JP4863885B2 - 骨ねじ - Google Patents
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- JP4863885B2 JP4863885B2 JP2006553407A JP2006553407A JP4863885B2 JP 4863885 B2 JP4863885 B2 JP 4863885B2 JP 2006553407 A JP2006553407 A JP 2006553407A JP 2006553407 A JP2006553407 A JP 2006553407A JP 4863885 B2 JP4863885 B2 JP 4863885B2
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- 210000000988 bone and bone Anatomy 0.000 title claims abstract description 46
- 230000007423 decrease Effects 0.000 claims description 6
- 239000011347 resin Substances 0.000 claims description 4
- 229920005989 resin Polymers 0.000 claims description 4
- 239000004696 Poly ether ether ketone Substances 0.000 claims description 2
- JUPQTSLXMOCDHR-UHFFFAOYSA-N benzene-1,4-diol;bis(4-fluorophenyl)methanone Chemical compound OC1=CC=C(O)C=C1.C1=CC(F)=CC=C1C(=O)C1=CC=C(F)C=C1 JUPQTSLXMOCDHR-UHFFFAOYSA-N 0.000 claims description 2
- 239000007769 metal material Substances 0.000 claims description 2
- 229920002530 polyetherether ketone Polymers 0.000 claims description 2
- 238000000034 method Methods 0.000 abstract description 2
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- 230000002745 absorbent Effects 0.000 description 1
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- 210000001061 forehead Anatomy 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
- A61B17/686—Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
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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
- A61B17/84—Fasteners therefor or fasteners being internal fixation devices
- A61B17/86—Pins or screws or threaded wires; nuts therefor
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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
-
- 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
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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
- A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
- A61B17/7241—Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
-
- 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
- A61B17/7233—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
-
- 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
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- Orthopedic Medicine & Surgery (AREA)
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Description
一つの特別な実施形態において、前記スリーブが雌ねじを有す。ねじのピッチによって軸方向の移動が生まれ、中心域(L4)の円錐状中心断面の特定の幾何形状によりスリーブの半径方向への拡大を引き起こす。回転およびねじ込み運動は髄内釘の横穿孔にねじを挿入するために、いずれにせよ必要になる。
