical 1o bias from horizontal defined by a line between the locations in the talus and calcaneus where bone pins are typically placed. Therefore, by biasing second member 110H, the fullest range of rotational adjustment in either direction is left for an attached pin clamp.
Such a bias makes the need for a notch, such as notch 128 shown in Figure 3, to provide for additional rotational freedom of the pin clamp less 'necessary. Figure 14 is a 1s perspective view of an embodiment of an apparatus according to he present invention configured to create an angular bias from normal between the longitudinal axis of the external fixation apparatus and a pin clamp of the apparatus. Biased second member 110H may be used with a bifurcated or unitary appendage extending from a second member to a pin clamp. The bias may be advantageous if different than 26 degrees. For 2o example, biases in the range of 1 degree to 60 degrees may be useful in certain exemplary embodiments according to the present invention.
Figure 15-18 show another embodiment of an external fixation apparatus according to the present invention. Figure 15 shows an embodiment of a pin clamp according to this invention over the ankle of a patient with two drill sleeves inserted in the pin clamp. Figure 16 shows an elevation view of an embodiment of an external fixation apparatus according to this invention, including the pin clamp of Figure 15 and a second member. Figure 17 shows an exploded cross-sectional elevation view of the embodiment of the external fixation apparatus shown in Figure 16. Figure 18 shows an exploded s elevation view of the pin clamp of Figures 15-17.
Referring now to Figures 15-18 and more specifically to Figures 16-18, this embodiment of an external fixation apparatus provides for releasable engagement of a second member 310 and a pin clamp 340. Pin clamp 340 may be pivoted about the second member 310 and used interchangeably from either the left or the right side of the leg of a patient. Second member 310 may be of a number of configurations, such as unilateral, bar connector, handle, or ring connector. As shown in Figures 16 and 17, second member 310 includes a unitary stem. Pin clamp 340 and second member 310 are designed such that pin clamp 340 can easily snap onto and be removed from second member 310 using a locator pin 360 in pin clamp 340 as fuxther described below.
~s Second member 310 includes ends 316 and 318. At end 316 is a ball joint for coimection with a first member (not shown) such as first member 102 described above in conjunction with Figure 1. Second member 310 may be similar to second member 110 in that second member 310 may include a mechanism by which ends 316 and 318 of second member 310 may translate transversely relative to the longitudinal axis of second member 310 in one or more dimensions. For example, second member 310 may include a carriage 130 with worm gears 132A and 132B, threaded holes 134A and 134B, and lceybolts and 138 to provide for translation of ends 316 and 318 relative to the longitudinal axis of the second member as described above in conjunction with second member 110.
At end 318 is a single prong that comprises a unitary stem. A shaft 320 extends from end 318, as shown in Figure 17, transverse to the longitudinal axis of second member 310. Shaft 320 includes at least one radial groove 322. Shaft 320 may include an alignment hole 314 through which a pin or wire may be placed into the bone.
Such s alignment may be useful to approximate a desired center of rotation of pin clamp 340.
For example, a wire may be placed through alig~unent hole 314 and into the talus to approximate the pivot axis of a patient's anlcle.
Pin clamp 340 includes a first jaw 346 and a second jaw 348. First jaw 346 has a hole 350 into which shaft 320 of second member 310 may be inserted. Once shaft 320 is 1o inserted within hole 350, first jaw 346 may rotate about shaft 320, and thus, when the first and second jaws are coupled together, pin clamp 340 may rotate about shaft 320. First jaw 346 and second jaw 348 are held together by clamp bolts 352. Clamp bolts 352 may serve to both hold the jaws together and to attach and clamp bone pins (not shown) to a bone segment (e.g., see Figure 1). Bone pins may be clamped in any of the three openings 1s defined by the six depressions 354, as shown in Figures 16 and 18. Clamp bolts 352 may be urged by biasing elements, such as springs 356, such that first jaw 346 and second jaw 348 tend to push together to stay loosely secured to bone pins prior to tightening clamp bolts 352. A lock bolt 358 may be provided to lock the rotation between second member 310 and pin clamp 340. Lock bolt 358 passes through holes in second jaw 348 and first 2o jaw 346 such that by sufficiently tightening lock bolt 358, the distal end of lock bolt 358 interferes with shaft 322 of second member 310 and locks rotation between second member 310 and pin clamp 340. As shown in Figure 18, the threaded hole with which lock bolt 358 engages is in first jaw 346.
First jaw 346 includes a stepped hole 362 that retains a biasing element, such as a spring 364, and locator pin 360. When shaft 320 of second member 310 is fully inserted within hole 350 of pin clamp 340, radial groove 322 receives locator pin 360, engaging second member 310 and first jaw 346 of pin clamp 340 while still allowing rotation of pin clamp 340 about shaft 320. To release engagement between second member 310 and pin clamp 340, locator pin 360 is pulled and shaft 320 of second member 310 may easily be removed from hole 350 of first jaw 346.
Figure 19 shows another exemplary embodiment of a pin clamp with a locator pin according to this invention. Pin clamp 340B is the same as pin clamp 340 shown in 1o Figures 15-18 except that the location and configuration of the locator pin assembly has changed. As shown in Figure 19, locator pin 360B is a pushbutton release mechanism rather than a pull release mechanism. Locator pin 360B and spring 364 are received within a stepped hole 366 in first jaw 346. The proximal tip of locator pin 360B is "pinned" to a button 368 in first jaw 346 in such a way that if you push button 368, locator pin 360B is translated up and out of a mating groove in a hinge shaft (not shown, but an example is shaft 320 with radial groove 322 shown in Figures 16 and 17) allowing removal of pin clamp 340 from a device with which it was engaged. Spring 364 biases locator pin 360B toward the center of hole 366. As pin clamp 340 is being engaged with shaft 320 with radial groove 322, locator pin 360B is forced up, compressing spring 364.
2o The tip of locator pin 360B slides along shaft 320 and then snaps into groove 322 on shaft 320, engaging shaft 320 and pin clamp 340: Pushing button 368 allows for shaft 320 and pin clamp 340 to separated from one another.
