JP2015155032A - 整形外科用移植片および締結具アセンブリ - Google Patents
整形外科用移植片および締結具アセンブリ Download PDFInfo
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- 239000007943 implant Substances 0.000 title claims abstract description 20
- 230000000399 orthopedic effect Effects 0.000 title claims description 11
- 230000006835 compression Effects 0.000 claims abstract description 121
- 238000007906 compression Methods 0.000 claims abstract description 121
- 238000000034 method Methods 0.000 claims description 8
- 210000000988 bone and bone Anatomy 0.000 description 36
- 206010017076 Fracture Diseases 0.000 description 21
- 208000010392 Bone Fractures Diseases 0.000 description 20
- 210000000689 upper leg Anatomy 0.000 description 19
- 230000007704 transition Effects 0.000 description 15
- 239000012634 fragment Substances 0.000 description 11
- 238000005452 bending Methods 0.000 description 8
- 239000000463 material Substances 0.000 description 8
- 230000008901 benefit Effects 0.000 description 7
- 238000003780 insertion Methods 0.000 description 7
- 230000037431 insertion Effects 0.000 description 7
- 208000008924 Femoral Fractures Diseases 0.000 description 6
- 210000001624 hip Anatomy 0.000 description 6
- 230000000712 assembly Effects 0.000 description 5
- 238000000429 assembly Methods 0.000 description 5
- 230000000295 complement effect Effects 0.000 description 5
- 210000002758 humerus Anatomy 0.000 description 5
- 230000007246 mechanism Effects 0.000 description 5
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- 238000005553 drilling Methods 0.000 description 4
- 230000000694 effects Effects 0.000 description 4
- 230000009286 beneficial effect Effects 0.000 description 3
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- 210000002436 femur neck Anatomy 0.000 description 3
- 210000000528 lesser trochanter Anatomy 0.000 description 3
- 230000002787 reinforcement Effects 0.000 description 3
- 210000002303 tibia Anatomy 0.000 description 3
- 241000587161 Gomphocarpus Species 0.000 description 2
- 206010020100 Hip fracture Diseases 0.000 description 2
- 230000001054 cortical effect Effects 0.000 description 2
- 238000005520 cutting process Methods 0.000 description 2
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- 230000035876 healing Effects 0.000 description 2
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- XRKOOHTZZDPJNE-UHFFFAOYSA-N CCCCCC(F)(F)F Chemical compound CCCCCC(F)(F)F XRKOOHTZZDPJNE-UHFFFAOYSA-N 0.000 description 1
- 206010069135 Periprosthetic fracture Diseases 0.000 description 1
- 208000031074 Reinjury Diseases 0.000 description 1
- 208000027418 Wounds and injury Diseases 0.000 description 1
- 210000000588 acetabulum Anatomy 0.000 description 1
- 230000001154 acute effect Effects 0.000 description 1
- 210000003484 anatomy Anatomy 0.000 description 1
- 238000013459 approach Methods 0.000 description 1
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- 238000005859 coupling reaction Methods 0.000 description 1
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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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7216—Intramedullary pins, nails or other devices for bone lengthening or compression
- A61B17/7225—Intramedullary pins, nails or other devices for bone lengthening or compression for bone compression
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- A—HUMAN NECESSITIES
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- 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
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- 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
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- A—HUMAN NECESSITIES
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- 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
- A61B17/72—Intramedullary pins, nails or other devices
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7258—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone
- A61B17/7266—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with laterally expanding parts, e.g. for gripping the bone with fingers moving radially outwardly
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- 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
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- A—HUMAN NECESSITIES
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- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
- A61B17/744—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to an intramedullary nail
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- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
- A61B17/742—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck
- A61B17/746—Devices for the head or neck or trochanter of the femur having one or more longitudinal elements oriented along or parallel to the axis of the neck the longitudinal elements coupled to a plate opposite the femoral head
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- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
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- 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
- A61B17/8061—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates specially adapted for particular bones
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
- A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
- A61F2/02—Prostheses implantable into the body
- A61F2/30—Joints
- A61F2/32—Joints for the hip
- A61F2/36—Femoral heads ; Femoral endoprostheses
- A61F2/3609—Femoral heads or necks; Connections of endoprosthetic heads or necks to endoprosthetic femoral shafts
- A61F2002/3611—Heads or epiphyseal parts of femur
- A61F2002/3613—Heads or epiphyseal parts of femur with lateral or oblique apertures, holes or openings
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- Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
- Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
- Y10S623/00—Prosthesis, i.e. artificial body members, parts thereof, or aids and accessories therefor
- Y10S623/909—Method or apparatus for assembling prosthetic
- Y10S623/911—Bone
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Neurology (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Veterinary Medicine (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
【解決手段】いくつかの実施例では、移植片は、非円形断面を有する横断アパーチャを備えた近位区画を有し、該非円形断面が、締結アセンブリを横断アパーチャ内で選択的に抑制するように形作られてもよい。締結アセンブリの2つ以上の構成要素は、制御された形で移植片の横断アパーチャ内で滑動するとともに、移植片に加えられる力モーメントに対して協働して抵抗するように受容されてもよい。
【選択図】図45
Description
本出願は、2009年6月30日出願の米国仮特許出願第61/222,078号に対する優先権を主張し、その全内容を参照により本明細書に組み込む。
102 近位区画
104 移行区画
106 遠位区画
108 外側面、外側部
109 内側面、内側部
110 第1の面
114 第1の丸みを付けた角
116 第2の面
118 近位側横断アパーチャ
120 円形アパーチャ
122 円形アパーチャ
128 近位端アパーチャ
130 長手方向ボア
132 ショルダー
134、136 側部
144 フィン
190 上腕骨釘
200 締結具アセンブリ
202 ラグねじ
204 圧迫ねじ
210 ねじ切部分
212 ヘッド区画、チャネル
214 ねじ切区画
300 ツール
302 ドリルビット
304 ほぞノミ
502 圧迫ペグ
503 スロット
504 キー
506 ラチェット歯
602 ラグねじ
606 細長い本体
610 十字ねじ
612 ヘッド部分
614 ねじ切部分
702 ラグねじ
704 圧迫ペグ
706 細長い本体
708 ねじ切端部
710 アパーチャ
712 キー
800 釘
800a 中心長軸
800b ヘッド
801 再構築アパーチャ
803 ショルダー
805 内壁
807 半円筒状区画
809 第2のU字形区画
810 半円筒状アパーチャ
811 第1の部分
812 近位部分
813 軸体
814 遠位部分
820 第2のU字形アパーチャ
821 第2の部分
831 最近位側の穴
832 中央の穴
833 最遠位側の穴
841 第1の開放面
Claims (11)
- 釘の中心長軸からずらして方向付けられた中心貫通軸を有する第1の非円形横断アパーチャであって、ショルダーを含み、圧迫アセンブリを受容するように構成され、前記釘の外側面上にある入口と前記釘の内側面上にある出口とを含む、第1の非円形横断アパーチャと、
前記釘の前記中心長軸からずらして方向付けられた中心貫通軸を有する第2の横断アパーチャであって、前記釘の前記外側面上にある入口と、前記第1の横断アパーチャの前記出口内で前記釘の前記内側面上にある出口と、を有する第2の横断アパーチャと、
を備え、
前記第2の横断アパーチャの前記中心貫通軸が、前記第1の横断アパーチャの前記中心貫通軸から放射方向にオフセットされた軸線に沿って延在する、髄内釘。 - ヘッドをさらに備え、
前記第1の横断アパーチャおよび前記第2の横断アパーチャが前記ヘッドに位置し、前記釘の遠位端に近接して位置する第3の横断アパーチャをさらに備える、請求項1に記載の髄内釘。 - 前記ヘッドが、前記長軸に対して角度が付けられている、請求項2に記載の髄内釘。
- 前記長軸の方向に延在するボアであって、前記第1の横断アパーチャと交差するボアをさらに備える、請求項1に記載の髄内釘。
- 長軸と、前記長軸からずらして方向付けられた貫通穴を画定する内壁と、前記貫通穴に近接した第1の横断アパーチャと、を有する釘を備える整形外科用移植片において、
前記内壁が、
180°を超える円弧を有する第1の半円筒状区画であって、前記貫通穴の第1の部分を画定する第1の半円筒状区画と、
一対の平行な壁と、約180°の円弧を有する半円筒状セグメントとを有する第2のU字形区画であって、前記貫通穴の第2の部分を画定する第2のU字形区画とを備え、