前記スリーブは1本または複数の縦スリットを有することがある。これによってスリーブの半径方向の拡大が、より少ない力およびより低い回転トルクで達成できるという長所が生まれる。スリーブのねじへの事前装着がより容易になる、せん断力が均衡化され、さらにスリーブの残留応力がより少なくなる。縦スリットが1本のみの場合、スリーブの全高に亘って走らせることができる。縦スリットは、またスリーブの高さの一部に亘って走らせることもできる。この形態の場合、スリーブの一方の側が開、または両側が閉にできる。このような部分スリットの場合、複数の縦スリットが有り得て、主として上か下のどちらかが開となる。
その他の実施形態においては、径DHのスリーブがその後端に、周りを囲い、より拡大した径DF>DHのフランジを有す。前記フランジはストッパとして、および髄内釘上におけるスリーブの位置決めとして使われるため、骨ねじはその円錐状に拡張する中央部でスリーブにねじ込まなくてはならず、骨ねじはスリーブ自体がストッパに止まっている間、スリーブを半径方向に拡張する。
前記スリーブは、例えば、非吸収性の樹脂、主としてPEEK、から成ることが有る。その長所は生体適合性、良好な生産性、容易な組み立て、および、釘が孔に引っ掛かった場合にも、釘を引き出す際にスリーブを押しつぶすことできることにある。
前記スリーブは金属材料から成ることも有る。その長所は高い強度、生体適合性、およびスリーブが髄内釘およびねじと同じ材料から成ることにある。金属スリーブはまた可塑性でもあるので、斜めに挿入されると、わずか降伏することもあり得る。結局、金属スリーブは破片が生じないという長所がある。
前記スリーブは吸収性樹脂から成ることもあり得る。第一の長所は、角度の変わらなくロックした部分が時間と共に衰えることにある。第二の長所は、この種のスリーブが紛失した場合にも、それが時間と共に吸収されるため大きな短所にはならないということにある。
その他の実施形態においては、骨ねじの後端とシャフトの大き目の外径「d2」を有す部分との間に、外径をd3>d2と、より大きくとった「L2」域の軸部が配置されている。この配置の長所は、それが骨の前面皮質の掘削孔を塞ぐことにある。それによりスリーブのフランジを大きな力を加えることなく、第一皮質孔の穴に挿入することができる。シャフト部はその場合、外径d3>d2を有す「L2」域では雄ねじを備えることができる。外径d3の雄ねじは、さらにねじの原理で骨にロック効果を与える。
上に記述した骨ねじに使用するべき髄内釘は外径DN、および縦軸に走る横穿孔を有す。その孔径DBは、目的に合わせd2より大きく、かつDB−L5より大きい。都合の良いことにスリーブの直径DHは条件DH <1.2DBに従う。スリーブの長さHLは、都合の良いことに1.5DN未満で、0.2DNを超える。
その他の実施形態においては、髄内釘は貫通する圧入溝および壁厚WNを持つ。スリーブの長さHLは、都合の良いことに髄内釘の壁厚WNに一致する。
発明と発明の再形成について、以降に多くの実施例を部分的に図解により詳細に説明する。
図1は、スリーブを被せた骨ねじの縦断面である、
図2は、横穿孔付き髄内釘に取り付けられた図1に基づくの骨ねじの縦断面である、
図3は、図1に基づく骨ねじの縦断面である、および
図4は、図1に基づくスリーブの遠近図である。
- 後端5から測って長さL1上に、ねじの頭6が占める、
- それに隣接して長さL2上に、一定の外径d3および一定の谷径k3を有す雄ねじ9を備えたシャフト部8が閉める、
- それに隣接して長さL3上に、一定の外径d2<k3および一定の谷径k2を有すねじ山2を備えたシャフト3のセグメントが占める、
- それに隣接して長さL4上に、前端4に対して角度αで減少するシャフト3のセグメントが占め、結果、前記セグメントにおいて、ねじ山の外径d2は外径d1に減少する。同様に、前記セグメントにおいて、谷径k2は谷径k1に減少し、そして
- 長さL4のセグメントおよび前端4との間に、一定の外径およびまた一定の谷径k1を備えたねじ山2を有すシャフト3のセグメントが広がる。
7…中心軸、8…シャフト部、9…雄ねじ、10…スリーブ、
11…縦スリット、12…フランジ、13…雌ねじ
Claims (21)
- 骨定着のための器具であって、
a)ねじ山(2)を付けたシャフト(3)、前端(4)および後端(5)を備えた少なくとも一本の骨ねじ(1)であって、前記ねじ山(2)の外径「d」または前記シャフト(3)の谷径「k」が、前記シャフト(3)の中央域(L4)において、前記シャフト(3)が長さ(L3)沿いに前記前端(4)に向かって示すそれぞれの大きめの寸法「d2」または「k2」からそれぞれの小さめの寸法「d1」または「k1」に減少して行き、「d1」または「k1」はゼロではない骨ねじ(1)と、
b)髄内釘(20)とを具備し、これにより、
c)前記シャフト(3)が、同軸に配置されて半径方向に拡張可能なスリーブ(10)を備え、
d)前記スリーブ(10)が前記シャフト(3)の小さめの外径「d1」を有する部分に配置され、
e)前記スリーブ(10)は、中央域(L4)へとねじ込まれることによって直径がdB−L5まで拡張可能であり、また長さ(L3)に渡ってねじ込まれることによって直径がdB−L3まで拡張可能であり、
f)前記髄内釘(20)が直径DNおよびその縦軸(21)を直角に通る横穿孔(22)を有し、前記横穿孔の孔径DBがd2を超え、およびdB−L5を超えることを特徴とする器具。 - 前記ねじ山(2)が一定の深さを有し、前記シャフト(3)の中央域(L4)における谷径「k」が、前端(4)に向かうに従って、ゼロになることなく、大きめの寸法「k2」から小さめの寸法「k1」に減少して行くことを特徴とする請求項1に記載の器具。
- 前記スリーブ(10)が雌ねじ(13)を有すことを特徴とする請求項1または2に記載の器具。