The embodiments shown and described in Figures 15-19 provide for quick and easy reconfiguration of a pin clamp for use with either left or right limb applications, eliminating the need for pin clamps specific to each limb. Additionally, these embodiments allow for quick attachment and removal of second members or stems and pin clamps of external fixation systems. Furthermore, a modular design is provided whereby a pin clamp or second member according to these embodiments may be provided s separately from each other and each may be connected with other components, elements, or devices of a fixation system that are similarly designed. For example, the handle assembly shown in Figure 20 may engage a pin clamp, such as pin clamp 340 or 340B, to form a drill guide for use by a surgeon. A shaft 384 with a radial groove 386 extends from one end of a handle 382, as shown in Figure 20. Shaft 384 may be inserted into a 1o hole of a pin clamp and the locator pin of the pin clamp is received within radial groove 386 to engage the handle assembly and the pin clamp. Shaft 384 may also include a key 388 that may engages an opening with a corresponding shape in a pin clamp to assist in aligning the pin clamp with the long axis of handle 382. The engaged handle assembly and pin clamp act as a drill guide, with openings in the pin clamp being able to receive a ~s drill, drill bit, depth gauge, or tissue sleeve used to assist a surgeon in placing a pin, wire, or similar fixation element into a patient's bone.
In another example, Figure 21 shows a capture member .390 for receiving- a bar 392 of an external fixation system coupled to a shaft 394 with a radial groove 396, shaft 394 being designed for engagement with an embodiment of a pin clamp, such as pin 20 clamp 340 or 340B, according to this invention. Capture members, such as capture member 390, for use in external fixation systems are described in detail in U.S.
Application No. 10/067,052, filed February 4, 2002, entitled "External Fixation System,"
and International Application No. PCT/L1S03/02712, filed January 30, 2003, entitled "External Fixation System," the entire contents of each of which are hereby incorporated by reference. For example, as shown in Figure 21, an end 398 of shaft 394 may include a generally spherical planetary member having inner and outer surfaces and an aperture adapted to receive a connector, while capture member 390 includes a cooperating surface adapted to receive and correspond generally in shape with the outer surface of the s planetary member and an aperture adapted to receive a connector. It should be understood that end 398 of shaft 394 may be formed to mate with capture member according to any of the principles disclosed in the above-referenced, incorporated-by-reference patent applications.
In addition to allowing for a pin clamp to be connected to additional external 1o fixation devices, the embodiments shown in Figures 15-19 also allow a second member according to this invention to be connected to various pin clamp configurations, including future versions of pin clamps or custom pin clamps that may be used in an external fixation apparatus or system. Using the connection mechanism shown in these embodiments provides flexibility not afforded by apparatuses where the second member ~s and at least a portion of the pin clamp are permanently affixed or connected to each other.
Certain exemplary embodiments of this invention include methods of reducing a fracture. Certain exemplary embodiments of apparatuses according to this invention offer the unique ability to precisely adjust and thereby precisely reduce a fracture after all of the bone pins are placed and the apparatus is tightened onto the pins. An exemplary 2o embodiment includes fixing a first member to one side of a bone fracture and fixing a second member to a second side of a bone fracture to approximately accomplish reduction of the fracture. Subsequently, adjustments of the members may be performed to precisely reduce the fracture. For example, referring to Figure 3, lceybolts 136 and 138 may be operated to adjust a fracture transversely relative to the longitudinal axis of the second member. All of the adjustments described in association with certain exemplary embodiments of apparatuses of this invention may also be accomplished under certain exemplary embodiments of methods according to this invention. Such adjustments are advantageous because loosening of the main couplings within the device may cause s additional fracture misalignment, leading to still further adjustment requirements.
In an exemplary embodiment according to a method of this invention, fixing a first member to one side of a bone fracture is accomplished. Then, the unique adjustment features of certain exemplary embodiments of this invention may be employed to make an advantageous position and orientation alignment of bone pins to a suitable location on the to other side of the fracture. Specifically, the multi-axis adjustments available between the first member and the second member and the multi-axis adjustments between the second member and the pin clamp may be used to make an advantageous position and orientation alignment of bone pins. Further, adjustments of the members may be performed to precisely reduce the fracture as noted above.
~s In another exemplary embodiment, lower bone pins may be placed prior to the placement of any upper bone pins and without the first or second members being attached to the pin clamp. According to one embodiment, lower bone pins may be placed within a pin clamp that releasably connects to a second member and affixed to the bone fracture.
Subsequently, a second member may be connected to the pin clamp, followed by a first 2o member with which the upper bone pins are then placed into the bone. This provides added flexibility to a user because the lower bone pins may be placed without the cumbersome first or second members of the external fixation apparatus being attached to the pin clamp, and greater degrees of freedom of the pin clamp are available for optimal placement of the lower bone pins.
The foregoing description of the exemplary embodiments of the invention has been presented only for the purposes of illustration and description and is not intended to be exhaustive or to limit the invention to the precise forms disclosed. Many modifications and variations are possible in light of the above teaching. The embodiments were chosen and described in order to explain the principles of the invention and their practical application so as to enable others skilled in the art to utilize the invention and various embodiments and with various modifications as are suited to the particular use contemplated. Alternative embodiments will become apparent to those skilled in the art to which the present invention pertains without departing from its spirit and scope.
Claims (18)
1. An external fixation apparatus for use with a first bone segment that is a tibia and a second bone segment that is a talus, calcaneus, or both, characterized in that the external fixation apparatus comprises:
a first member attachable to the first bone segment through pins;
a second member coupled to the first member through a lockable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member; and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to the second bone segment.
a first member attachable to the first bone segment through pins;
a second member coupled to the first member through a lockable ball joint, wherein first and second ends of the second member may be translated transversely relative to a longitudinal axis of the second member; and a pin clamp coupled to and rotatable about the second member through a lockable joint and attachable to the second bone segment.
2. An external fixation apparatus according to claim 1, further characterized in that translation of the first and second ends of the second member relative to each other is possible in at least two dimensions.
3. An external fixation apparatus according to claims 1 or 2, further characterized in that the second member includes:
a carriage that fits within an upper recess and a lower recess of the second member, the carriage including two threaded holes each receiving a worm gear;
and keybolts that operate each worm gear such that the carriage may be moved transversely to the longitudinal axis in one dimension within the upper recess and transversely to the longitudinal axis in another dimension within the lower recess.
a carriage that fits within an upper recess and a lower recess of the second member, the carriage including two threaded holes each receiving a worm gear;
and keybolts that operate each worm gear such that the carriage may be moved transversely to the longitudinal axis in one dimension within the upper recess and transversely to the longitudinal axis in another dimension within the lower recess.
