System for measuring stiffness of a fractured bone

• US 5,339,533 A
• Filed: 12/08/1993
• Issued: 08/23/1994
• Est. Priority Date: 07/01/1993
• Status: Expired due to Fees

• Current Assignee: James B. Richardson
• Original Assignee: James B. Richardson
• Inventors: Richardson, James B.
• Primary Examiner(s): Cuchlinski, Jr., William
• Assistant Examiner(s): BENNETT, GEORGE B
• Application Number:
  US08/163,426
• Time in Patent Office: 258 Days
• Field of Search: 128/774, 128/782, 33/511, 33/645, 33/512, 33/515, 33/806
• US Class Current: 33/512
• CPC Class Codes: A61B 17/60 for external osteosynthesis, e.g. distractors, contractors
• CPC Class Codes: A61B 5/4504 Bones A61B5/4547 takes precedence
• CPC Class Codes: A61B 90/06 Measuring instruments not otherwise provided for

Abstract

A bone-stiffness measuring instrument comprises a set or kit of readily assembled and adjusted components, namely a goniometer, a light-weight load cell, and a small computer package, adapted to continuously respond to the outputs of the load cell and goniometer and to display and/or record (i.e., store) measured stiffness data; plus hardware in duplicate, namely, a bone-screw clamp and bracket for fixed reference to bone-screws that are externally exposed on each of the respective sides of the fracture (following removal of an external fixator), a stiff arcuate arm member of radius at least twice the diameter of the fractured bone, and a goniometer-end mount. The arcuate arm member is adjustably fixed to the bracket for bone-screw reference, and the goniometer-end mount is also adjustably fixed to the arcuate arm member, with a releasably lockable ball-joint connection for adjusted orientation of an end mounting to the goniometer.

Claims

1. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced clamps each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein the external fixation and said spaced clamps have been removed for a goniometer evaluation of bone-strength;

said combination comprising;

(a) a bone-screw clamp having two jaw members and two bolts on spaced alignments through both jaw members, for fixing said jaw members in simultaneous squeezing engagement with two bone screws on one longitudinal side of the fracture;

(b) a bracket having a flat base with bolt apertures spaced for registry with said bolts, whereby to clamp said base on one side of one of said jaw members upon securing said bone-screw clamp to the engaged two bone screws;

said bracket having a headed body portion extending away from said base, said body portion having a bore inclined at an acute angle to the plane of said flat base;

(c) a stiff arcuate arm member of radius at least twice the diameter of the fractured bone, said arm member being adjustably positionable in the bore of said headed part, and selectively operable means for securing said arm member to said bracket in an adjusted position thereof; and

(d) a goniometer-end mount having a selectively lockable ball-joint connection to a base unit, wherein the base unit has an elongate bore for adjustable positioning of said base unit along said arm member, and selectively operable means for clamping said base unit to said arm member in an adjusted position thereof.

2. The combination of claim 1, in which the headed body portion of said bracket is otherwise flat and extends at an acute angle from said base.

3. The combination of claim 1, in which said goniometer-end mount has a straight guide for generally horizontal reception and orientation of a goniometer end, with means carried by said mount for selectively fixed retention of the orientation of the goniometer end.

4. The combination of claim 3, in which an elongate bubble-sight level indicator is fixedly connected to said mount with its elongation axis substantially normal to the direction of said straight guide, whereby to establish a predetermined horizontal reference for subsequently stressed deflection of a mounted goniometer.

5. The combination of claim 1, in which said arm member is a rod of constant polygonal section.

6. The combination of claim 5, in which said constant polygonal section is hexagonal.

7. The combination of claim 5, in which said polygonal section is characterized by opposed parallel sides that respectively define concave and convex limiting surfaces of the arc of said rod.

8. The combination of claim 7, in which the selectively operable means for securing said rod to said bracket is a set-screw threaded to the headed part on an alignment parallel to the flat body part of said bracket and normal to the bore of said headed part.

9. The combination of claim 7, in which the selectively operable means for clamping said base unit to said rod is a set-screw threaded to said base unit on an alignment normal to said elongate bore.

10. The combination of claim 9, in which the base unit connected to said goniometer-end mount is via a ball-mounting stem anchored to said base unit on an axis normal to said elongate bore, the ball being captive in a seat formation of said goniometer-end mount.

