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It consists for example of a stainless steel. Die Verstärkungselemente 2 sind mit Vorteil aus einem Kunststoff, beispielsweise aus Polyacetal POM, hergestellt, oder auch aus einem Gemisch von Polymeren, die zumindest zu einem Teil bioresobierbare Polymere sein können.

The reinforcing elements 2 are advantageously made of a plastic, for example made of polyacetal POM, manufactured, or else of a mixture of polymers, which may be bioresobierbare polymers at least in part.

Es ist in It is in Fig. Mit dem Pfeil ist gezeigt, an welcher Stelle und in welcher Richtung der erfindungsgemässe Marknagel 1 illustrated with reference to two views of the upper part of a femur F, with the greater trochanter T1, the lesser trochanter, and the intertrochanteric crest T2 C.

The arrow is shown, at which point and the direction in which the intramedullary nail 1 according to the invention Fig.

To be inserted into the medullary cavity. Strichpunktiert ist die Mittellinie des Kanals eingezeichnet, in den der Marknagel 1 zu liegen kommt.

Dash-dot line the center line of the channel is shown in which the intramedullary nail 1 is positioned.

Wie bei der Innenansicht, links, ersichtlich ist, muss aus geometrischen Gründen der Marknagel 1 an der Insertionsstelle beim Einführen gekrümmt werden.

As with the Interior, left, is seen, the intramedullary nail 1 must be curved at the insertion site during insertion geometric reasons.

In der Markhöhle muss er anschliessend wieder gestreckt oder leicht gebogen sein. In the marrow cavity no deposit bonus qala , he must be a straight or slightly bent then again.

Die Erfindung betrifft einen Marknagel, insbesondere einen Femurmarknagel für Kinder, mit den Merkmalen des Anspruchs 1.

The invention relates to an intramedullary nail, in particular a femoral medullary nail for children, with the features of claim 1.

Die Segmente 51 bilden die versteifenden Teile, die mit der Innenseite des biegeweichen Rohrs 10 in Kontakt gebracht werden.

The segments 51 form the reinforcing parts, which are brought into contact with the inside of the flexible tube Statt diskreter Segmente 51 kann auch ein zusammenhängender, helixförmiger Streifen vorgesehen sein.

Instead of discrete segments 51 and a contiguous, helix-shaped strip can be provided. Nachfolgend wird die Erfindung anhand der Zeichnungen erläutert.

The invention will be explained with reference to drawings. Es zeigen: In the drawings: Fig. An intramedullary nail in accordance with any one of the claims 1 to 5, characterised in that the inner tube space converges in the pushing in direction at the proximal end 11 ; and in that the tube 10 is open or has a closed tip at the distal end Bei einem chirurgischen Verfahren zur Fixierung eines gebrochenen Oberschenkelknochens mit einem erfindungsgemässen Marknagel wird dieser seitlich am Knochen zugeführt.

In a surgical procedure for the fixation of a fractured femur with an intramedullary nail according to the invention this is fed laterally to the bone.

Der Insertionspunkt wird dorsal, lateral von der Crista intertrochanterica gewählt. The insertion point is dorsal, lateral elected by the intertrochanteric crest.

Über der Eintrittsstelle am Knochen liegt der M. About the entry point to the bone is the quadratus femoris muscle.

Zur Einführung des Marknagels wird die Markhöhle schräg von oben aufgebohrt, und es wird beispielsweise mit einem flexiblen Bohrer ein Kanal hergestellt.

For the introduction of the intramedullary nail the medullary cavity is drilled obliquely from above, and a channel it is, for example, with a flexible drill made.

Das Rohr des Marknagels - ohne Verstärkungselemente - kann dann unter Verwendung eines Gleithammers eingetrieben werden.

The tube of the intramedullary nail - without reinforcing elements - can then be collected using a slide hammer.

Dank seines biegeweichen Bereichs ist das Rohr so elastisch, dass es sich am gewählten Insertionspunkt im erforderlichen Mass krümmen lässt.

Thanks to its bendable portion, the tube is so elastic that it can bend the extent required at the selected point of insertion.

Nachdem das Rohr eingeführt ist, werden die Verstärkungselemente beispielsweise mittels eines Montagestabes eingefügt. After the tube is inserted, the reinforcing elements are inserted, for example by means of a mounting rod.

Dabei wird die Biegesteifigkeit des Marknagels so vergrössert, dass die für die Frakturheilung erforderliche Fixation sichergestellt ist. The bending stiffness of the intramedullary nail is so enlarged that required for fracture healing fixation is ensured.