4. An external fixation apparatus according to any of claims 1-3, further characterized in that the second member includes a unitary stem.
5. An external fixation apparatus according to any of claims 1-4, further characterized in that the lockable joint coupling the second member and the pin clamp provides for rotation of the pin clamp about the second member along a single axis.
6. An external fixation apparatus according to claim 5, further characterized in that the lockable joint coupling the second member and the pin clamp includes:
an axle extending through a hole in a first jaw of the pin clamp and a hole in the second end of the second member;
an anti-rotation pin inserted through a portion of the second member and into the axle; and a first bolt that passes through openings in first and second jaws of the pin clamp such that tightening of the first bolt interferes with the axle and locks rotation of the pin clamp and the second member.
an axle extending through a hole in a first jaw of the pin clamp and a hole in the second end of the second member;
an anti-rotation pin inserted through a portion of the second member and into the axle; and a first bolt that passes through openings in first and second jaws of the pin clamp such that tightening of the first bolt interferes with the axle and locks rotation of the pin clamp and the second member.
7. An external fixation apparatus according to claim 5, further characterized in that the lockable joint coupling the second member and the pin clamp includes:
a shaft extending transversely from the second end of the second member, the shaft including at least one radial groove;
a hole within a first jaw of the pin clamp that receives the shaft;
a locator pin of the pin clamp that is received within the at least one radial groove to releasably couple the second member and the pin clamp; and a first bolt that passes through openings in the first jaw and a second jaw of the pin clamp such that tightening of the first bolt interferes with the shaft and locks rotation of the pin clamp and the second member.
a shaft extending transversely from the second end of the second member, the shaft including at least one radial groove;
a hole within a first jaw of the pin clamp that receives the shaft;
a locator pin of the pin clamp that is received within the at least one radial groove to releasably couple the second member and the pin clamp; and a first bolt that passes through openings in the first jaw and a second jaw of the pin clamp such that tightening of the first bolt interferes with the shaft and locks rotation of the pin clamp and the second member.
8. An external fixation apparatus according to claim 7, further characterized in that the locator pin is pulled to allow for release of the second member from the pin clamp.
9. An external fixation apparatus according to claim 7, further characterized in that the locator pin is pushed to allow for release of the second member from the pin clamp.
10. An external fixation apparatus according to any of claims 6-9, further characterized in that the pin clamp includes second and thud bolts that hold the first and second jaws together and attach and clamp pins or wires to the second bone segment.
11. An external fixation apparatus according to claim 10, wherein the pin clamp further comprises openings in the first and second jaws that receive biasing elements and threaded ends of the second and third bolts.
12. An external fixation apparatus according to any of claims 1-4, further characterized in that the lockable joint coupling the second member and the pin clamp provides for multi-axis rotation between the second member and the pin clamp.
13. An external fixation apparatus according to any of claims 1-4, further characterized in that the second member is biased at the second end from the longitudinal axis of the second member up to approximately sixty degrees.
14. Am external fixation apparatus according to any of claims 1-4, further characterized in that the pin clamp is symmetrical or asymmetrical.
15. An external fixation system for attaching pins or wires to at least one bone segment, characterized in that the system comprises an external fixation device; and a pin clamp comprising:
a first jaw and a second jaw;
biasing elements received within openings in the first and second jaws;
first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together;
a hole in the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove;
a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp;
and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external fixation device.
a first jaw and a second jaw;
biasing elements received within openings in the first and second jaws;
first and second bolts that extend through the openings in the first and second jaws, compressing the biasing elements and holding the first and second jaws together;
a hole in the first jaw that receives a shaft of an external fixation device, the shaft having at least one radial groove;
a locator pin that is received within the at least one radial groove of the shaft to releasably couple the external fixation device and the pin clamp;
and a third bolt that passes through openings in the first and second jaws such that sufficient tightening of the third bolt interferes with the shaft and locks rotation of the pin clamp and the external fixation device.