11. The combination of claim 10, in which a set-screw is threaded to said goniometer-end mount on an alignment which intersects the ball center and is generally normal to a geometric plane established by the direction of said straight guide and by the elongation axis of said level indicator.

12. The combination of claim 3, in which said straight guide is adapted to support a goniometer-end fitting of constant isosceles-triangular section having a base that is larger than its two other sides, said straight guide having a section which conforms to one of said two sides and to at least a portion of the other of said two sides adjacent an apex connecting said two other sides, and selectively operable means including a set-screw threaded to said mount on an alignment normal to the base side of said triangular section for releasably clamping the goniometer-end fitting in fixed seated engagement with the other two side portions of said triangular section.

13. The combination of claim 12, in which said straight guide is one of two parallel straight-guide formations of said mount, wherein the selectively clamped orientation of the base of the triangular section in one of said straight-guide formations is normal to the selectively clamped orientation of the base of the triangular section in the other of said straight-guide formations.

14. The combination of claim 1, in which said jaw members are pivotally connected to each other at one longitudinal end thereof.

15. The combination of claim 1, in which the flat base of said bracket is one of said jaw members, whereby said bracket is an integral part of a portion of said bone-screw clamp.

16. A kit of adjustably connectable components for use in selective mounting of one of two longitudinal ends of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced clamps each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein the external fixation and said spaced clamps have been removed for goniometer evaluation of bone strength;

said kit comprising;

(a) a bone-screw clamp having two jaw men%bets and two bolts on spaced alignments through both jaw members, for fixing said jaw members in simultaneous squeezing engagement with two bone screws on one longitudinal side of the fracture;

(b) a bracket having a flat base with bolt apertures spaced for registry with said bolts, whereby to clamp said base on one side of one of said jaw members upon securing said bone-screw clamp to the engaged two bone screws;

said bracket having a headed body portion extending away from said base, said body portion having a bore inclined at an acute angle to the plane of said flat base;

(c) a stiff arcuate arm member of radius at least twice the diameter of the fractured bone, said arm member being adjustably positionable in the bore of said headed part, and selectively operable means for securing said arm member to said bracket in an adjusted position thereof; and

(d) a goniometer-end mount having a selectively lockable ball-joint connection to a base unit, wherein the base unit has an elongate bore for adjustable positioning of said base unit along said arm member, and selectively operable means for clamping said base unit to said arm member in an adjusted position thereof.

17. The kit of claim 16, in which the headed body portion of said bracket is otherwise flat and extends at an acute angle from said base.

18. The kit of claim 16, in which said goniometer-end mount has a straight guide for generally horizontal reception and orientation of a goniometer end, with means carried by said mount for selectively fixed retention of the orientation of the goniometer end.

19. The kit of claim 18, in which an elongate bubblesight level indicator is fixedly connected to said mount with its elongation axis substantially normal to the direction of said straight guide, whereby to establish a predetermined horizontal reference for subsequently stressed deflection of a mounted goniometer.

20. The kit of claim 16, in which said arm member is a rod of constant polygonal section.

21. The kit of claim 20, in which said constant polygonal section is hexagonal.

22. The kit of claim 20, in which said polygonal section is characterized by opposed parallel sides that respectively define concave and convex limiting surfaces of the arc of said rod.

23. The kit of claim 22, in which the selectively operable means for securing said rod to said bracket is a set-screw threaded to the headed part on an alignment parallel to the flat body part of said bracket and normal to the bore of said headed part.

24. The kit of claim 22, in which the selectively operable means for clamping said base unit to said rod is a set-screw threaded to said base unit on an alignment normal to said elongate bore.

25. The kit of claim 24, in which the base unit connected to said goniometer-end mount is via a ballmounting stem anchored to said base unit on an axis normal to said elongate bore, the ball being captive in a seat formation of said goniometer-end mount.

26. The kit of claim 25, in which a set-screw is threaded to said goniometer-end mount on an alignment which intersects the ball center and is generally normal to a geometric plane established by the direction of said straight guide and by the elongation axis of said level indicator.

27. The kit of claim 18, in which said straight guide is adapted to support a goniometer-end fitting of constant isosceles-triangular section having a base that is larger than its two other sides, said straight guide having a section which conforms to one of said two sides and to at least a portion of the other of said two sides adjacent an apex connecting said two other sides, and selectively operable means including a set-screw threaded to said mount on an alignment normal to the base side of said triangular section for releasably clamping the goniometer-end fitting in fixed seated engagement with the other two side portions of said triangular section.

