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Publication numberUS2243717 A
Publication typeGrant
Publication dateMay 27, 1941
Filing dateNov 2, 1938
Priority dateSep 20, 1938
Publication numberUS 2243717 A, US 2243717A, US-A-2243717, US2243717 A, US2243717A
InventorsGodoy Moreira Franciseo Elias
Original AssigneeGodoy Moreira Franciseo Elias
Export CitationBiBTeX, EndNote, RefMan
External Links: USPTO, USPTO Assignment, Espacenet
Surgical device
US 2243717 A
Images(1)
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Description  (OCR text may contain errors)

May 27, 1941.

F. E DE G. MORI-:IRA

SURGICAL DEVICE Filed Nov. 2, 1958 was.: HA

wm wk ATTORNEY.

Patented May 27, 1941 UNI/'TED sTA'srATENT OFFICE SURGICAL DEVICE Francisco Elias de Godoy Moreira, Sao Paulo,

. Brazil Application November, 1938, Serial No. 238,404 In Brazil September 20, 1938 :icl/aims."

My invention relates to surgical instruments and more particularly to an apparatus for treating bone fractures.

The fracture of some bones in the body, particularly in older people, is very often unresponsive to treatment that involves merely reducing the fracture and maintaining it thus for some time in anticipation of the bonesknitting. In addition to merely maintaining the broken parts in proper contact, it is often necessary and even essential that the parts be brought into extremely intimate contact by the application of pressure. The femur, or hip bone, is the most prominent member of the class of bones abovementioned and -the present application will concern itself chiefly with the fracture of the neck of the femurand its treatment by the application of pressure to draw the head of the femur toward the trochanter r'upper'portion of the shaft, and to maintain it''xed in its proper position.

One of the objects of my invention is to provide a novel type of xing member, in the form of a screw particularly adaptable for the treatment of the condition above outlined.

Another object of my invention is to provide in combination with such a screw, a novel form oi' nut and clamp to contribute to the firm grip of the screw in the bone and to prevent displacement of the screw when the nut and clamp are tightened thereon.

Another object of my invention is to provide a wrench for driving the screw into the bone, the wrench being such that the disengaging of the wrench from the screw is not attended by the displacement of the screw from its bed.

Other objects of my invention will be obvious from the following description it being understood that the above general statement of the objects of my invention is intended to explain and not to limit it in any manner.

Fig. 1 is a side view, partly in section illustrating the action of the wrench.

Fig. 2 is a side view of the bone screw as it appears at the completion of the operation.

Fig. 3 is alongitudinal section through the screw, clamp and nut vin the relation shown in Fig. 4 is a section on line I-I of Fig. 1.

Fig. 7 is a side view of the nut partly broken l away.

Fig. 8 is a side view of the clamp partly broken away.

In the drawing I0 represents a guide wire,

known in the art as a Kirschner Wire, which guide wire is located in the bore II of inner wrench member I2. The inner wrench I2 is formed with a shoulder I3 a short distance from its end and is internally threaded along its neck I4. e

The outer wrench member I5 is formed with a longitudinal bore I6 which is adapted to house the inner wrench I2 as shown in Fig. 1. The outer Wrench I5 has a shoulder I1 formed near its end and has a slot I8 formed in its neck I9. The neck I9 is internally threaded along a portion thereof to accommodate the externally threaded end portion 20 of the bone screw S.

The bone screw S comprises the threaded end 20, the square shaft 2|, the round shaft 22 and the screw portion 23. The screw portion 23 is formed of threads of very high pitch as shown and which are almost razor-sharp, the said threads being specially and individually sharpened after the screw has been formed by the usual machine methods. The bone-screw S is likewise provided with a longitudinal bore 24 to accommodate the guide wire l0.

As shown in Fig. 2 and Fig. 8 the clamp 25 is formed with a head 26 and skirt 2l. The head 26 is somewhat rounded and obliquely disposed in relation to the skirt 2l in order to conform to the contour of the periphery of the shaft but it may be shaped so as to fit other portions of the trochanter or shaft depending on where the bone screw has been inserted, and the bone contour peculiar to the patient being operated on. The skirt 2l is turned in at the base of the clamp to form the flange 28. The bore 29 accommodates the threaded end 20 of the bone screw which in turn houses a portion of the guide wire I0.

