CN100435743C - 骨骼固定装置 - Google Patents

骨骼固定装置 Download PDF

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CN100435743C
CN100435743C CNB2004800365575A CN200480036557A CN100435743C CN 100435743 C CN100435743 C CN 100435743C CN B2004800365575 A CNB2004800365575 A CN B2004800365575A CN 200480036557 A CN200480036557 A CN 200480036557A CN 100435743 C CN100435743 C CN 100435743C
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screw
lining
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head
penetration channel
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CN1889891A (zh
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布赖恩·E·多尔顿
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Esculap
Aesculap Inc
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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
    • A61B17/70—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
    • 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
    • A61B17/8023—Variable length plates adjustable in both directions
    • 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

Abstract

一种固定脊骨的脊椎的接骨板装置(10)，具有至少一个穿透通道(15，22)采用骨骼固定螺钉(23)将板固定到骨骼上。将骨骼固定螺钉(23)的螺纹轴穿过位于接骨板装置的穿透通道(15，22)中的衬套(30)，将螺钉(23)通过螺纹固定到下面的骨骼上，通过旋转穿透通道(15，22)中的衬套受驱动的凸轮(37)向内压缩衬套抵靠螺钉(23)的螺钉头(25)，相对于接骨板装置锁定螺钉(23)。衬套被向内压缩抵靠螺钉(23)的螺钉头(25)且被凸轮(37)向下压入座部(39)以将接骨板装置的分离元件(11，12)夹在一起。衬套的上表面(41，42)中的进入通道(51)的尺寸(d)适于通过其接收螺钉头(25)使其进入衬套内的承插孔(35)中。

Description

骨骼固定装置
技术领域
本发明一般地涉及脊骨固定系统。更具体地说，本发明涉及脊骨板装置，其包括以期望的角度将骨骼固定螺钉固定地连接并锁定到板上并且同时将板中可以以其它方式调节的部分锁定在一起的机构。
背景技术
