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CN100337601C - 具有可靠骨骼螺钉的医用植入体 - Google Patents

具有可靠骨骼螺钉的医用植入体 Download PDF

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CN100337601C
CN100337601C CNB038258498A CN03825849A CN100337601C CN 100337601 C CN100337601 C CN 100337601C CN B038258498 A CNB038258498 A CN B038258498A CN 03825849 A CN03825849 A CN 03825849A CN 100337601 C CN100337601 C CN 100337601C
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skeleton
implant
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CN1735382A (zh
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A·凯勒
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Waldemar Link GmbH and Co KG
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • 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
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61B—DIAGNOSIS; SURGERY; IDENTIFICATION
    • A61B17/00—Surgical instruments, devices or methods, e.g. tourniquets
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    • 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
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    • 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
    • A61B17/70—Spinal positioners or stabilisers ; Bone stabilisers comprising fluid filler in an implant
    • 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
    • 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
    • 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
    • A61B17/8625—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
    • A61F—FILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00—Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/02—Prostheses implantable into the body
    • A61F2/30—Joints
    • A61F2002/30001—Additional features of subject-matter classified in A61F2/28, A61F2/30 and subgroups thereof
    • A61F2002/30316—The prosthesis having different structural features at different locations within the same prosthesis; Connections between prosthetic parts; Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30535—Special structural features of bone or joint prostheses not otherwise provided for
    • A61F2002/30576—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs
    • A61F2002/30578—Special structural features of bone or joint prostheses not otherwise provided for with extending fixation tabs having apertures, e.g. for receiving fixation screws

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Abstract

具有可靠骨骼螺钉(4)的医用植入体，该骨骼螺钉通过植入体(1，2)的一个孔(3)导向。所述孔(3)含有一个和螺钉的螺纹相匹配的螺纹。在该螺钉的头(6)和螺纹(5)之间设置有一个无螺纹部段(10)，该无螺纹部段的直径不大于螺纹孔(3)的无螺纹部分的直径，并且其长度至少与螺纹孔(3)的长度一样大。这些螺纹阻止螺钉在不旋转的情况下的轴向通过。该旋转通过一个旋转阻止装置(15、16)阻止或者排除。