'I'he nut 30 comprises a head 3| internally threaded shank 32. I t as in Fig. 3, that the shank 32 is slightly longer than the skirt- 21 of clamp 25 so that pressure is exerted on the clamp without the necessity of contact withl the head 26 thereof, the shank 32 bearing against the flange 28. 'It will also be noted in Fig. 3 that the periphery of shank 32 is slightly spaced from the inner periphery of cirt 2l when theparts are in assembled rela- My invention is practiced in the following manner:

After anesthesia and the incision having been made `in the body of -the patient being operated upon, the femur is exposed, the fracture having and a hollow, will be noted,

been previously reduced by suitable means well known in the art.

After determining the site that the bone screw will occupy depending on the location of fracture and other facts which are known to the surgeon, the guide or Kirschner wire I is introduced thereat and inserted into the shaft, through the center of the neck and into the head or ball of the femur. This practice is standard and requires no explanation of its procedure. When the guide wire Ill #has been thus inserted it should be tapped with a mallet so as to firmly lodge it in the spongy bone of the head of the femur.

A drill having a longitudinal bore formed therethrough is introduced over the guide wire and the channel for receiving the bone screw is drilled through the femur, the channel being shaped according to the particular parts of the bone screw S which will thereafter occupy it. A drill driven by an electric motor is utilized for this purpose. Neither the drill nor the motor is shown or claimed herein, comprising as they do the subject of a separate application.

The threaded end 20 of the bone screw is inserted in the neck I of the outer wrench I5 and given a few turns in the threaded portion thereof so that about A inch of the bone screw is visible through the slot I8. The inner wrench I2 is then inserted into the bore I6 of wrench I5 and being turned clockwise is caused to engage the threaded end 20 by its neck Il. When this has been accomplished, the turning of the inner wrench I2 will cause it to proceed along the threaded end 20 as a. follower proceeds upon a rotating screw. This action, however, can only occur until the shoulder I3 of inner wrench I2 meets the shoulder I1 of outer wrench I5. At this point, the inner wrench I2 can travel no further so that further turning tends to draw the bone-screw up into the inner wrench. However, this action is resisted by the grip that the internally threaded neck I9 maintains on the threaded portion 20 of the screw. As a result, the bone-screw is locked in the wrench members which only now functions as a. true wrench, that is, there is no relative movement between the wrench members and the scew. This condition must remain as long as the shoulder I3 abuts the shoulder I1.

Scr'ew portion 23 of the lbone-screw S is then inserted over the guide wire I0 and into the channel formed by the drill and when it reaches the head of the femur, it is driven home, the sharp threads and high pitched threads thereof biting into the spongy bone and anchoring the bonescrew thereat. As shown in-Fig. 1, the neck I9 of the outer wrench member I5 may be caused to enter the channel formed in the femur and the slot I8 is effective to apprise the surgeon as to the distance that the bone-screw S has been driven into the femur.

I have found that a frequent cause of post-operative failure of the fixing member has been due to the displacement of the screw which attends the disengagement of the wrench. Similarly, such a force is instrumental in moving the head or ball of theV femur and destroying the reduction th'eretofore accomplished, Of course, if a slotted screw is used, this cannot occur but a. slotted screw is inferior to one that is provided with a nut and clamp. When a threaded lug wrench is used,as is preferable, the screw or lug has a tendency to turn in its seat unless it is very firmly anchored and usually the more firmly anchored that it is, the tighter is the grip maintained by the wrench so that the force used in disengaging it, either loosens the screw, or, as is more probable, causes the head of the femur to turn, whereby the reduction is impaired.

In my invention, however, as noted above, the bone-screw is constrained to turn with the wrench members only because of the resistance of the internally threaded neck of the outer Wrench member I5 to the pull exercised on the bone-screw by the inner wrench member I2. When, therefore. the inner wrench I2 is turned counter-clockwise, there is practically no similar force exerted on the bone-screw except a very slight force necessary to cause the shoulders of the wrench members to separate. However, it is so slight as to have no effect on the bonescrew. When the shoulders have been separated and the neck I4 has been disengaged from the threaded portion 20, the outer wrench member I5 is most easily disengaged from the bone-screw, since only the pull of the bone-screw occasioned by the meeting of the shoulders created any resistance to relative movement. The pull no longer being present, the disengagement is most easily effected.

'Ihe bone-screw S is now firmly anchored in the head or ball of thefemur and the proper re atively small portion of the screw, this feature being important in that fractures in different parts of the neck of the femur can be accommodated since the said threads should not traverse the point of fracture. The very sharp and high-pitched threads are peculiarly adaptable to the spongy bone found in the head of the femur and thus compensate for the shortness of the length of said screw threaded portion.