- 前記スリーブ(10)が少なくとも1本の縦スリット(11)を有すことを特徴とする請求項1から3のいずれかに記載の器具。
- 前記縦スリット(11)がスリーブ(10)の高さの全体に亘って走ることを特徴とする請求項4に記載の器具。
- 前記縦スリット(11)が前記スリーブ(10)の高さの一部のみに亘って走ることを特徴とする請求項4または5に記載の器具。
- 直径DHの前記スリーブ(10)がその後端に、周りを囲い、より拡大した径DF>DHを持つフランジ(12)を有すことを特徴とする請求項1から6のいずれかに記載の器具。
- 前記スリーブ(10)が非吸収性の樹脂、主としてPEEK、から成ることを特徴とする請求項1から7に記載の器具。
- 前記スリーブ(10)が金属材料からなることを特徴とする請求項1から8のいずれかに記載の器具。
- 前記スリーブ(10)が生体適合性の樹脂からなることを特徴とする請求項1から8のいずれかに記載の器具。
- その後端(5)と前記シャフト(3)のねじ山(2)の大きめの外径「d2」を備えた部分との間に、より拡大した外径d3>d2を有する「L2」域にシャフト部(8)が配置されていることを特徴とする請求項1から10のいずれかに記載の器具。
- 外径d3>d2を有す「L2」域のシャフト部(8)が雄ねじ(9)を有すことを特徴とする請求項11に記載の器具。
- A)後端(5)から測って長さ(L1)上に占めるねじの頭(6)を含み、
B)長さ(L3)上に、一定の外径「d2」および一定の谷径「k2」を有するねじ山(2)を備えたシャフト(3)のセグメントが占め、
C)それに隣接して長さ(L4)上に、前端(4)に対して角度αで減少する前記シャフト(3)のセグメントが占める、結果、このセグメントにおいて、ねじ山の外径「d2」が外径「d1」に減少し、
D)長さ(L4)のシャフト(3)のセグメントと前端(4)との間の長さ(L5)上に、一定の外径「d1」および同様に一定の谷径「k1」を有すねじ山(2)が占め、
E)セグメントの長さおよび外径がゼロを超えることを特徴とする請求項1から12に記載の器具。 - 前記シャフト(3)の長さ(L4)のセグメントにおいて、谷径「k2」が谷径「k1」に減少することを特徴とする請求項13に記載の器具。
- 長さ(L1)に隣接した長さ(L2)上に、一定の外径「d3>d2」および一定の谷径「k3」を有す雄ねじ(9)を有すシャフト部(8)が広がることを特徴とする請求項13または14に記載の器具。
- 長さ(L5)および(L3)のセグメント上の、ねじ山深さ「t1」および「t2」が一致することを特徴とする請求項13から15のいずれかに記載の器具。
- 請求項1から16のいずれかに記載の1つまたは複数の骨ねじ(1)およびスリーブ(10)を含み、1つの髄内釘(20)を用いた骨定着のための器具であって、前記髄内釘(20)が直径DNおよびその縦軸(21)を直角に通る横穿孔(22)を有し、その孔径DBがd2を超え、およびdB−L5を超えることを特徴とする器具。
- 前記スリーブ(10)の長さHLが1.5DN未満であることを特徴とする請求項17に記載の器具。
- 前記スリーブ(10)の長さHLが0.2DNを超えることを特徴とする請求項17または18に記載の器具。
- 前記髄内釘(20)が貫通する圧入溝(23)を持ち、壁厚WNを持つことを特徴とする請求項17から19のいずれかに記載の器具。
- 前記スリーブ(10)の長さHLが髄内釘(20)の壁厚WNに一致することを特徴とする請求項20に記載の器具。
Applications Claiming Priority (1)
Application Number | Priority Date | Filing Date | Title |
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PCT/CH2004/000095 WO2005079685A1 (de) | 2004-02-23 | 2004-02-23 | Knochenschraube |
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JP2007522846A JP2007522846A (ja) | 2007-08-16 |
JP4863885B2 true JP4863885B2 (ja) | 2012-01-25 |
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JP2006553407A Expired - Lifetime JP4863885B2 (ja) | 2004-02-23 | 2004-02-23 | 骨ねじ |
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US (2) | US8162998B2 (ja) |
EP (1) | EP1718229B1 (ja) |
JP (1) | JP4863885B2 (ja) |
KR (1) | KR101085711B1 (ja) |
CN (1) | CN1913839B (ja) |
AT (1) | ATE390893T1 (ja) |
BR (1) | BRPI0418311B8 (ja) |
CA (1) | CA2526384C (ja) |
DE (1) | DE502004006741D1 (ja) |
ES (1) | ES2301972T3 (ja) |
PL (1) | PL212656B1 (ja) |
TW (1) | TWI346544B (ja) |
WO (1) | WO2005079685A1 (ja) |
