WO2006007736A1

WO2006007736A1 - Device for fixing surgical devices

Info

Publication number: WO2006007736A1
Application number: PCT/CH2004/000464
Authority: WO
Inventors: Kaj Klaue
Original assignee: Synthes Ag Chur; Synthes (U.S.A.)
Priority date: 2004-07-22
Filing date: 2004-07-22
Publication date: 2006-01-26

Abstract

The invention comprises a device (1) for fixing surgical instruments relative to a patient having n ≥ 2 frame elements (2; 5; 19), which can be assembled via their ends (3; 4; 6; 7;20;21) whereby forming a rigid frame (11) or cage.

Description

Device for attaching surgical devices

The invention relates to a device for attaching surgical instruments and / or devices relative to a patient according to claim 1.

C-arm frame members or carriers are used in surgery, for example, in target devices, reduction devices, compression devices or even in surgical image intensifiers (X-ray devices). Such C-shaped frame members having a longitudinal beam member and two cross beam members are subject to deformations, in particular because of their shape where the cross beams may act as lever arms, which may limit the use of such arcuate frame members. The forces on the free ends of such a C-shaped frame member may be generated, for example, by the weight of the instruments attached to the ends (image intensifiers) or by forces generated by repositioning or compression of bone by means of repositioning or compression screws attached to the frame member ,

From DE 197 11 964 SIEMENS a method for determining the deformation of a C-arm (X-ray machine), in particular with respect to bending and torsion is known, which then allows a correction of the X-ray image.

From US Pat. No. 5,649,930 KERTZNER a target device is known with a longitudinal beam adjustable in its length and two cross beams fixed at the end on the longitudinal beam and likewise adjustable in length. One of the cross members is fixed with its free end to the bone, while the second cross member comprises a drill sleeve with the longitudinal member parallel central axis.

Furthermore, from CH 680 561 WHOLE, a pelvic forceps for repositioning pelvic bone fragments is known, which has a longitudinal splint and two arms arranged perpendicular thereto. This known Beckenzwinge is designed C-shaped. A disadvantage of these known devices that C-curved frame elements with respect to bending, in particular against spreading of the bow and torsion, ie, distortion of the device have low stability. Such deformations can significantly reduce the accuracy in the application of the device.

The invention aims to remedy this situation. The invention has for its object to provide a device for attachment of surgical instruments relative to a patient whose frame has a maximum stability with respect to bending and torsion.

The invention achieves the stated object with a device having the features of claim 1.

The advantages achieved by the invention are to be seen essentially in the fact that thanks to the device according to the invention,

- During use of the device because of the annularly closed frame or cage, a higher stability of the device can be achieved. This takes into account, for example, the large forces occurring during reduction or compression of bone. When using the device on an X-ray device can thereby reduce the distortions of the X-ray image; and

- The device in its open for manipulating the device position, for example, simple and a bone is feasible.

In a preferred embodiment, the apparatus comprises two frame members, each of the two C-arm frame members having first and second ends to which mutually engageable connecting means are disposed. These first and second connecting means are engageable with each other such that the first end of the first frame member is joined to the first end of the second frame member and, analogously, the second ends of the two frame members are joined together. The version with only two frame elements has the Advantage that an increase in the stability of the device can be achieved without significantly increasing the volume of the device or additionally impair access to the surgical site for the surgeon.

In another embodiment, the connecting means at the ends of the frame members are releasably engageable with each other. This achieves the advantage that, for example, the first frame element is first positioned on the patient, i. in particular can be guided around a bone, while the second frame member is subsequently connected to the first frame member.

In yet another embodiment, the connecting means comprise complementary, releasably fixable plug-in connections, so that thus the advantage can be achieved that the device is easy to assemble. include.

In a further embodiment, the connecting means comprise joints. The advantages of a hinged connection of the frame members is that the apparatus is in one piece and the frame members can be adjusted at a suitable angle relative to each other so that disabilities for the surgeon can be reduced. Preferably, the device each includes a releasably lockable hinge between the first ends and between the second ends of the frame members, such that the frame members are pivotable relative to each other about a rotation axis intersecting the first and second ends of the first frame member so as to open into one another. a C-shaped arc forming position A or in a closed, a rigid frame forming position B can be brought. The joints may be formed, for example, as hinge joints, each having an axis coaxial with the axis of rotation. Thus, the advantage is achieved that by the fact that hinge joints are pivotable only about a single axis of rotation, the forces transversely to the axis of rotation, as they occur for example when expanding parallel to the axis or twisting of the frame, form-fitting record.

In yet another embodiment, a plurality, preferably three frame members are provided. Thus, the merged frame elements form a cage-like structure with a further increased stability of the device. In yet another embodiment, the connecting means comprise releasably lockable locking means for blocking or unblocking the frame members relative to one another. By a positive or positive locking, for example, the hinge joints and a high rigidity of the annular device against torsion, ie twisting achievable.

In yet another embodiment, the locking means comprise releasably engageable snap closures to allow easy blocking or deblocking of the connection means. Preferably, such snaps include at least one resilient pin and at least one complementary bore on the connecting means, the frame members being locked relative to each other when the pins are snapped into the holes and movable relative to each other when the pins are disengaged from the holes.

