US2607339A - Adjustable fracture nail guide - Google Patents

Description

Aug. 19, 1952 J. w. PRICE ADJUSTABLE FRACTURE NAIL GUIDE- 2 SHEETS-SHEET 1 Filed April 7, 1950 INVENTOR ATTORNEY Aug. 19, 1952 J, w, PRlCE 2,607,339

ADJUSTABLE FRACTURE NAIL GUIDE A Filed April '7,l 195o 2 SHEETS-SHEET 2 INVENTOR d? yuan maar ATTORNEY Patented Aug. 19, 1952 UNITED A,

James W.`Price,Roanoke,fVa. L y l Y p ApplicationApril?, 1950, 'SerialNm 1544646 1 Y .'In recent years great and fbenecial advances have been made in bone surgery. One commonly practiced bone surgery operation is the fixation of the fractured neck of a femur by the use of a fracture nail or pin. Y

While preparing for the insertion of a vfracture nail, such Ias the Well .known Sn'iith-Petersen nail, many X-ray pictures from various 4angles are made to determine the exact angle at which the nail should be inserted into the fractured neck of the femur.

rAn object of my invention is to provide a fracture nail guide which may be readily adjusted to introduce a fracture nail intothe neck of the femur at a proper anglejto the shaft of the femur.

8. Claims. (Cl. 12S-92) A further object isto provide an adjustable y guide for the proper angular introduction of a direction wire and/or the subsequent introduction of a fracture nail into the neck of a femur.

A still further object is to .provide an adjustable fracture vnailV gui-de which may be readily changed to direct a fracture nail at any elected degree of several different degrees of angulari'ty.

yIn the drawings:

Fig. 1 is a View in sideelevation;

Fig. 2 is a view infront elevation;

Fig. 3 is an enlarged irregular vertical crosssection taken on the line 3--3 of Fig. 1, looking in the direction of thegarrows; A

Fig. 4 is an enlarged perspective view of the portion ofthe guide adapted to y'be held against the shaft of a femur;

Fig. 5 is an enlarged perspective view, partly broken away, showing the nai-lor pin directing portion of the guide;

there maybe .a diierec'e in this, fdesired angle, the same varying 'as muchas from'5110""v to..135'. By the `use of. my adjustablefguide, that angle may be suitablyset before the' fracture nail'is introduced I'through the. guide andin'to vthe neck ofthe femurj vI p The adjustable nail guideLis.provided` with a suitablefhandle I0. conveniently made o'fA a lat metal bar and to the end ofvvhichV aknurled hand .grip l2.may bes'ecured 'Thehandle III is suitablysecured toa .nail or .pin .guide or tumbler I4 .by conventional screws 51B.' `The A,nail or pin guideor tumbler l-4 isprefei'ablyfmade of one piece -of stainless steel ,or'other non-'corrosive metal and through whihkjlehannelor .bore i8 is machined .having y.a7proper;diameterv'so that a ,selected.fracture'lnail andor ladirection wire guiding sleeve ZUJmay passl `YThe ltumbler or block `I4 4is lalso machined te .provide studs 2-2 outstanding `from its oppo's'itefsides, .or theblock may bedrilled :and tapped for. a si-iitable `pivot stud.

The nail orpin guide -I4 is' also provided. with l a transversely :drilled bore yor channel '24 within Fig. 6 is an enlarged perspective `view of the Y guiding sleeve through which a direction wire may be inserted; i y i Fig. 7 is a view -in side elevation showing the adjustable guide `positioned against "the shaft `of a' femur showing a direction wire inserted through the guiding sleeve andl into vthe fractured neck ofY the femur; and

y Fig. 8 is a view in side elevation showing the adjustable guide in proper position, a fracture pin or nail inserted through the guide and partially into a femur, andin"dotte d 'l`ines, the representation of a naildriver secured to the hea'd of a fracture nail. l

'In a great many instanceswhen a'fra'cture nail is to be inserted into the fractured neck of a femur, it Will be found that the .nailj must be introduced through the .trochanter 'at an .angle of 120 'from the shaft of the 'femur bone. Often the shaft of a femur bone.

.After the -lug'sl andstheir .cups 2 -6 .have thus been positioned within the borevfZll; the guide I4 is -placed between two gplates ger lblocks 32 which Vare provided with-'concave faces34. The two concave faces 34 whenplacedtogether form a concave surface `which 'is 4'adapted to :lie against The blocks 32 are suitably secured togetherltheir adjusted position by screws 315. f f;

Apertures -40 vare provided' inith'e upper yportion ofthe platesor'blocks 32 to fprovideia sufficient amount of tolerance so ,that'the studsj22'imay be pivotally `positioned Vt-lfie'rein.` Alsotlie plates or blocks 32 are providedwithla' "plurality of apertures 4|, 42, 43,v 44,j"'45jarrd 46' positioned arcu'ately 'from the` apertu 40, bein-g radially equidistant therefrom.- The aperturesil', y43 land 45 are Vpositioned approximately 5' out'foff'alli-gn- I 3 ment, transversely, with the apertures 42, 44, and 46 respectively.

As recited above, the channel or bore I8 is provided through the nail guide I4 so that either a guiding sleeve 20 may be placed therein for the introduction of a guide wire 2| if it should be desired to utilize a guide wire for the subsequent introduction of a fracture nail, or for the direct introduction and guiding of a fracture nail. Normally, if a'guide wireV 2| is used, eitherv a cannulated or a drilled nail 'is subsequentlyinserted into the fractured neck of the femur, its insertion being directed by the guide wire 2|. In order to properly insert such a nail, the guiding sleeve 20 will be removed from the bore |8 and a drilled or cannulated nail 50 willgbe*placed-y ,f j v Y a block having a concave face and spaced-apart 4 1221/22 1271/2", 132%", 1371/2; or at any other desirable degree of angularity, the possible change in angularity being approximately 5. Obviously any other degrees of angularity may readily be provided by adjusting the positions of the apertures 4| to 46.