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US20060129148A1 (en) * | 2004-10-01 | 2006-06-15 | Simmons Edward D | Screw sleeve made of polyetheretherketone (PEEK) for augmentation of bone screw insertion in osteoporotic or revision lumbar spine instrumentation |
US7799062B2 (en) | 2004-11-30 | 2010-09-21 | Stryker Trauma S.A. | Self-guiding threaded fastener |
US8540777B2 (en) * | 2005-01-31 | 2013-09-24 | Arthrex, Inc. | Method and apparatus for performing an open wedge, high tibial osteotomy |
US8382807B2 (en) | 2005-07-25 | 2013-02-26 | Smith & Nephew, Inc. | Systems and methods for using polyaxial plates |
AU2006272646C1 (en) | 2005-07-25 | 2018-06-21 | Smith & Nephew, Inc. | Systems and methods for using polyaxial plates |
US20080221624A1 (en) * | 2005-10-17 | 2008-09-11 | Gooch Hubert L | Systems and Methods for the Medical Treatment of Structural Tissue |
US20080221623A1 (en) * | 2005-10-17 | 2008-09-11 | Gooch Hubert L | Systems and Methods for the Medical Treatment of Structural Tissue |
US20070118131A1 (en) * | 2005-10-17 | 2007-05-24 | Gooch Hubert L | Anchor for Augmentation of Screw Purchase and Improvement of Screw Safety in Pedicle Screw Fixation and Bone Fracture Fixation Systems |
EP2068771B1 (en) * | 2006-08-02 | 2014-03-26 | Arthrex, Inc. | Apparatus for performing an open wedge, high tibial osteotomy |
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- 2004-02-23 WO PCT/CH2004/000095 patent/WO2005079685A1/de active IP Right Grant
- 2004-02-23 KR KR1020067016968A patent/KR101085711B1/ko active IP Right Grant
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- 2004-02-23 DE DE502004006741T patent/DE502004006741D1/de not_active Expired - Lifetime
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US9011440B2 (en) | 2015-04-21 |
CA2526384A1 (en) | 2005-09-01 |
US8162998B2 (en) | 2012-04-24 |
AU2004316051A1 (en) | 2005-09-01 |
WO2005079685A1 (de) | 2005-09-01 |
ES2301972T3 (es) | 2008-07-01 |
US20120203226A1 (en) | 2012-08-09 |
BRPI0418311B1 (pt) | 2015-05-05 |
EP1718229B1 (de) | 2008-04-02 |
EP1718229A1 (de) | 2006-11-08 |
KR101085711B1 (ko) | 2011-11-21 |
ATE390893T1 (de) | 2008-04-15 |
DE502004006741D1 (de) | 2008-05-15 |
CN1913839B (zh) | 2010-04-28 |
CN1913839A (zh) | 2007-02-14 |
JP2007522846A (ja) | 2007-08-16 |
PL380240A1 (pl) | 2007-01-08 |
TWI346544B (en) | 2011-08-11 |
PL212656B1 (pl) | 2012-11-30 |
TW200528062A (en) | 2005-09-01 |
BRPI0418311A (pt) | 2008-06-10 |
KR20070032280A (ko) | 2007-03-21 |
CA2526384C (en) | 2012-05-29 |
US20060095040A1 (en) | 2006-05-04 |
BRPI0418311B8 (pt) | 2021-06-22 |
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