对腰椎和胸椎进行的脊椎手术传统上为开放式手术，这意味着所使用的器械通过切口进行放置，因为需要看得清楚，该切口暴露要安装器械的脊骨以及要安装器械的区域上面和下面的一部分脊骨。这种大范围的暴露会破坏大量组织，特别是为了暴露脊椎骨而需要剥离的腰背肌筋膜组织。这种剥离会引起肌肉损伤，所述肌肉损伤由电灼烧或手动切割直接引起，或者因为血管的凝结或切割而断开肌肉的血管供应从而间接引起，并且还因为在需要保持暴露的肌肉上应用的牵开器的压缩而在手术过程中阻断血管供应从而引起。另外，脊骨植入件可能对脊骨的小关节产生影响，特别是最上面的一对椎弓根螺钉，这可能导致相关关节的疼痛或机能障碍。这一定程度上是因为椎弓根螺钉系统被设计用于赋予稳定性而进行制造时没有考虑正常的解剖结构。换句话说，脊骨被迫适应金属器械，而非让金属器械适应脊骨。
因此，由于手术的暴露范围、主要由暴露过程中脊骨的后纵肌组织引起的肌肉损伤、失血和感染的危险，当今的手术方法增加了患者的发病率。大的开放式手术还会导致巨大的术后疼痛和行动不便。因此，这些问题导致更长的住院时间，更高的术后并发症，例如由不活动引起的静脉炎和肺炎，以及治疗其产生的副作用而引起的更大的术后医疗消耗。另外，肌筋膜组织损伤已经暗示着产生术后腰部机械性机能障碍和硬化，从而导致术后疼痛综合症或背部手术失败综合症。而且，金属植入件对喙关节的正常功能的干扰已经暗示着这些关节的早期变性，以及疼痛和行动不便，所有这些都可能导致其它更多的相关手术。
本发明的主要目的是提供一种系统，其包括脊骨植入件和用于应用植入件的传递系统，其中传递系统允许以最小的侵害放置脊骨植入件由此降低现有技术手术过程的上述不期望的缺陷。
本发明的另一个目的是提供一种用于相应美国申请No.10/615196中所公开的脊骨稳定应用方法中的骨骼固定装置，其允许将螺钉多轴锁定到板上并且同时根据需要将接骨板中可以以其它方式调节的部分锁定在一起。
发明内容
本发明的骨骼固定装置包括接骨板，所述接骨板具有穿透通道用于插入紧固螺钉的螺纹轴以将板固定在下面的骨骼上。带螺纹的螺钉轴被插入穿过位于接骨板的穿透通道中的衬套并且通过螺纹固定在下面的骨骼中。衬套具有适当的结构和尺寸以至于通过凸轮压缩而抵靠螺钉头，而所述凸轮通过在板的穿透通道中旋转衬套而被驱动，由此螺钉相对于接骨板被锁定。衬套还可以同时被向下压入座部中以便于将可以以其它方式调节的接骨板的分离元件夹在一起以将其牢固锁定。
骨骼固定螺钉头具有基本上为截头球形的侧面，并且其中接收螺钉头的衬套具有形成承插孔的内表面并且在其上表面上具有进入通道，所述承插孔延伸穿过衬套的上表面和下表面，所述进入通道具有适当的尺寸用于接收穿过其中进入承插孔的螺钉头，并且所述衬套具有适当的结构和尺寸用于螺钉头在其中进行多轴旋转。衬套的外表面具有适当的结构和尺寸用于在固定器件或接骨板的穿透通道内进行有限的轴向旋转。至少一个槽缝设置于衬套的侧壁中用于允许向内压缩衬套孔使其抵靠螺钉头。凸轮机构设置在板的穿透通道与衬套之间，并且具有适当的结构和尺寸用于通过衬套在穿透通道内的轴向旋转向内压缩衬套，由此压缩孔使其抵靠螺钉头以便相对于固定器件或板以期望的姿态锁定螺钉。
衬套承插孔设置为带有中心纵轴的基本上为截头球形的形状以允许螺钉头在其中进行初始多轴旋转。衬套内的一个槽缝可以从衬套的上表面一直延伸穿过衬套的下表面，由此衬套基本上为C形并且采用凸轮机构更容易向内进行压缩。
在一种优选结构中，固定器件的穿透通道设置有倒截头圆锥形座部并且衬套的外表面设置有配合的倒截头圆锥形底座，该底座具有适当的结构和尺寸用于座靠在该座部上。该座部和底座与衬套和穿透通道的中心轴线同轴。凸轮机构可以采用不同的结构。作为示例，凸轮机构可以为螺纹凸轮斜面的螺纹接合或者其它类型的凸轮斜面的应用。例如，凸轮机构可以由在衬套的上表面上环形间隔并向上延伸的斜面凸轮构成，并且向内延伸的突出部分在凸轮或衬套上表面的上方设置在穿透通道上，并且该突出部分设置有朝向下的凸轮从动表面，所述凸轮从动表面具有适当的结构和尺寸用于在衬套在其座部中轴向旋转时接合衬套顶上的斜面凸轮。该旋转导致衬套被斜面凸轮向下推动到其倒截头圆锥形座部中，由此向内压缩衬套孔使其抵靠螺钉头。凸轮和凸轮从动表面还可以设置有脊用于防止凸轮退出。