I claim: 1. An adjustable fracture nail guide including a block adapted to lie along the shaft of a femur, a drilled. block pivoted between plates extending from the first mentioned block, and spring urged studs extending outwardly from said drilled block f Aand adapted to fit into alternate apertures posiover the guide wire 2| which is leftterriporarily v in its directed position within the neckV of the tioned inthe said plates at points equally spaced from the said pivot point.

2.- An adjustable fracture nail guide including plates extending outwardly from near one end femur. i f

In Fig. 8 I have shown, in dotted lines, a nail driver 52 which.maybefscrew-threaded into the head of the nail 50 in order to properly drive the nail through the nail guide and into the fractured neck Yof the femur. It. will be understood, of course, that the bore I8will provide commercial tolerance so that aV nail 50 and/or: a nail driver 52 may readily pass therethrough.' Generally a nail driver is used tomaterially assist in k,directing the nail, but the driver is not essential', particularly when my nail guide is used. l l

In adjusting the nail guide for use, X-rays will rst be taken, and by the subsequentuse of protractors or the like, theangle between the axis of the shaft of the femur'and the axis of the :neck of the femur may be determined. I-Iavingthus determinedthe'angle, the nail guide will be adjusted until the lug 28 is seated in its proper aperture` to provide the desired` angle between the concave faces 34 and the axisnof the bore I8'. As shown in Figs. '7 and 8, the lug 28 has been positioned within the aperture 43 and consequently the axis of the bore |8 is at 120 from the axis of the surface of the concave faces 34 of the guide block or plate 32. As shown in Fig. 1, the lug 28 is seated in the aperture 4| and consequently the bore |8 is at an angle of* 110 vfrom the axis of the concave faces 34 of the block 32.V Y Y Y In view of the f act that the apertures 4| and 42, 43 and 4 4, and Alvliivandlli areno't in alignment, it will be understood that the lug 28 onv one side, when in engagement with an aperture, will be so aligned with its complementary lug 29 and cup 21, that the latter will not be in a position ftov exrtend within an aperture ontheir side of the guide. Thus, angular adjustment may be changed by approximately 5 by first positioning a ylug 28 Within the aperture 4|, subsequently the lug 29 within the aperturev42','ixt, the lug 28 within the aperture 43, etc., until'fthe desired degree of angularity is attained.- It will be understood that the apertures 4|, 43 and 45 will thus vbe positioned to'eiect Ya change yof the angle .between the axis of the faces 34 and theaxis of the bore I8 the equivalent'of 10.v Any suitable'distance apart may be provided,but it has been found that it would be impractical to 'have the apertures positioned closer together. a :ya f

Likewise it will bei understood, underv theabove circumstances; that it probablyjwillfbe desirable to produce one adjustable guide which may be adjusted to direct a nail at 110, 115271209, 125,

jfonsay 1o71/2,f1121/2, 1171/21, 1221/22 1271/2?,

1321/5 and/or to have a guide, provided in order to be adjustable to angles such as 1121/2", 1171/2", 1

thereof, aligned apertures in said plates, a solid block having a drilled bore p-ivoted at the said apertures, the drilled bore in said block being transverse to the axis of the said pivot points, and a plurality of spaced-apart apertures in said plates positioned radially to the rst mentioned apertures.

3. An adjustable fracture nail guide including a positioning portion adapted to lie along the shaft of a femur bone, a block, having a bore therethrough, pivotally secured tothe said positioning portion, a plurality of spaced-apart apertures in opposite sides of the said positioning portion, and spring-urged studsheld within` the said block and adapted to penetrateY alternate apertures. 4. An adjustable fracture nail guide including a positioning block adapted to lie along the shaft of a femur bone, spaced-apart plates extending from the said block, a solid block having a bore therethrough and pivotally secured to the said positioning block between the said plates, apertures in the said plates equally spaced from the said pivot point, the said solid block having' an additional bore therethrough positioned transversely to the first mentioned bore, and outwardly urged spring pressed studs adapted tov engage selected individual apertures. t Y

5. A fracture nail guide including a block having a concave face and spaced-apart plates extending from the opposite side thereof, a solid block pivotally secured between the said plates and having a drilled bore therethrough, ay plurality of apertures in said plates spaced radially from the pivot point of the-said solid block, and spring urged studs adapted to protrude laterally from the said solid block.

6. A fracture nail guide including a block having a concave face and spaced-apart plates extendingfrom the opposite side thereof, ablock pivotally secured between the said plates and'having a bore therethrough laterally to they said rst mentioned block, a plurality ofv spaced-apart apertures in said plates equidistant fromthe pivot point of the said solid blockfand trans'- versely positioned spring-urged studs within the Y said solid block and adapted-to become engaged in the said spaced-apart apertures.

'7. An adjustable fracture nail guide including a block adapted to lie along the shaft of a femur, a drilled tumbler pivoted between plates extending from the said block, spring urged studs-'extending outwardly from said drilled tumbler'and adapted to fit into alternate -apertures positioned in the said plates at pointsequally spaced from the said pivot point. l v

8. An adjustable fracture nail guide including JAMES W. PRICE.

6 I REFERENCES CITED The following references are of record in the file of this patent:

UNITED STATES PATENTS Name Date Nauth May 7, 1940 OTHER REFERENCES Number 10 Surgery, Gynecology and Obstetrics for Sept.

1938, pages 356-362. (Original in Scientic Library, C'op'y in 12S-92.4.)

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