JP2003530196A - 骨固定組立体 - Google Patents
骨固定組立体Info
- Publication number
- JP2003530196A JP2003530196A JP2001575920A JP2001575920A JP2003530196A JP 2003530196 A JP2003530196 A JP 2003530196A JP 2001575920 A JP2001575920 A JP 2001575920A JP 2001575920 A JP2001575920 A JP 2001575920A JP 2003530196 A JP2003530196 A JP 2003530196A
- Authority
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- Prior art keywords
- screw
- bone
- fastening screw
- bushing
- hole
- Prior art date
- Legal status (The legal status is an assumption and is not a legal conclusion. Google has not performed a legal analysis and makes no representation as to the accuracy of the status listed.)
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8047—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers wherein the additional element surrounds the screw head in the plate hole
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/80—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates
- A61B17/8033—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers
- A61B17/8038—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates having indirect contact with screw heads, or having contact with screw heads maintained with the aid of additional components, e.g. nuts, wedges or head covers the additional component being inserted in the screw head
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
- A61B17/7059—Cortical plates
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/56—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
- A61B17/58—Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor for osteosynthesis, e.g. bone plates, screws, setting implements or the like
- A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
- A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
Landscapes
- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Animal Behavior & Ethology (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
- Materials For Medical Uses (AREA)
Abstract
Description
組立体に関する。
用により骨に頻繁に結合される。例えば、骨板は板穴に挿入される骨ねじで骨に
固定し得る。板へのねじの固定は、板とねじの間の一定角度関係を与え、ゆるみ
の発生を減少する。ねじを板に固定する一つの方法は、所謂“膨張ヘッドねじ”
