WO2016144271A1

WO2016144271A1 - An inner gripper for the lower part of the wire retainers

Info

Publication number: WO2016144271A1
Application number: PCT/TR2015/000093
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 an inner gripper (IG) having a threaded tip part, which allows a wire retainer (R) lower part (5), remaining on the bone surface, to be gripped and removed subsequent to removing the retainer upper part and the balls inside said retainer out of the tissue, during the removal of the wire retainers.

Description

AN INNER GRIPPER FOR THE LOWER PART OF THE WIRE RETAINERS

DESCRIPTION TECHNICAL FIELD

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

The invention is particularly related to an inner gripper which allows the retainer lower part remaining on the bone surface to be gripped and removed subsequent to removing the retainer upper part and the balls inside said retainer, during the removal of the wire retainers. STATE OF THE ART

Techniques developed for surgical treatment of fractures so far are Kirschner wire (k-wire) . screw, plate-screw, intramedullary nail and external fastening The purpose of such techniques is to hold the fractured bone pieces in the desired position until fracture heaiing. 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 small 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 piate 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. An inner gripper has been developed for allowing the removal of this wire retainer, or of the k-wire along with the wire retainer, out of the tissue after being used in fastening the fractured bones.

OBJECTS OF THE INVENTION

The main object of the invention is to provide an apparatus that grips and removes the lower part of the wire retainer remaining on the bone surface out of the tissue after the upper part thereof is removed by means of the squeezing apparatus and the balls therein are removed by means of the magnetic 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 will 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 overall view of the inner gripper according to the invention.

Fig. 2 is the detailed/close-up view of the formed tip of the inner gripper according to the invention which is connected to the retainer.

Fig. 3 is the overall view of the wire retainer in an alternative embodiment where the upper part is male and the lower part is female.

Fig. 4 is the view of the use of inner gripper according to the invention along with the working cannula.

Fig. 5 shows the views of the lower part and upper part of the wire retainer, said lower part being produced in threaded form and upper part being connected with the squeezing apparatus, in an alternative embodiment where the upper part is male and the lower part is female.

DESCRIPTION OF THE REFERENCES

IG. Inner Gripper

R. Retainer

G. Gripper

C. Working Cannula

S. Squeezing Apparatus

1. Threaded Tip

2. Body

3. Holding Part

4. Upper Part

5. 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 inner gripper (IG) according to the invention are described only for a better understanding of the subject matter.

The applications of the working cannula, magnetic apparatus, gripper, ball remover, 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 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-locks 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 bail remover is an apparatus which is used for mobilizing the bails inside the retainer (R). it has a formed tip which is in convex form from the body to the tip: has a form in accordance with the sizes of the balls inside the wire retainer (R); and is thin (sharp) enough to get between the contacting portions of the balls with the k-wire. 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. The inner gripper (IG) according to the invention allows the removal of the retainer (R) according to the Application No 2010/05662 via percutaneous techniques.

The inner gripper (IG) according to the invention is in general an apparatus which, in order for the k-wire to be removed via percutaneous techniques, loosens and removes the lower part (5) of the wire retainer (R) remaining on the bone surface out of the tissue via percutaneous technique, the balls and upper part (4) of said wire retainer having been removed previously, wherein said inner gripper comprises a body (2) sized in a way to pass through the gripper (G),

• a tip part (1) which, in order to be placed into the Iower part (5) of the wire retainer (R), is sized in accordance with the inner diameter of the Iower part (5) and is of a threaded configuration that is suited for the dimensions of the threads in the inner surface of the Iower part (5), and

* a holding part (4) which allows manual guiding.

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 is being removed after fracture treatment, the retainer (R), and hence the k-wire, 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 (G) and the squeezing apparatus are placed on the retainer (R) by passing through the working cannula (C). While the gripper (G) is held still, the squeezing apparatus is rotated counterclockwise, thereby loosening the retainer (R) gently. The gripper (G) and squeezing apparatus are removed. The magnetic apparatus is made to pass through the working cannuia (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 balls inside the wire retainer (R) during surgery, !n this case:

• The working cannula (C) is placed again. While the gripper (G) Is held still inside the working cannula (C), the squeezing apparatus is placed in the upper part (4) of the wire retainer. The squeezing apparatus is rotated counterclockwise and the upper part (4) of the retainer (R) is taken fully out of the tissue. The gripper (G) is removed.

The magnetic apparatus is made to pass through the working cannula (C) and the retainer (R) is pushed. The balls inside the retainer (R) are removed out of the tissue together with the magnetic apparatus. (In case of failing while the balls are being removed, the balls are mobilized by means of the ball remover passed through the working cannula and the magnetic apparatus is applied once more. This process continues until ail the balls are removed out of the tissue.)

• When the balls are taken out of the tissue, the gripper (G) and the inner gripper (iG) are passed through the working cannuia. The tip part ( f } is connected into the lower part (5). The inner gripper (IG) is rotated clockwise such that the gripper (G) will remain stable, and thus the retainer lower part (5) is gripped and removed with the gripper (G).

The inner gripper (IG) according to the invention has been developed in order for the lower part (5) of the wire retainer (R) to be gripped and removed subsequent to the removal of the bails inside the wire retainer (R).

After the removal of the wire holder (R), the k-wire may also be removed in a much easier way by percutaneous techniques.

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 to 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

An inner gripper (IG) which removes the retainer (R) lower part (5) remaining on bone surface out of the tissue by means of percutaneous technique after the upper part (4) of the wire retainers (R) and the balls inside the retainers (R) are taken out of the tissue in order to enable the wire retainers (R) 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 the following in a body (2) suited for passing through the gripper (G) such that it will be possible to work inside a gripper (G) passing through a working cannula (C) forming a working corridor from outside the tissue to the retainer (R) while the retainer (R) lower part (5) is being accessed and the lower part (5) is being taken out of the tissue;

• a tip part (1) which, in order to be placed into the lower part (5) of the wire retainer (R), is sized in accordance with the inner diameter of the lower part (5) and is of a threaded configuration that is suited for the dimensions of the threads in the inner surface of the lower part (5), and

• a holding part (3) which allows the inner gripper (IG) to be directed manually.

The inner gripper (IG) according to Claim 1 , characterized in that said body (2) has a cylindrical form.