WO2016144270A1

WO2016144270A1 - A removal apparatus for the balls inside the wire retainer

Info

Publication number: WO2016144270A1
Application number: PCT/TR2015/000092
Authority: WO
Inventors: Emre KARADENİZ
Original assignee: Karadeni̇z Emre
Priority date: 2015-03-10
Filing date: 2015-03-10
Publication date: 2016-09-15

Abstract

The invention is related to a ball remover (BR) which has been developed for moving the balls (B) which are provided in a wire retainer for compressing a k-wire, and for making the balls loose enough to be withdrawn by a magnetic apparatus, or for removing them, subsequent to opening the upper cover of the wire retainers by means of a screwdriver; and thus allowing the wire retainer at one side of the bone to be removed from where it is, i.e. get outside the tissue, by being easily separated from the k-wire, at the same time enabling the k-wire, along with retainer at the other side of the bone, to be removed therefrom and taken outside the tissue.

Description

DESCRIPTION

A REMOVAL APPARATUS FOR THE BALLS INSIDE THE WIRE RETAINER TECHNICAL FIELD

The invention is related to an apparatus which, subsequent to fracture healing, enables the k -wires and wire retainers that fix the Kirschner wire used for fastening and treating the fractured bones by- being passed through the bones, to be removed from where they are, in the field of orthopedic surgery.

The invention is particularly related to a ball remover which has been developed for moving the balls which are provided in the wire retainer and compressing the k-wire and for making the balls loose enough to go out of the tissue by means of a magnetic apparatus after the upper part of the wire retainers is opened by means of a squeezing apparatus; and thus allowing the wire retainer at one side of the bone/fastening to be removed from where it is, i.e. get outside the tissue, by being easily separated from the k-wire, at the same time enabling the k-wire, along with retainer at the other side of the bone, to be removed therefrom and taken outside the tissue. STATE OF THE ART

Techniques developed for surgical treatment of fractures so far are Kirschner wire (k-wire), screw, plate-screw, intramedullary nail and externa! fastening. The purpose of such techniques is to hold the fractured bone pieces in the desired position until fracture healing. The advantages and disadvantages of these techniques vary according to the type of fracture and they shape the treatment plan of the surgeon.

Among these techniques, in the technique of fastening with k-wire, after setting (reducing) the broken bones, these straight wires are made to pass between the bone pieces, whereby the broken bones are fastened. After reduction, fractured bone pieces may move back and forth through the wire since the wires cannot provide compression between fractured bone pieces. In addition, these wires may also move after being placed into the body.

In fastening the broken bones with screw, the fractured bone pieces are placed into their original places first. Compression between the pieces is obtained according to the principle of forming mutual force between the screw head and the screw threads, which is the working principle of screw In this technique, it is required to increase the dimensions of the screw in order to increase the attachment and compression force between the pieces. However, if the bone pieces are smaii in size, the dimension of the screw cannot be increased. Due to the screw dimension, there may be no space left to locate an additional screw between the pieces. Moreover, as a surgical technique, first the bone is drilled with a drill, and then grooves are opened for screw threads (tapering), subsequent to which the screw is located. Additionally, prior to these processes, sometimes k-wire is needed to be placed to guide the screw. As a result, the surgical technique is relatively difficult. Moreover, the attachment intended to be provided by screw threads is not practical for patients with osteoporosis.

On the other hand, in fastening the fractured bones with plate screw, fractured bone pieces are secured to their locations by plates held by screws, subsequent to reduction. However, since the plates are held by screws, all of the disadvantages of screw technique are also experienced herein The process of placing plates requires abrading more tissue surrounding the bone. This, in turn, means more incision and more nutrition problem for the bone pieces. The plate may prevent the healing of skin where the under skin tissue is very thin and may be felt by hand. When the bone pieces are too small or too close to the joints, it becomes impossible to place the plates. Furthermore, when the plates are to be taken out, the surrounding tissues are damaged again.

As a consequence, due to the aforementioned disadvantages and the insufficiency of the existing solutions regarding the subject matter, the product with the Application No. 2010/05662 titled A wire retainer" has been developed, as distinct from the known methods. The removing apparatus (also referred to as ball remover) has been developed which makes the balls inside the retainer move in order for them to be removed subsequent to using the k-wire, along with the wire retainer, for fastening the fractured bones. OBJECTS OF THE INVENTION

The main object of the invention is to provide an apparatus that moves the balls inside the retainer, after the upper part is removed by means of the squeezing apparatus so that "A wire retainer" according to the Application No. 2010/05662 can be taken outside the tissue without causing any damage thereto after the treatment is over.