本发明的骨骼固定装置设计为独立使用或者补充前面提到的本发明人的相关申请中所述的骨骼固定装置和应用方法。该实施例的骨骼固定器件可以调节并且在板装置的远端设置有第一螺钉接收承插元件，所述元件设置有用于借助于骨骼固定螺钉与骨骼连接的螺钉杆通道和螺钉头座部。细长臂从该第一承插元件向近端延伸并且沿其具有细长的穿透槽缝。另外设置有第二螺钉接收承插元件，其包括接收有衬套和凸轮机构的上述穿透通道。该第二螺钉接收承插元件可滑动地接收在臂上，其承插孔对准槽缝用于接收穿过其中与骨骼连接的固定螺钉的杆。衬套座部包括穿透槽缝的一些部分，由此当衬套被凸轮机构向下压入座部中时第二承插元件被夹紧并锁定在臂上。
附图说明
在下面说明部分和权利要求书中可以发现其它目的和优势。出于举例说明的目的，附图显示了本发明的某些实用的实施例，而不限制本发明或所附权利要求书，其中：
图1是本发明的骨骼固定装置的俯视图，其中不包括螺钉头衬套；
图2是图1所示骨骼固定装置的竖直中间横截面前视图，其沿着剖切线A-A观看并且包括螺钉头衬套；
图3是图1和图2所示装置中使用的C形压缩衬套的俯视图；
图4是图3所示衬套的右视图；
图5是图3所示衬套的前视图；
图6是图3所示衬套的左视图；
图7、图8、图9和图10是顺序的示意性表达图，其举例说明了沿中间横截面观看时图1所示装置的锁定机构的操作；
图11是图1和图2所示装置中使用的C形压缩衬套的可选实施例的俯视图；
图12是图11所示衬套的前视图；和
图13、图14和图15是顺序的示意性表达图，其举例说明了沿剖切线B-B观看时图1所示装置的锁定机构的可选实施例的操作并且包括图11和图12所示的衬套。
具体实施方式
首先参考图1和图2，本发明的骨骼固定装置10用于稳定脊骨，其是本发明人的上述相关申请中所显示和说明的植入板装置的改进性修改，该装置用于在所说明的创造性手术过程中以最小的侵害性手术植入用于固定骨骼的板装置。装置10由两个单独的部分构成，即可调节地装配在一起的第一部分11和第二部分。第一部分11包括位于装置10的远端14的第一接收承插元件13。该第一螺钉接收承插元件13设置有螺钉杆穿透通道15用于借助于骨骼固定螺钉23将元件13连接到脊椎骨上，如图2中所示。图1的俯视图没有包括图2中所包含的骨骼固定螺钉和其它内部部件，以便于提供元件12和13的螺钉杆穿透通道内部的暴露视图。
第一部分11还包括从第一承插元件13向近端延伸的细长臂18。细长臂18设置有沿其延伸的细长穿透槽缝20。装置10的第二部分包括同样设置有螺钉杆穿透通道22的第二螺钉接收承插元件。第二螺钉接收承插元件12可滑动地接收在臂18上，而其穿透通道22位于槽缝20的中心并且与其对准，用于通过其接收固定螺钉23的杆24以便与下面的脊椎骨连接。骨骼固定或紧固螺钉23具有螺纹杆或轴24，用于插入穿过各自的穿透通道15和22，并且它们还设置有螺钉头25，所述螺钉头具有基本上为截头球形的侧面。
为每个承插元件12和13设置衬套30以接收各自的螺钉头25。这些衬套具有上表面31和下表面32以及侧壁33。这些衬套30的细节在图3、图4、图5和图6中得到最佳显示。