28. The kit of claim 27, in which said straight guide is one of two parallel straight-guide formations of said mount, wherein the selectively clamped orientation of the base of the triangular section in one of said straight-guide formations is normal to the selectively clamped orientation of the base of the triangular section in the other of said straight-guide formations.

29. The kit of claim 16, in which said jaw members are pivotally connected to each other at one longitudinal end thereof.

30. The kit of claim 16, in which the flat base of said bracket is one of said jaw members, whereby said bracket is an integral part of a portion of said bone-screw clamp.

31. A kit according to claim 16, wherein the components (a), (b), (c) and (d) are in duplicate.

32. A kit according to claim 31, further comprising an elongate bending-stress goniometer having end fittings adapted for mounting in the straight guides of the respective duplicate mounts.

33. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced clamps each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein the external fixation and said spaced clamps have been removed for a goniometer evaluation of bone-strength;

said combination comprising

(a) a bone-screw clamp having two jaw members and two bolts on spaced alignments through both jaw members, for fixing said jaw members in simultaneous squeezing engagement with two bone screws on one longitudinal side of the fracture;

(b) a bracket having a flat base with bolt apertures spaced for registry with said bolts, whereby to clamp said base on one side of one of said jaw members upon securing said bone-screw clamp to the engaged two bone screws;

said bracket having a headed body portion extending away from said base, said body portion having a bore inclined at an acute angle to the plane of said flat base;

(c) a stiff arcuate arm member of radius at least twice the diameter of the fractured bone, said arm member being adjustably positionable in the bore of said headed part, and selectively operable means for securing said arm member to said bracket in an adjusted position thereof; and

(d) a goniometer-end mount having a ball-joint connection to a base unit, wherein the base unit has an elongate bore for adjustable positioning of said base unit along said arm member, and selectively operable means for clamping said ball-joint connection and for clamping said base unit to said arm member.

34. A kit of adjustably connectable components for use in selectively mounting of one of two longitudinal ends of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced clamps each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein the external fixation and said spaced clamps have been removed for goniometer evaluation of bone strength;

said kit comprising;

(a) a bone-screw clamp having two jaw members and two bolts on spaced alignments through both jaw members, for fixing said jaw members in simultaneous squeezing engagement with two bone screws on one longitudinal side of the fracture;

(b) a bracket having a flat base with bolt apertures spaced for registry with said bolts, whereby to clamp said base on one side of one of said jaw members upon securing said bone-screw clamp to the engaged two bone screws;

said bracket having a headed body portion extending away from said base, said body portion having a bore inclined at an acute angle to the plane of said flat base;

(c) a stiff arcuate arm member of radius at least twice the diameter of the fractured bone, said arm member being adjustably positionable in the bore of said headed part, and selectively operable means for securing said arm member to said bracket in an adjusted position thereof; and

(d) a goniometer-end mount having a ball-joint connection to a base unit, wherein the base unit has an elongate bore for adjustable positioning of said base unit along said arm member, and selectively operable means for clamping said ball-joint connection and for clamping said base unit to said arm member.

35. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced locations each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein external fixation has been disconnected for a goniometer evaluation of bone-strength;

said combination comprising;

(a) a goniometer-end mount adapted for longitudinally orienting one end of an elongate goniometer, said mount including level-sensitive indicating means for an alignment transverse to the mounted longitudinal orientation of a goniometer end;

(b) rigid base structure including selectively operable adjustable and releasably clampable means for rigid reference of said base unit to the bone screws at one of said locations; and

(c) means including a selectively clampable ball-joint connection operative between said goniometer-end mount and said rigid base structure.

36. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evalution of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, (i) wherein the external fixation has been between longitudinally spaced clamps each of which has been fixed to externally projecting ends of at least two bone screws, (ii) wherein the respective clamps and their respective bone screws are at opposite longitudinal offset from the fracture, and (iii) where the external fixation has been disconnected for a goniometer evaluation of bone-strength;

said combination comprising;

(a) a goniometer-end mount having upper structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongate goniometer in a vertical plane which includes the elongation axis of the bone;

(b) said mount having lower structure connected to said upper structure and including selectively adjustable and releasably clampable means for rigid bone-screw referenced positioning of said upper structure in external vertical offset above the bone and on the same longitudinal side of the fracture as the side of the associated bone screws; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

37. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of an elongate bone via first and second clamps which are referenced to the bone at longitudinally spaced locations along the bone, said combination comprising:

(a) a goniometer-end mount having upper structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongate goniometer in a vertical plane which includes the elongation axis of the bone between said spaced locations;

(b) said mount having lower structure connected to said upper structure and including selectively adjustable and releasably clampable means for rigid bone-screw referenced positioning said upper structure in external vertical offset above the bone at the longitudinal location of said one clamp; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

38. In combination, for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of an elongate bone via first and second clamps which are referenced to the bone at longitudinally spaced locations along the bone, said combination comprising:

(a) a goniometer-end mount having first structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongate goniometer in a vertical plane which includes the elongation axis of the bone between said spaced locations;

(b) said mount having second structure connected to said first structure and including selectively adjustable and releasably clampable means for rigidly referenced connection to one of said clamps and positioning said first structure in external vertical offset with respect to the bone at the longitudinal location of said one clamp; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

39. The combination of claim 38, in which the vertical offset of said first structure is above the bone.

40. A kit of adjustably connectable components for use in selective mounting of one of two longitudinal ends of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, wherein the external fixation has been between longitudinally spaced locations each of which was fixed to externally projecting ends of at least two spaced bone screws, and wherein the external fixation has been disconnected for a goniometer evalution of bone-strength;

said kit comprising;

(a) a goniometer-end mount adapted for longitudinally orienting one end of an elongate goniometer, said mount including level-sensitive indicating means for an alignment transverse to the mounted longitudinal orientation of a goniometer end;

(b) rigid base structure including selectively operable adjustable and releasably clampable means for rigid reference of said base unit to the bone screws at one of said locations; and

(c) means including a selectively clampable ball-joint connection operatively between said goniometer-end mount and said rigid base structure.

41. A kit of adjustably connectable components for use in selective mounting of a bending-stress goniometer in an evaluation of the strength of a bone fracture which has been under external fixation for a period of bone-recovery time, (i) wherein the external fixation has been between longitudinally spaced clamps each of which has been fixed to externally projecting ends of at least two bone screws, (ii) wherein the respective clamps and their respective bone screws are at opposite longitudinal offsets from the fracture, and (iii) wherein the external fixation has been disconnected for a goniometer evaluation of bone-strength;

said kit comprising;

(a) a goniometer-end mount having upper structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongation goniometer in a vertical plane which includes the elongation axis of the bone;

(b) said mount having lower structure connected to said upper structure and including selectively adjustable and releasably clampable means for rigid bone-screw referenced positioning of said upper structure in external vertical offset above the bone and on the same longitudinal side of the fracture as the side of the associated bone screws; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

42. A kit of adjustably connectable components for use in selective mounting of a bending-stress goniometer in an evaluation of the strength of an elongate bone via first and second clamps which are referenced to the bone at longitudinally spaced locations along the bone, said kit comprising:

(a) a goniometer-end mount having upper structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongate goniometer in a vertical plane which includes the elongation axis of the bone between said spaced locations;

(b) said mount having lower structure connected to said upper structure and including selectively adjustable and releasably clampable means for rigid bone-screw referenced positioning of said upper structure in external vertical offset above the bone at the longitudinal location of said one clamp; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

43. A kit of adjustably connectable components for use in duplicate in selective mounting of a bending-stress goniometer in an evaluation of the strength of an elongate bone via first and second clamps which are referenced to the bone at longitudinally spaced locations along the bone, said kit comprising:

(a) a goniometer-end mount having first structure for keyed longitudinal accommodation and for generally horizontal orientation of one end of an elongate goniometer in a vertical plane which includes the elongation axis of the bone between said spaced locations;

(b) said mount having second structure connected to said first structure and including selectively adjustable and releasably clampable means for rigid bone-screw referenced positioning said first structure in external vertical offset with respect to the bone at the longitudinal location of said one clamp; and

(c) said mount further including level-sensing means adjacent said one end and oriented to sense tilt of said one end about the longitudinal axis at said one end.

44. A kit according to claim 43, wherein the components (a), (b), and (c) are in duplicate.

45. A kit according to claim 44, further comprising an elongate bending-stress goniometer having end fittings adapted for mounting accommodation in the respective duplicate mounts.