'I'he guide wire I0 is now withdrawn and the clamp 25 is applied to the threaded end 20 of the bone-screw S. I prefer to supply various types of clamps 25 so that the heads 2G thereof can conform to the contour of the periphery of the bone.

For example, were the screw to be inserted at the base of the trochanter, the head 26 would be set at the proper angle in relation to the skirt 21.

The nut 30 is caused to engage the threaded end 25 and it will be noted that should the bonescrew be slightly short it can nevertheless be engaged by the shank 32.

Referring to Fig. 2, the head 26 of the clamp 25 does not lie in a plane parallel to that of the head 3| of nut 30 dueto the angular disposition of the head 26. It is obvious therefore that were the nut 30 tightened by causing it to bear against the head 25, such pressure would be concentrated on one point on the periphery of the head 26, requiring great force to tighten it, nsuch force having a tendency to turn the bone-screw in the direction taken by the nut 30. The'dangers ofl such turning have been hereinbefore pointed out. It will be noted. however, in the present construction, that the heads of the nut and clamp cannot.

come intccontact since the shank 32 of the nut 3Ii, whenscevgeg down, meets the flange 2B of clamp 25 `flush ,ailthe nut can no longer descend relative to the clamp.` Thus the pressure of tightening on the clamp 25 is uniform. While this process is referred to as tightening the nut" in effect the net result is to draw the fractured parts into closer contact so that healing is expedited.

The space between the outer periphery of the shank 32 and the inner periphery of the clamp 25 is effective in permitting the clamp 25 to be held otherwise than perfectly parallel with the bone-screw so that the clamp 25 can conform to slight irregularities in the channel drilled for the bone-screw without creating a pressure against said bone-screw.

Should it ever be necessary to remove the bonescrew and if the threaded end 20 of the bonescrew S has become stripped due to diierent conditions existing in the bone, such removal would be practically impossible and for that reason I have provided the square shaft portion 2| which can be engaged by a wrench. The bone-screw is preferably of a high quality stainless steel.

I have shown a preferred embodiment of my invention but it is obvious that numerous changes and omissions may be made Without departing from its spirit.

I claim:

1. The combination with a bone-screw of a clamp and nut, said clamp having a ange formed thereon, said nut hiaving a depending shank adapted to bear against the ange of said clamp.

2. The combination with a bone-screw, of a clamp having a shoulder and a skirt formed integral therewith, a flange formed on said skirt,

a nut having a head and a'depending shank, said shank being longer than said skirt of said clamp, said shank being adaptedto bear against said ange of said skirt when the parts are in assembled and operative relation, whereby the shoulder of said clamp and the head of said shank are maintained spaced from each other..

3. 'I'he combination with a bone-screw, of a clamp having a depending skirt, a flange formed on said skirt, anut having a depending shank adapted to bear against said flange, the outer di-l ameter of said shank being less than the inner diameter of said skirt whereby said nut may have relative lateral movement in respect to said clamp when the parts are being assembled.

FRANCISCO ELIAS DE GODOY MOREIRA.

