Title of Invention

"INTRAMEDULLARY NAIL"

Abstract This intramedullary pin (1), particularly intended for the tibia, has a proximal end portion (2), a distal end portion (3) intended for the introduction into the medulla and a central axis (6). The intramedullary pin (1) has an overall length of L in the range of 200-500 mm and a curved section (4) with the length of G <L The curved section (4), with the length of G, has a curvature radius R in the range of 300-1300 mm and the L/R ratio is in the range of 0.2-0.8.
Full Text X
The invention concerns an intramedullary nail, in particular for the tibia, according
to the preamble of patent claim 1. The expression "intramedullary nail" is
employed herein interchangeably with the expression "intramedullary pin".
From CH-A 674 613 a generic intramedullary pin is known, that has a proximal
and a distal end portion, both of them angled away from the central part. The
proximal end portion can have a curvature with a maximum radius of 220 mm.
Because by nature the tibiae is different for each patient and particularly its length
and the size of the tibial plateau, which are interdependent, are of different size,
the intramedullary pin should also have parameters which change according to
the length. Thus a firm curvature radius, valid for every intramedullary pin of
whatever length, is not optimal for the insertion, because it will require an
increased force and will lead to an increased loss of reduction.
This is where the invention wants to provide remedy. The object of the invention is
to produce an intramedullary pin that takes the anatomical ratios of the tibia,
relative to its length, into consideration and is optimal particularly regarding the
course of the medullary canal.
This objective is achieved according to the invention with an intramedullary pin
having the features of claim 1.
The advantages achieved by the invention are essentially that as a result of the
intramedullary pin according to the invention
a) the insertion force is reduced in the case of certain indications, especially in the
case when the technique of not-opening drilling is used,
b) due to the low insertion force a lesser loss of reduction is present,
c) after the insertion the intramedullary pin is in the biomedically ideal position in
the medullary canal,
2
d) as soon as the intramedullary pin comes against the posterior wall during the
insertion, its curvature becomes effective (in the case of the state-of-the-art the
intramedullary pin has to be either bent at this stage or the loss of reduction
has to be taken into account).
5
In the case of a particular embodiment the distal end of the intramedullary pin is
constructed as a straight section having a length of I several advantages, namely:
a) a concurrence with the biomechanical axis,
10 b) the possibility of a distal fraction repair without loss of reduction, and
c) the displacement of distal bone fragments is avoided.
The length I of the distal end portion of the intramedullary pin is advisedly in
the range of 0.20-0.55 L, preferably in the range of 0.25-0.50 L.
15
In the case of a particular embodiment the curved section includes with the
straight section an angle a, that is in the range of 7°-12° and preferably in the
range of 8°-9°. Together with the distal end section and the special curvature
radius this will result in an optimum position of the intramedullary pin in the
20 medullary canal relative to the entry point of the intramedullary pin.
In the case of a particular embodiment the cross-section, at right angle to the
central axis of the intramedullary pin, is not circular and has preferably an oval or
elliptical construction. By virtue of this the intramedullary pin can be introduced
25 deeper into the medullary canal until it reaches the posterior wall.
In the case of a further embodiment the intramedullary pin has a longitudinal bore
(7) that is coaxial with the central axis. This makes the introduction of the
intramedullary pin possible by a guide wire, that can also be used for the drilled
30 out operating technique.
In the case of a further embodiment the proximal end portion of the intramedullary
pin is constructed as a straight section with a length of P 3
. ^ advantages as far as production technology is concerned. The length P of the
proximal end portion is advisedly in the range of 1/6-1/3 L
In the case of a further embodiment in the region of the proximal end portion at
5 least one locking hole, extending transversely to the central axis, is present.
