WO1994020040A1 - Dispositif de fixation et de compression possedant un pas de vis non homogene - Google Patents

Dispositif de fixation et de compression possedant un pas de vis non homogene Download PDF

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Publication number
WO1994020040A1
WO1994020040A1 PCT/US1994/002209 US9402209W WO9420040A1 WO 1994020040 A1 WO1994020040 A1 WO 1994020040A1 US 9402209 W US9402209 W US 9402209W WO 9420040 A1 WO9420040 A1 WO 9420040A1
Authority
WO
WIPO (PCT)
Prior art keywords
shaft
screw
fastener
screw thread
bone
Prior art date
Application number
PCT/US1994/002209
Other languages
English (en)
Inventor
Henry Fletcher
Original Assignee
Synvasive Technology, Inc.
Priority date (The priority date 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 date listed.)
Filing date
Publication date
Application filed by Synvasive Technology, Inc. filed Critical Synvasive Technology, Inc.
Publication of WO1994020040A1 publication Critical patent/WO1994020040A1/fr

Links

Classifications

    • F—MECHANICAL ENGINEERING; LIGHTING; HEATING; WEAPONS; BLASTING
    • F16—ENGINEERING ELEMENTS AND UNITS; GENERAL MEASURES FOR PRODUCING AND MAINTAINING EFFECTIVE FUNCTIONING OF MACHINES OR INSTALLATIONS; THERMAL INSULATION IN GENERAL
    • F16B—DEVICES FOR FASTENING OR SECURING CONSTRUCTIONAL ELEMENTS OR MACHINE PARTS TOGETHER, e.g. NAILS, BOLTS, CIRCLIPS, CLAMPS, CLIPS OR WEDGES; JOINTS OR JOINTING
    • F16B33/00—Features common to bolt and nut
    • F16B33/02—Shape of thread; Special thread-forms
    • 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

