CN1913839A - 接骨螺钉 - Google Patents

接骨螺钉 Download PDF

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CN1913839A
CN1913839A CNA2004800414228A CN200480041422A CN1913839A CN 1913839 A CN1913839 A CN 1913839A CN A2004800414228 A CNA2004800414228 A CN A2004800414228A CN 200480041422 A CN200480041422 A CN 200480041422A CN 1913839 A CN1913839 A CN 1913839A
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sleeve pipe
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A·施林格
P·森
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AO Technology AG
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/686Plugs, i.e. elements forming interface between bone hole and implant or fastener, e.g. screw
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/7241Intramedullary pins, nails or other devices with special means of locking the nail to the bone the nail having separate elements through which screws pass
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72Intramedullary pins, nails or other devices
    • A61B17/7233Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61BDIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00Surgical instruments, devices or methods, e.g. tourniquets
    • A61B17/56Surgical instruments or methods for treatment of bones or joints; Devices specially adapted therefor
    • A61B17/58Surgical 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
    • A61B17/68Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/84Fasteners therefor or fasteners being internal fixation devices
    • A61B17/86Pins or screws or threaded wires; nuts therefor
    • A61B17/8625Shanks, i.e. parts contacting bone tissue
    • A61B17/863Shanks, i.e. parts contacting bone tissue with thread interrupted or changing its form along shank, other than constant taper

Abstract

接骨螺钉(1)包括一个带有螺纹(2)的杆(3)、一个前端部(4)和一个后端部(5),其中螺纹(2)的外径“d”或芯直径“k”在杆(3)的中间区域(L4)内从一个较大的尺寸“d2”或“k2”向前端部(4)缩小为一个较小的尺寸“d1”和“k1”,其中“d1”或“k1”不等于零。杆(3)设有一个同心设置的、可径向扩展的套管(10),其中套管(10)定位在杆(3)的具有较小外径“d1”的那部分上。

