CN85108896A - 用于骨接合术的紧固元件 - Google Patents

用于骨接合术的紧固元件 Download PDF

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CN85108896A
CN85108896A CN85108896.1A CN85108896A CN85108896A CN 85108896 A CN85108896 A CN 85108896A CN 85108896 A CN85108896 A CN 85108896A CN 85108896 A CN85108896 A CN 85108896A
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plug sleeve
screw
tightening member
endoporus
diameter
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CN1006954B (zh
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阿图尔·费希尔
沃尔夫冈·克雷默
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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
    • 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
    • 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
    • F16B13/00—Dowels or other devices fastened in walls or the like by inserting them in holes made therein for that purpose
    • F16B13/12—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like
    • F16B13/124—Separate metal or non-separate or non-metal dowel sleeves fastened by inserting the screw, nail or the like fastened by inserting a threaded element, e.g. screw or bolt
    • Y—GENERAL TAGGING OF NEW TECHNOLOGICAL DEVELOPMENTS; GENERAL TAGGING OF CROSS-SECTIONAL TECHNOLOGIES SPANNING OVER SEVERAL SECTIONS OF THE IPC; TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10—TECHNICAL SUBJECTS COVERED BY FORMER USPC
    • Y10S—TECHNICAL SUBJECTS COVERED BY FORMER USPC CROSS-REFERENCE ART COLLECTIONS [XRACs] AND DIGESTS
    • Y10S606/00—Surgery
    • Y10S606/907—Composed of particular material or coated
    • Y10S606/912—Radiolucent material

Abstract

本发明涉及一种用于骨接合术的，特别是用于采用一块支撑板来固定骨的碎片的紧固元件。为了实现一种经得住剧烈的应力和容易拆除的紧固，这种紧固元件包括一个设有一个凸缘的塞套和一个与塞套啮合的螺钉。塞套内孔后部直径比螺钉的螺纹外径稍小一点，而内孔前部的直径则小于螺钉的螺纹底径。