The object of the invention is to remove the wire retainers from where they are via percutaneous techniques by minimizing the damage to the bones and the surrounding soft tissues during the removal of implants.

The structural and distinctive characteristics and all advantages of the invention wiil be better understood with the figures below and the detailed description written by referring to these figures, therefore, the invention should be evaluated by taking these figures and the detailed explanations into account.

FIGURES FOR A BETTER UNDERSTANDING OF THE INVENTION

Fig. 1 is the view of the use of ball remover according to the invention along with the working cannula.

Fig. 2 is the view of the use of ball remover according to the invention along with the working cannula and washer. It also illustrates the state when the formed tip of the ball remover reach the balls inside the retainer, the upper cover of which has been removed.

Fig. 3 is the overall view of the ball remover according to the invention.

Fig. 4 is the detailed close-up view of the formed tip of the ball remover according to the invention Fig. 5 is the overall view of the ball remover according to the invention together with the wire retainer when the upper cover thereof has been removed.

Fig. 6 is the overall view of the wire retainer in an alternative embodiment where the upper part is male and the lower part is female.

DESCRIPTION OF THE REFERENCES BR. Ball Remover

R. Retainer

C. Cannula

W. Washer

B. Ball

1. Formed Tip

1.1. Sharp Edge

2. Body

3. Holding Part

4. K-wire / Kirschner Wire

5. Upper Part

6. Lower Part

The drawings do not necessarily need to be scaled and the details that are not required for understanding the present invention may have been ignored. Apart from that, the components that are at least substantially identical or have at least substantially identical functions are referred with the same numeral. DETAILED DESCRIPTION OF THE INVENTION In this detailed description, the preferred embodiments of the ball remover (BR) according to the invention are described only for a better understanding of the subject matter.

The applications of the working cannula, magnetic apparatus, gripper, washer, and the squeezing apparatus, which are mentioned in the embodiment of the present invention, have ail been made by us.

As shown in Fig. 1 , the working cannula (C) is an apparatus which

comprises a knurled tip which abrades the bone tissue of the soft tissues thereon, allows advancing without cutting the surrounding tissues, is formed in compliance with the diameter of the wire retainer (R), and has protrusions and recesses

and constitutes a working corridor for various surgical apparatuses.

The magnetic apparatus removes the retainers (R) out of the body by following a working area formed by the working cannula (C) at a distance from the bone tissue to the skin, wherein said retainers (R) comprising;

a tip part which grips the wire retainer (R) and is suited for the dimension and the shape of the wire retainer (R), and

a magnet located in the tip part,

and wherein said wire retainers (R) are used for fastening and treating the fractured bones.

The squeezing apparatus is a component which comprises a formed tip which is seated in the grooves in the upper part (5) of the retainer (R) by passing therethrough; and which tightens-iocks or loosens-removes the retainer (R) on the bone surface by rotating the screw system of the retainer (R).

The gripper is a component which comprises a formed tip which prevents the release of the retainer (R) by passing through the working cannula (C) and which is formed in accordance with the shape of the retainer (R) in order to fully contact with the wire retainer (R). The washer (W) is a flat component which has an opening in the midst thereof so that the k-wire (4) can pass. It is preferably of a hollow washer type. The present invention is used together with "A wire retainer" according to the Application No 2010/05662, which has been granted an examined patent certificate by Turkish Patent Institute and which is used for fastening the broken bones. Said ball remover (BR), in particular, mobilizes the bails inside the retainer (R) according to the Application No. 2010/05662 and loosens the connection between the retainer (R) lower part (6) and the k-wire (4), whereby it allows the removal o? the lower part (6) of the wire retainer (R) via percutaneous techniques.

The ball remover (BR) according to the invention generally comprises the following in order to secure the k-wire (4), which is passed through the bone for fastening the fractured bones, from two sides of the bone {k-wire (4) inlet and k-wire (4) outlet), and to allow loosening the wire retainers (R) located on bone surface to that end via percutaneous technique;

- a body (2) suited for passing through the working cannula (C),

- a formed tip (1 ) which is in convex form so as to make the balls mobilize by performing a slight rotational movement; has a form in accordance with the sizes of the balls inside the wire retainer (R); and is thin enough (forming a sharp edge (1.1 )) to get between the contacting portions of the balls with the k-wire (4); and

- a holding part (3) which allows guiding the ball remover (BR) manually.

