JP2019013772A - 骨固定システム - Google Patents
骨固定システム Download PDFInfo
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 281
- 239000007943 implant Substances 0.000 claims abstract description 165
- 238000004873 anchoring Methods 0.000 claims description 29
- 238000003780 insertion Methods 0.000 abstract description 57
- 230000037431 insertion Effects 0.000 abstract description 57
- 208000020089 femoral neck fracture Diseases 0.000 abstract description 10
- 230000001681 protective effect Effects 0.000 description 55
- 238000000034 method Methods 0.000 description 28
- 230000007246 mechanism Effects 0.000 description 20
- 238000005553 drilling Methods 0.000 description 12
- 210000002436 femur neck Anatomy 0.000 description 9
- 210000000689 upper leg Anatomy 0.000 description 8
- 206010017076 Fracture Diseases 0.000 description 6
- 230000008878 coupling Effects 0.000 description 6
- 238000010168 coupling process Methods 0.000 description 6
- 238000005859 coupling reaction Methods 0.000 description 6
- 208000010392 Bone Fractures Diseases 0.000 description 5
- 238000011282 treatment Methods 0.000 description 5
- 238000000429 assembly Methods 0.000 description 4
- 230000000712 assembly Effects 0.000 description 4
- 238000002513 implantation Methods 0.000 description 3
- 239000000463 material Substances 0.000 description 3
- 230000000149 penetrating effect Effects 0.000 description 3
- 230000008569 process Effects 0.000 description 3
- 230000006835 compression Effects 0.000 description 2
- 238000007906 compression Methods 0.000 description 2
- 230000035876 healing Effects 0.000 description 2
- 238000012966 insertion method Methods 0.000 description 2
- 238000004519 manufacturing process Methods 0.000 description 2
- 239000000203 mixture Substances 0.000 description 2
- 238000012986 modification Methods 0.000 description 2
- 230000004048 modification Effects 0.000 description 2
- 230000002980 postoperative effect Effects 0.000 description 2
- 210000004872 soft tissue Anatomy 0.000 description 2
- 210000005065 subchondral bone plate Anatomy 0.000 description 2
- OKTJSMMVPCPJKN-UHFFFAOYSA-N Carbon Chemical compound [C] OKTJSMMVPCPJKN-UHFFFAOYSA-N 0.000 description 1
- 206010020100 Hip fracture Diseases 0.000 description 1
- 208000006670 Multiple fractures Diseases 0.000 description 1
- 208000006735 Periostitis Diseases 0.000 description 1
- 230000004075 alteration Effects 0.000 description 1
- 230000004323 axial length Effects 0.000 description 1
- 229910052799 carbon Inorganic materials 0.000 description 1
- 238000012937 correction Methods 0.000 description 1
- 210000003275 diaphysis Anatomy 0.000 description 1
- 210000000527 greater trochanter Anatomy 0.000 description 1
- 210000004394 hip joint Anatomy 0.000 description 1
