US 3489143 A
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Description (OCR text may contain errors)
Jan. 13, 1970 w. X. HALLORAN 3,489,143
ATTORNEYS United Statesv Patent O 3,489,143 CONVERTIBLE HIP PIN William X. Halloran, 1965 Orange Ave., Costa Mesa, Calif. 92627 Filed Dec. 15, 1967, Ser. No. 690,843 Int. Cl. A61t` 5/04, 13/10 U.S. Cl. 128--92 4 Claims ABSTRACT OF THE DISCLOSURE A hip pin adapted for use in a conventional hip pinning operation, but convertible for use as a compression assembly or the like where indicated. The pin includes a plate extending along the subtrochanteric lateral surface of the femoral shaft for aftixation thereto, and further includes' an elongated nail portion for projection through an axial bore provided in the neck of the femur. The nail portion is made of suicient length to project inwardly of the location of the normal femur fracture and into the femoral head for support. The nail portion includes a longitudinal through passage to receive a compression device for engagement upon the pelvis bone to form a compression arthrodesis.
BACKGROUND OF THE INVENTION Field of the invention The present invention relates generally to hip pins adapted for use in conventional hip pinning procedures, and more particularly to hip pins which are further adapted to anchor the femur to the pelvis, or to mount an artificial head to the femur.
Description of the prior art Most existing hip pins include nail portions for projection through the femoral neck and beyond the fracture, but none includes a nail portion having a longitudinal passage to receive a compression device adapted to anchor the existing femur to the pelvis or to mount an artificial head to the femur. Thus, for example, if there is a deterioration in the condition of the pinned area subsequent to use of one of the hip pins of the prior art, a radical procedure is indicated to remove the hip pin and mount a compression device or the like.
SUMMARY OF THE INVENTION The present invention is a hip pin providing the usual hip-pinning function, but uniquely characterized by a nail portion having a central bore or through passage adapted for receiving a compression device whereby the pin forms part of an assembly operative to anchor the femur to the pelvis bone in compression.
Other objects and features of the invention will become apparent from consideration of the following description taken in connection with the accompanying drawings.
DESCRIPTION OF THE DRAWINGS FIG. 1 is an elevational view partially in section, showing a hip pin embodying the present invention;
FIG. 2 is a sectional view taken along the lines 2-2 of FIG. l;
FIG. 3 is a perspective view of the hip pin shown in FIG. l;
FIG. 4 is similar to FIG. l except that a compressi-on device is installed in said hip pin;
FIG. 5 is similar to FIG. 4 except that auxiliary screws have been inserted in the hip pin;
FIG. 6 is a view similar to FIG. l except that an artificial femoral head is installed on the hip pin; and
3,489,143 Patented Jan. 13, 1970 A hip pin P according to the present invention is shown in FIGS. l through 3, the pin P comprising, generally, a shank plate 11 which extends along the shank of the femur F, and a nail portion 13 which is attached to the upper central portion of the plate 11. The nail portion 13 projects generally transversely of the plate 11 and extends inwardly through a bore provided in the neck 15 of the femur F.
The nail portion 13 includes a through passage or axial bore 21 for receiving a compression device D characterized by an elongated shaft or stud, threaded at its outer extremity and including pivotable gripping elements 23 at its opposite extremity. As will be seen, rotation of the pin P pulls the gripping elements 23 inwardly against the pelvic bone 25 forming the acetabulum 27, as best seen in FIG. 4.
The inner surface 31 (FIG. 2) of the rectangularly shaped plate 11 is concave for complemental abutment with the generally convex subtrochanteric lateral surface 33 of the femoral shaft 35. A plurality of bolt receiving bores 39 are provided in the upper extremity of the plate 11 and are each directed inwardly toward a common center such that a corresponding plurality of bolts 41 extending therethrough lie along respective diameters of the femoral shaft 35, as best seen in FIG. 2. The ends of the bolts 41 are threaded to receive a plurality of nuts 43 which can be tightened to rigidly support the pin P upon the femur F.
The projection of the nail portion 13 from the shank plate 11 is at an angle providing optimum support for the particular fractured femoral neck 15, the angle being approximately 135, as shown in FIG. l.
Referring to FIG. 4, it is particularly noted that the nail portion 13 projects inwardly, beyond the fracture line 16, and into the femoral head 51. With the nail portion 13 providing support for the femoral head 51 in this manner, the hip pin P can be installed without the compression device D, as shown in FIG. l, and will provide the usual support obtained with conventional hip pins. If, however, the pinned area should deteriorate, not respond properly or otherwise suffer a poor prognosis, it is a relatively simple matter to use the bore 21 of the pin P as a guide for drilling a bore 52 inwardly, through the femoral head 51, and into the pelvis bone 25 for reception of the compression device D. In this regard, the outer end of the nail portion 13 projects outwardly of the shank plate 11 and terminates in a surface 53 substantially perpendicular to the axial bore 21, and the associated portion of the axial bore 21 is complementally threaded for receiving the threads 55 of the compression device D.
The end of the compression device D, outwardly of the threads 55, is in the form of a hex head 57 to enable the device D to be turned with a wrench to enable the compression device D to be backed out of the bore 21 and thereby tighten the femur F against the pelvic bone 25.
Referring to FIG. l, when the hip pin P is utilized without the compression device D a plug in the form of a relatively short stud 60 can be screwed into the outer end of the passage 21 to prevent access thereto whereby any infection at the outer end of the nail portion 13 will be prevented from traveling up the bore 21 and into the hip joint.
Referring to FIGS. 3 and 5, a circular crown 61 includes three bores 63 for receiving auxiliary screws 65 and curves generally outwardly to complement the shape of the major trochanter 62 whose purpose will be described below.