Description

具有可靠骨骼螺钉的医用植入体
在借助一个骨骼螺钉固定在骨骼上的医用植入体中，常常要求防止螺钉从为它设计的位置中回转出来，从而不会对邻近的器官造成危害。(US-A5275601)防止螺钉沿松动方向旋转的办法是不够的，因为当螺钉的螺纹线松动地啮合到骨骼材料中时存在螺钉在没有任何明显的旋转的情况下就轴向地往回移出骨骼并移出植入体的危险。在用于骨板的一种骨骼螺钉的情况下，已知(US-A-2002/0022843，FR-A-2802082)在螺钉头上并且在骨板的关联的孔中提供了相互作用的螺纹圈数，所述螺纹圈数比骨骼螺纹有较小的螺距。以这种方式使得抵制螺钉回退的摩擦增加了。以这种方式使得拧松螺钉变得困难，但不会被阻止。最后公开了这样一种办法对螺钉进行保险，即在植入体上设置一种覆盖装置，它是在螺钉拧入以后设置到螺钉头上的，为的是排除它的反向移动(WO 97/20526，WO 01/26567，WO 99/56653)。但是这种覆盖装置需附加的空间，而有时这是所不希望的。
因此本发明的任务是，在骨骼螺钉具有防止后退运动的可靠构件的情况下阻止螺钉从植入体中轴向向外的移动。
本发明的方案存在于权利要求的特征之中。因此规定，骨骼螺钉通过植入体的一个孔被导向，该孔配置有一个和螺钉的螺纹相匹配的螺纹；螺钉杆在螺钉头和螺纹之间具有一个无螺纹的部段，该部段的长度至少和螺纹孔的长度一样大；植入体和螺钉装配有阻止螺钉逆转的构件。当螺钉位于为它设计的位置之中时，螺钉杆的无螺纹部段就位于植入体的螺纹孔之中。在这种状态中孔和螺钉的螺纹彼此不啮合。螺钉的防止反向运动在于，螺钉螺纹不能轴向地穿过螺纹孔。孔螺纹和螺钉螺纹的彼此面对的最后几道螺纹线形成了轴向止挡，这些轴向止挡阻止螺钉的反向运动。只有当螺钉螺纹通过旋转能够运动到孔的螺纹中时才可以想像螺钉从植入体中出来。而这点通过逆转闭锁就阻止了。
下面参考几个表示优选的实施例的附图对本发明进行更加详细地说明。这些附图是：
图1：根据图2的I-I线的一个人造植入关节(Endoprothese)的剖面图；
图2：所述人造植入关节的腹侧示图；
图3：根据图2的III-III线的剖面图；
图4：在布置中使用了骨骼螺钉的横截面图，该图为螺钉头的柄端面。
人们看到一个具有一个板1的人造植入关节，在该板的边缘设置了一个法兰2，该法兰含有两个用于容纳应将法兰2固定在骨骼表面上的骨骼螺钉4的孔3。为了锚定在骨骼中，骨骼螺钉具有一个螺钉螺纹5，该螺纹在图1的右边出现的螺钉的靠近尖端部的部段仅用虚线表示。在另一端处骨骼螺钉4的柄设置有一个螺钉头6，该头具有用于作用旋转工具的表面，在所示实施例中该工作面设计为内六棱边7。在螺钉头6的面向柄的端面8和螺钉螺纹5的邻近端9之间设置有一个无螺纹的部段10。
所属的孔3可以(但不是必须)包含一个用于完全或者部分地容纳螺钉头6的凹槽11，它形成一个用于放置螺钉头6的后端面8的端面12。在端面12和该孔的法兰2的背面13之间的孔段含有孔螺纹14，该螺纹和骨骼螺钉4的螺钉螺纹5相匹配。端面12和背面13之间的在所述孔中的螺纹部段的长度至多和螺钉的无螺纹的部段10的轴向长度一样长，并且不是短很多。螺钉的无螺纹的部段10的直径不比孔3中的无螺纹部分的钻心截面(freier Kernquerschnitt)的大。因此，在骨骼螺钉4完全拧入后螺钉螺纹5就不受孔3的孔螺纹14的限制。螺钉可以如所要求的那样自由地旋转，以便通过螺钉拧紧在骨骼中而将法兰2完全拉近在骨骼的表面上。
螺钉螺纹5的后端部9和孔3中的孔螺纹14的面向该后端部9的端部形成挡块、该挡块使得骨骼螺钉4从植入体法兰2中出来的轴向无旋转的反向运动成为不可能。也为了阻止逆转动，螺钉和植入体设置有一个旋转阻止构件。如在所述技术中对于阻止螺钉的退回通常所公开的那样，这种构件可以是任意的和很简单的那种类型的。例如可以为螺钉头在它的柄侧端面设置一个锯齿构件15，为的是和法兰2的相应构件防止逆转地共同起作用。在本实施例中，图3中的防止逆转构件是作为一种弹性舌簧16表示的，该舌簧从法兰的凹槽11的基面12弹性地伸出，这样，它的边缘可以和锯齿构件15啮合。该构件是如此设置的，即螺钉只能沿拧入到骨骼中去的方向旋转。若试图将螺钉沿松动方向转动，则舌簧16的前边缘与锯齿构件15啮合，并且阻止其继续逆转。
孔3中的孔螺纹14无需具有特别的长度。相反地它可以极短。甚至它无需是一个完全环绕的螺纹线。例如在孔的一侧以一个凸起的形状表示一个螺纹线就够了。这个凸起正好能阻止螺钉的设有螺纹的部分的轴向通过。
只要骨骼螺钉4以无螺纹的部段10位于孔3中，这种阻止逆转就应该是有效的。也就是说，在这种状态中螺钉头6必须如此地靠近法兰2，即舌簧16的前边缘啮合到螺钉头6的锯齿构件15中。这一点通过螺纹端部9在孔螺纹14的最后一道螺纹线上的止挡得到保证。换句话说，在弹性舌簧处于松驰、并且伸出得最远状态时螺纹端部9到锯齿构件15的距离比孔螺纹14的后端部到弹性舌簧16的前边缘的距离小。其中必须考虑到，所述螺纹端部的止挡只以一种不可靠的螺距高度决定法兰和螺钉的相对位置。因此，弹性舌簧16的前边缘的弹性行程无论如何必须大于一个螺距高度。这个条件可通过下述措施变得简单起来，即起阻止逆转作用的锁定构件(锯齿和弹性舌簧)不是设置在螺钉头的后端面上，而是设置在螺钉头的圆周面上，或者设置在后端面和圆周面之间的过渡区域中。

Claims (1)

1.包括一个骨骼螺钉的医用植入体，该骨骼螺钉由一个阻止逆转的构件来固定，并通过植入体(1，2)的一个孔(3)被导向，该孔(3)含有一个和螺钉(4)的螺钉螺纹(5)相匹配的孔螺纹(14)，所述螺钉(14)在它的螺钉头(6)和螺钉螺纹(5)之间具有一个无螺纹的部段(10)，该无螺纹部段(10)的直径不大于孔(3)的自由的直径，并且其轴向长度至少与孔(3)的孔螺纹部段的长度一样大。
CNB038258498A 2003-01-23 2003-05-19 具有可靠骨骼螺钉的医用植入体 Expired - Fee Related CN100337601C (zh)

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US10/349,175 US7160303B2 (en) 2003-01-23 2003-01-23 Medical implant with a secured bone screw

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ATE414479T1 (de) 2008-12-15
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KR20050092776A (ko) 2005-09-22
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US20050090826A1 (en) 2005-04-28
NZ541244A (en) 2007-08-31
RU2307617C2 (ru) 2007-10-10
DE50310814D1 (de) 2009-01-02
WO2004064655A1 (de) 2004-08-05
EP1585450A1 (de) 2005-10-19
EP1585450B1 (de) 2008-11-19
ZA200506055B (en) 2006-05-31
US7160303B2 (en) 2007-01-09
AR049243A1 (es) 2006-07-12
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JP4303686B2 (ja) 2009-07-29
CA2512494A1 (en) 2004-08-05

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