- 230000036512 infertility Effects 0.000 description 1
- 238000001746 injection moulding Methods 0.000 description 1
- 230000000968 intestinal effect Effects 0.000 description 1
- 210000002414 leg Anatomy 0.000 description 1
- 210000003041 ligament Anatomy 0.000 description 1
- 239000002184 metal Substances 0.000 description 1
- 238000012978 minimally invasive surgical procedure Methods 0.000 description 1
- 210000003205 muscle Anatomy 0.000 description 1
- 238000004806 packaging method and process Methods 0.000 description 1
- 210000003460 periosteum Anatomy 0.000 description 1
- 238000002360 preparation method Methods 0.000 description 1
- 230000002265 prevention Effects 0.000 description 1
- 230000004936 stimulating effect Effects 0.000 description 1
- 238000006467 substitution reaction Methods 0.000 description 1
- 238000003786 synthesis reaction Methods 0.000 description 1
- 238000001721 transfer moulding Methods 0.000 description 1
- ZIBGPFATKBEMQZ-UHFFFAOYSA-N triethylene glycol Chemical compound OCCOCCOCCO ZIBGPFATKBEMQZ-UHFFFAOYSA-N 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
- A61B17/74—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
-
- A—HUMAN NECESSITIES
- A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
- A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
- A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
- A61B17/16—Bone cutting, breaking or removal means other than saws, e.g. Osteoclasts; Drills or chisels for bones; Trepans
- A61B17/17—Guides or aligning means for drills, mills, pins or wires
- A61B17/1721—Guides or aligning means for drills, mills, pins or wires for applying pins along or parallel to the axis of the femoral neck
-
- 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
- A61B17/74—Devices for the head or neck or trochanter of the femur
-
- 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
- A61B17/8052—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded
- A61B17/8057—Cortical plates, i.e. bone plates; Instruments for holding or positioning cortical plates, or for compressing bones attached to cortical plates immobilised relative to screws by interlocking form of the heads and plate holes, e.g. conical or threaded the interlocking form comprising a thread
-
- 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
- A61B17/8605—Heads, i.e. proximal ends projecting from bone
-
- 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
- A61B17/8625—Shanks, i.e. parts contacting bone tissue
- A61B17/863—Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper
-
- 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
-
- 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
- A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
- A61B17/90—Guides therefor
-
- 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