16. An external fixation system according to claim 15, further characterized in that the external fixation device is a handle such that the pin clamp and handle coupled thereto may be used as a drill guide.
17. An external fixation system according to claim 15, further characterized in that the external fixation device is a fixation component that includes a capture member that receives a pin, bar, or wire.
18. An external fixation system according to claim 15, further characterized in that the external fixation device is a second member with first and second ends that may be translated transversely relative to a longitudinal axis of the second member in at least two dimensions.
Applications Claiming Priority (5)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US43919503P | 2003-01-10 | 2003-01-10 | |
US60/439,195 | 2003-01-10 | ||
US10/607,010 | 2003-06-26 | ||
US10/607,010 US7608074B2 (en) | 2003-01-10 | 2003-06-26 | External fixation apparatus and method |
PCT/US2003/039307 WO2004062514A1 (en) | 2003-01-10 | 2003-12-10 | External fixation apparatus |
Publications (1)
Publication Number | Publication Date |
---|---|
CA2512074A1 true CA2512074A1 (en) | 2004-07-29 |
Family
ID=32718060
Family Applications (1)
Application Number | Title | Priority Date | Filing Date |
---|---|---|---|
CA002512074A Abandoned CA2512074A1 (en) | 2003-01-10 | 2003-12-10 | External fixation apparatus |
Country Status (6)
Country | Link |
---|---|
US (2) | US7608074B2 (en) |
EP (1) | EP1581127B1 (en) |
JP (1) | JP2006512970A (en) |
AU (1) | AU2003296463B2 (en) |
CA (1) | CA2512074A1 (en) |
WO (1) | WO2004062514A1 (en) |
Families Citing this family (60)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
GB0107708D0 (en) * | 2001-03-28 | 2001-05-16 | Imp College Innovations Ltd | Bone fixated,articulated joint load control device |
US7004943B2 (en) * | 2002-02-04 | 2006-02-28 | Smith & Nephew, Inc. | Devices, systems, and methods for placing and positioning fixation elements in external fixation systems |
US7758582B2 (en) * | 2002-06-14 | 2010-07-20 | Smith & Nephew, Inc. | Device and methods for placing external fixation elements |
US7608074B2 (en) * | 2003-01-10 | 2009-10-27 | Smith & Nephew, Inc. | External fixation apparatus and method |
US20060155276A1 (en) * | 2005-01-11 | 2006-07-13 | Walulik Stephen B | Bone fixation assembly and related method |
JP2008538527A (en) * | 2005-04-22 | 2008-10-30 | エーエムイーアイ テクノロジーズ,インコーポレイテッド | Drive system and device incorporating drive system |
US8758343B2 (en) * | 2005-04-27 | 2014-06-24 | DePuy Synthes Products, LLC | Bone fixation apparatus |
GB2427141B (en) * | 2005-06-13 | 2010-12-22 | Intelligent Orthopaedics Ltd | Fixator |
ES2246744B1 (en) * | 2005-10-11 | 2006-12-01 | Implantvet, S.L. | ARTICULATION FOR MUTUAL SOLIDARIZATION BETWEEN BARS AND / OR NEEDLES IN AN EXTERNAL FIXING DEVICE FOR THE REDUCTION OF OSE FRACTURES. |
US8147491B2 (en) * | 2007-06-27 | 2012-04-03 | Vilex In Tennessee, Inc. | Multi-angle clamp |
US7806843B2 (en) * | 2007-09-25 | 2010-10-05 | Marin Luis E | External fixator assembly |
PL2190368T3 (en) * | 2007-09-25 | 2011-07-29 | Synthes Gmbh | Transconnector |
US7955333B2 (en) * | 2007-11-15 | 2011-06-07 | Yeager David A | Method of preparing a patient's leg in need of treatment, for ambulation |
US20090292320A1 (en) * | 2008-02-29 | 2009-11-26 | Mullaney Michael W | Internal Joint Distraction Device |
WO2010030960A1 (en) * | 2008-09-11 | 2010-03-18 | Board Of Regents, The University Of Texas System | Foot, ankle, and lower extremity compression and fixation system and related uses |
US20100179548A1 (en) | 2009-01-13 | 2010-07-15 | Marin Luis E | External fixator assembly |
EP2250968B1 (en) | 2009-05-15 | 2013-12-11 | Stryker Trauma SA | Fixation clamp |
US9066757B2 (en) * | 2009-08-10 | 2015-06-30 | Virak Orthopedic Research Llc | Orthopedic external fixator and method of use |
US8282636B2 (en) * | 2009-08-10 | 2012-10-09 | Imds Corporation | Orthopedic external fixator and method of use |
US8894648B2 (en) | 2009-08-28 | 2014-11-25 | Stryker Trauma Sa | Surgical clamping device |
US8858555B2 (en) | 2009-10-05 | 2014-10-14 | Stryker Trauma Sa | Dynamic external fixator and methods for use |
JP5497194B2 (en) | 2009-12-11 | 2014-05-21 | スモール・ボーン・イノベーションズ・インコーポレーテッド | Ankle fusion device, instrument, and method |
CN101785691B (en) * | 2010-03-30 | 2012-07-11 | 武汉康斯泰德科技有限公司 | Ankle joint flexible connection rod for treating far-end trauma of tibia or peripheral trauma of ankle joint |
US20110313419A1 (en) * | 2010-06-22 | 2011-12-22 | Extraortho, Inc. | Hexapod External Fixation System with Collapsing Connectors |
EP2417923B1 (en) | 2010-08-11 | 2013-11-13 | Stryker Trauma SA | External fixator system |
US8945128B2 (en) | 2010-08-11 | 2015-02-03 | Stryker Trauma Sa | External fixator system |
US11141196B2 (en) | 2010-08-11 | 2021-10-12 | Stryker European Operations Holdings Llc | External fixator system |
US8940020B2 (en) | 2012-04-06 | 2015-01-27 | DePuy Synthes Products, LLC | Rod connector |
CA2878967C (en) * | 2012-07-25 | 2021-02-23 | Orthofix S.R.L. | Elongated pin for an external modular fixation system for temporary and/or permanent fixation applications and external modular fixation system |
US9101398B2 (en) | 2012-08-23 | 2015-08-11 | Stryker Trauma Sa | Bone transport external fixation frame |
