Method for transporting a bone segment in order to bridge a bone

Details Method for transporting a bone segment in order to bridge a bone Method for transporting a bone segment in order to bridge a bone

1999-01-18

2000-05-02

Buiz, Michael

Surgery

Instruments

Orthopedic instrumentation

606 62, 606 63, A61F 500

Patent

active

060567554

DESCRIPTION:

BRIEF SUMMARY
BACKGROUND OF THE INVENTION

1. Field of the Invention
The invention relates to a method of the generic type described in the preamble of claim 1.
2. Description of Related Art
In accident surgery and orthopedic practice, it is often necessary to bridge bone defects on long tubular bones. Such operations involve the creation of new bone tissue by displacing a preserved bone segment along the long tubular bone, essentially by means of the osteogenic power of the periosteum.
Segment displacement is a tried and tested method which has been known for a long time. Currently, the force required to transport the segment is generally produced extracorporeally by means of so-called Fixateur externe systems (external tensioners) or, using the most recent developments, in a fully implanted manner by means of an electric motor which is positioned intracorporeally and an intramedullary implant (medullary nail). A further method uses a rotational principle (tube inside tube) in conjunction with a ratchet in order to introduce its force, but this method can only be used to extend tubular bones. All of the known techniques to date have drawbacks, some of which are considerable, for the patient, such as the risk of infection when external tensioners are used, uncomfortable handling and long periods of inpatient treatment.
Furthermore, as in the case of the implant with an electric motor which cannot be re-used, disproportionately high cost are incurred.


SUMMARY OF THE INVENTION

The object of the invention is to develop an alternative method for transporting a bone segment with devices and which are fully implanted, which can be self operated, i.e. without external aid, by the patient him/herself and avoids the drawbacks mentioned above.
The object is achieved by means of a method as described in the defining part of claim 1. The fundamental novelty of the method according to the invention is the inclusion of the joint adjoining the damaged tubular bone. To drive the bone segment, the method uses the tensile force which is generated during the flexural movement of the two bones which are articulated at the joint and which is converted into a translational movement of a traction cord which engages on the healthy bone, spans the condyles and the joint outside the joint pivot point, is guided inside the medullary nail in the medullary cavity of the defective bone and acts directly or indirectly on the segment which is to be moved. The cord can be tensioned in a self-inductive manner by the patient. There is no need for any external power source, and a simple, inexpensive device is sufficient. The patient can control the procedure without help from a physician. Passive movement is also possible if the patient is unable to carry out the active movement him/herself.
The device is fully implanted and does not include any extracorporeal components. The method may be used at the knee joint and at the elbow joint. A precondition for its use is that there be sufficient joint mobility with regard to flexion/extension.
A drive which directly transmits the tensile force from the bent healthy bone of the joint to the segment and converts the translational movement of the traction cord into an axial displacement of the segment is proposed as a further development of the method according to the invention.
A device for carrying out the method according to the invention has a traction cord or similar traction element, bone end of the traction cord can be attached to the healthy bone of the joint by means of an anchor and the other end can be connected to the bone segment in such a manner that it is possible, by means of a flexural movement of the healthy bone relative to the defective bone, to transmit a tensile force and a translational movement from the anchor to the bone segment.


BRIEF DESCRIPTION OF THE DRAWINGS

Further details of the invention can be found in the appended drawings, in which:
FIG. 1 shows a section through a device according to the invention, along the longitudinal axis of the bone, based on the example of a defecti

REFERENCES:
patent: 4862883 (1989-09-01), Freeland
patent: 5356411 (1994-10-01), Spievack
patent: 5505733 (1996-04-01), Justin et al.
patent: 5855579 (1999-01-01), James et al.

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