In the case of a further embodiment in the region of the distal end portion at least
one locking hole, extending transversely to the central axis, is present. By using a
locking element, introduced through the locking hole, both a positional fixing in
10 the axial direction, i.e. fixing against axial dislocation, and a rotational fixing, i.e.
fixing against torsional dislocation, is affected.
In the case of a further the curvature radius R of the curved section is in the
range of 350-1200 mm, preferably in the region of 400-1100 mm. The L/R ratio is
15 advisedly in the range of 0.3-0.7, preferably in the range of 0.4-0.6.
In the case of a further embodiment two locking holes, extending transversely to
the central axis, are present in the region of the distal end portion. This will bring
about several advantages:
20 a) the possibility of locking in several directions,
b) an angularly stable fixing of the bone fragments relative one another,
c) a more favourable absorption of the bending moments and axial and torsional
loads.
25 In the case of a further embodiment the two locking holes, extending transversely
to the central axis, include between them an angle of 45° to 90°.
In the case of a further embodiment the distal end portion has three locking holes,
while the middle locking hole is at a different distance from the other two holes.
30 The advantage of this arrangement is that none of the axes of the three locking
holes can potentially become an axis of rotation. This results in a reduced play
between the intramedullary pin and the locking elements.
4
, . The implanting method is briefly described in the following based on a cannulated
intramedullary pin:
step A: establishing and holding the optimal reduction, depending on the type of
fracture,
5 step B: opening the medullary canal with the aid of an opening instrument, so that
the entry angle and the orientation relative to the medullary canal, to suit
the operating technique employed, agree,
step C: introducing a guide wire up to the distal, future end position of the
intramedullary pin and determining the length of the required
10 intramedullary pin,
step D: the intramedullary pin, pre-assembled on the insertion handle, is
introduced into the medulla through the entry channel via the guide wire,
step E: after checking the axial position of the intramedullary pin and the
reduction the intramedullary pin is locked by using the locking options.
15
The invention and developments of the invention are explained in detail in the
following based on the partly schematic illustrations of an embodiment.
They show in:
20
Fig.1 - a longitudinal section through the intramedullary pin, and
Fig.2 - a section along line 11-11 of Fig.1.
25 The intramedullary pin 1, illustrated in Figs.1 and 2, is intended to be used on the
tibia. It has a proximal end portion 2, a distal end portion 3 intended for the
introduction into the medulla and a central axis 6. The proximal end portion 2 is
provided with a threaded bore 11 to accept a conventional assistance. The
overall length L of the intramedullary pin 1 is 255 mm. Furthermore, the
30 intramedullary pin has a curved section 4 with the length of G = 127.5 mm,
having a curvature radius R of 380 mm. Thus the LIR ratio is 0.67. After the
intramedullary pin 1 has been implanted, the curvature of the intramedullary pin in
the plane of the drawing corresponds to the anatomical medio-lateral plane, i.e.
5
I
after the implantation the intramedullary pin 1 is bent in the antero-posterior
direction.
The distal end portion 3 is a straight section 5 with the length of I = 127.5 mm.
5 The curved section 4 includes an angle a = Q° with the straight section 5.
The intramedullary pin further has a passing through longitudinal bore 7, that is
coaxial with the central axis 6.
The proximal end portion 2 is constructed as a straight section 8 with a length of
10 P = 75mm, sothatP = 0.3L.
In the region of the proximal end portion 2 of the intramedullary pin 1 there are
two locking holes 9 extending transversely to the central axis 6, while one of them
is constructed as a slot, so that to enable to carry out a compression.
15
In the region of the distal end portion 3 there are three locking holes (10,12, 10)
extending transversely to the central axis 6, which are provided in different radial
directions and include an angle of 90° with one another. At the same time the
middle locking hole 12 is at a different distance to the other two locking holes 10.
Q