US9232966B2 (en) * | 2012-09-24 | 2016-01-12 | Refai Technologies, Llc | Articulating spinal rod system |
ITVR20130013A1 (en) * | 2013-01-21 | 2014-07-22 | Tecres Spa | EXTERNAL FIXING DEVICE FOR THE TREATMENT OF BONE FRACTURES |
US9155561B2 (en) | 2013-03-06 | 2015-10-13 | Stryker Trauma Sa | Mini-rail external fixator |
US10463522B2 (en) | 2013-03-14 | 2019-11-05 | Mdpo Llc | Dynamic foot plate |
US20140276260A1 (en) * | 2013-03-14 | 2014-09-18 | Luis E. Marin | Dynamic foot plate |
US10980655B1 (en) | 2013-03-14 | 2021-04-20 | Mdpo Llc | Dynamic foot plate |
US10993868B2 (en) | 2013-03-14 | 2021-05-04 | Mdpo Llc | Dynamic foot plate |
US9463045B2 (en) | 2013-03-15 | 2016-10-11 | Biomet Manufacturing, Llc | Polyaxial pivot housing for external fixation system |
US9962188B2 (en) | 2013-10-29 | 2018-05-08 | Cardinal Health 247. Inc. | External fixation system and methods of use |
US9579122B2 (en) | 2014-07-07 | 2017-02-28 | Texas Scottish Rite Hospital For Children | Collapsible fixator system |
US10314618B2 (en) * | 2014-07-25 | 2019-06-11 | The General Hospital Corporation | System and method for an external hip fixator |
US9936975B2 (en) | 2014-09-09 | 2018-04-10 | Integra Lifesciences Corporation | External fixation system |
US10485721B2 (en) * | 2014-11-27 | 2019-11-26 | AOD Holdings, LLC | Surgical leg positioner |
US10751241B2 (en) | 2014-11-27 | 2020-08-25 | AOD Holdings, LLC | Surgical leg positioner |
US9445841B2 (en) | 2014-12-10 | 2016-09-20 | Texas Scottish Rite Hospital For Children | Wire tensioner tip for use with wire fixation bolt |
US10531896B2 (en) | 2015-08-10 | 2020-01-14 | Stryker European Holdings I, Llc | Distraction tube with wire clamp |
CN105232125B (en) * | 2015-10-20 | 2018-06-29 | 天津市新中医疗器械有限公司 | A kind of calcaneum orthopaedics ring stick combines exterior fixing rack |
US9872707B2 (en) | 2015-12-03 | 2018-01-23 | Globus Medical, Inc. | External fixator assembly |
US10136919B2 (en) | 2015-12-03 | 2018-11-27 | Globus Medical, Inc. | External fixator assembly |
US10682160B2 (en) | 2015-12-03 | 2020-06-16 | Globus Medical, Inc. | External fixator assembly |
US9943337B2 (en) | 2015-12-03 | 2018-04-17 | Globus Medical, Inc. | External fixator assembly |
US10010350B2 (en) | 2016-06-14 | 2018-07-03 | Stryker European Holdings I, Llc | Gear mechanisms for fixation frame struts |
EP3522801A4 (en) | 2016-10-04 | 2020-07-08 | Acumed LLC | Fixation system and method for hoffa fractures |
US10874433B2 (en) | 2017-01-30 | 2020-12-29 | Stryker European Holdings I, Llc | Strut attachments for external fixation frame |
CN109793562B (en) * | 2019-01-23 | 2020-06-16 | 胡将碟 | Dismantle convenient fracture fixation support frame |
US11844704B2 (en) * | 2019-09-18 | 2023-12-19 | Restor3D, Inc. | Instruments and method for ankle replacement surgery |
USD920515S1 (en) | 2020-01-08 | 2021-05-25 | Restor3D, Inc. | Spinal implant |
USD920517S1 (en) | 2020-01-08 | 2021-05-25 | Restor3D, Inc. | Osteotomy wedge |
US11806028B1 (en) | 2022-10-04 | 2023-11-07 | Restor3D, Inc. | Surgical guides and processes for producing and using the same |
US11960266B1 (en) | 2023-08-23 | 2024-04-16 | Restor3D, Inc. | Patient-specific medical devices and additive manufacturing processes for producing the same |
Family Cites Families (150)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
DE375151C (en) | 1923-05-08 | Ernst Fabian | Vice | |
US149430A (en) * | 1874-04-07 | Improvement in hose-nozzles | ||
US26190A (en) * | 1859-11-22 | Kotaky steam-engine | ||
US575631A (en) * | 1897-01-19 | brooks | ||
US554284A (en) * | 1896-02-11 | Peter lorang | ||
US1271792A (en) * | 1914-11-16 | 1918-07-09 | United Shoe Machinery Corp | Blank-holder. |
US1442929A (en) * | 1917-04-25 | 1923-01-23 | Elia Giovanni Emanuele | Aerial shell |
US1563242A (en) | 1924-05-27 | 1925-11-24 | Jacob M Tweit | Wrench |
US2250417A (en) * | 1939-12-02 | 1941-07-22 | Zimmer Mfg Company | Fracture reduction and retention device |
US2251209A (en) * | 1940-02-17 | 1941-07-29 | Stader Otto | Bone splint |
US2346346A (en) * | 1941-01-21 | 1944-04-11 | Anderson Roger | Fracture immobilization splint |
US2393831A (en) * | 1942-12-29 | 1946-01-29 | Stader Otto | Bone splint |
US2391537A (en) | 1943-09-27 | 1945-12-25 | Anderson Roger | Ambulatory rotating reduction and fixation splint |
US2391693A (en) | 1943-12-09 | 1945-12-25 | Zimmer Mfg Company | Surgical splint |
US2393694A (en) | 1945-04-10 | 1946-01-29 | Otto S Kirschner | Surgical apparatus |
US2427128A (en) * | 1946-01-28 | 1947-09-09 | Zimmer Mfg Company | Surgical bone clamp |
DE1603999U (en) | 1950-01-24 | 1950-03-30 | Toussaint & Hess Gmbh | HYDRAULIC PRESS. |
CH303453A (en) | 1952-05-13 | 1954-11-30 | Raoul Dr Hoffmann | Fixer, especially for the treatment of bone fractures. |
US2822986A (en) * | 1954-11-09 | 1958-02-11 | Frank J Schreier | Rail fastener |
US2774271A (en) | 1955-03-18 | 1956-12-18 | Mecaniques Et D Organisation I | Lever-actuated, slidable jaw wrench |
US2876027A (en) * | 1957-02-26 | 1959-03-03 | William B Sulmonetti | Locking swivel type clamp assembly |
US2932029A (en) * | 1957-12-20 | 1960-04-12 | Ind Dev Corp | Machine for the assembly of eye members in textile materials |
US3154331A (en) * | 1960-04-25 | 1964-10-27 | Armin E Engelhardt | Shaft clamping devices |
US3044512A (en) * | 1960-05-31 | 1962-07-17 | Monogram Prec Ind Inc | Clamp |