Referenced by
Citing PatentFiling datePublication dateApplicantTitle
US2526959 *Jul 1, 1947Oct 24, 1950Lorenzo Frank AFracture reduction apparatus
US2612159 *Mar 1, 1949Sep 30, 1952Marie B CollisonTrochanteric plate for bone surgery
US2621653 *Apr 29, 1949Dec 16, 1952Henry BriggsFracture reducing device
US3051169 *Dec 5, 1958Aug 28, 1962Stille Werner AbSurgical screw connector
US3678925 *Oct 1, 1970Jul 25, 1972Artur FischerConnector for fractured bones
US3716051 *Sep 8, 1971Feb 13, 1973Fischer ArturExpandible connector for fractured bones
US3760802 *Feb 18, 1972Sep 25, 1973Fischer ArturSupporting device for fractured tubular bones
US3805775 *Sep 16, 1971Apr 23, 1974Fischer ArturExpanding bone connector
US3990438 *Apr 21, 1975Nov 9, 1976Pritchard Rowland WBone fracture fixation and compression apparatus
US4530355 *Jan 18, 1982Jul 23, 1985Richards Manufacturing Co., Inc.Compression screw assembly
US4616638 *Nov 28, 1984Oct 14, 1986Richards Medical CompanyCompression screw assembly
US4617922 *Nov 28, 1984Oct 21, 1986Richards Medical CompanyCompression screw assembly
US4641640 *Nov 28, 1984Feb 10, 1987Calvin GriggsCompression screw assembly
US5047030 *Jun 20, 1990Sep 10, 1991Klaus DraenertSuction drainage-bone screw
US5078718 *Apr 17, 1990Jan 7, 1992Origin Medsystems, Inc.Multi-part method and apparatus for removing pre-placed prosthetic joints and preparing for their replacement
US5152765 *Sep 3, 1991Oct 6, 1992Linvatec CorporationInserter for engaging tissue to be oriented adjacent bone
US5190551 *Dec 14, 1990Mar 2, 1993Zimmer, Inc.Controlled apparatus and method for extracting cement mantles from bone recesses
US5192282 *Sep 9, 1991Mar 9, 1993Klaus DraenertSuction drainage-bone screw
US5222957 *Apr 10, 1992Jun 29, 1993Zimmer, Inc.Method and apparatus for extracting a cement mantle from a bone recess
US5409490 *Aug 16, 1993Apr 25, 1995Depuy Inc.Shoulder separation reconstruction
US5441502 *Feb 17, 1993Aug 15, 1995Mitek Surgical Products, Inc.System and method for re-attaching soft tissue to bone
US5514138 *Feb 4, 1994May 7, 1996Pfizer Inc.Connector having a stop member
US5593410 *Mar 2, 1993Jan 14, 1997Vrespa; GiuseppeScrew device for fixing prostheses to bones
US6033407 *Jan 27, 1998Mar 7, 2000Behrens; Alfred F.Apparatus and method for intramedullary nailing and intramedullary nail therefor
US6074395 *Feb 2, 1999Jun 13, 2000Linvatec CorporationCannulated tissue anchor insertion system
US6146387 *Aug 26, 1998Nov 14, 2000Linvatec CorporationCannulated tissue anchor system
US6280448Jun 9, 2000Aug 28, 2001Linvatec CorporationCannulated tissue anchor system
US6290702Jun 9, 2000Sep 18, 2001Linvatec CorporationCannulated tissue anchor system
US6346109Jun 9, 2000Feb 12, 2002Linvatec CorporationCannulated tissue anchor system
US6361535Apr 26, 2001Mar 26, 2002Roger P. JacksonBone screw threaded plug closure with central set screw
US6379356 *Apr 26, 2000Apr 30, 2002Roger P. JacksonClosure for open ended medical implant
US6436100Aug 7, 1998Aug 20, 2002J. Lee BergerCannulated internally threaded bone screw and reduction driver device
US6730089Aug 26, 2002May 4, 2004Roger P. JacksonNested closure plug and set screw with break-off heads
US6981974Feb 4, 2003Jan 3, 2006Berger J LeeCannulated internally threaded bone screw with aperatured insert
US7153309Nov 19, 2003Dec 26, 2006Acumed LlcGuide system for bone-repair devices
US7204838Dec 20, 2004Apr 17, 2007Jackson Roger PMedical implant fastener with nested set screw and method
US7207995 *Jan 29, 2004Apr 24, 2007Biomer Manufacturing Corp.Method and apparatus for retaining a guide wire
US7578825Apr 19, 2005Aug 25, 2009Acumed LlcPlacement of fasteners into bone
US7611521 *Apr 2, 2004Nov 3, 2009Tendon Technology, Ltd.Apparatus and methods for tendon or ligament repair
US7686807 *Mar 1, 2004Mar 30, 2010Interventional Spine, Inc.Tool for bone fixation device
US7766915Sep 14, 2006Aug 3, 2010Jackson Roger PDynamic fixation assemblies with inner core and outer coil-like member
US7766917Oct 22, 2007Aug 3, 2010Stryker Trauma SaExtractor for a bone connection element
US7850699 *Apr 7, 2003Dec 14, 2010Henrik HanssonDevice for extraction of pins at fixation means for fixation of bone fragments at bone fractures
US7901437Jan 8, 2008Mar 8, 2011Jackson Roger PDynamic stabilization member with molded connection
