US 2760488 A
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Description (OCR text may contain errors)
Aug. 28, 1956 R. B. PIERCE 2,760,488
INTERNAL BONE FIXATION APPARATUS Filed April 20, 1955 HFORNEYS INTERNAL BONE FIXATION APPARATUS Robert B. Pierce, Olivia, Minn.
Application April 20, 1955, Serial No. 502,608 6 Claims. (Cl. 128-52) This invention relates to apparatus for fixing fragments of a bone together in an oblique fracture.
Where a person has suffered an oblique fracture such as in one of the bones in his leg, it is oftentimes desirable to fix the bone fragments together without employing, a plaster cast. In an oblique fracture, the bone fragments must be held together tightly after they have been reduced so that the bone will heal properly and grow straight. The use of a plaster cast for holding the bone fragments together may retard the healing of the leg and flesh areas around the fracture because the circulation of blood may be substantially reduced. Another disadvantage in the use of a plastic cast is the ankylosing effect produced by the cast on the joints adjacent to and on. either side of the fracture site.
An object of my invention is the provision of apparatus of simple and inexpensive construction and operation for fixing together the reduced fragments of a bone in an oblique fracture.
Another object of my invention is to provide a novel apparatus for fixing together the reduced fragments of a bone in an oblique fracture which eliminates the need for a plaster cast and which permits the flesh adjacent the bone fracture to heal in a substantially normal manner.
A further object of my invention is the provision of an improved apparatus for fixing and holding together the reduced bone fragments in an oblique fracture, which apparatus may be left in the leg internally of the flesh While the bone heals and which apparatus will continuously firmly clamp the bone fragments without permitting the same to loosen during the healing of the bone.
These and other objects and advantages of my invention will more fully appear from the following description made in connection with the accompanying drawings wherein like reference characters refer to the same or similar parts throughout the several views and in which:
Fig. 1 is an elevation view of the invention;
Fig. 2 is a cross, section view taken on a plane extending substantially transversely through the apparatus substantially at- 2-2 of Fig. 1, and
Fig. 3 is a section view taken through a persons leg on a vertical plane showing several of the devices constituting the invention secured in the leg bone, the several devices being shown at different stages in their application to the leg.
The invention as best shown in Figs. 1 and 2 comprises an elongated and thin wire or rod which is relatively stiff but may be bent by manual means and which may be easily severed by a pair of pincers or nippers. At the distal end 11 of wire 10, the wire is sharpened as by swaging. Adjacent to the proximal end 12 of the wire 10 an enlargement or enlarged bead 13 is aflixed to the wire. Bead 13 is smoothly rounded and may be formed integrally of the wire. Wire 10 has a threaded portion 14 medially between the opposite ends thereof and adjacent the enlarged bead 13, and a threaded Patented Aug. 28, 1956 portion 14 of the wire extends toward the distal end 11 from bead 13. The diameter of the wire 10 between the threaded portion 14 thereof and the distal end 11 thereof should be somewhat less than the external diameter of the threaded portion 14 thereof.
An elongated sleeve 15 has an inner end portion 16 which is internally threaded and of such internal size as to be threadedly secured on the threaded portion 14 of wire 10. An elongated slot 17 is formed in sleeve 15 and extends longitudinally thereof from the inner end portion 16 through the outer end portion 18 thereof. Slot 17 is of slightly greater width than the diameter of wire 10 so as to permit the wire to pass through the slot. The inner end portion 16 of sleeve 15 may be slightly enlarged and smoothly rounded.
Figure 3 clearly shows the means by which the device is used in fixing the bone fragments together of a reduced oblique fracture. I have found by experience that it is desirable to use several of the devices in fixing an oblique fracture and in the form shown I have used four such devices which may be indicated in general by letters A, B, C and D which are assembled to show the different stages in the operation of the devices. Each of the devices in Fig. 3 is identical to that shown in Figs. 1 and 2 and like numerals and characteristics will therefore be used. Device A is shown in the initial stages in the application to the leg. The pointed distal end of the wire will be drilled through the bone and then the wire will be pulled through the bone substantially in the arrangement that device A is shown. with the bead 13 engaging one of the bone fragments. The sleeve 15 of device A has been. slipped over the distal end of the wire 10 and is partially screwed down toward the bone.
It is good practice when applying the device to the fractured bone to operate all the devices substantially simultaneously, particularly the device adjacent the ends of the oblique fracture. When the devices are substantially in the condition of device A as shown traction should be applied to the distal ends of the devices and particularly the two end devices, A and D in the form shown, so as to cause the beads 13 of each of the devices to engage the bone. After the traction has been applied to the distal end of the device the sleeve 15 will be screwed down onto the bone substantially into the condition of the device B so as to cause the inner end portion 16 thereof to engage the bone in a position substantially opposite the bead 13 and to cause the bonefragments to be tightly clamped together. The wire 10 will then be bent at a position within the sleeve 15 and within the flesh of the leg so as to cause the wire to extend outwardly through the slot 17 of the sleeve 15 and extend substantially transversely of the sleeve, to be in the condition of device C as shown. The proximal end 12 of wire 10 will have been severed at a position inwardly of the skin of the leg. As is shown in.
device D, the sleeve 15 will thereafter be severed at a position below the skin of the leg and the wire 10' will also be severed and will be bent to be wholly contained below the skin of the leg. Because the wire extends laterally through the sleeve 15, the sleeve cannot rotate with respect to the wire and therefore cannot loosen itself from the bone.