DE1935977U (en) | 1961-08-16 | 1966-03-31 | Adolf Lauster & Co | TRANSPORT CONTAINER. |
US3195380A (en) * | 1963-09-20 | 1965-07-20 | Bicks Jean Leonard | Device for engaging, holding and releasing objects |
US3364381A (en) * | 1965-06-23 | 1968-01-16 | Rosena E. Porter | Vehicle safety lights |
US3509882A (en) * | 1967-09-18 | 1970-05-05 | American Hospital Supply Corp | Parallel jaw spring clip and applicator |
US3828791A (en) * | 1973-03-21 | 1974-08-13 | M Santos | Surgical instruments |
CH579438A5 (en) * | 1974-05-22 | 1976-09-15 | Jaquet Henri | |
GB1582133A (en) * | 1976-04-30 | 1980-12-31 | Nat Res Dev | Orthopaedic fracture fixing apparatus |
US4170990A (en) * | 1977-01-28 | 1979-10-16 | Fried. Krupp Gesellschaft Mit Beschrankter Haftung | Method for implanting and subsequently removing mechanical connecting elements from living tissue |
DE2745504A1 (en) | 1977-10-10 | 1979-04-19 | Erich Strickle | DEVICE FOR RESTING OR SUPPORTING LIMBS OF PEOPLE AND ANIMALS |
US4187840A (en) * | 1978-08-14 | 1980-02-12 | Watanabe Robert S | Bone plate clamp |
ES253459Y (en) * | 1978-11-10 | 1982-04-16 | EXTERNAL CLINICAL FIXER, OF HIGH STABILITY, TO REDUCE FRACTURES. | |
US4227826A (en) * | 1979-02-16 | 1980-10-14 | Dynaloc Corporation | Hub-locking device |
US4364381A (en) | 1980-01-31 | 1982-12-21 | Sher Jay H | Surgical clamp and drill-guiding instrument |
US4502473A (en) * | 1981-08-06 | 1985-03-05 | National Research Development Corp. | Apparatus for external fixation of bone fractures |
US4548199A (en) * | 1981-11-13 | 1985-10-22 | Agee John M | Fracture splint |
US4696293A (en) * | 1982-09-30 | 1987-09-29 | Ciullo Jerome V | Hinged external fixator |
US4483334A (en) * | 1983-04-11 | 1984-11-20 | Murray William M | External fixation device |
US4475546A (en) * | 1983-06-23 | 1984-10-09 | Patton Stephen M | External fixation apparatus |
US4611586A (en) * | 1983-10-06 | 1986-09-16 | John M. Agee | Articulated Colles' fracture splint |
US4666109A (en) * | 1985-01-25 | 1987-05-19 | Draft Systems, Inc. | Tube support assembly |
US4635634A (en) * | 1985-07-12 | 1987-01-13 | Santos Manuel V | Surgical clip applicator system |
US4620533A (en) | 1985-09-16 | 1986-11-04 | Pfizer Hospital Products Group Inc. | External bone fixation apparatus |
US4730608A (en) * | 1986-03-05 | 1988-03-15 | Schlein Allen P | External bone-anchoring fixator |
US4785694A (en) | 1986-04-16 | 1988-11-22 | Platte River Welding-Tool Division | Spring clip extractor |
SU1491492A1 (en) | 1986-05-28 | 1989-07-07 | Г. С. Сушко | Apparatus for osteosynthesis of neck of the femur fractures |
JPH0339605Y2 (en) * | 1986-07-23 | 1991-08-21 | ||
IT1197951B (en) * | 1986-11-04 | 1988-12-21 | Promeda Srl | ARTICULATION SUPPORT DEVICE |
DE3701533A1 (en) * | 1987-01-21 | 1988-08-04 | Medi System Gmbh | OSTEOSYNTHESIS TOOLS |
US4836485A (en) * | 1987-01-30 | 1989-06-06 | Alliance Research Corporation | Universally adjustable mounting device |
US4922856A (en) * | 1987-05-15 | 1990-05-08 | Sweeney Enterprises, Inc. | Vibrationally activated control apparatus for detecting signals from fish to enable demand feeding |
DE3805178A1 (en) | 1988-02-19 | 1989-08-31 | Abdul Kader Dr Martini | External fixator |
US4848368A (en) * | 1988-04-25 | 1989-07-18 | Kronner Richard F | Universal external fixation frame assembly |
DE3823746A1 (en) | 1988-07-13 | 1990-01-18 | Leibinger Medizintech | EXTERNAL BONE BREAKAGE CONNECTING DEVICE |
CH678485A5 (en) | 1988-12-15 | 1991-09-30 | Jaquet Orthopedie | |
IT1228305B (en) * | 1989-01-04 | 1991-06-11 | Confida Sas | BONE SUPPORT DEVICE. |
US5207676A (en) * | 1989-02-27 | 1993-05-04 | Jaquet Orthopedie S.A. | External fixator with controllable damping |
US5451226A (en) * | 1989-03-06 | 1995-09-19 | Pfeil; Joachim | Unilateral, extensible, external tensioning device for treating bone diseases |
IT1234756B (en) * | 1989-03-17 | 1992-05-26 | Orthofix Srl | EXTERNAL FIXER PARTICULARLY SUITABLE TO BE APPLIED ON THE BASINS. |
DE3926893C1 (en) * | 1989-08-16 | 1991-04-11 | Dietmar Dr.Med. 4400 Muenster De Pennig | |
US5167725A (en) | 1990-08-01 | 1992-12-01 | Ultracision, Inc. | Titanium alloy blade coupler coated with nickel-chrome for ultrasonic scalpel |
FR2665353A1 (en) | 1990-08-03 | 1992-02-07 | Pinaud Jean Claude | External fixator for reducing fractures of the wrist |
US5062844A (en) | 1990-09-07 | 1991-11-05 | Smith & Nephew Richards Inc. | Method and apparatus for the fixation of bone fractures, limb lengthening and the correction of deformities |
US5219349A (en) * | 1991-02-15 | 1993-06-15 | Howmedica, Inc. | Spinal fixator reduction frame |
JP3084303B2 (en) | 1991-07-04 | 2000-09-04 | 長野計器株式会社 | Bone drilling surgery template device |
US5827282A (en) * | 1991-07-12 | 1998-10-27 | Orthofix S.R.1. | Clamping coupling |
DE9108566U1 (en) | 1991-07-12 | 1991-10-10 | Pennig, Dietmar, Dr.Med., 4400 Muenster, De | |
CH686902A5 (en) | 1991-07-23 | 1996-07-31 | Synthes Ag | clamp connection |
FR2683446A1 (en) * | 1991-11-08 | 1993-05-14 | Hardy Jean Marie | MODULAR EXTERNAL FIXER FOR IMMOBILIZING A FRACTURE FIREPLACE. |
US5810817A (en) * | 1992-06-19 | 1998-09-22 | Roussouly; Pierre | Spinal therapy apparatus |
US5304177A (en) * | 1992-06-26 | 1994-04-19 | Dietmar Pennig | Auxiliary device for osteosynthesis |
CA2106777C (en) * | 1992-08-24 | 1999-06-29 | Slobodan Tepic | External fixation device for osteosynthesis |
