Surgery – Instruments – Orthopedic instrumentation
Patent
1995-10-16
1998-08-04
Tucker, Guy V.
Surgery
Instruments
Orthopedic instrumentation
606142, A61B 1768
Patent
active
057886989
DESCRIPTION:
BRIEF SUMMARY
This application is filed under 35 USC 371 based on PCT/FR94/00433 which was filed on Apr. 18, 1994.
FIELD OF THE INVENTION
The present invention relates to an osteosynthesis clip adapted to secure the site of a fracture or osteotomy for its consolidation, as well as an ancillary material for emplacement of such a clip.
BACKGROUND OF THE INVENTION
Different osteosynthesis clips are known. There could be cited for example the clip described in FR-A-2.668.361, which is formed of a martensitic thermo-elastic alloy with shape memory. It comprises two legs, adapted to be inserted forcibly on opposite sides of the site of the fracture of the bone to be repaired, and a connecting base. The legs are trained to come together under the influence of temperature above the austenitic transformation temperature and the connecting base is trained to pass from rectilinear shape at a temperature lower than the martensitic transformation temperature, to a wavy shape giving rise to a shortening of its length, at a temperature higher than the austenitic transformation temperature. Such a clip has dynamic and auto-retention characteristics. However it does not permit adjusting precisely the position of the two bone fragments to be stabilized because the operator is not master of the shape transformation of this clip and cannot make tests with the clip before its use, which is to say before it has its final shape.
There is also known, from FR-A-2.562.416 (U.S. Pat. No. 4.848.328), an osteosynthesis clip constituted by a core to which are connected two lateral legs. The core comprises two parts inclined toward each other at an outwardly opening obtuse angle. The legs are divergent. The legs and the core have a square or rectangular cross section. Each of the legs comprises, on its internal surface, a succession of projections or saw teeth forming an anti-return device. Wings are provided on the frontal surfaces of each leg of the clip. Each of the legs terminates at its distal end in a bevel delimited by the outwardly opening surfaces in FR-A-2.562.416 and inwardly opening in U.S. Pat. No. 4.848.328. This clip is adapted essentially to secure the site of an osteotomy pending the consolidation of the latter, below the tibial plate. Such a clip, whose legs diverge, however does not permit good compression of the osteotomy site. On the contrary, it preferentially produces a distension, which is to say a spacing of the two bone fragments to be stabilized, because the memory of the metal tends to create a spacing.
For carpal scaphoidal fractures, there are known so-called Kirschner clips, which give mediocre stability and which are the object of frequent migration, the source of cutaneous irritation and tolerance problems. There are also known screws, which are difficult to emplace and which can give rise to a poor grip along a scaphoidal proximal pole of poor quality, particularly of the Schernberg II type. There are also known Herbert screws, but they have, in addition to the drawbacks recited above, the major defect of passing through a fundamental articulation of the first column which is the trapezial scapho articulation. As to clips of the Warner type available on the market, they are insufficient to bridge a loss of material from pseudoarthrosis and do not lock against the rotation of bone fragments.
There has also been proposed (SU-A-1.463.268) an osteosynthesis clip constituted by an elastic element of U-shape, with converging legs and a curved connection element on the arc of a circle whose center is the point of convergence of the legs. The angle of the legs is comprised between 30 and 900. These legs have external teeth. The emplacement of such a clip is extremely delicate because the legs must be resiliently spaced so as to be disposed in the recesses previously formed at an angle less than the angle of the legs. The compression supplied is very uncertain and it depends on the prestress supplied by the preliminary spacing of the legs. Moreover, the connecting element is not at all adapted to the morphology of the f
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