US2500993A - Fracture fixation device - Google Patents

Description

web 21, 1950 c, MASQN FRACTURE FIXATION DEVICE Filed March '7, 1945 I INVENTQR. C

asropk/se ATTORNEY.

Patented Mar. 21, 1950 UNITED STATES PATENT OFFICE 2,500,993 FRACTURE FIXATION DEVICE Christopher Mason, Los Angeles, Calif. Application March 7, 1945, Serial No. 581,402

This invention relates to the fixation of fractures of the intertrochanteric and subtrochanteric regions of the femur bone and particularly the femur neck, and contemplates more specifically to provide simple, effective and sure means An object of this invention is to provide means of the character indicated which may be set into fixation position without the need for special tools for insertion or removal.

' Another object is to provide internal fixation means for the purpose indicated which permits of insertion into position by merely tapping into place, and removal without the need of special tools.

A further object is to provide a device of the indicated type which may be caused to assume a suitable position whereby the portions thereof engaged with both the neck and the proximal fragment of a fractured femur, for instance, are held in suitable fixation.

This invention possesses many other advantages and has other objects which may be made more easily apparent from a consideration of several embodiments of the invention.' For this purpose there are shown two forms in the drawings accompanying and forming part of the pres ent specification. These forms will now be described in detail, illustrating the general principles of the invention; but it is to be understood that this detailed description is not to be taken in a limiting sense, since the scope of the invention is best defined by the appended claims.

Referring to the drawings:

Figure 1 is a semi-diagrammatic front view showing an application of a fracture fixation device according to the present invention;

Figure 2 is a similar side view thereof;

Figure 3 is an enlarged side view taken as indicated by line 3-3 of Figure 2; v

Figure 4 is a side view of a fracture fixation device embodying the present invention;

Figure 5 is a plan view thereof;

Figure 6 is a fragmentary detail sectional view showing hinge means employed in the invention, in one position thereof;

2 Claims. (01. 12892) Figure 7 is a similar view of said hinge means in another position; and,

Figures 8 and 9 are cross sectional detail views astaken on the respective lines 88 and 99 of Figure 4.

As an example of application of the invention,

. a human femur is illustrated as providing the means of application of the preferred embodiment of the fracture fixation device.

As shown; the femur comprises a shank H], a trochanter H, a neck l2, and a head 13. As well understood, the femur, in the manner of bone structure, has a relatively hard bony cortex surrounding a relatively soft, spongy and cellular structure. Also, the spongy interior of the. femur "varies in density, being most dense in the interior of the femur head. The foregoing known structure of the femur has been set forth for the purpose of more clearly demonstrating the manner in which the invention utilizes and takes advantage ofthe femur structure in order to provide safe, sure and efficacious fixation of a fracture thereof.

Also, as shown in Figure 3, the femur may be fractured at one 0r' more of the points I4, (5 and [6, the present device being applicable to all of these'fracture points by varying the lengths of the nail and/or plate portions.

The herein contemplated device preferably comprises a member 20, herein termed a nail, a second member 2|, herein termed a plate, and preferably includes means such as a hinge or pivot pin 22 whereby said nail and plate ma have relative articulation.

The nail 20, of the present embodiment, is V-shaped in cross-section, as best seen in Figure 8, comprising the sides 23 arranged substantially at right angles. This form of section of the nail is preferred to obviate rotation or twistof the nail when being inserted into the spongy parts of a bone. One end of said nail is preferably sharpened as at 24 and the other end formed with the sides 23 in folded parallel relation as at 25 for connection with the pivot pin 22. The nail, at the pivot end, is also preferably provided with an angled edge 26 affording the stop points 2! and 28. The plate 2! is preferably of arcuate cross section as seen best in Figure 9, and the end thereof,

connected to the nail 20 by pivot pin 22, may be arranged to provide parallel walls 29 engaged over end 25 of said nail, both the nail end 25 and the walls 29 having aligned holes for the hinge or pivot pin 22.