DE4231443C1 (en) * | 1992-09-19 | 1993-10-14 | Pennig Dietmar | Osteosynthesis tools |
EP0673230A1 (en) | 1992-10-05 | 1995-09-27 | Albert E. Sanders | Nitinol instrumentation and method for treating scoliosis |
DE4238582A1 (en) | 1992-11-16 | 1994-05-19 | Erwin Prof Dr Med Brug | Guide for boring holes in bones - has block with two guide holes mounted on system of arms with spherical joints |
US5545162A (en) * | 1995-02-15 | 1996-08-13 | Huebner; Randall J. | External fixator for repairing fractures of distal radius and wrist |
US5658283A (en) * | 1995-02-15 | 1997-08-19 | Huebner; Randall J. | External fixator for repairing fractures |
US5976134A (en) | 1995-06-01 | 1999-11-02 | Huebner; Randall J. | External fixator for repairing fractures |
US5662649A (en) * | 1995-02-15 | 1997-09-02 | Huebner; Randall J. | External fixator for repairing fractures of distal radius and wrist |
US5405347A (en) | 1993-02-12 | 1995-04-11 | Zimmer, Inc. | Adjustable connector for external fixation rods |
IT1262781B (en) * | 1993-03-15 | 1996-07-04 | Giovanni Faccioli | TOOL AND METHOD FOR THE EXTERNAL REDUCTION OF FRACTURES |
ES2163441T3 (en) * | 1993-04-30 | 2002-02-01 | Eastern Virginia Med School | TOPICAL COMPOSITIONS FOR THE REPITELIZATION OF PERSISTENT EPITHELIAL DEFECTS. |
US5405437A (en) * | 1993-06-01 | 1995-04-11 | National Starch And Chemical Investment Holding Corporation | All natural, starch-based, water resistant corrugating adhesive |
US5451225A (en) * | 1993-06-10 | 1995-09-19 | Texas Scottish Rite Hospital For Crippled Children | Fastener for external fixation device wires and pins |
US5766173A (en) * | 1993-06-10 | 1998-06-16 | Texas Scottish Rite Hospital For Children | Distractor mechanism for external fixation device |
US5403313A (en) * | 1993-07-29 | 1995-04-04 | Lin; Chih-I | External fixation device for fractured bone |
DE69422256D1 (en) * | 1993-10-15 | 2000-01-27 | Merck Patent Gmbh | Reactive liquid crystal compounds |
US5507760A (en) * | 1993-11-09 | 1996-04-16 | Devices For Vascular Intervention, Inc. | Cutter device |
GB9325698D0 (en) * | 1993-12-15 | 1994-02-16 | Richardson James B | Patient-operated orthopedic device |
IT1268282B1 (en) * | 1994-08-23 | 1997-02-27 | Orthofix Srl | EXTERNAL TROCANTERIC FIXER |
DE19528839A1 (en) * | 1994-09-03 | 1996-03-14 | Veith Wolfgang | Fixator |
CH690293A5 (en) | 1994-09-06 | 2000-07-14 | Jaquet Orthopedie | Joint for components of an external fixator. |
US5690633A (en) | 1994-09-23 | 1997-11-25 | Smith & Nephew Richards, Inc. | Orthopedic fracture fixation device |
US5683389A (en) | 1994-12-05 | 1997-11-04 | Smith & Nephew, Inc. | External fixator for distal radius fractures |
KR100477282B1 (en) | 1995-03-01 | 2005-05-16 | 스미쓰 앤드 네퓨, 인크. | Spatial frame |
US5971984A (en) * | 1995-03-01 | 1999-10-26 | Smith & Nephew, Inc. | Method of using an orthopaedic fixation device |
US5728095A (en) * | 1995-03-01 | 1998-03-17 | Smith & Nephew, Inc. | Method of using an orthopaedic fixation device |
US5624447A (en) * | 1995-03-20 | 1997-04-29 | Othy, Inc. | Surgical tool guide and entry hole positioner |
GB2300357A (en) | 1995-05-01 | 1996-11-06 | Biomet Ltd | Bone fixation system with data logging device |
US5662650A (en) * | 1995-05-12 | 1997-09-02 | Electro-Biology, Inc. | Method and apparatus for external fixation of large bones |
US5743898A (en) * | 1995-05-12 | 1998-04-28 | Electro-Biology, Inc. | Method and apparatus for external fixation of small bones |
GB9510926D0 (en) * | 1995-05-31 | 1995-07-26 | Nastech Europ Ltd | Shaft coupling |
IT1278856B1 (en) * | 1995-09-19 | 1997-11-28 | Orthofix Srl | ACCESSORY FOR EXTERNAL FIXER |
IT1278858B1 (en) * | 1995-09-20 | 1997-11-28 | Orthofix Srl | INSTRUMENTS FOR THE TREATMENT OF ARTICULAR FRACTURES OF THE ANKLE |
JP3742648B2 (en) * | 1996-03-25 | 2006-02-08 | ジンテーズ アクチエンゲゼルシャフト クール | Adjustable clamp for bone anchoring element |
US5746741A (en) * | 1996-05-06 | 1998-05-05 | Tufts University | External fixator system |
US5891144A (en) * | 1996-05-10 | 1999-04-06 | Jaquet Orthopedie S.A. | External fixator |
US5709685A (en) * | 1996-05-21 | 1998-01-20 | Sdgi Holdings, Inc. | Positionable clip for provisionally capturing a component on a spinal rod |
DE29619711U1 (en) * | 1996-11-13 | 1998-03-12 | Synthes Ag | Device for repositioning bone fracture fragments |
US5823486A (en) * | 1997-02-07 | 1998-10-20 | Margaret K. Smith | Universal flexible arm |
US6106528A (en) * | 1997-02-11 | 2000-08-22 | Orthomatrix, Inc. | Modular intramedullary fixation system and insertion instrumentation |
IT1298413B1 (en) * | 1997-05-21 | 2000-01-05 | Orthofix Srl | EXTERNAL MINIFIXER DEVICE FOR SMALL BONE TREATMENT |
US5891143A (en) * | 1997-10-20 | 1999-04-06 | Smith & Nephew, Inc. | Orthopaedic fixation plate |
NL1007426C1 (en) | 1997-11-03 | 1999-05-04 | Gerrit Johannes Termaten | Device for mutually fixing bone parts. |
US5931837A (en) * | 1997-12-09 | 1999-08-03 | University Of Iowa Research Foundation | Method and apparatus for external fixation of an ankle |
US6010501A (en) * | 1997-12-15 | 2000-01-04 | Electro-Biology, Inc. | Method and apparatus for external fixation of small bones |
US5941877A (en) * | 1998-01-14 | 1999-08-24 | The Board Of Regents Of The University Of Texas System | Hand external fixation and joint mobilization and distraction device |
DE59810997D1 (en) * | 1998-01-16 | 2004-04-22 | Ct Pulse Orthopedics Ltd | Construction kit for socket prostheses |