の使用を伴う。米国特許第4,484,570 号は、くぼみを有するヘッドを備えた膨張
ヘッドねじを開示しており、そのくぼみの壁が幾つかのスリットを含む。膨張ヘ
ッドねじが固定装置中の穴を通って骨に挿入された後に、ロックねじがくぼみに
挿入されてくぼみの壁を膨張させ、それによりねじを固定装置にロックする。
置に対する角度で挿入することがまたしばしば望ましい。その従来技術は幾つか
のこれらの所謂“多軸”系を開示しており、これらの殆どが固定装置中の穴に配
置されたブシュを利用して固定装置に対するねじの角度調節を与える。例えば、
米国特許第5,954,722 号は、穴内で回転可能なブシュを有する板穴を含む多軸ロ
ック板を開示している。ねじがブシュ及び板穴を通って骨に挿入されている際に
、ねじのねじ込みヘッドがブシュのねじ込み内面に係り合ってブシュを板穴の壁
に対して膨張させ、それによりねじを板に対する所望の角度配向でロックする。
一旦所望の配向にある場合の締結ねじのロックを可能にする改良された骨固定組
立体に関する。
組立体は、固定装置、ブシュ、締結ねじ、及びロックねじを含む。ブシュは固定
装置の貫通穴内の多軸回転のための形状とされ、そして寸法とされた外面及びブ
シュの上表面及び下表面中に延びる穴を形成する内面を有する側壁を有する。側
壁は固定装置の貫通穴に対する側壁の外向きの膨張を可能にし、それによりブシ
ュを固定装置の貫通穴の軸線に対して選ばれた角度でロックするための少なくと
も一つのスロットを有する。
定装置を骨に固定するために骨にねじ込み自在に挿入可能なねじ込み軸を有する
。締結ねじのヘッドはブシュ中の挿入のための形状、寸法にされ、半径方向の壁
及びくぼみを形成する開いた端部を含む。半径方向の側壁は半径方向の壁の外向
きの膨張を可能にし、それによりブシュの側壁を外向きに膨張するための少なく
とも一つのスリットを有する。ロックねじは締結ねじのヘッドにねじ込み自在に
受容され、それにより締結ねじの半径方向の壁を外向きに膨張するねじ込みボデ
ィを有する。
がブシュの中心軸中に延び、上表面及び下表面に垂直である。例示の実施形態に
おいて、ブシュは環状ショルダを有し、締結ねじのヘッドがショルダに対して載
っている場合に、締結ねじのヘッドはブシュの上表面と同一平面(flush )にあ
る。締結ねじは締結ねじが穴にねじ込まれる場合に環状ショルダに載る半径方向
の壁から突出するリップを備えることができる。
トを含む。更に、スロットの一つは上表面から完全に下表面中に延びることがで
きる。貫通穴内のブシュの安全性を更に増大するために、ブシュの側壁及び/又
は固定装置の貫通穴の壁の外面はうね(ridge )を備えることができる。
ングねじであってもよい。締結ねじはまたセルフドリリングねじであってもよい
。例示の実施形態において、締結ねじのヘッドはねじ込み軸に近位のテーパ付き
部分を含む。
みボディの少なくとも一部をねじ込み自在に受容するためのねじ穴を有する。ロ
ックねじはテーパ付き端部を有し得る。更に、締結ねじのヘッドの半径方向の壁
はマッチングテーパ付き内面を有し得る。
じは固定装置の貫通穴に配置されたブシュ中に挿入される。次いで締結ねじは骨
にねじ込まれる。ねじ込み工程が完結された後に、締結ねじがブシュ及び固定装
置にロックされる。締結ねじは固定装置に対し外科医により選ばれた配向でブシ
ュ中に挿入し得る。締結ねじヘッドはブシュに対し膨張されることが好ましく、
それによりブシュを固定装置にロックする。ロックねじは締結ねじヘッド中のく
ぼみに挿入されて膨張を生じ得る。
中の同様の要素を表す。
素が同じ参照番号で同定された。更に、以下の記載中、配向又は方向へのあらゆ
る言及は主として記載の便宜のために意図され、本発明の範囲をそれに限定する
ことを何ら意図していない。
12を有する骨固定装置10を示す。装置10は骨板として示されるが、装置10はいか
なる好適な内部又は外部固定装置であってもよい。このような装置の例として、
外部固定装置、脊髄杆体用のクランプ及び同様のもの等が挙げられる。貫通穴12
の夫々がブシュ14を有する。
び側壁20を有する。側壁20は貫通穴12内の多軸回転のための形状とされ、そして
寸法とされた外面22を有する。結果として、また以下に更に詳しく記載されるよ
うに、ブシュ14の内面26により形成され、上表面16及び下表面18の両者を通って
延びる穴24中に挿入されたファスナが、装置10に対し種々の配向にて挿入し得る
。例示の実施形態において、ブシュ14は切頭球形を有する。また、ブシュ14は切
頭円錐形を有し得る。いずれの形状でも、穴24が平行な上表面16及び下表面18に
垂直な中央の長さ方向の軸線を通じて延びることができる。
穴12に対して外向きに膨張することを可能にする。この外向きの膨張がブシュ14
を貫通穴12の軸に対し選ばれた配向(方向決め)にてロックする。膨張後のロッ