After all of the devices A, B, C and D have been put into the condition of device D as shown, the area of the skin through which the devices have been inserted will be closed by any suitable means such as by clamps or sutures. The flesh is permitted to heal and the fixation devices are left in the limb so as to hold the bone at the fracture site until it is completely healed.
After the bone has healed the leg will again be cut open to remove the fixation devices. The sleeve 15 and the wire will be severed at a position between the bend in the wire and the inner end portion 16 of the sleeve. The inner end portion of the sleeve will be unscrewed from the wire 10 and the remaining wire and bead 13 will be withdrawn from the opposite side of the bone.
It should be noted that the various devices A, B, C and D which are used to hold the bone fragments at the fracture site may be inserted from opposite sides of the leg so as to assure proper fixation of the bone.
It will be seen that I have provided new and improved apparatus of simple and inexpensive construction for securely fixing bone fragments together in an oblique fracture without the need for a plaster cast and which apparatus is relatively easy to apply to the fractured bone and to remove therefrom.
It will, of course, be understood that various changes may be made in the form, detail, arrangement and proportion of the parts without departing from the scope of my invention which consists of the matter described herein and set forth in the appended claims.
What is claimed is:
1. A surgical appliance for fixation of fragments of bones in an oblique fracture, comprising an elongated wire having a distal end insertable through such fragments at the fracture site and having a proximal end, said wire having an enlargement therein adjacent said proximal end and said wire having a threaded portion disposed in proximity with said enlargement and extending toward said distal end therefrom, an internally threaded sleeve removably and threadably mounted on said wire and having an outer end extending toward said distal end of said wire and having an inner end extending toward said enlargement, said sleeve having an elongated slot therein extending longitudinally thereof and inwardly from said outer end thereof, whereby when the wire extends through the bone fragments with said enlargement engaging one side of the bone and the inner end of said sleeve engaging the other side of the bone for clamping the same against said enlargement, said wire may be bent within said sleeve to extend outwardly through said slot therein to prevent said sleeve from turning and shifting away from the bone.
2. Apparatus for fixing reduced bone fragments in an oblique fracture, comprising a thin and elongated rod having distal and proximal ends and having a threaded portion disposed intermediate of said ends, an enlarged bead fixed to said rod and being disposed between said threaded portion and said proximal end, an elongated sleeve having an internally threaded inner end portion and having an outer end portion, and said sleeve also having a slot therein extending longitudinally thereof and through said outer end portion, said sleeve being slidable on said rod adjacent the distal end thereof and being threadably mounted on said threaded portion of said rod, whereby said sleeve will be removed from said rod to permit said distal end thereof to be inserted through such bone fragments and said sleeve will be threadably shifted on said rod toward said bead for clamping the bone fragments therebetween, and said wire will be bent at a position within said sleeve to extend outwardly through said slot thereof.
3. The structure recited in claim 2 and said sleeve having an enlargement at the inner end thereof for engaging the bone and clamping the same without causing injury thereto.
4. The structure recited in claim 2 and said rod being sharpened at the distal end thereof to permit the distal end of the rod to be drilled through the bone fragments at the fracture site.
5. Apparatus for fixing the bone fragments in an oblique fracture which has been reduced, comprising an elongated wire having a proximal end and a distal end and having an enlarged bead thereon for engaging one of the bone fragments through which the distal end of the wire is extended, said wire having a threaded portion disposed in proximity with said head and extending toward said distal end therefrom, an elongated sleeve having an internally threaded inner end portion and having an outer end portion, said sleeve being threadably mounted on said wire with the inner end portion thereof disposed adjacent said bead and with the outer end portion thereof extending toward said distal end, the inner end portion of said sleeve and said head cooperating to clamp the fractured and reduced bone fragments therebetween, said sleeve having an elongated slot extending longitudinally thereof through said outer end portion and into proximity with said inner end portion, said wire and said sleeve both being constructed of a severable material, whereby said wire will be bent at a position within said sleeve to extend outwardly through the slot thereof for restricting shifting of said sleeve longitudinally of the wire, and when the bone is healed, said sleeve and wire may both be severed between the inner end portion of said sleeve and the bend in the Wire to permit the sleeve to be removed from the wire and thereby permit the wire to be removed from the bone.
6. Apparatus for fixing reduced bone fragments in an oblique fracture, comprising an elongated wire having a distal end insertable through such fragments at the fracture site and having a proximal end, said wire having an enlarged bead disposed intermediate of said ends and having a threaded portion disposed in proximity with said head and extending toward said distal end therefrom, an internally threaded sleeve removably and threadably mounted on said wire and having an inner end extending toward said bead for engaging the bone and for cooperating with said bead in clamping the bone therebetween, whereby said wire may be severed adjacent said sleeve and adjacent said head to permit the flesh to heal around the fracture as said bone fragments grow back together and said wire and sleeve may be removed after the bone has healed.
References Cited in the file of this patent UNITED STATES PATENTS 2,143,922 Longfellow Jan. 17, 1939 FOREIGN PATENTS 1,045,555 France July 15, 1953