Since the dimensions of 'A wire retainer" are equal to the size of screw heads, the retainer (R) occupies less space compared to the plates located onto the broken bones and the problem of feeling the retainer (R) under the skin with hand is less experienced. Because the compression force provided by threads in screws requires attachment to the bone marrow; the usage thereof causes difficulties in patients with low bone quality. However, as "A wire retainer" provides attachment over the bone cortex, it provides very important advantages in terms of use in patients with low bone quality, e.g. patients with osteoporosis. Since cortical attachment is provided by "A wire retainer', the problem of dislocation of retainers (R) is eliminated. While the k-wire (4) is being removed after fracture treatment, the retainer (R), and hence the k-wire (4), can be taken out by means of a magnetic apparatus via percutaneous techniques. The retainer (R) is removed by means of the magnetic apparatus as below;

• A small incision is made to reach the retainer (R). The working cannula (C) is placed on the retainer (R). The gripper and the squeezing apparatus are placed on the retainer (R) by passing through the working cannula (C). While the gripper is held siili, the squeezing apparatus is rotated counterclockwise, thereby loosening the retainer (R) gently. Gripper and squeezing apparatus are removed. The magnetic apparatus is made to pass through the working cannula (C) in a way to get closer to the retainer (R). The retainer (R) is pushed gently by means of the magnetic apparatus. The retainer (R) is taken out of the tissue at tip of the magnetic apparatus.

However, for a variety of reasons, the magnetic apparatus might fail to move the bails inside the wire retainer (R) during surgery, in this case:

♦ The working cannula (C) is placed again. While the gripper is held still inside the working cannula (C), the squeezing apparatus is placed in the upper part (5) . The squeezing apparatus is rotated counterclockwise and the upper part (5) is taken fully out of the tissue. The gripper is removed. The magnetic apparatus is made to pass through the working cannula (C) and the retainer (R) is pushed. The magnetic apparatus is made closer again in order to remove the balls inside the retainer (R) from the tissue, in case of failing again while the bails are being removed, the balls are mobilized by means of the ball remover (BR) according to the invention, which is also passed through the working cannula. The balls are loosened in a way to be withdrawn by the magnetic apparatus and the magnetic apparatus is applied once more. This process continues until all the balls are removed from the tissue.

The damage to the bone and surrounding soft tissue is minimized by way of using the bali remover (BR) during removal of the wire retainers (R) after fracture treatment. Subsequent to removal of the wire retainer (R), k-wires (4) can also be removed in a much easier way again via percutaneous techniques.

The ball remover (BR), thanks to its body (2) suited for the working cannula (C), reaches the balls inside the lower part (6) by means of percutaneous technique. Manual guiding of the ball remover (BR) is possible by means of the holding part (3).

When the upper part (5) of the wire retainer (R) is opened and introduced among the balls inside the ball remover (BR), the sharp edge (1.1 ) of the formed tip (1) which is formed in accordance with the dimensions of the wire retainer (R) moves ferromagnetic balls of the wire retainer (R) disclosed in the Application No. 2010/05662, thereby allowing the magnetic apparatus to be used subsequently to easily withdraw these balls. in an alternative embodiment of the invention,

The tip (1) of the invention can have different shapes, varieties and dimensions in accordance with the dimension and shape of the wire retainer (R). The transverse section of the body (2) according io the invention may have a shape other than cylinder (such as hexagonal, rectangle) and a different length. The holding part (3) of the invention may be "T", "L", "C" shaped or may have another shape.

Claims

1. A ball remover (BR) which moves the balls inside the retainer (R) subsequent to removing the upper part (5) of the wire retainer (R) from the tissue, in order to enable the wire retainers (R)

5 developed for the k-wires (4) used for fastening and treating the fractured bones by being passed through the bones, to be removed out of the tissue from where they are after reduction of the fractures, characterized in comprising in a body (2) suited for passing through a work ing cannula (5) forming a hollow working corridor from outside the tissue to the retainer (RV.

- a tip part (1) having a form suitable for the sizes of the balls inside the wire retainer (R) ; and i o - a holding part (3) which allows the ball remover (BR) to be guided manually.

2. The ball remover (BR) according to Claim 1 , characterized in that, in order to mobilize the balls, said formed tip (1)

- has a convex form and

- has a sharp edge (1.1) thin enough to get into the contacting portions of the balls with the k- 15 wire (4).

3. The ball remover (BR) according to Claim 1 , characterized in that said body (2) has a cylindrical form. 0