Description

接骨螺钉
技术领域
本发明涉及一种按权利要求1前序部分所述的接骨螺钉以及一种按权利要求14的前序部分所述的、包括一个或多个这种接骨螺钉的用于骨固定的装置。
背景技术
从DE-A 35 38 238中已知这样一种接骨螺钉,该接骨螺钉此外还具有一个与它共同作用的骨板接合钉(Dübel)。然而,在这种已知的装置上,骨板接合钉首先被单独固定在骨中,然后再将接骨螺钉拧入骨板接合钉中。这种已知的装置的目的在于按照已经出自普通的固定技术的公知的骨板接合钉/螺钉原则连接两个骨碎片。
该发明首先不涉及两个骨碎片的固定(其次仅借助髓内钉实现该目的),而是在髓内钉的横向孔中稳定地固定接骨螺钉。已知的横向锁紧螺钉与髓内钉的横向孔之间都具有一个间隙。
发明内容
在这里本发明提供一种解决办法。本发明的目的在于,提供一种可以无间隙地插入髓内钉的横向孔中的接骨螺钉。
本发明借助一个具有权利要求1所述的特征的接骨螺钉达到该目的。
通过本发明达到的优点基本上在于其简易性(在接骨螺钉上预先安装的套管)和由此可以达到与髓内钉之间的无间隙性。
在一个特殊的实施方式中,接骨螺钉的螺纹具有恒定的深度,其中杆芯的直径在中间区域Ld内沿向前端部的方向从一个较大的值“k2”减小到一个较小的值“k1”,但假设不为零。径向扩张由此通过芯直径的扩大得以实现,这保证在髓内钉横向孔中一个特定的夹紧力。与螺纹外径的扩大相比,芯直径的扩大造成一个扩大的块体,其可以用于锁紧螺钉。
在一个专门的实施方式中,套管具有内螺纹。通过内螺纹的螺距产生轴向移动,这种移动通过锥形芯段特定的几何在中间区域Ld内产生套管的径向扩张。旋转或旋紧运动对于螺钉插入髓内钉的横向孔中总归是必需的。
套管可以具有一个或多个纵向缝。由此达到的优点在于,套管的径向扩张能够以较小的力耗费或较小的扭矩实现。套管预先安装在螺钉上更加简便,剪切力被补偿,套管承受较小的内应力。如果设置一个唯一的纵向缝,它可以在套管的整个高度上延伸。但是,纵向缝也可以仅仅在套管高度的一部分上延伸,在此它在该实施方式中可以一侧开放或者两侧都封闭。在这样的部分缝的情况下也可以具有多个纵向缝,优选地交替地在上部和下部开放。
在另一种实施方式中,直径为DH的套管在其一端部具有一个在周围环绕的、带有扩大的直径DF>DH的凸缘。该凸缘用作止挡即套管在髓内钉上定位,使得接骨螺钉以其锥形扩展的中间区域必须穿过套管贯穿旋紧,接骨螺钉径向扩张,而套管自身与中间区域相接触。
例如,套管可以由不可吸收的塑料、优选PEEK组成。优点在于生物适应性,良好的可制造性、简易的安装和以下这种情况,即在取出髓内钉时,如果套管保持悬挂在髓内钉的孔中,它可以被共同挤压。
但是,套管也可以由金属材料组成。这里的优点在于较高的强度、生物适应性和以下这种情况,即套管由与髓内钉和螺钉相同的材料组成。但金属套管也具有更好的可延展性,使得当它被倾斜插入时,它可以略微流动。最后,金属套管还有不会出现断裂的优点。
套管也可以由可吸收的塑料组成。第一个优点在于,角度稳定的锁紧随着时间减弱。第二个优点在于,在可能失去这样一个套管时不会出现很大的缺点,因为它随着时间被吸收。
在另一种实施方式中,在接骨螺钉后端部和带有较大外径“d2”的杆的那部分之间,一个杆部分设置在具有扩大的外径d3>d2的区域“L2”中。这种结构的优点在于,它封闭在骨前部外皮上钻出的孔,使得套管的凸缘无需耗费很大的力便可以穿过第一层外皮中的孔。在此在具有外径d3>d2的区域“L2”中,杆部分可以设有外螺纹。具有外径的d3的外螺纹再次以旋紧的方式固定在骨内。
与上述的接骨螺钉一起使用的髓内钉具有直径DN和垂直于纵向轴线延伸的横向孔,该横向孔符合目的具有直径DB,该直径DB既大于d2又大于dB-L5。有利地套管直径DH满足条件DH≤1.2DB。套管长度HL应当有利地小于1.5DN而大于0.2DN
在另一种实施方式中,髓内钉具有连续的中空管和壁厚WN。套管的长度HL有利地与髓内钉的壁厚WN相应。
附图说明
以下借助多个实施例的部分示意图更详细地说明本发明和本发明的扩展结构。
附图中:
图1示出套装套管的接骨螺钉的纵剖视图
图2示出按图1的接骨螺钉插入具有横向孔的髓内钉的纵剖视图
图3示出按图1的接骨螺钉的纵剖视图
图4示出按图1的套管的透视图
具体实施方式
在图1和3中示出接骨螺钉1的一种实施方式,它包括一个杆3、一个前端部4和一个带有螺钉头6的后端部5。接骨螺钉1具有五个轴向依次设置的部分,这些部分如下地设计:
-从后端部5起测量,螺钉头6延伸一段长度L1
-与此相邻,杆部分8延伸一段长度L2,该杆部分8具有带有一个恒定的外径d3和恒定的芯直径k3的外螺纹9;
-与此相邻,杆3的一部分延伸一段长度L3,该部分具有带有一个恒定的外径d2<k3和恒定的芯直径k2的螺纹2;
-与此相连,杆3的一个以角度α向前端部4缩小的部分延伸一段长度L4,使得在这个部分中,螺纹外径d2减小到外径d1。同样在这一部分中,芯直径k2减小到芯直径k1
-杆3的一部分在具有长度L4的部分和前端部4之间延伸,该部分具有一个带有恒定的外径d1和同样恒定的芯直径k1的螺纹2。
螺纹2如此设计,使得螺纹深度t1和t2在具有长度L5和L3的部分上一样。此外,在图1中,套管10从前端部4经由杆3旋紧,直至它设有凸缘12的端部达到具有长度L4的锥形部分。由于锥度,套管10容易被扩展,并具有一个外径dB-L5>DH(图4)。如果套管10继续向后端部5旋紧(以虚线示出),它便通过具有长度L4的锥形部分进一步扩展,直到它在具有连续外径d3的且具有长度L3的部分上达到直径dB-L3