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WE CLAIM:
1. Intramedullary nail (1), in particular for the tibia, with a proximal extremity
(2), a distal extremity (3) suitable for inserting into the medullary space and a
central axis (6), which
a) presents an overall length L in the range from 200 to 500 mm; and
b) presents a curved section (4) of a length G^L;
characterized in that
c) the curved section (4) of the length G presents a radius of curvature R in
the range from 300 to 1300 mm,
d) the ratio UR is in the range from 0.2 to 0.8; and
e) the distal extremity (3) is conformed as a straight section of a length
" I " 2. Intramedullary nail (1) as claimed in claim 1, wherein the length " I " is in the
range from 0.20 L to 0.55 L.
3. Intramedullary nail (1) as claimed in claim 2, wherein the length "I" is in the
range from 0.25 L to 0.50 L.
4. Intramedullary nail (1) as claimed in claim 2 or 3, wherein the tangents to
the two endpoints of the curved section (4) enclose an angle a in the range from
7° to 12°, preferably from 8° to 10°.
5. Intramedullary nail (1) as claimed in any one of the claims from 1 to 4,
wherein the cross-section set orthogonally to the central axis (6) is conformed in
a noncircular and preferably in an oval or elliptical shape.
,
I

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6. Intramedullary nail (1) as claimed in any one of the claims from 1 to 5,
wherein it presents a longitudinal borehole (7) coaxial with the central axis (6).
7. Intramedullary nail (1) as claimed in any one of the claims from 1 to 6,
wherein the proximal extremity (2) is conformed as a straight section (8) of a

length P 8. Intramedullary nail (1) as claimed in claim 7, wherein the length P of the
proximal extremity (2) is in the range from 1/6 L to 1/3 L.
9. Intramedullary nail (1) as claimed in any one of the claims from 1 to 8,
wherein in the range of the proximal extremity (2), there is at least one locking
hole (9) extending across the central axis (6).
10. Intramedullary nail (1) as claimed in any one of the claims from 1 to 9,
wherein in the range of the distal extremity (3), there is at least one locking hole
(10) extending across the central axis (6).
11. Intramedullary nail (1) as claimed in any one of the claims from 1 to 10,
wherein the radius of curvature R of the curved section (4) is in the range from
350 to 1200 mm, preferably in the range from 400 to 1100 mm.
12. Intramedullary nail (1) as claimed in any one of the claims from 1 to 11,
wherein the ratio UR is in the range from 0.3 to 0.7, preferably in the range from
0.4 to 0.6.
13. Intramedullary nail (1) as claimed in any one of the claims from 1 to 12,
wherein in the range of the distal extremity (3) there are two locking holes (10)
extending across the central axis (6).
14. Intramedullary nail (1) as claimed in claim 13, wherein the two locking holes
(10) extending across the central axis (6) enclose an angle of from 45° to 90°
between them.
8
4'«
J- • >
15. Intramedullary nail (1) as claimed in any one of the claims from 1 to 14,
wherein the distal extremity (3) presents three locking holes (10, 12, 10), where
the central locking hole (12) presents a different distance to the other two locking
holes (10).
Dated this 23'^ day of March, 2006.
F. S. GROSER
of GROSER & GROSER
AGENT FOR THE APPLICANTS
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Documents:

1567-delnp-2006-abstract.pdf

1567-delnp-2006-assignment.pdf

1567-delnp-2006-Claims-(14-08-2013).pdf

1567-delnp-2006-claims.pdf

1567-delnp-2006-Correspondence Others-(04-04-2008).pdf

1567-delnp-2006-Correspondence Others-(28-03-2013).pdf

1567-delnp-2006-Correspondence-Others-(13-08-2013).pdf

1567-delnp-2006-Correspondence-Others-(14-08-2013).pdf

1567-DELNP-2006-Correspondence-Others-(23-03-2010).pdf

1567-delnp-2006-Correspondence-Others-(29-08-2013).pdf

1567-DELNP-2006-Correspondence-Others-(30-03-2010).pdf

1567-delnp-2006-correspondence-others-1.pdf

1567-delnp-2006-correspondence-others.pdf

1567-delnp-2006-Description (Complete)-(14-08-2013).pdf

1567-delnp-2006-description (complete).pdf

1567-delnp-2006-Drawings-(14-08-2013).pdf

1567-delnp-2006-drawings.pdf

1567-delnp-2006-form-1.pdf

1567-delnp-2006-form-18.pdf

1567-delnp-2006-Form-2-(14-08-2013).pdf

1567-delnp-2006-form-2.pdf

1567-delnp-2006-Form-3-(13-08-2013).pdf

1567-delnp-2006-form-3.pdf

1567-delnp-2006-form-5.pdf

1567-delnp-2006-form-6.pdf

1567-DELNP-2006-GPA-(23-03-2010).pdf

1567-DELNP-2006-GPA-(30-03-2010).pdf

1567-delnp-2006-gpa.pdf

1567-delnp-2006-pct-210.pdf

1567-delnp-2006-pct-308.pdf

1567-delnp-2006-pct-338.pdf

1567-delnp-2006-pct-409.pdf

1567-delnp-2006-Petition-137-(29-08-2013).pdf


Patent Number 263622
Indian Patent Application Number 1567/DELNP/2006
PG Journal Number 46/2014
Publication Date 14-Nov-2014
Grant Date 07-Nov-2014
Date of Filing 23-Mar-2006
Name of Patentee SYNTHES GmbH
Applicant Address of Eimattstrasse 3,CH-4436,Oberdorf,
Inventors:
# Inventor's Name Inventor's Address
1 PETER SENN BURGMATTSTRASSE 18, CH-4437 WALDENBURG, SWITZERLAND
2 ANDRE SCHLIENGER TUNNELWEG 16, CH-4142 MUNCHENSTEIN, SWITZERLAND
3 MARKUS BUETTLER IM RANK 199, CH-4717, MUMLISWIL, SWITZERLAND
PCT International Classification Number A61B 17/72
PCT International Application Number PCT/CH2003/000683
PCT International Filing date 2003-10-21
PCT Conventions:
# PCT Application Number Date of Convention Priority Country
1 NA