每个衬套30的侧壁33设置有外表面34，所述外表面的尺寸使其可在螺钉接收承插元件12和13的各自的穿透通道15和22内轴向旋转。衬套30的内表面形成延伸穿过上表面31和下表面32的承插孔并且具有适当的结构和尺寸使得螺钉头25在其中进行多轴旋转。在侧壁33中设置有多个槽缝36用于允许孔35向内压缩而抵靠螺钉头25。凸轮机构37设置在穿透通道15和22与衬套30之间，并且该凸轮机构37具有适当的结构和尺寸用于通过每个衬套30在其各自的穿透通道15和22内的轴向旋转向内压缩衬套30，由此衬套30的孔35抵靠着接收于其中的各自的螺钉头25以便以期望的姿态相对于固定板或装置10锁定螺钉23。衬套衬套孔35具有与螺钉头25互补的基本上为截头球形的形状，并且其中心纵轴垂直于上表面31和下表面32。而且，衬套30的具有槽缝38形式的一个槽缝36从上表面31穿过下表面32完全延伸穿过侧壁33。这为衬套30提供了C形形状并且允许衬套的更大压缩。
每个穿透通道15和22的底部设置有倒截头圆锥形座部39，并且衬套30的外表面33设置有与之相配合的倒截头圆锥形底座40，该底座具有适当的结构和尺寸以便于分别座靠在所述座部39上。座部39和底座40与衬套孔35的中心轴线同轴。
凸轮机构37包括在衬套30的上表面31上环形间隔并向上延伸的斜面凸轮41和位于衬套30的上表面31上方在穿透通道15和22上向内延伸的突出部分42。突出部分42设置有朝向下的凸轮从动表面43，所述凸轮从动表面具有适当的结构和尺寸用于当衬套30在穿透通道15或22中轴向旋转时接合凸轮斜面41，由此衬套30被斜面凸轮41向下推动到座部39中，由此向内压缩衬套孔35使其抵靠螺钉头25。
该凸轮机构37还包括在衬套30的外表面33上径向延伸的斜面凸轮44，并且这些另外的斜面凸轮具有适当的尺寸和结构用于当衬套30在穿透通道15或22中轴向旋转时因为穿透通道15和22的构成方式也向内压缩衬套孔35。如图3至图6中所示，斜面凸轮41和44设置有脊用于防止衬套30在其已经固定在各自的穿透通道15或22内之后旋转退出。
用于第二接收承插元件12的衬套座部39包括用于臂18的穿透槽缝22的倾斜配合部分50，因此当衬套30被凸轮机构37向下压入穿透通道22到达座部39上时第二接收承插元件12被牢固夹在臂18上。衬套30不仅以期望的姿态牢固锁定螺钉头25，同时还在期望的位置将第二螺钉接收承插元件12牢固锁定在臂18上。该锁定功能在图7至图10中通过分步显示说明。这里主要期望这些示意性图解显示沿剖切线B-B观看的图1所示固定装置10的横截面。然而，出于简化说明的目的，衬套30相对于装置10的准确方位不同于图1和图2中所示。
图7显示了部件初始装配起来准备使用时的准备位置。衬套30已经被插入接收承插元件12中。这是在制造阶段通过充分压缩C形衬套30使其通过元件12的上部进入通道51来实现的。在插入之后，衬套30被解除压缩并且上表面31的外边缘径向向外扩张，由此它们位于突出部分42下面。这防止衬套30意外移出元件12。
要注意的是，在该准备位置中，衬套30的上唇直径d稍小于螺钉头25的直径并且下唇直径d′小于螺钉头25的直径。因此，在整个过程的第二个步骤中，螺钉杆24被插入穿过衬套孔35并且继续插入元件12的穿透通道22，螺钉头25然后强行径向扩张衬套30，并且螺钉头25向下锁扣到衬套30中，在这里它被保持在衬套孔35中，而直径d′太小以至于螺钉头25不能从中强行通过。该步骤通过将螺钉23的螺纹杆24旋入下面的脊椎中直到螺钉头25向下锁扣在衬套30中而完成，如图8中所示。为了完成该步骤，螺钉23当然如箭头所示顺时针旋转。
然后，下一个步骤示意性示于图9中，其中衬套30如图9顶部的箭头所示逆时针旋转。这动作通过外八齿菲利普起子实现，该起子接合槽缝36并且其具有中空轴内部以至于其设置或者同轴接收在用于驱动螺钉23的中心六角头起子上。图中没有显示这种组合式改锥，但是其很容易想象并且允许外科医生在逆时针旋转衬套30的同时保持螺钉头25固定。