Instead of snap closures, the locking means may also comprise releasably engageable gears.

In further embodiments, the device comprises first and second means for repositioning bones, which are preferably connectable to the frame members.

Preferably, the first and second bone repositioning means are disposed opposite one another on a connecting line on the frame members.

Further advantageous embodiments of the invention are characterized in the dependent claims. The invention and further developments of the invention will be explained in more detail below with reference to the partially schematic representations of several embodiments.

Show it:

Figure 1 is a perspective view of an embodiment of the inventive device with relatively pivotable frame members in their open, forming a C-shaped arc position A.

FIG. 2 shows the embodiment of the device according to the invention according to FIG. 1 in its closed position B forming a rigid frame; FIG.

3 shows an embodiment of the connecting means using the example of the embodiment of the device according to the invention shown in FIGS. 1 and 2;

4 shows a view of an embodiment of the device according to the invention using the example of an X-ray machine with plug-in frame elements in its closed position B; and

5 is a perspective view of an embodiment of the device according to the invention with three free frame elements in their closed position B.

1 and 2, an embodiment is shown, which comprises two C-shaped frame members 2, 5, each having a first and a second end 3, 4. First mechanical connecting means 17 are arranged at the two ends 3, 4 of the first frame element 2, which each have a joint 9 in pairs with the second connecting means 18 arranged at the first and second ends 6, 7 of the second frame element 5, so that the two frame elements 2, 5 about a first and the second ends 3, 4 of the first frame member 2 and the first and second ends 6, 7 of the second frame member 5 intersecting axis of rotation 12 are pivotally connected relative to each other. The joints 9 are here designed as hinge joints, so that they are pivotable only about the axis of rotation 12 and with respect to an axis transverse to the axis of rotation 12 a form-fitting Form a connection. By means of the preferably releasably lockable joints 9, the two frame members 2; 5 are pivotable relative to each other so that they in an open, a C-shaped arc-forming position A (Fig. 1) or in a closed, a rigid frame 11 forming position B (Fig. 2) can be brought. The joints 9 formed as first and second connecting means 17; 18 are preferably provided with locking means 25 (Figure 3) so that the two frame members 2, 5 are releasably lockable relative to each other at least in the position B (Figure 2). Such locking means 25 (FIG. 3) can be designed, for example, as screwable clamping elements, as intermeshable toothings on the adjacent surfaces of the joints 9, or as resilient snap closures (FIG. 3). Furthermore, the device 1 comprises first and second means 13; 15 for the reduction of bone or bone fragments, which are arranged here on a coincident with the axis of rotation 12 connecting line 10 and coaxial with the axis of rotation 12 in the axes of the joints 9 screwed bolts.

A possible embodiment of the first connection means 17 is shown in FIG. 3 using the example of a segment of the first frame element 2. The connecting means 17 comprise a slotted sleeve 30 whose slot 32 extends substantially parallel to the axis of rotation 12, so that the sleeve 30 is slidable transversely to the axis of rotation 12 about the axis 8 coaxial to the axis of rotation 8 of the joint 9. After sliding the sleeve 30 over the axis 8, the sleeve 31 is inserted parallel to the rotation axis 12, wherein the outer diameter of the sleeve 31 is formed to match the inner diameter of the sleeve bore 38 and the inner diameter of the central bore 36 in the sleeve 31 to the outer diameter of the shaft 8 suitable is trained. Furthermore, the connecting means 17 comprise a screw 33 which can be screwed into a bore 37 having an internal thread running transversely to the axis of rotation 12 at the first end 3 of the first frame element 2. The sleeve 30 is by means of the screw 33, which viewed the slot 32 - orthogonal to the rotation axis 12 - bridged like a chord outside the sleeve bore 38, clamped on the sleeve 31. The screw 33 is removable from the sleeve 30 prior to assembly and comprises a relative to the screw axis 34 angled, preferably removable handle 35. The locking means 14 for releasably blocking the joint 9 can by other non-positively or positively acting means (not drawn) be formed. Coaxially attached to the axles 8 are the first bone reduction means 13. Analogously, second means 15 for repositioning bones may be inserted or screwed in on a further axis 8 (not shown) on the second end 4 of the first frame element 2.

Another possibility of the embodiment of the joint 9 is that a first sleeve 31 at the first ends 3, 6, 20 and a second sleeve 31 at the second ends 4, 7, 21 of the frame members 2, 5, 19 in the sleeve bores of all three connecting means 17, 18, 24 (Figures 1 and 5) is inserted, so that all the frame elements 2, 5, 19 are pivotally connected to the two bushings 31 about the axis of rotation 12. The sleeves 30 of the frame elements 2, 5, 19 mounted on a sleeve 31 are arranged axially one behind the other and are detachably fixable by means of the screws 33, which serve as locking means 14 in this embodiment.