前記第1の半円筒状区画の前記円弧が前記貫通穴の前記第1の部分の第1の開放面を画定し、前記第2のU字形区画の前記平行な壁が、前記第1の開放面に対向する前記貫通穴の前記第2の部分の第2の開放面を画定し、それによって、前記第2の半円筒状区画の円弧とほぼ同じ直径の円筒状部材が前記貫通穴の前記第2の部分から前記貫通穴の前記第1の部分に向かって通り抜けることができる、整形外科用移植片。 - 前記第1の横断アパーチャが、前記内壁に位置する出口を有する、請求項5に記載の整形外科用移植片。
- 前記第1の横断アパーチャが、前記貫通穴の向きから放射方向にオフセットされた軸線に沿って延在する、請求項5に記載の整形外科用移植片。
- 前記釘が、前記釘の遠位端に近接して位置する第2の横断アパーチャをさらに備える、請求項5に記載の整形外科用移植片。
- 前記第2の横断アパーチャが、前記釘の前記長軸に対して垂直でない軸線に沿って延在する、請求項8に記載の整形外科用移植片。
- 前記第1の横断アパーチャが前記長軸からずらして方向付けられるとともに、前記釘のヘッドに位置する入口を有し、前記釘の前記ヘッドが前記釘の前記長軸に対して角度が付けられている、請求項5に記載の整形外科用移植片。
- 前記釘の遠位端に近接して位置する第2の横断アパーチャをさらに備え、前記第2の横断アパーチャが前記第1の近位側アパーチャの前記出口と一直線に並ぶ開口部を有する、請求項5に記載の整形外科用移植片。
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US22207809P | 2009-06-30 | 2009-06-30 | |
US61/222,078 | 2009-06-30 |
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JP2012517894A Division JP5801297B2 (ja) | 2009-06-30 | 2010-06-30 | 整形外科用移植片および締結具アセンブリ |
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JP2015112340A Active JP6138856B2 (ja) | 2009-06-30 | 2015-06-02 | 整形外科用移植片および締結具アセンブリ |
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US (1) | US8834469B2 (ja) |
EP (1) | EP2448505B1 (ja) |
JP (2) | JP5801297B2 (ja) |
KR (1) | KR101743051B1 (ja) |
CN (2) | CN102639074B (ja) |
AU (2) | AU2010266297B2 (ja) |
BR (1) | BRPI1011556A2 (ja) |
CA (1) | CA2765376C (ja) |
RU (1) | RU2580978C2 (ja) |
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Cited By (5)
Publication number | Priority date | Publication date | Assignee | Title |
---|---|---|---|---|
JP2019511347A (ja) * | 2016-03-18 | 2019-04-25 | ドン フン リー | チルト防止機能を有する髄内釘 |
JP2019080918A (ja) * | 2017-10-27 | 2019-05-30 | ライト メディカル テクノロジー インコーポレイテッドWright Medical Technology, Inc. | 髄内部分及びずれた髄外部分を有するインプラント |
US10682168B2 (en) | 2016-09-15 | 2020-06-16 | Wright Medical Technology, Inc. | Intramedullary implant with proximal plate and method for its use |
JP2021115433A (ja) * | 2020-01-23 | 2021-08-10 | 株式会社シミズテック | 人工股関節用ステム |
US11660201B2 (en) | 2018-10-25 | 2023-05-30 | Wright Medical Technology, Inc. | Systems, apparatuses, and methods for correcting a bone defect |
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ES2435573T3 (es) | 2007-11-26 | 2013-12-20 | Biedermann Motech Gmbh & Co. Kg | Clavo ortopédico para el talón |
US20110046625A1 (en) * | 2008-05-07 | 2011-02-24 | Tornier | Surgical technique and apparatus for proximal humeral fracture repair |
EP2498701B1 (en) * | 2009-11-10 | 2022-01-05 | Smith & Nephew, Inc. | Controlling bone compression |
US10588647B2 (en) | 2010-03-01 | 2020-03-17 | Stryker European Holdings I, Llc | Computer assisted surgery system |
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US10881436B2 (en) | 2017-10-27 | 2021-01-05 | Wright Medical Technology, Inc. | Implant with intramedullary portion and offset extramedullary portion |
US11813003B2 (en) | 2017-10-27 | 2023-11-14 | Wright Medical Technology, Inc. | Implant with intramedullary portion and offset extramedullary portion |
US11660201B2 (en) | 2018-10-25 | 2023-05-30 | Wright Medical Technology, Inc. | Systems, apparatuses, and methods for correcting a bone defect |
JP2021115433A (ja) * | 2020-01-23 | 2021-08-10 | 株式会社シミズテック | 人工股関節用ステム |
Also Published As
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EP2448505A2 (en) | 2012-05-09 |
KR20120090932A (ko) | 2012-08-17 |
CN102639074A (zh) | 2012-08-15 |
CN105726112A (zh) | 2016-07-06 |
JP5801297B2 (ja) | 2015-10-28 |
BRPI1011556A2 (pt) | 2016-03-29 |
AU2010266297B2 (en) | 2016-02-25 |
US8834469B2 (en) | 2014-09-16 |
WO2011002903A2 (en) | 2011-01-06 |
RU2012101964A (ru) | 2013-08-10 |
CN105726112B (zh) | 2021-04-27 |
CA2765376A1 (en) | 2011-01-06 |
RU2580978C2 (ru) | 2016-04-10 |
AU2010266297A1 (en) | 2012-01-19 |
US20120143192A1 (en) | 2012-06-07 |
CN102639074B (zh) | 2016-03-16 |
EP2448505A4 (en) | 2014-11-26 |
JP2012531955A (ja) | 2012-12-13 |
AU2016202215B2 (en) | 2017-08-31 |
JP6138856B2 (ja) | 2017-05-31 |
KR101743051B1 (ko) | 2017-06-02 |
EP2448505B1 (en) | 2019-06-26 |
CA2765376C (en) | 2017-06-06 |
WO2011002903A3 (en) | 2011-04-28 |
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