Description

本发明涉及一种用于骨接合术的紧固构件，特别是关于用一块支撑板来固定骨的碎片。
根据骨折的类型，可直接使用拉力螺栓，或与支撑板配合使用来固定骨的碎片。根据使用它们的位置，可使用具有不同螺纹形状的皮层的或松质螺钉。为了能在非常软的骨组织中获得足够的牢固，松质螺钉具有一个非常明显的深螺纹。然而，这些螺钉的缺点是，一旦骨折恢复，尤其是从皮层组织中要拧下它们非常困难。而且直接用螺钉把骨紧固在一起，还有一个缺点是螺钉与骨的接合是硬性的。骨受过应力经过一个短时间后，结果会使接合处损坏，导致螺钉松驰，并且甚至可能断裂。
本发明是以提出可允许使用高拉出值的骨接合术用的紧固元件的问题为依据，使紧固元件能够有弹性地吸收过应力并能易于拆除。
按照本发明，得到的紧固元件包括一个具有凸缘的塞套，并且，有一个的塞套啮合的螺钉，在这里塞套内孔后部的直径是比螺钉螺纹的外径稍微小一点，而内孔前部的直径则小于螺钉螺纹的底径。
为了安装紧固构件，在骨上先钻一个相应于塞套外径的孔。然后将塞套插入这个孔中，直到它的凸缘停止移动紧靠皮层物质的外部表面上为止。为了紧固用来直接固定碎骨的支撑板时，螺钉应拧入塞套内。当螺钉拧进后，螺钉的螺纹齿顶已在内孔的后部稍微切入由一个组织相容的塑料材料组成的塞套内壁，然而没有引起任何膨胀。塞套前部没有缝隙的较细部分，首先产生锚固作用。螺钉的螺纹引起塞套外壁有几处臌出，所以就实现了塞套固定在松质中。骨的碎片，或支撑板，则是通过螺钉头来夹紧。
为了拆除这紧固元件，先将螺钉拧松直到它只处在塞套后部不膨胀部分为止。利用螺纹齿顶切入内孔这一部分的内壁所形成的联结，可以用力拉螺钉将塞套从内孔拉出来。如果已经使用了一块支撑板，则首先拧下螺钉将支撑板取走;将螺钉再拧回到内孔的后部，然后将塞套拔出来。
在本发明进一步的设计中，塞套内孔的前部可以扩大到与内孔后部的直径相同。当螺钉拧入塞套时，材料向前挤压，在某种情况下结果会使前端撕裂。但通过将前端内孔扩大后，可以防止塞套撕裂。
在本发明进一步补充中，纵向肋片设置在塞套的部分外壁上。一旦塞套膨胀以后，这些纵向肋片首先可改善配合，其次，可防止塞套的旋转。如果纵向肋片以螺旋形式安排，则塞套应类似拧入到一个有螺纹的套筒中，这里最好使用合适的丝锥使螺纹事先成锥形。
最后，在本发明的进一步设计中，在内孔后部塞套的外壁上可加装一个金属护套。例如，塞套由超高分子量的聚乙烯组成，它不能在X射线图象中检测出来。为了更好地检测塞套装置或确定塞套的位置，故使用由不锈钢制成的金属护套，它可以制成套筒的形式，或通过真空蒸涂于塞套的不膨胀部分上。
本发明的具体实施方案用图解说明，即：
图1表示根据本发明紧固元件的截面图;
图2表示紧固元件已锚固在骨中。
紧固元件包括一个不锈钢螺钉1和由一个组织相容的塑料制成的塞套2，例如，用超高分子量的聚乙烯材料。塞套2上设置的凸缘3作为限定插入的深度的装置，并且紧靠在皮层物质的外部表面。内孔4的后部4a的直径小于螺钉1螺纹的外径。当螺钉拧入时，于是螺纹齿顶稍微切入塞套的内壁，然而没有在这个区域内引起任何膨胀。沿着这个部分向前，内孔4成锥形变细直到直径小于螺钉螺纹的底径。就是在这个区域发生塞套的膨胀，因而保证塞套2锚定在骨组织中。为了改进紧贴配合和作为一个防止旋转的装置，在这个区域内可装设螺旋形的纵向肋片5。在塞套前端部4b中，为了防止塞套撕裂，内孔再次扩大到与内孔后部相同的直径。为了塞套能够在X射线图象上检测出来的不锈钢金属护套6装在塞套将靠近凸缘3的部位。金属护套6可以先制成一个金属套管然后推上，或者通过由真空蒸涂的金属层形成。
图2，表示紧固元件已插入并已锚定在骨7中。为了固定紧固元件，首先准备孔8，塞套2于是被推入孔8中，直到它的凸缘停止在紧靠皮层物质上。当装上支撑板9时，螺钉1正好经过支撑板9上的孔拧入塞套2的内孔4中。在内孔成锥形变细的区域中，塞套膨胀，引导它锚定在松质中。支撑板是通过螺钉1的头10与骨夹紧。
当骨折恢复时，拆去支撑板9和紧固元件。为了这个目的，先拧下螺钉1，以便拆去支撑板。然后螺钉再次拧入内孔后部4a中，用螺钉1将塞套2从孔8中拉出来。

Claims (5)

1、用于骨接合术，特别是用于采用一块支撑板来固定骨碎片的紧固元件，其特征在于包括一个有凸缘的塞套，和一个与塞套啮合的螺钉，其中塞套内孔的后部直径比螺钉螺纹的外径稍小一点，而内孔前端的直径小于螺钉螺纹的底径。
2、根据权利要求1的紧固元件，其特征在于塞套内孔前端的区域中的直径扩大成与内孔后部相同的直径。
3、根据权利要求1的紧固元件，其特征在于塞套的部分外壁上装有纵向肋片。
4、根据权利要求3的紧固元件，其特征在于纵向肋片被安排成螺旋形。
5、根据权利要求1的紧固元件，其特征在于塞套内孔后部区域的外壁上装有金属护套。
CN85108896A 1985-03-11 1985-12-04 用于骨接合术的紧固元件 Expired CN1006954B (zh)

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DE3508567 1985-03-11
DEP3508567.3 1985-03-11

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CN1006954B CN1006954B (zh) 1990-02-28

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EP (1) EP0194409B1 (zh)
JP (1) JPS61206437A (zh)
CN (1) CN1006954B (zh)
AT (1) ATE44226T1 (zh)
CA (1) CA1268677A (zh)
SU (1) SU1591799A3 (zh)

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CN102119007A (zh) * 2008-06-19 2011-07-06 斯恩蒂斯有限公司 骨螺钉抓紧增强植入件、系统和技术

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CN1006954B (zh) 1990-02-28
US4716893A (en) 1988-01-05
CA1268677A (en) 1990-05-08
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