In Fig. 4, an embodiment is shown, which is mounted on a mobile C-arc type X-ray device, wherein the X-ray source 26 is disposed at the first end 3 of the first frame member 2 and the connecting line 10 on the opposite side disposed receiver 27 at the second end 4 of the first Frame element 2 is attached. The embodiment of the device 1 only differs from the embodiment illustrated in FIGS. 1 and 2 in that the first and second connecting means 17; 18 are not designed as a hinge 9 (FIGS. 1 and 2) but as a plug connection. The first frame element 2 with the X-ray source 26 and the receiver 27 can thus be positioned without the second frame element 5 in the open position A (not shown) relative to a patient lying on the operating table 28 and then the second frame element 5 transversely to the connecting line 10 at first frame member 2 are attached. For this purpose, locking means 25 are provided on the first connection means 17 on the first frame element 2 and on the second connection means 18 on the second frame element 5 as snap-in closures which can be brought into engagement with one another. These snap locks comprise per locking means 25 a resilient pin 22 on the second connecting means 18 and a complementary bore 23 on the first connecting means 17, the two frame members 2, 5 being locked relative to each other when the pins 22 are engaged in assembled holes in the holes 23 are. At out the bores 23 disengaged pins 22, the second frame member 5 for the purpose of removing the X-ray device again transversely to the connecting line 10 from the first frame member 2 are removed.

The embodiment shown in FIG. 5 differs from the embodiment shown in FIGS. 1 and 2 in that

the device 1 comprises a third frame element 19 having a first and a second end 20, 21, as well as third mechanical connection means 24 arranged at the two ends 20, 21,

in the closed position B, the three frame elements 2; 5; 19 enclose substantially the same angles α, β, γ of approximately 120 ° with respect to each other in a cross-section perpendicular to the connecting line 10; and that

the first and the second end 3, 4 of the first frame element 2, the first and second ends 6, 7 of the second frame element 5 and the first and second ends 20, 21 of the third frame element 19 by means of plug connections (analogous to FIG. are zusammenfügbar.

Claims

claims

Device (1) for attaching surgical devices relative to a patient, characterized by n> 2 frame elements (2; 5; 19) which are connectable with their ends (3; 4; 6; 7; 20; 21), so that they form a rigid frame (11) or cage.

2. Device (1) according to claim 1, characterized in that they at least

A) comprises a first C-arm frame member (2) having first and second ends (3; 4) and first mechanical connection means (17) at the two ends (3; 4); and

B) comprises a second C-arm frame member (5) having first and second ends (6; 7) and second mechanical connection means (18) at the two ends (6; 7) of the second frame member (5)

C) the first and second connecting means (17; 18) are engageable with each other such that the first end (3) of the first frame member (2) is connected to the first end (6) of the second frame member (5) and the second end (5). 3,4) of the first frame member (2) is joined to the second end (6; 7) of the second frame member (5).

A device (1) according to claim 2, characterized in that the first and second connection means (17; 18) are releasably engageable with each other.

4. Device (1) according to one of claims 2 to 4, characterized in that the first and second connecting means (17,18) comprise a complementary, releasably fixable connector.

5. Device (1) according to one of claims 2 to 4, characterized in that the first and second connecting means (17; 18) comprise a hinge (9).

6. Device (1) according to one of claims 1 to 6, characterized in that it comprises a plurality of frame elements (2; 5; 19).

7. Device (1) according to one of claims 1 to 7, characterized in that it comprises a third frame element (2; 5).

8. Device (1) according to one of claims 1 to 8, characterized in that it comprises a releasably lockable joint (9) between the first ends (3; 6; 20) and between the second ends (4; 7; 21) the frame members (2; 5; 19) so that the frame members (2; 5; 19) are pivotable relative to one another about a pivot axis (12) intersecting the first and second ends (3; 4) of the first frame member (2) are that they can be brought into an open, a C-shaped arc forming position A or in a closed, rigid frame forming position B.

9. Device (1) according to one of claims 2 to 9, characterized in that the first and second connecting means (17; 18) releasably lockable locking means (25) for blocking or unblocking the frame members (2; 5; 19) relative to each other ,

10. Device (1) according to any one of claims 6 to 10, characterized in that the joints (9) are designed as hinged joints, each with an axis of rotation (12) coaxial axis (8).

11. Device (1) according to claim 9 or 10, characterized in that the locking means (25) comprise releasably engageable snap closures.

12. Device (1) according to claim 10 or 11, characterized in that the locking means (25) comprise releasably engageable teeth.

A device (1) according to claim 11, characterized in that the snap locks comprise at least one resilient pin (22) and at least one complementary bore (23) on the first and second connection means (17; 18), the frame members (2; 5; 19) are locked relative to each other when the pins (22) are engaged in the bores (23) and are movable relative to each other when the pins (22) are disengaged from the bores (23).

Device (1) according to any one of Claims 1 to 13, characterized in that it comprises first and second means (13; 15) for repositioning bones.

15. Device (1) according to claim 14, characterized in that each one of the first and second means (13; 15) for repositioning bone is arranged on each frame element (2; 5; 19).

The apparatus (1) according to claim 15, characterized in that said first and second bone replaceable means (13; 15) are disposed opposite one another on a connecting line (10) on said frame members (2; 5; 19).