因为凸轮机构37提供了向上伸出的凸轮斜面41和径向伸出的斜面凸轮44，衬套30的该逆时针旋转导致径向延伸的斜面凸轮44向内压缩衬套30和相应的孔35，并且由此牢固接合螺钉头25，并且衬套30的继续逆时针旋转还导致衬套30被向下推动到座部39中，如图10中进一步显示，于是，因为斜面凸轮41作用于突出部分42的从动凸轮表面43上而将螺钉头25锁定在其相对于固定装置10的轨道中。这相对于接收承插元件12牢固锁定臂18并且相对于整个装置10以特定姿态牢固锁定螺钉23。
如图2中最佳显示，突出部分42的从动凸轮43可以设置有如图所示向下延伸的斜面凸轮从而与衬套30的向上延伸的斜面凸轮41互补。从动凸轮表面41以及元件12的径向朝向的凸轮表面49可以设置有补充性的脊用于防止衬套30在其锁定在适当位置之后旋转退出。
另外参考图1和图2，接收承插元件12的凸轮表面49设置有锁定凹陷65。衬套30只需要四分之一圈逆时针旋转就使衬套完全压缩螺钉头25。因此，凹陷65被设置为刚刚超过衬套30的最大压缩点。两个这样的锁定凹陷设置在元件12的相对侧上，它们分别用于每个径向伸出的斜面凸轮44。一旦衬套30已经通过四分之一圈逆时针旋转而被完全压缩，衬套30就可以稍微扩张，由此径向延伸的斜面凸轮44的角部锁扣在锁定凹陷65中。这防止衬套30顺时针旋转并且自身释放并且它还为外科医生提供表示衬套30被完全锁定的机械反馈。在装置中包括锁定凹陷65就可以不需要斜面凸轮41和44上的脊。该布置还允许衬套30超过四分之一圈克服最大力矩逆时针旋转通过另一个四分之一圈返回到衬套的静止点或起始点，这允许释放衬套30和螺钉头25。以这种方式，外科医生甚至可以在衬套30已经锁定之后选择调节植入件。
设置在骨骼固定装置10的近端41上的穿透槽缝57和保持槽缝56用于将装置联接到如本发明人的上述相关申请中所显示和说明的插入枪上，用于以最小的侵害性手术应用本发明的装置。要获得这方面的更多信息，请参考该文献，因此该文献在此被引作参考。
在图11至图15中显示了凸轮机构37的可选实施例。在该实施例中，C型衬套30同样设置有倒截头圆锥形底座部分33用于配合并座靠在承插元件13的穿透通道15的倒截头圆锥形座部39中。然而，在该实施例中，凸轮机构37通过衬套30的倒截头圆锥形表面33上的阳螺纹45和穿透通道15的倒截头圆锥形配合座部上的配合阴螺纹46设置为螺纹凸轮斜面的形式。
图13显示了安装的初始状态，其中螺钉23被插入衬套30的孔35中。衬套30通过突出部分42保持在承插元件13中的适当位置中由此防止衬套30退出，其中突出部分42突出于衬套30的环形唇47之上。
一旦向下推压螺钉头25，如图14中箭头所示，C形衬套30就被扩张并且允许螺钉头25进入并由内孔35限制。通过合适的改锥顺时针旋转螺钉头25直到杆部24完全接合在下面的骨骼(未示出)中。
此时，使用专门的改锥接合衬套30顶部31中的驱动凹陷46，如图11中最佳显示，由此将衬套30向下推动并且如图15中箭头所示逆时针旋转。这导致凸轮机构37的螺纹45和46接合，由此进一步向内和向下压缩C形衬套30直到伸出的环形唇47接合在环形座部48下面，由此接合衬套30并且防止其退出其螺纹接合。该过程牢固锁定螺钉23的螺钉头25使其不能在衬套30的孔35内进一步多轴旋转。

Claims (9)

1、一种骨骼固定装置，包括：
(a)固定器件，其具有穿透通道；
(b)紧固螺钉，其具有插入穿过所述穿透通道并且通过螺纹插入骨骼中的螺纹轴和具有截头球形的侧面的螺钉头；
(c)衬套，其具有
(i)上表面和下表面；
(ii)侧壁，其带有外表面和内表面，所述外表面的结构和尺寸使其在固定器件的所述穿透通道内进行轴向旋转，所述内表面形成延伸穿过上表面和下表面的承插孔并且所述内表面的结构和尺寸适于所述螺钉头在其中进行多轴旋转；和