图2示出图1示出的接骨螺钉1的实施方式连同一个插入髓内钉20的横向孔22中的套管10。髓内钉20设有一个与其纵向轴21同轴的贯穿的中空管23(Kannulierung),并具有外径DN和壁厚WN。横向孔22有直径DB,它大约为套管10直径dB-L3的90%。套管10完全插入到横向孔22中,凭借凸缘12与横向孔22的倾斜部24的壁相接触。
图4示出具有一个直径DH的可以径向扩展的套管10的一种实施方式。套管10的外壳设计为带有一个贯穿的纵向缝11,通过该纵向缝套管10获得了其弹性。此外,套管10的空腔配有内螺纹13。为了轴向地紧靠在一个适当的支承平面上,在套管10的端部上设置一个带有直径DF>DH的凸缘12。
权利要求书
(按照条约第19条的修改)
1.一种接骨螺钉(1),具有一个带有螺纹(2)的杆(3)、一个前端部(4)和一个后端部(5),其中螺纹(2)的外径“d”或杆(3)的芯直径“k”在杆(3)的中间区域(L4)内从一个较大的尺寸“d2”或“k2”向前端部(4)缩小为一个较小的尺寸“d1”或“k1”,其中“d1”或“k1”不等于零,其特征在于,
A)杆(3)设有一个同心设置的、可径向扩展的套管(10),其中,
B)套管(10)定位在杆(3)的具有较小外径“d1”的部分上。
2.按权利要求1所述的接骨螺钉(1),其特征在于,螺纹(2)具有一个恒定的深度,杆(3)的芯(7)的直径在中间区域(L4)内向前端部(4)的方向从一个较大的值“k2”减小到一个较小的值“k1”,但假设不为零。
3.按权利要求1或2所述的接骨螺钉(1),其特征在于,套管(10)具有内螺纹(13)。
4.按权利要求1至3中任一项所述的接骨螺钉(1),其特征在于,套管(10)具有至少一个纵向缝(11)。
5.按权利要求1至4中任一项所述的接骨螺钉(1),其特征在于,纵向缝(11)在套管(10)的整个高度上延伸。
6.按权利要求1至4中任一项所述的接骨螺钉(1),其特征在于,纵向缝(11)仅仅在套管(10)高度的一部分上延伸。
7.按权利要求6所述的接骨螺钉(1),其特征在于,有多个纵向缝(11),优选地交替地在上部和下部开口。
8.按权利要求1至7中任一项所述的接骨螺钉(1),其特征在于,直径为DH的套管(10)在其一个端部上具有一个在周围环绕、具有扩大的直径DF>DH的凸缘(12)。
9.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由不可吸收的塑料、优选由PEEK组成。
10.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由金属材料组成。
11.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由生物可吸收的塑料组成。
12.按权利要求1至11中任一项所述的接骨螺钉(1),其特征在于,在其后端部(5)和杆(3)的带有较大外径“d2”的那部分之间,杆部分(8)设置在具有扩大的外径d3>d2的区域“L2”中。
13.按权利要求12所述的接骨螺钉(1),其特征在于,在具有扩大的外径d3>d2的区域“L2”中的杆部分(8)设有外螺纹(9)。
14.按权利要求1至13中任一项所述的接骨螺钉(1),其特征在于,
A)该接骨螺钉包括一个螺钉头(6),该螺钉头延伸一段从后端部(5)起测量的长度L1
B)杆(3)的一部分延伸一段长度(L3),该部分具有一个带有恒定的外径“d2”和恒定的芯直径“k2”的螺纹(2);
C)与其相邻,杆(3)的以角度α向前端部(4)缩小的部分延伸一段长度(L4),使得在这个部分中,螺纹外径“d2”减小到外径“d1”;
D)杆(3)的一部分在具有长度(L4)的部分和前端部(4)之间延伸一段长度(L5),该部分具有一个带有恒定的外径“d1”和同样恒定的芯直径“k1”的螺纹(2)。
E)这些部分的长度和直径都大于零。
15.按权利要求14所述的接骨螺钉(1),其特征在于,在杆(3)的具有长度(L4)的部分中,芯直径“k2”减小到芯直径“k1”。
16.按权利要求14或15所述的接骨螺钉(1),其特征在于,杆部分(8)延伸一段与长度(L1)相邻的长度(L2),该杆部分具有一个带有恒定的外径“d3>d2”和恒定的芯直径“k3”的外螺纹(9)。
17.按权利要求14至16中任一项所述的接骨螺钉(1),其特征在于,在具有长度(L5)和(L3)的部分上的螺纹深度“t1”和“t2”是相同的。
18.一种包括按权利要求1至17中任一项所述的一个或多个接骨螺钉(1)的用于骨固定的装置,具有一个髓内钉(20),其特征在于,髓内钉(20)具有直径DN和横向于纵向轴线(21)延伸的横向孔(22),该横向孔具有直径DB,该直径DB既大于d2又大于dB-L5
19.按权利要求18所述的装置,其特征在于,套管(10)的直径DH满足条件DH≤1.2DB
20.按权利要求18或19所述的装置,其特征在于,套管(10)长度HL小于1.5DN
21.按权利要求18至20中任一项所述的装置,其特征在于,套管(10)长度HL大于0.2DN
22.按权利要求18至21中任一项所述的装置,其特征在于,髓内钉(20)具有连续的中空管(23)和壁厚WN
23.按权利要求22所述的装置,其特征在于,套管(10)的长度HL与髓内钉(20)的壁厚WN相应。