ク効果を高めるために、側壁20及び/又は貫通穴12の周囲の外面22はうね30を備
え得る。うね30は側壁20が外向きに一旦膨張すると、装置10に対するブシュ14の
移動に抵抗する付加的な機構を与える。ブシュ14は四つのスロットを有して示さ
れるが、選ばれた数のスロットが側壁20の外向きの膨張を与える限り、一つを含
む、いかなる数のスロットでも使用可能である。図5に示されるように、スロッ
ト28a が上表面16から下表面18を通して延び、一方、スロット28の残りは下表面
18へは延びない。スロット28の全てがブシュ14の上表面16から延びる。しかしな
がら、図9に示されるように、スロット28は上表面16及び下表面18の両方から延
びることができる。図9のスロット28は交互パターンで延びるが、その他のパタ
ーンが使用し得る。
じ34を含む。締結ねじ32は、ブシュ14の貫通穴24に挿入するねじ込み軸36を有し
、骨にねじ込まれてブシュ14及び装置10を骨に固定する。締結ねじ32は、骨中に
作られた穴に前もってねじ込む必要をなくすためにセルフタッピングねじであっ
てもよい。更に、締結ねじ32はまた穴を前もって開ける必要をなくすためにセル
フドリリングであってもよい。締結ねじ32のヘッド38は締結ねじ32が骨にねじ込
まれた場合に実質的にブシュ14内に位置する。例示の実施形態において、穴24は
環状ショルダ40(図4)を有し、その結果、ヘッド38はヘッド38がショルダ40に
対し載る場合にブシュ14の上表面16と同一平面にある。これは本発明の固定組立
体について低プロフィールをもたらす。ヘッド38は半径方向の壁44から突出する
リップ42を備え得る。リップ42は締結ねじ32が骨にねじ込まれた場合にショルダ
40に対し載ってプロフィールを更に減少する。
も一つのスリット46を含む。こうして、ヘッド38がブシュ14の穴24内に配置され
る場合、締結ねじ32の半径方向の壁44の外向きの膨張がブシュ14の側壁20の外向
きの膨張を生じる。締結ねじ32は、該締結ねじ32がブシュ14の穴24を通って骨に
ねじ込まれる際に、膨張効果を最大にするために、ねじ込み軸36の近位のテーパ
付き部分を含むことができる。
半径方向の壁44は、ロックねじ34が挿入されて半径方向の壁44を外向きに膨張さ
せるくぼみ50を形成する。ロックねじ34は締結ねじ32中のねじ込み盲穴54中に受
容されるねじ込みボディ52を有する。締結ねじ32のヘッド38の半径方向の壁44は
ロックねじ34のテーパ付き端部58と協力するテーパ付き内面56を有し、その結果
、ロックねじ34が盲穴54にねじ込まれる際に、テーパ付き端部58が半径方向の壁
44を外向きに推し進める。
リングではない場合、穴が装置10に対し所望の方向に骨を通して開けられる(図
10)。これは、貫通穴12内でブシュ14を回転させることにより達成される。締結
ねじ32がブシュ14中に挿入され、骨にねじ込まれて装置10を骨に固定する(図11
)。ヘッド38は骨にねじ込むためのドライバと係り合うための機構を備え得る。
例えば、図7はスロット28が骨への挿入のためのドライバのブレードを受容する
ことを可能にするパターンでスロットが形成されることを示す。
れる。ロックねじ34がねじ込み盲穴54にねじ込まれる際に、ロックねじ34のテー
パ付き端部58が締結ねじ32の半径方向の壁44に対し押しつけて半径方向の壁44の
外向きの膨張を推し進める。半径方向の壁のこの外向きの膨張が順にブシュ14の
側壁20の外向きの膨張を生じ、それにより締結ねじ32、ブシュ14、及び装置10を
剛性構造として骨にロックする。締結ねじ32が骨にねじ込まれた後に締結ねじ32
のロックが生じるので、締結ねじ32を骨に挿入することが或る種の従来技術のデ
ザイン(これらは同時の挿入及びロックをもたらす)よりも容易である。更に、
ヘッド38がロック工程中に物理的に変形されるので(ブシュの物理的変形とは丁
度反対のように)、本発明の組立体は、ブシュ14と締結ねじ32の間の相互ロック
を改良してゆるみが時間につれて生じないことを確実にするように助ける。
合わせで使用し得ることが理解されるべきである。それ故、本発明は本明細書に
示された特別好ましい実施形態のみに限定されるべきではない。
じ得ることが理解されるべきである。それ故、本発明の範囲内にある本明細書に
示された開示から当業者により容易に得られるあらゆる適当な改良が本発明の更
なる実施形態として含まれるべきである。それ故、本発明の範囲は特許請求の範
囲に示されるように特定される。
板の平面図を示す。
有する本発明の骨固定組立体の斜視図を示す。
Claims (20)
- 【請求項1】 貫通穴12を有する固定装置10と、 上表面16及び下表面18を備え、固定装置10の貫通穴12内の多軸回転のための形
状とされそして寸法とされた外面22、並びに上表面16及び下表面18を貫いて延び