- A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
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- Health & Medical Sciences (AREA)
- Orthopedic Medicine & Surgery (AREA)
- Surgery (AREA)
- Life Sciences & Earth Sciences (AREA)
- Heart & Thoracic Surgery (AREA)
- Veterinary Medicine (AREA)
- Engineering & Computer Science (AREA)
- Biomedical Technology (AREA)
- Nuclear Medicine, Radiotherapy & Molecular Imaging (AREA)
- Medical Informatics (AREA)
- Molecular Biology (AREA)
- Animal Behavior & Ethology (AREA)
- General Health & Medical Sciences (AREA)
- Public Health (AREA)
- Neurology (AREA)
- Dentistry (AREA)
- Oral & Maxillofacial Surgery (AREA)
- Surgical Instruments (AREA)
- Prostheses (AREA)
Abstract
Description
本願は、米国特許仮出願第61/561,439号(2011年11月18日出願、名称「Fastener」)及び同第61/692,053号(2012年8月22日出願、名称「Femoral Neck Fracture Implant」)に対する優先権を主張するものであり、これらの開示全体は、参照することにより本明細書に組み込まれるものとする。
本発明は、概して、締結具、締結具アセンブリ、締結具アセンブリ用キット、締結具アセンブリの組み立て方法、及び骨への締結具アセンブリの埋め込み方法に関する。
(1) 骨固定システムを埋め込むための装置であって、
近位端から遠位端まで延在する挿入器具であって、該遠位端が骨プレートの近位端と取り外し可能に係合するための係合部分を有し、該挿入器具が、該挿入器具を貫通する細長い溝を有して、該細長い溝を通して第1の保護スリーブを挿入でき、該細長い溝の長手方向軸が該骨プレートを貫通する第1の開口部の長手方向軸と同軸である、挿入器具と、
該細長い溝に挿入可能であり、内部を通しかつ該骨プレートを通した回転防止ねじの挿入を誘導する第1の保護スリーブであって、該第1の保護スリーブの長手方向軸が、該細長い溝の該長手方向軸に対して角度を設定されている、第1の保護スリーブと、を含む装置。
(2) 前記第1の保護スリーブ及び前記細長い溝が、5°、6°、7.5°、及び8°のうちの1つの角度を囲む、実施態様1に記載の装置。
(3) 前記第1の保護スリーブ及び前記細長い溝が5°超の角度を囲む、実施態様1に記載の装置。
(4) 前記挿入器具に挿入可能であり、内部を通した、前記骨プレートの第2の開口部への止めねじの挿入を誘導する、第2の保護スリーブを更に含む、実施態様1に記載の装置。
(5) 前記第2の保護スリーブ及び前記細長い溝が約45°の角度を囲む、実施態様4に記載の装置。
(7) 前記第1の保護スリーブに接続され、前記細長い溝に挿入可能である細長いシャフト部分を更に含む、実施態様1に記載の装置。
(8) 前記細長いシャフト部分の近位端がロック機構を含んで、前記挿入器具と固定的に係合する、実施態様7に記載の装置。
(9) 前記ロック機構が、前記挿入器具内に形成された対応する開口部とスナップ嵌めで係合するように構成されている偏向可能なタブを含む、実施態様8に記載の装置。
(10) 前記ロック機構が、ねじ切り部分及びねじ機構を含み、該ねじを回転させると、前記第1の保護スリーブに対して前記細長いシャフトが回転して、該ねじ切り部分が前記挿入器具内の対応するねじ切り開口部とねじ方式で係合できる、実施態様8に記載の装置。
(12) 前記挿入器具の側壁が、前記細長い溝に対して開いている細長いスロットを含み、該スロットを通過して前記Yコネクタを挿入できる、実施態様1に記載の装置。
(13) 前記装置が使い捨てアセンブリである、実施態様1に記載の装置。
(14) 前記装置が、複数の処置を実行するために使用され得る、実施態様1に記載の装置。
(15) 骨への骨固定装置の挿入を誘導する照準器具であって、
第1の部分及び第2の部分を含む照準アームであって、該第1の部分が近位端から遠位端まで延在し、該第1の部分を貫通する細長い溝を有し、該遠位端が該骨固定装置の近位端と取り外し可能に係合する係合部分を有し、該照準アームの側壁が該細長い溝に対して開いている細長いスロットを含む、照準アームと、
該細長い溝に取り外し可能に挿入できる細長い要素であって、該細長い要素が第1のシャフト部分及び第2のシャフト部分を有し、該第1のシャフト部分が該細長い溝に挿入され、該照準アームと固定的に係合し、該第2のシャフト部分が該細長いスロットを貫通して延在し、該第2のシャフト部分の中を貫通する開口部を有して、該開口部を通した、該骨固定装置への回転防止ねじの挿入を誘導する、細長い要素と、を含む、照準器具。
(17) 前記第1の部分の前記遠位端に向かって前記開口部を通して挿入可能な保護スリーブを更に含み、該保護スリーブの遠位端が前記骨固定装置の近位端に隣接して位置付けられるようになっている、実施態様16に記載の照準器具。
Claims (7)
- 骨固定システムであって、
近位端から遠位端まで長手方向中心軸に沿って延在するインプラントシャフトであって、第1のインプラント溝軸に沿って、前記インプラントシャフトの前記近位端から前記インプラントシャフトの側壁に形成された側面開口部まで延在する第1のインプラント溝を含み、前記第1のインプラント溝軸が前記長手方向中心軸に対して角度を設定されている、インプラントシャフトと、