US7938836 *Oct 25, 2005May 10, 2011Trans1, Inc.Driver assembly for simultaneous axial delivery of spinal implants
US7951170May 30, 2008May 31, 2011Jackson Roger PDynamic stabilization connecting member with pre-tensioned solid core
US8012177Jun 19, 2009Sep 6, 2011Jackson Roger PDynamic stabilization assembly with frusto-conical connection
US8066739Dec 6, 2007Nov 29, 2011Jackson Roger PTool system for dynamic spinal implants
US8092500Sep 15, 2009Jan 10, 2012Jackson Roger PDynamic stabilization connecting member with floating core, compression spacer and over-mold
US8100915Sep 4, 2009Jan 24, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8100916 *Jul 21, 2005Jan 24, 2012Depuy Spine, Inc.Instrument for inserting, adjusting and removing a surgical implant
US8105368Aug 1, 2007Jan 31, 2012Jackson Roger PDynamic stabilization connecting member with slitted core and outer sleeve
US8152810Nov 23, 2004Apr 10, 2012Jackson Roger PSpinal fixation tool set and method
US8162948Jul 22, 2008Apr 24, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8273089Sep 29, 2006Sep 25, 2012Jackson Roger PSpinal fixation tool set and method
US8292892May 13, 2009Oct 23, 2012Jackson Roger POrthopedic implant rod reduction tool set and method
US8292926Aug 17, 2007Oct 23, 2012Jackson Roger PDynamic stabilization connecting member with elastic core and outer sleeve
US8303601Jun 7, 2006Nov 6, 2012Stryker SpineCollet-activated distraction wedge inserter
US8353932Aug 20, 2008Jan 15, 2013Jackson Roger PPolyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member
US8366745Jul 1, 2009Feb 5, 2013Jackson Roger PDynamic stabilization assembly having pre-compressed spacers with differential displacements
US8377067Jan 24, 2012Feb 19, 2013Roger P. JacksonOrthopedic implant rod reduction tool set and method
US8394133Jul 23, 2010Mar 12, 2013Roger P. JacksonDynamic fixation assemblies with inner core and outer coil-like member
US8425574Feb 16, 2011Apr 23, 2013Acumed, LlcBone fixation with a bone plate attached to a fastener assembly
US8444681Apr 13, 2012May 21, 2013Roger P. JacksonPolyaxial bone anchor with pop-on shank, friction fit retainer and winged insert
US8475498Jan 3, 2008Jul 2, 2013Roger P. JacksonDynamic stabilization connecting member with cord connection
US8506599Aug 5, 2011Aug 13, 2013Roger P. JacksonDynamic stabilization assembly with frusto-conical connection
US8556938Oct 5, 2010Oct 15, 2013Roger P. JacksonPolyaxial bone anchor with non-pivotable retainer and pop-on shank, some with friction fit
US8591515Aug 26, 2009Nov 26, 2013Roger P. JacksonSpinal fixation tool set and method
US8591560Aug 2, 2012Nov 26, 2013Roger P. JacksonDynamic stabilization connecting member with elastic core and outer sleeve
US8613760Dec 14, 2011Dec 24, 2013Roger P. JacksonDynamic stabilization connecting member with slitted core and outer sleeve
US8696711Jul 30, 2012Apr 15, 2014Roger P. JacksonPolyaxial bone anchor assembly with one-piece closure, pressure insert and plastic elongate member
US8715293Mar 12, 2007May 6, 2014Biomet Manufacturing, LlcMethod and apparatus for retaining a guide wire
US8734462Mar 5, 2013May 27, 2014Si-Bone Inc.Systems and methods for the fixation or fusion of bone using compressive implants
US8778026Mar 8, 2013Jul 15, 2014Si-Bone Inc.Artificial SI joint
US8808292Nov 11, 2008Aug 19, 2014Zimmer GmbhOrthopedic screw
US8814913Sep 3, 2013Aug 26, 2014Roger P JacksonHelical guide and advancement flange with break-off extensions
US8840623Jan 23, 2014Sep 23, 2014Si-Bone Inc.Systems and methods for the fixation or fusion of bone
US8840651Nov 12, 2012Sep 23, 2014Si-Bone Inc.Systems and methods for the fixation or fusion of bone
US20060149245 *Feb 8, 2006Jul 6, 2006Spinal Generations, LlcBone fixation system
US20110118796 *Jan 18, 2011May 19, 2011Reiley Mark ASystems and methods for the fixation or fusion of bone
DE2906054A1 *Feb 16, 1979Jun 26, 1980Synthes AgEinrichtung zum herstellen eines loches in einem knochen
DE2906068A1 *Feb 16, 1979Jun 26, 1980Synthes AgEinrichtung zur befestigung von knochenstuecken
WO2004018306A2 *Aug 22, 2003Mar 4, 2004Roger P JacksonNested closure plug and set screw with break-off heads
Classifications
U.S. Classification606/65, 411/548, 606/104
International ClassificationA61B17/68, A61B17/74
Cooperative ClassificationA61B17/742
European ClassificationA61B17/74D