(iii)设置于侧壁上的至少一个槽缝，以允许向内压缩所述孔使其抵靠所述螺钉头；和
(iv)位于所述上表面中的进入通道，所述进入通道的尺寸适于通过其接收所述螺钉头使螺钉头进入所述承插孔；
(d)凸轮机构，其设置在所述穿透通道与所述衬套之间，并且所述凸轮机构的结构和尺寸适于通过衬套在所述穿透通道中的轴向旋转向内压缩所述衬套，由此所述孔被压缩抵靠着所述螺钉头以便相对于所述固定器件以期望的姿态锁定所述螺钉，
其特征在于，所述穿透通道的底部具有倒截头圆锥形座部，并且所述衬套的所述外表面具有相配合的倒截头圆锥形底座，所述底座的结构和尺寸使其适于座靠在所述座部中，所述座部和所述底座与所述中心轴线同轴，所述凸轮机构包括在所述衬套的所述上表面上环形间隔并向上延伸的斜面凸轮，并且所述进入通道包括在所述穿透通道上向内延伸的突出部分，所述突出部分设置在所述上表面的上方并且具有朝向下的凸轮从动表面，所述凸轮从动表面的结构和尺寸使其适于在所述衬套在所述穿透通道中轴向旋转时接合所述斜面凸轮，由此所述衬套被所述斜面凸轮向下推动到所述座部中，由此向内压缩所述衬套孔使所述衬套孔抵靠所述螺钉头。
2、根据权利要求1所述的骨骼固定装置，其特征在于所述衬套承插孔具有带中心纵轴的截头球形的形状。
3、根据权利要求2所述的骨骼固定装置，其特征在于所述承插孔延伸穿过所述衬套的中心轴线并且与上表面和下表面垂直。
4、根据权利要求3所述的骨骼固定装置，其特征在于所述至少一个槽缝中的一个是从上表面穿过下表面延伸完全穿过所述侧壁的槽缝，并且所述进入通道的尺寸适于通过扩张所述进入通道从而通过所述进入通道接收所述螺钉头并锁扣配合。
5、根据权利要求1所述的骨骼固定装置，其特征在于所述凸轮机构包括在所述衬套的所述外表面上径向延伸的斜面凸轮，所述斜面凸轮的尺寸和结构使其适于在所述衬套在所述穿透通道中轴向旋转时向内压缩所述承插孔。
6、根据权利要求5所述的骨骼固定装置，其特征在于所述凸轮机构包括位于至少一个所述凸轮上的脊。
7、根据权利要求4所述的骨骼固定装置，其特征在于所述穿透通道的底部具有倒截头圆锥形座部，并且所述衬套的所述外表面具有相配合的倒截头圆锥形底座，所述底座的结构和尺寸使其适于座靠在所述座部中，所述座部和所述底座与所述中心轴线同轴，所述凸轮机构包括所述穿透通道的所述底部与所述衬套底座之间的螺纹接合部，由此当所述衬套在所述穿透通道座部中旋转时，所述衬套被拉入所述座部中并由此被向内压缩抵靠所述螺钉头。
8、根据权利要求7所述的骨骼固定装置，其特征在于所述螺纹接合部设置有左旋螺纹。
9、根据权利要求1所述的骨骼固定装置，其特征在于所述固定器件是在所述装置的远端具有第一螺钉接收承插元件的接骨板，所述元件设置有用于借助于骨骼固定螺钉与骨骼相连接的螺钉杆通道和螺钉头座部，细长臂从所述第一承插元件向近端延伸并且沿着所述细长臂具有细长的穿透槽缝，第二螺钉接收承插元件包括接收有所述衬套和所述凸轮机构的所述穿透通道并且可滑动地接收在所述臂上，同时所述承插孔对准所述槽缝以便通过其接收固定螺钉的杆以便与骨骼连接，所述衬套座部包括所述穿透槽缝的一些部分，由此当所述衬套被所述凸轮机构向下压入所述座部中时，所述第二承插元件被夹紧在所述臂上。
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US20050010218A1 (en) 2005-01-13
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US6945975B2 (en) 2005-09-20
ES2404031T3 (es) 2013-05-23

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