US6238400B1 (en) * | 1998-05-01 | 2001-05-29 | Medtronic Xomed, Inc. | Method and apparatus for trephination and irrigation of the frontal sinus cavity |
US5997537A (en) | 1998-05-28 | 1999-12-07 | Electro Biology, Inc. | Ring system for external fixation of bone and related method |
US6030386A (en) * | 1998-08-10 | 2000-02-29 | Smith & Nephew, Inc. | Six axis external fixator strut |
US6066142A (en) * | 1998-10-22 | 2000-05-23 | Depuy Orthopaedics, Inc. | Variable position bone drilling alignment guide |
CH693164A5 (en) * | 1998-12-29 | 2003-03-27 | Stryker Trauma Sa | A locating and locking. |
ATE247930T1 (en) * | 1998-12-31 | 2003-09-15 | Orthofix Srl | EXTERNAL FIXATION DEVICE, ESPECIALLY FOR ANKLE BREAKS |
IT1307909B1 (en) * | 1999-01-21 | 2001-11-29 | Medicalplastic S R L | EXTERNAL FIXER FOR ORTHOPEDICS AND TRAUMATOLOGY. |
US6129727A (en) * | 1999-03-02 | 2000-10-10 | Smith & Nephew | Orthopaedic spatial frame apparatus |
US6245071B1 (en) | 1999-03-10 | 2001-06-12 | Synthes (U.S.A.) | External fixation device for bone |
US6616664B2 (en) * | 1999-10-21 | 2003-09-09 | Ebi L.P. | Clamp assembly for an external fixation system |
US6613049B2 (en) * | 2000-02-02 | 2003-09-02 | Robert A. Winquist | Adjustable bone stabilizing frame system |
US6423061B1 (en) * | 2000-03-14 | 2002-07-23 | Amei Technologies Inc. | High tibial osteotomy method and apparatus |
US6386786B1 (en) * | 2000-04-07 | 2002-05-14 | Delaware Capital Formation, Inc. | Rotating clamp |
ES2277825T3 (en) | 2000-05-09 | 2007-08-01 | Orthofix S.R.L. | COMPONENT TO ENSURE A RING FIXER USED IN ORTHOPEDIC SURGERY. |
ATE276703T1 (en) | 2000-05-26 | 2004-10-15 | Orthofix Int Bv | AXIAL EXTERNAL FIXATOR |
IL152561A0 (en) | 2000-05-26 | 2003-05-29 | Orthofix Srl | Disposable external fixation device |
US6503340B1 (en) * | 2000-08-02 | 2003-01-07 | The Babcock & Wilcox Company | Method for producing chromium carbide coatings |
US6565564B2 (en) * | 2000-12-14 | 2003-05-20 | Synthes U.S.A. | Multi-pin clamp and rod attachment |
ES2272432T3 (en) | 2001-03-05 | 2007-05-01 | Orthofix S.R.L. | EXTERNAL OSEA FIXING DEVICE. |
US7147640B2 (en) | 2003-03-12 | 2006-12-12 | Acumed Llc | External fixator |
US6709433B1 (en) * | 2001-12-20 | 2004-03-23 | Biomet, Inc. | Bridging/non-bridging external bone fixator |
US7048735B2 (en) * | 2002-02-04 | 2006-05-23 | Smith & Nephew | External fixation system |
US7004943B2 (en) * | 2002-02-04 | 2006-02-28 | Smith & Nephew, Inc. | Devices, systems, and methods for placing and positioning fixation elements in external fixation systems |
US7367977B2 (en) | 2002-02-28 | 2008-05-06 | Estrada Jr Hector Mark | Apparatus for dynamic external fixation of distal radius and wrist fractures |
US6652524B1 (en) | 2002-05-30 | 2003-11-25 | Millennium Medical Technologies, Inc. | Fixator with outrigger |
US7758582B2 (en) | 2002-06-14 | 2010-07-20 | Smith & Nephew, Inc. | Device and methods for placing external fixation elements |
US7282052B2 (en) | 2002-09-17 | 2007-10-16 | Ebi, L.P. | Unilateral fixator |
US7608074B2 (en) | 2003-01-10 | 2009-10-27 | Smith & Nephew, Inc. | External fixation apparatus and method |
WO2006007553A2 (en) | 2004-07-01 | 2006-01-19 | Smith & Nephew, Inc. | Fixation elements |
-
2003
- 2003-06-26 US US10/607,010 patent/US7608074B2/en active Active
- 2003-12-10 JP JP2004566531A patent/JP2006512970A/en active Pending
- 2003-12-10 CA CA002512074A patent/CA2512074A1/en not_active Abandoned
- 2003-12-10 WO PCT/US2003/039307 patent/WO2004062514A1/en active Application Filing
- 2003-12-10 EP EP03815197.3A patent/EP1581127B1/en not_active Expired - Lifetime
- 2003-12-10 AU AU2003296463A patent/AU2003296463B2/en not_active Expired
-
2007
- 2007-06-27 US US11/823,178 patent/US8382755B2/en active Active
Also Published As
Publication number | Publication date |
---|---|
JP2006512970A (en) | 2006-04-20 |
US20070255280A1 (en) | 2007-11-01 |
EP1581127A1 (en) | 2005-10-05 |
AU2003296463B2 (en) | 2009-09-03 |
EP1581127B1 (en) | 2017-09-20 |
US8382755B2 (en) | 2013-02-26 |
WO2004062514A1 (en) | 2004-07-29 |
US7608074B2 (en) | 2009-10-27 |
US20040138659A1 (en) | 2004-07-15 |
AU2003296463A1 (en) | 2004-08-10 |
Similar Documents
Publication | Publication Date | Title |
---|---|---|
EP1581127B1 (en) | External fixation apparatus | |
US10722268B2 (en) | External fixator assembly | |
EP0891159B1 (en) | Adjustable clamp for bone fixation element | |
EP0955928B1 (en) | External fixator for large bones | |
CA2474388C (en) | External fixation system | |
EP2627273B1 (en) | External fixation surgical clamp with swivel | |
US8540713B2 (en) | Clamp for temporary or definitive external orthopaedic fixation, and external fixation system comprising said clamp | |
US5743898A (en) | Method and apparatus for external fixation of small bones | |
EP1302169B1 (en) | Spinal polyaxial cross connector | |
US20140276820A1 (en) | External fixation system | |
US11672566B2 (en) | External fixator assembly | |
US20060089651A1 (en) | Apparatus and method for anchoring a surgical rod | |
JP5654579B2 (en) | Surgical instrument for securing the clamp to the bone anchoring device | |
WO2003105704A1 (en) | Device and methods for placing external fixation elements | |
US20160045226A1 (en) | Quick-release systems for extraskeletal fixation |
Legal Events
Date | Code | Title | Description |
---|---|---|---|
FZDE | Discontinued |