Claims (19)

1.一种接骨螺钉(1),具有一个带有螺纹(2)的杆(3)、一个前端部(4)和一个后端部(5),其中螺纹(2)的外径“d”或杆(3)的芯直径“k”在杆(3)的中间区域(L4)内从一个较大的尺寸“d2”或“k2”向前端部(4)缩小为一个较小的尺寸“d1”或“k1”,其中“d1”或“k1”不等于零,其特征在于,
A)杆(3)设有一个同心设置的、可径向扩展的套管(10),其中,
B)套管(10)定位在杆(3)的具有较小外径“d1”的那部分上。
2.按权利要求1所述的接骨螺钉(1),其特征在于,螺纹(2)具有一个恒定的深度,杆(3)的芯(7)的直径在中间区域(L4)内向前端部(4)的方向从一个较大的值“k2”减小到一个较小的值“k1”,但假设不为零。
3.按权利要求1或2所述的接骨螺钉(1),其特征在于,套管(10)具有内螺纹(13)。
4.按权利要求1至3中任一项所述的接骨螺钉(1),其特征在于,套管(10)具有至少一个纵向缝(11)。
5.按权利要求1至4中任一项所述的接骨螺钉(1),其特征在于,纵向缝(11)在套管(10)的整个高度上延伸。
6.按权利要求1至4中任一项所述的接骨螺钉(1),其特征在于,纵向缝(11)仅仅在套管(10)高度的一部分上延伸。
7.按权利要求6所述的接骨螺钉(1),其特征在于,有多个纵向缝(11),优选交替地在上部和下部开口。
8.按权利要求1至7中任一项所述的接骨螺钉(1),其特征在于,直径为DH的套管(10)在其一个端部上具有一个在周围环绕的、具有扩大的直径DF>DH的凸缘(12)。
9.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由不可吸收的塑料、优选由PEEK组成。
10.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由金属材料组成。
11.按权利要求1至8中任一项所述的接骨螺钉(1),其特征在于,套管(10)由生物可吸收的塑料组成。
12.按权利要求1至11中任一项所述的接骨螺钉(1),其特征在于,在其后端部(5)和杆(3)的带有较大外径“d2”的那部分之间、在具有一个扩大的外径d3>d2的区域“L2”中设置一个杆部分(8)。
13.按权利要求12所述的接骨螺钉(1),其特征在于,在具有扩大的外径d3>d2的区域“L2”中的杆部分(8)设有外螺纹(9)。
14.一种包括按权利要求1至13中任一项所述的一个或多个接骨螺钉(1)的用于骨固定的装置,具有一个髓内钉(20),其特征在于,髓内钉(20)具有直径DN和横向于纵向轴线(21)延伸的横向孔(22),该横向孔具有直径DB,该直径DB既大于d2又大于dB-L5
15.按权利要求14所述的装置,其特征在于,套管(10)直径DH满足条件DH≤1.2DB
16.按权利要求14或15所述的装置,其特征在于,套管(10)长度HL小于1.5DN
17.按权利要求14至16中任一项所述的装置,其特征在于,套管(10)长度HL大于0.2DN
18.按权利要求14至17中任一项所述的装置,其特征在于,髓内钉(20)具有连续的中空管(23)和壁厚WN
19.按权利要求18所述的装置,其特征在于,套管(10)的长度HL与髓内钉(20)的壁厚WN相应。
CN2004800414228A 2004-02-23 2004-02-23 用于骨固定的装置 Expired - Lifetime CN1913839B (zh)

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CN102619839A (zh) * 2011-01-28 2012-08-01 通用电气公司 紧固件
CN102619839B (zh) * 2011-01-28 2015-11-25 通用电气公司 紧固件
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CN103889351B (zh) * 2011-08-25 2016-11-23 美多斯国际有限公司 骨锚
CN111107808A (zh) * 2017-07-19 2020-05-05 牙科材料工贸有限公司 牙齿植入物
CN111107808B (zh) * 2017-07-19 2022-07-19 牙科材料工贸有限公司 牙齿植入物
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