Definitions

  • the invention relates generally to surgical fasteners for piercing and fixedly binding together bone, and more particularly to surgical wire and the like holding together in compressive engagement small portions of fractured bone.
  • the Herbert screw Although able to achieve compressive coupling, the Herbert screw suffers from certain serious drawbacks that affect its practical utilization.
  • the diameter of the unthreaded intermediate section is smaller than the major diameter of the threaded distal end, and smaller than the minor diameter of the threaded proximal end.
  • the unthreaded intermediate section resides in a bore section that must be large enough to accommodate the minor diameter of the proximal end thread, and therefore does not fully fill the bore.
  • Th result is a lateral instability that sacrifices the integrity of the fragment interface during the healing process.
  • Yet another object of the invention is to provide a means of compressive engagement that is suitable both to broad gauge screws as well as narrow gauge wire.
  • the invention meets these objects by providing a depth-tolerant, surgical bone fastener in which the thread pitch extends the length of the fastener and in which the thread pitch increases gradually from the screw tip to the screw head.
  • the shaft of the screw is generally of a uniform diameter, although in one embodiment, the screw shaft is slightly tapered toward the screw tip.
  • the screw may be further provided with a sharply tapered tip for easier initial insertion.
  • the invention comprises a surgical screw having a shaft diameter greater than 0.062 inch and generally of at least 0.10 inch. Such screws are suitable in surgery involving large bones, such as the hip and femur, as well as in the fastening of larger bone fragments.
  • the invention comprises surgical wire, much like Kirschner wire, except that the screw threads are configured in the progressively tightening pitch described above. Typical diameter for this embodiment is 0.062 inch or less, and generally within the range of 0.028 to 0.062 inch. Such an embodiment is particularly suited to the repair of small bones, such as those found in the hands and feet.
  • the fastener of the invention is clearly advantageous over the prior art in that it is depth insensitive. That is, it allows bone fragments to be successfully joined in compressive engagement without the need to align precisely the position of the fastener relative to the bone fragments.
  • Another advantage of the invention is the ability to precisely adjust the amount of compression desired. Because the pitch of the fastener is gradually increased over the length of the fastener, it is possible to apply compression more precisely than is possible with existing compression screws. Where the pitch of the screw thread is fixed within a particular region.
  • a further advantage of the invention is its application to surgical wire. Because of the very narrow diameter of most surgical wire, the Herbert/Ross compression screw configuration is unsuitable. The use of a fastener-long screw thread with variable pitch permits the incorporation of compression engagement capabilities into surgical wire that is lacking in the prior art.
  • FIG. 1 shows a side view of a fastener according to one embodiment of the invention.
  • FIG. 2 shows a side view of a fastener according to another embodiment of the invention.
  • the fastener 10 comprises a shaft 12 that has n insertion or leading end 14 and a head or trailing end 16.
  • the shaft may be uniform in thickness and roughly cylindrical, as shown in FIG. 1 , or it may be slightly tapered toward leading end 14, as shown in FIG. 2.
  • the shaft will have a diameter of 0.10 inch or greater, and in no case shall the shaft be 0.062 inch or less.
  • Trailing end 16 may be flat-topped, but is preferentially provided with a depression for receipt of a screw driver or similar device, as shown in FIGS. 1B-C.
  • Screw thread 18 extends substantially the entire length of shaft 12, although it is acceptable for screw thread 18 to stop somewhat short of trailing end 16.
  • the pitch of screw thread 18 is not uniform, but rather is variable, increasing from leading end 14 to trailing end 16.
  • the form of screw thread 18 is conventionally symmetric, forming a substantially isosceles-shaped triangle in cross-section. However, other screw thread configurations may be suitable for particular applications.
  • the fastener can also be provided with a canula 20 as shown by ghost lines in FIG.1.
  • Canula 20 extends the entire length of shaft 12, with a leading opening 21 and a trailing end opening 23. Provision of a canula permits a guide wire to be threaded through the fastener, thereby allowing the fastener to be accurately guided into place in situations where the surgeon's view is partially obstructed or where the bone to be repaired is difficult or awkward to reach.
  • a narrow bore is formed using a drill or similar tool through both a the proximate and remote bone fragments, the drilling into the remote bone fragment being at least sufficient to accept enough of the leading end of the fastener to secure the remote bone fragment.
  • the bore is generally about the diameter of or slightly smaller than the diameter of the shaft of the fastener.
  • shaft 12 is provided with a sharply tapered tip region 20 for facilitating initial insertion of the fastener.
  • shaft 12 may be slightly tapered from trailing edge 16 down to leading edge 14. Such tapering functions similarly to tapered end 22 in that it provides for greater ease in insertion of the fastener.
  • an improved surgical wire or Kirschner wire is provided. It differs from the fasteners just described in that the shaft has an extremely narrow gauge, generally ranging from 0.028 to 0.062 inch in diameter.
  • the surgical wire embodiment differs significantly in several respects.
  • the surgical wire embodiment is considered self-threading, that is, there is no need to form or pre-drill a hole into which the surgical wire is inserted. Rather, the surgical wire is of sufficient strength that, when inserted with a standard wire driver, the wire acts as its own drill.
  • the narrow diameter of the shaft forecloses the possibility of a canula, which would be redundant in any event in as much as this embodiment acts both as its own guide wire and fastener.
  • Narrow gauge fasteners such as this are particularly well suited to coupling very small bones and bone fragments, such as those found in the hands and feet.
  • the fastener of the invention can be fabricated from any suitable non- rusting, biocompatible alloy, such as surgical steel and the like, although it is preferred to fabricate the fastener from a titanium alloy or having a titanium plating.
  • the fastener of the invention is also depth insensitive in that it does not require precise alignment within and between the objects to be joined.
  • the fastener is also advantageous in that it can be used singly without the fear of loosing the compressive grip or having the objects torque about the axis of the fastener.

Landscapes

  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Orthopedic Medicine & Surgery (AREA)
  • General Engineering & Computer Science (AREA)
  • Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Heart & Thoracic Surgery (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)
  • Veterinary Medicine (AREA)
  • Neurology (AREA)
  • Mechanical Engineering (AREA)
  • Surgical Instruments (AREA)

Abstract

Dispositif de fixation et de compression (10) sur la longueur duquel s'étend un pas de vis (18) augmentant graduellement depuis la pointe (14) vers la tête (16) de la vis. La tige (12) du dispositif (10) présente généralement un diamètre uniforme, bien qu'elle puisse avoir une forme légèrement conique vers la pointe (14). Le dispositif (10) peut être, de plus, pourvu d'une pointe conique très effilée de manière à faciliter l'introduction.
PCT/US1994/002209 1993-03-01 1994-03-01 Dispositif de fixation et de compression possedant un pas de vis non homogene WO1994020040A1 (fr)

Applications Claiming Priority (2)

Application Number Priority Date Filing Date Title
US2470993A 1993-03-01 1993-03-01
US08/024,709 1993-03-01

Publications (1)

Publication Number Publication Date
WO1994020040A1 true WO1994020040A1 (fr) 1994-09-15

Family

ID=21821988

Family Applications (1)

Application Number Title Priority Date Filing Date
PCT/US1994/002209 WO1994020040A1 (fr) 1993-03-01 1994-03-01 Dispositif de fixation et de compression possedant un pas de vis non homogene

Country Status (1)

Country Link
WO (1) WO1994020040A1 (fr)