る穴24を形成する内面26を有する側壁20を備え、固定装置10の貫通穴12に対する
側壁20の外向きの膨張を可能にし、それにより固定装置10の貫通穴12の軸線に対
する選ばれた角度でブシュ14をロックするために側壁20に配置された少なくとも
一つのスロット28,28a を備えるブシュ14と、 ブシュ14の穴24中への挿入のための形状とされそして寸法とされ、かつブシュ
14及び固定装置10を骨に固定するために骨にねじ込み自在に挿入可能なねじ込み
軸36を備え、ブシュ14中への挿入のための形状とされそして寸法とにされ、かつ
半径方向の壁44及びくぼみ50を形成する開いた端部を含むヘッド38を備え、半径
方向の壁44の外向きの膨張を可能にし、それによりブシュ14の側壁20を外向きに
膨張させるために半径方向の壁44に配置された少なくとも一つのスリット46を備
える締結ねじ32と、 締結ねじ32のヘッド38中にねじ込み自在に受容され、それにより締結ねじ32の
半径方向の壁44を外向きに膨張させるねじ込みボディ52を有するロックねじ34と
、 を含むことを特徴とする骨固定組立体。 - 【請求項2】 固定装置10が骨板である請求項1に記載の骨固定組立体。
- 【請求項3】 ブシュ14が中心の長さ方向の軸線を備えた実質的に切頭球形
を有する請求項1に記載の骨固定組立体。 - 【請求項4】 穴24がブシュ14の中心軸線を通って延び、上表面16及び下表
面18に対し垂直である請求項3に記載の骨固定組立体。 - 【請求項5】 ブシュ14の穴24が環状ショルダ40を有し、締結ねじ32のヘッ
ド38がショルダ40に対し載っている場合に、締結ねじ32のヘッド38がブシュ14の
上表面16と同一平面にある請求項1に記載の骨固定組立体。 - 【請求項6】 締結ねじ32のヘッド38が半径方向の壁44から突出するリップ
42を有する請求項5に記載の骨固定組立体。 - 【請求項7】 少なくとも一つのスロット28,28a がブシュ14の上表面16か
ら延びる複数のスロット28,28a を含む請求項1に記載の骨固定組立体。 - 【請求項8】 複数のスロット28,28a の一つが上表面16から下表面18を通
じて延びる請求項7に記載の骨固定組立体。 - 【請求項9】 ブシュ14の側壁20の外面22がうね30を含む請求項1に記載の
骨固定組立体。 - 【請求項10】 固定装置10の貫通穴12がうね30を含む請求項1に記載の骨
固定組立体。 - 【請求項11】 締結ねじ32がセルフタッピングねじである請求項1に記載
の骨固定組立体。 - 【請求項12】 締結ねじ32がセルフドリリングねじである請求項1に記載
の骨固定組立体。 - 【請求項13】 締結ねじ32のヘッド38がねじ込み軸36に近位のテーパ付き
部分を含む請求項1に記載の骨固定組立体。 - 【請求項14】 締結ねじ32のヘッド38の半径方向の壁44がテーパ付きの内
面56を有する請求項1に記載の骨固定組立体。 - 【請求項15】 ロックねじ34がテーパ付きの端部58を有する請求項1に記
載の骨固定組立体。 - 【請求項16】 締結ねじ32のくぼみ50がロックねじ34のねじ込みボディ52
の少なくとも一部をねじ込み自在に受容するためのねじ穴を有する下表面を有す
る請求項1に記載の骨固定組立体。 - 【請求項17】 貫通穴12を有する固定装置10を骨に固定する方法であって
、その方法が 締結ねじ32を固定装置10の貫通穴12中に配置されたブシュ14中に挿入する工程
、 締結ねじ32を骨にねじ込む工程、及び 該ねじ込む工程が完結した後に締結ねじ32をブシュ14及び固定装置10にロック
する工程 を含むことを特徴とする上記固定方法。 - 【請求項18】 締結ねじ32を固定装置10に対して外科医により選ばれた配
向でブシュ14中に挿入する請求項17に記載の方法。 - 【請求項19】 締結ねじ32がヘッド38を有し、ロックする工程が、それに
よりブシュ14を固定装置10にロックするべく締結ねじヘッド38をブシュ14に対し
て膨張させる工程を含む請求項17に記載の方法。 - 【請求項20】 膨張させる工程がロックねじ34をヘッド38中のくぼみ50に
挿入する工程を含む請求項19に記載の方法。
Applications Claiming Priority (3)
Application Number | Priority Date | Filing Date | Title |
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US09/453,911 US6235033B1 (en) | 2000-04-19 | 2000-04-19 | Bone fixation assembly |
US09/453,911 | 2000-04-19 | ||
PCT/CH2001/000190 WO2001078615A1 (en) | 2000-04-19 | 2001-03-28 | Bone fixation assembly |