Referring now to FIG. 6, the fixation shown in FIG. 1 may fail because of the development of some unforeseen circumstance and it will be necessary to install an artificial femoral. The artificial femoral head 71 may be made of acrylic or any other suitable material, `and usually includes an axial bore 73 through which the nail portion 13 is adapted to project. In order to prevent rotation of the artificial head 71, with respect to the remainder of the femur F, `a bore 75 is drilled beyond the inner extremity of the nail 13 and threaded for receiving the threaded extremity of an elongated stud 77. The stud 77 extends through the passage 21 and is screwed into the threaded bore T of the femoral head 71 to afiix it securely to the femur.
In certain circumstances it becomes necessary to provide positive constraint against rotation of the artificial femoral head 71, with respect to the acetabulum 27. Accordingly, the spherical surface of the artificial head 71 is provided with a plurality of serrations 81 which frictionally resist rotation of the head 71 relative to the acetabulum 27. If desired, auxiliary `screws (not shown) similar to screws 65 may be inserted through the bores 63 in the crown 61 and disposed through the head 71 and into the pelvic bone 25.
Referring to FIG. 7, in certain individuals it is desirable to provide auxiliary support for the fracture area by attaching a support flange, generally designated 85, to the crown 61. The ange 85 fits over the major trochanter 62 and includes an upper portion complementally shaped to fit the outer surface 83 of the fiare of the pelvic bone -above the acetabulum 27. The lower portion of the support fiange 85 includes at least one bore 91 which confronts one of the bores 63 to receive a screw 93 for disposition through the associated bore 63. The screw 93 threads into the trochanter 62. The upper portion of the support flange 85 includes a pair of bores which accept support screws 97 that are screwed into the pelvic bone to secure the support ange 85 thereto.
In use, the hip pin P of the present invention may be utilized for providing support to a femur having a transverse fracture 98 in the lower neck area as shown in FIG. 1. In such situations the hip pin P is similar in operation to existing hip pins, but offers the advantage that if the initial pinning operation fails, a compresson arthrodesis of the type shown in FIG. 4 may be performed without removing the hip pin P. That is, the plug 60 may be removed, a bore 52 drilled on through the femoral head 71 and pelvic bore 25, and the compression device D inserted. The device D is screwed into the pin P until its inner extremity projects a suficient distance behind the pelvic bone 25 to receive the fastener 23. After the fastener 23 has been installed, the device D will be retracted outwardly in the passage 21 a distance suficient to effect the desired compression of the femur F upon the pelvic bone 25.
Installation of the compression device D without removal of the hip pin P is particularly advantageous in the case of elderly people Where their physical condition will not permit prolonged operating periods. All presently existing hip pins must be removed from the femur F before a compression device can be installed and, as a consequence, once a pinning operation of the type shown in FIG. 1 fails the patient is frequently destined to confinement in a wheel chair for the remainder of his days because of his inability to withstand an operation entailing removal of the hip pin P and substitution of the compression device D.
When it is desirable to prevent rotation of the femoral head I51 relative to the acetabulum, as for instance when the pain effected by such rotation is intolerable, the fixation screws 65 (FIG. 5) are inserted through the bores 63.
4 The screws 65 project inwardly through bores in the neck 15 and femur head 51 and on into the back wall of the acetabulum.
If either of the operative procedures shown in FIGS. 4 or 5 fail, it may become necessary to insert an artificial femoral head 71. The artificial femoral head 71 is generally scored or serrated at 81 to induce purchasing in the acetabulum. Such an artificial head 7.1 can be attached to the hip pin P without removal of the hip pin P.
If the patients hip joint is in such a state of deterioration that it will not support the patient, the support flange 85 shown in FIG. 7 can be installed to provide additional support for the patient.
From the foregoing it will be clear that the hip pin of the present invention can be utilized not only as a conventional hip pin would be utilized, but also to form a compression prosthesis or an arthrodesis if the initial hip pinning has failed. This is of particular importance in that it enables such operations to be performed on patients who would not be able to endure the lengthy procedures now required to remove a hip pin and substitute a compression device.
Various vmodifications and changes may be made with regard to the foregoing detailed description without departing from the spirit of the invention or the scope of the following claims.
1. Support apparatus to provide support for a fractured upper femur, said apparatus comprising:
a hip pin including a plate for projection along the subtrochanteric lateral surface of the femoral shaft and including mounting means for affixing said plate to said shaft, an elongated nail portion projecting from said plate for projection inwardly through a portion of the upper femur, said nail portion including ya longitudinal through passage;
and a compression device extending through said passage, including means on its inner extremity for engagement upon the pelvis bone forming the acetabulum which receives the head of said femur, and including tightening means for urging said plate toward said pelvic bone to create a compression joint.
2. Support apparatus as set forth in claim 1 wherein said tightening means includes threads in said passage and complementary threads on said compression device.
3. Support apparatus as set forth in claim 1 wherein said compression device includes:
an elongated stud for projection inwardly through said passage and through the pelvis bone forming said acetabulum; and
fastening means on said stud for engagement upon said pelvic bone.
`4. Support apparatus as set forth in claim 1 that includes:
an artificial femoral head for selectively being secured to the inner extremity of said nail portion.
References Cited UNITED STATES PATENTS 2,077,804 4/ 1937 Morrison 128-83 2,441,765 5/ 1948 Hopkins 12S-92 2,485,531 10/ 1949 Dzus et al 12S-92 2,631,584 3/1953 Purifcato 12S-92 2,699,774 1/ 1955 Livingston 128-92 FOREIGN PATENTS v86,969 4/1966` France. 1,046,827 12/ 1958 Germany.
868,185 5/ 1961 Great Britain.
L. W. TRAPP, Primary Examiner