Mit den Verstärkungselementen ergibt sich auch eine radiale Verankerung des Rohrs in der Markhöhle, nämlich aufgrund einer Erweiterung des Querschnitts an den Stellen, wo er sich zuvor beim Einführen des Rohrs infolge von Krümmungen und Verengungen der Markhöhle durch Deformierungen verengt hat.

With the reinforcing elements results in a radial anchoring the tube in the medullary cavity, namely due to an expansion of the cross section at the places where he has previously narrowed during insertion of the tube due to curvature and narrowing of the medullary cavity by deformation.

Die abhängigen Ansprüche 2 bis 12 beziehen sich auf vorteilhafte Ausführungsformen des erfindungsgemässen Marknagels. The dependent claims 2 to 12 relate to advantageous embodiments of the inventive intramedullary nail.

Beim Marknagel 1 gemäss When intramedullary nail 1 according to Fig. Bei einer weiteren vorteilhaften Ausführungsform sind die Stäbe 16 in einem Mündungsstück 11' mit einem axialen Spiel befestigt: siehe In a further advantageous embodiment mobile yahoo calendar , the rods 16 are mounted in a mouth piece 11 'with an axial play: see Fig.

Nach dem Einschieben der Versteifungselemente 2 in das Rohr 10 werden die Stäbe 16 mit einem Verschlussstück 17 in ihren axialen Lagen fixiert, die sie nach dem Einsetzen des Marknagels 1 einnehmen.

After insertion of the stiffening elements 2 in the pipe 10, the rods 16 is fixed with a closure member 17 in its axial positions which they occupy after insertion of the intramedullary nail 1.

Diese axialen Lagen hängen beispielsweise davon ab, ob und wie stark der Marknagel 1 nach dem Einsetzen in den Knochen gebogen ist.

This axial positions depend, for example, on whether and how much the intramedullary nail 1 after the onset bent into the bone.

Das in The in Fig. Es hat neben einem Gewinde für die Verschraubung einen konischen Bereich mit Rillen Beim Einschrauben graben sich diese Rillen in die nach innen vorstehenden Stäbe 16 ein, die gleichzeitig gegen Rillen des Mündungsstücks 11' gepresst werden.

It has in addition a thread for screwing a conical region with grooves When screwing these grooves dug in the inwardly projecting rods 16 which are simultaneously pressed against grooves of the mouthpiece 11 '.

Zur Frakturheilung bei gebrochenen Oberschenkelknochen werden Femurmarknägel verwendet. For fracture healing in broken femur Femurmarknägel be used.

Bei bekannten Marknägeln, die steif sind, wird der Insertionspunkt so gewählt, dass dieser auf die proximale Verlängerung der Markhöhle zu liegen kommt.

In known intramedullary nails that are stiff, the insertion point is chosen so that it comes to rest on the proximal extension of the medullary cavity.

Bei Kindern hätte eine Knochenöffnung an diesem Insertionspunkt eine schädigende Wirkung auf die Blutversorgung am Schenkelhals und auf das Knochenwachstum zur Folge.

In children, a bone hole would at this point of insertion a damaging effect on the blood supply to the femoral neck and on bone growth resulted.

Daher rät die Fachwelt von der Verwendung von steifen Femurmarknägeln bei Kindern ab. Therefore, the art does not recommend the use of rigid Femurmarknägeln in children.

An intramedullary nail in accordance with claim 1 roulette strategy tips , characterised in that the elements which can be pushed in at least partly form one part or a plurality of parts of a contiguous stiffening body 4; 5 which in particular comprises radially stiff regions and resiliently elastic connections between these regions.

Am proximalen Ende des Rohrs 10, im Mündungsbereich 11, verjüngt sich der Rohrinnenraum in Einschieberichtung. At the proximal end of the tube 10, in the mouth region 11, the tube interior tapered insertion.

Der proximale Teil ist soweit aufgeweitet, dass die Verstärkungselemente 2 ohne Schwierigkeiten einschiebbar sind. The proximal portion is widened so far that the reinforcing elements 2 are inserted without difficulty.

Am distalen Ende ist das Rohr 10 offen. At the distal end of the tube 10 is open. Es kann auch eine geschlossene Spitze aufweisen vgl.

It may also have a closed tip see FIG. Das offene Rohrende ist konisch verjüngt casino spiele blog , damit sich der Spitzenbereich 12 in der Markhöhle zentriert.

The open end of the tube is conical tapered so that the tip portion 12 centered in the medullary cavity. An intramedullary nail in accordance with any one of the claims 1 to 6, characterised in that the openings 13 are arranged in the wall of the tube 10 such that the cross-section has at least one opening in the tube wall at each point in the flexible region.

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