Cited By (9)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
WO1999018873A1 (fr) * 1997-10-09 1999-04-22 Sesic Nenard Vis conique appliquant une force permettant de stimuler la croissance de transplantation osseuse
WO2000038586A1 (fr) 1998-12-23 2000-07-06 Nenad Sesic Vis centromedullaire axiale utilisee pour l'osteosynthese des os longs
GB2460909A (en) * 2008-01-28 2009-12-23 Mark B Sommers Bone nail with helical ridges
US7862573B2 (en) 2006-04-21 2011-01-04 Darois Roger E Method and apparatus for surgical fastening
US7975700B2 (en) 2005-02-08 2011-07-12 Koninklijke Philips Electronics N.V. System for adjustable tissue anchors
KR101066312B1 (ko) 2006-02-16 2011-09-20 워쏘우 오르쏘페딕 인코포레이티드 다중 나사식 뼈스크류 및 방법
US9161793B2 (en) 1993-01-21 2015-10-20 Acumed Llc Axial tension screw
US9549742B2 (en) 2012-05-18 2017-01-24 OrthAlign, Inc. Devices and methods for knee arthroplasty
US10863995B2 (en) 2017-03-14 2020-12-15 OrthAlign, Inc. Soft tissue measurement and balancing systems and methods

Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US146023A (en) * 1873-12-30 Improvement in wood-screws
US3454070A (en) * 1967-10-10 1969-07-08 Res Eng & Mfg Differential pitch fastener device
US4175555A (en) * 1977-02-24 1979-11-27 Interfix Limited Bone screw
US5120171A (en) * 1990-11-27 1992-06-09 Stuart Surgical Bone screw with improved threads

Patent Citations (4)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US146023A (en) * 1873-12-30 Improvement in wood-screws
US3454070A (en) * 1967-10-10 1969-07-08 Res Eng & Mfg Differential pitch fastener device
US4175555A (en) * 1977-02-24 1979-11-27 Interfix Limited Bone screw
US5120171A (en) * 1990-11-27 1992-06-09 Stuart Surgical Bone screw with improved threads

Cited By (19)

* Cited by examiner, † Cited by third party
Publication number Priority date Publication date Assignee Title
US9161793B2 (en) 1993-01-21 2015-10-20 Acumed Llc Axial tension screw
GB2355051A (en) * 1997-10-09 2001-04-11 Nenad Sesic Strain-inducing conical screw for stimulating bone transplant growth
GB2355051B (en) * 1997-10-09 2002-02-27 Nenad Sesic Strain-inducing conical screw for stimulating bone transplant growth
US6398786B1 (en) 1997-10-09 2002-06-04 Nenad Sesic Strain-inducing conical screw for stimulating bone transplant growth
WO1999018873A1 (fr) * 1997-10-09 1999-04-22 Sesic Nenard Vis conique appliquant une force permettant de stimuler la croissance de transplantation osseuse
WO2000038586A1 (fr) 1998-12-23 2000-07-06 Nenad Sesic Vis centromedullaire axiale utilisee pour l'osteosynthese des os longs
US6517541B1 (en) 1998-12-23 2003-02-11 Nenad Sesic Axial intramedullary screw for the osteosynthesis of long bones
US7992567B2 (en) 2005-02-08 2011-08-09 Koninklijke Philips Electronics N.V. System and method for percutaneous glossoplasty
US7975700B2 (en) 2005-02-08 2011-07-12 Koninklijke Philips Electronics N.V. System for adjustable tissue anchors
KR101066312B1 (ko) 2006-02-16 2011-09-20 워쏘우 오르쏘페딕 인코포레이티드 다중 나사식 뼈스크류 및 방법
US7862573B2 (en) 2006-04-21 2011-01-04 Darois Roger E Method and apparatus for surgical fastening
US8979874B2 (en) 2006-04-21 2015-03-17 Davol, Inc. Method and apparatus for surgical fastening
GB2460909B (en) * 2008-01-28 2010-09-08 Mark B Sommers Bone Nail
US8092505B2 (en) 2008-01-28 2012-01-10 Acumed Llc Bone nail
GB2460909A (en) * 2008-01-28 2009-12-23 Mark B Sommers Bone nail with helical ridges
US9549742B2 (en) 2012-05-18 2017-01-24 OrthAlign, Inc. Devices and methods for knee arthroplasty
US10716580B2 (en) 2012-05-18 2020-07-21 OrthAlign, Inc. Devices and methods for knee arthroplasty
US10863995B2 (en) 2017-03-14 2020-12-15 OrthAlign, Inc. Soft tissue measurement and balancing systems and methods
US11786261B2 (en) 2017-03-14 2023-10-17 OrthAlign, Inc. Soft tissue measurement and balancing systems and methods

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