It will be noted that the V-section of the nail and the curved section of the plate are oppositely disposed (see Figure 5) and that, with the nail and plate in aligned straight position, the stop point 2'! of the nail abuts the extreme end 30 of the plate and that, in this straight condition of the parts, the pivot 22 is on the opposite side of a line 3! drawn between the free ends of the nail and plate from the stop points 2! and 30. It becomes evident then, that pressure or force applied to the end 32 of the plate, as by means of a hammer-or'mallet, will be transmitted directlyito the sharpened end 24 of the nail to force ordrive the same into a mass of the consistency of a bone interior. Thus, in its straight condition, the 'device may be applied as intended.

As may be seen from the drawing, limited articulation between the nail 20 and plate #2! is airorded. The limit of the included obtuse angle is in the nature of 130 to 135 in accordance with the norminal angle between the neckzandshank of a femur. The stop point 23, adapted to en- Igage the plate at-a point between its end 32 and the point 36 is provided to limitrelative movementof the parts in that direction.

The plate 1i may be provided with aplurality of holes such as shown at 33.

Assuming that fixation of a fracture of the iemuratany of the points M, [5 or 16 isdesired, :a flesh incision is made to give access to the affected femoral parts. A .hole, approximately one-half inch in diameter, is then drilled or chiseled through the cortex of the femur :helow the greater trochanter and in the line -.of-direction-of the femoral'neck and head. The fracture is reduced with the femur :held in suitable .Iiexion and neutral rotation. The sharpiend 24 5- 'of thenail ZBisthen inserted in the ,driiledihole and-eitherprmsedzor tapped into the-spongyin- ,terior of the femoral neck and then into the denser interior of the femoral head;- ;As this phase of the operation proceedathe properangular and rotational disposition of the nail'maybe checked and ascertained by, .from time to time, swinging the plate 2| on the pivot pin--22 to check its ultimate disposition with respect to .theproximal portion of the femur. After the nail iisxin position and firml inserted into the dense interior of the femoral head, the plate-2i is "swung down on its pivot -22 to engage against distalgportions of the femur. And finally, screws, such as 34 may be employed for securing the plate in position, care being taken that these screws are suificiently .long to pass completely from side to side of the femur cortex to afiord firmanchorage therein. The incision is thenclosed andidressed.

After the necessary bone knitting period, the

fixation device may be removed by simply .ex-

tracting the screws 34 and exerting .a pull on the plate 2|, which may be first swung into alignment with the nail .portion .23. This vcanoe done with .pliers or by inserting .an instrument in one of the holes 33 and pulling or tapping the device clear of the femur. When in extended position, the plate serves conveniently as a handle by which the device may be grasped and the nail portion pulled from the bone.

I claim:

1. A fracture fixation device comprising a nail part, a plate part and a pivot connecting said parts, said nail part having a sharpened end porztion, said'- ,plate 'part having -,a' force application point, andcoacting portions of said parts adjacent said pivot for maintaining said parts in a straight line arrangement, the pivot and portions being ,positioned so that a straight line connecting the'sharpened portion and the force applying 1-point apasseszbetween said coacting portions and said pivot.

"2. A'fracture' fixation device comprising a nail part,:ia;:-,plate part, and a pivot connecting said parts, said nail part having a sharpened end por- .tion, said plate ,part having ,a force application point, and coactingportions of said parts serving ptollimitipivotal movement of said parts in one jtioniirom said ,onedirection to assume an angu- .lar relation enabling .the device to .be attached forffixation.

"CHRISTOPHER MASON.

REFERENCES CITED The following references are of record .in the file of this patent:

UNITED STATES PATENTS Number Name Date "817,785 ,Kritsch .Apr. 17, 1906 13375817 Bode Apr. 20, 1920 "2,235,319 Callahan et a1 'Mar. '18, 1941 OTHER .REFERENCES -Blount,'W. P., Blade-Plate Internal Fixation for High'FemoralOsteotomies, The Journal of Bone and Joint Surgery, Apr. l943, page 322.

Jewett, Eugene L., One-Piece Angle Nail for Trochanteric Fractures, The Journal of Bone and Joint Surgery, Oct. 1941,'pp. 803-910 (see pages 807-808) Moore, A.'T., The Journal of Bone and Joint Surgery, Jan. 1944, p. 54.

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