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Publication Number | Publication Date |
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JP2003530196A true JP2003530196A (ja) | 2003-10-14 |
JP4416982B2 JP4416982B2 (ja) | 2010-02-17 |
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JP2001575920A Expired - Lifetime JP4416982B2 (ja) | 2000-04-19 | 2001-03-28 | 骨固定組立体 |
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US (3) | US6235033B1 (ja) |
EP (1) | EP1276430B1 (ja) |
JP (1) | JP4416982B2 (ja) |
AT (1) | ATE337739T1 (ja) |
AU (1) | AU778117B2 (ja) |
CA (1) | CA2405053C (ja) |
DE (1) | DE60122699T2 (ja) |
ES (1) | ES2269359T3 (ja) |
NZ (1) | NZ520840A (ja) |
WO (1) | WO2001078615A1 (ja) |
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JP2008543434A (ja) * | 2005-06-15 | 2008-12-04 | ストライカー・スピン | 頚椎前方プレート |
JP4887360B2 (ja) * | 2005-06-15 | 2012-02-29 | ストライカー・スピン | 頚椎前方プレート |
JP2010535063A (ja) * | 2007-07-31 | 2010-11-18 | ストライカー・スピン | 椎体プレーティングのためのシステムおよび方法 |
US8556944B2 (en) | 2007-07-31 | 2013-10-15 | Stryker Spine | System and method for vertebral body plating |
JP2014097407A (ja) * | 2007-11-02 | 2014-05-29 | Biomet Cv | 肘骨折固定システム |
US9750549B2 (en) | 2007-11-02 | 2017-09-05 | Biomet C.V. | Plate benders for bone plates |
JP2016526433A (ja) * | 2013-06-25 | 2016-09-05 | グローバス メディカル インコーポレイティッド | 整形外科用アンカー組立体 |
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US20030199876A1 (en) | 2003-10-23 |
DE60122699D1 (de) | 2006-10-12 |
US20010037112A1 (en) | 2001-11-01 |
EP1276430A1 (en) | 2003-01-22 |
AU778117B2 (en) | 2004-11-18 |
NZ520840A (en) | 2004-05-28 |
CA2405053A1 (en) | 2001-10-25 |
US6235033B1 (en) | 2001-05-22 |
WO2001078615A1 (en) | 2001-10-25 |
JP4416982B2 (ja) | 2010-02-17 |
US6890334B2 (en) | 2005-05-10 |
EP1276430B1 (en) | 2006-08-30 |
DE60122699T2 (de) | 2007-09-20 |
ES2269359T3 (es) | 2007-04-01 |
ATE337739T1 (de) | 2006-09-15 |
CA2405053C (en) | 2007-01-09 |
US6575975B2 (en) | 2003-06-10 |
AU3908801A (en) | 2001-10-30 |
ZA200206444B (en) | 2003-04-29 |
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