第1および第2の髄内くぎ溝によって形成された横方向開口部を有する髄内くぎであって、前記第1の髄内くぎ溝は、第1の開口軸に沿って前記髄内くぎを通って延在し、かつ、前記第1の開口軸に沿って骨の頭部内に前記インプラントシャフトを挿入できるように前記第1の髄内くぎ溝を通って前記インプラントシャフトを受け入れるように構成され、前記第2の髄内くぎ溝は、前記第1の髄内くぎ溝に対して開いており、かつ、前記第1のインプラント溝を通って挿入された骨固定要素が第2の開口軸に沿って前記インプラントシャフトを通って延在するように前記第2の開口軸に沿って前記髄内くぎを通って延在する、髄内くぎと、を含む骨固定システム。 - 前記インプラントシャフトは、第2のインプラント溝軸に沿って前記近位端から前記遠位端まで延在する第2のインプラント溝を含む、請求項1に記載の骨固定システム。
- 前記第1の髄内くぎ溝は、第1の角度で前記髄内くぎを通って延在し、前記第2の髄内くぎ溝は、前記第1の角度と異なる第2の角度で前記髄内くぎを通って延在する、請求項1に記載の骨固定システム。
- 前記第1および第2の髄内くぎ溝の各々は、実質的に円形である、請求項1に記載の骨固定システム。
- 前記第1および第2の髄内くぎ溝は、前記横方向開口部を形成するように重なり合う、請求項1に記載の骨固定システム。
- 前記インプラントシャフトの外壁は、前記インプラントシャフトが前記横方向開口部に対して回転するのを妨げるために、前記第1の髄内くぎ溝に設けられた、それぞれ成形された接合部と係合するように構成された切り取り部を含む、請求項1に記載の骨固定システム。
- 前記インプラントシャフトの前記遠位端は、前記インプラントシャフトが骨を切り裂くのを防ぐため、鈍化されている、請求項1に記載の骨固定システム。
Applications Claiming Priority (4)
Application Number | Priority Date | Filing Date | Title |
---|---|---|---|
US201161561439P | 2011-11-18 | 2011-11-18 | |
US61/561,439 | 2011-11-18 | ||
US201261692053P | 2012-08-22 | 2012-08-22 | |
US61/692,053 | 2012-08-22 |
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JP2017079537A Division JP6404397B2 (ja) | 2011-11-18 | 2017-04-13 | 大腿骨頸部骨折用インプラント |
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JP2020069662A Division JP6992115B2 (ja) | 2011-11-18 | 2020-04-08 | 骨固定システム |
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JP2014542407A Active JP6144271B2 (ja) | 2011-11-18 | 2012-11-14 | 大腿骨頸部骨折用インプラント |
JP2014541507A Active JP6130389B2 (ja) | 2011-11-18 | 2012-11-19 | 大腿骨頸部骨折用インプラント |
JP2017079537A Active JP6404397B2 (ja) | 2011-11-18 | 2017-04-13 | 大腿骨頸部骨折用インプラント |
JP2017087008A Active JP6779828B2 (ja) | 2011-11-18 | 2017-04-26 | 大腿骨頸部骨折用インプラント |
JP2018168566A Active JP6689928B2 (ja) | 2011-11-18 | 2018-09-10 | 骨固定システム |
JP2019040367A Active JP6786646B2 (ja) | 2011-11-18 | 2019-03-06 | 大腿骨頸部骨折用インプラント |
JP2020069662A Active JP6992115B2 (ja) | 2011-11-18 | 2020-04-08 | 骨固定システム |
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JP2014542407A Active JP6144271B2 (ja) | 2011-11-18 | 2012-11-14 | 大腿骨頸部骨折用インプラント |
JP2014541507A Active JP6130389B2 (ja) | 2011-11-18 | 2012-11-19 | 大腿骨頸部骨折用インプラント |
JP2017079537A Active JP6404397B2 (ja) | 2011-11-18 | 2017-04-13 | 大腿骨頸部骨折用インプラント |
JP2017087008A Active JP6779828B2 (ja) | 2011-11-18 | 2017-04-26 | 大腿骨頸部骨折用インプラント |
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JP2020069662A Active JP6992115B2 (ja) | 2011-11-18 | 2020-04-08 | 骨固定システム |
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US (4) | US9662156B2 (ja) |
EP (3) | EP3441029B1 (ja) |
JP (7) | JP6144271B2 (ja) |
KR (3) | KR102035468B1 (ja) |
CN (4) | CN104114113B (ja) |
AU (3) | AU2012339665B2 (ja) |
BR (2) | BR112014011984B1 (ja) |
CA (3) | CA3118659A1 (ja) |
TW (2) | TWI528937B (ja) |
WO (2) | WO2013074659A1 (ja) |
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