CN104224303A - 骨螺钉 - Google Patents

骨螺钉 Download PDF

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Publication number
CN104224303A
CN104224303A CN201410482097.4A CN201410482097A CN104224303A CN 104224303 A CN104224303 A CN 104224303A CN 201410482097 A CN201410482097 A CN 201410482097A CN 104224303 A CN104224303 A CN 104224303A
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bone screw
tubular body
bone
screw according
opening
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L·比德曼
W·马蒂斯
J·哈姆斯
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Biedermann Motech GmbH and Co KG
Biedermann Technologies GmbH and Co KG
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Biedermann Technologies GmbH and Co KG
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    • 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
    • A61B17/8605—Heads, i.e. proximal ends projecting from bone
    • A61B17/861—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver
    • A61B17/862—Heads, i.e. proximal ends projecting from bone specially shaped for gripping driver at the periphery of the screw head
    • 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
    • A61B17/8635—Tips of screws
    • 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
    • A61B17/7001—Screws or hooks combined with longitudinal elements which do not contact vertebrae
    • A61B17/7035—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other
    • A61B17/7037—Screws or hooks, wherein a rod-clamping part and a bone-anchoring part can pivot relative to each other wherein pivoting is blocked when the rod is clamped
    • 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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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
    • A61B17/72—Intramedullary pins, nails or other devices
    • A61B17/7233—Intramedullary pins, nails or other devices with special means of locking the nail to the bone
    • A61B17/725—Intramedullary pins, nails or other devices with special means of locking the nail to the bone with locking pins or screws of special form
    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/864—Pins or screws or threaded wires; nuts therefor hollow, e.g. with socket or cannulated
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    • A—HUMAN NECESSITIES
    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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    • A61B17/68—Internal fixation devices, including fasteners and spinal fixators, even if a part thereof projects from the skin
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    • A61B17/86—Pins or screws or threaded wires; nuts therefor
    • A61B17/8685—Pins or screws or threaded wires; nuts therefor comprising multiple separate parts
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    • A61—MEDICAL OR VETERINARY SCIENCE; HYGIENE
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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
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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
    • A61B17/88—Osteosynthesis instruments; Methods or means for implanting or extracting internal or external fixation devices
    • A61B17/92—Impactors or extractors, e.g. for removing intramedullary devices
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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
    • A61B2017/8655—Pins or screws or threaded wires; nuts therefor with special features for locking in the bone

Abstract

本发明提供了一种骨螺钉，包括：管状主体(1)，所述管状主体(1)在它的外壁的至少一部分中具有骨螺纹(5)，所述管状主体具有开口的第一端(2)和开口的第二端(3)；其中在所述开口的第一端(2)设置有多个切割齿(4)，并且在所述开口的第二端(3)设置有用于与拧入工具(100)接合的接合结构(31，310)。本发明还提供了一种用于插入上述骨螺钉的工具，其中所述工具包括接合结构(102，103)，所述工具的接合结构(102，103)与所述骨螺钉的接合结构(31，310)接合并且构造成用于引导导丝。

Description

骨螺钉
本发明专利申请是申请日为2010年11月30日、申请号为201010570498.7、发明名称为“骨螺钉”的发明专利申请的分案申请。
技术领域
本发明涉及骨螺钉。特别地，本发明涉及能够用作融合螺钉(fusion screw)的骨螺钉。这种螺钉促进在周围骨中的熔合。
背景技术
从US2004/0015172A1中已知这种类型的骨螺钉。该骨螺钉具有管状螺纹部分，并且在它的壁中具有骨螺纹和多个凹槽。头部和尖端能连接到管状螺纹部分。使用中，管状部分能填充有骨材料或者其它促进生长的材料，然后尖端和/或头部连接到管状部分。首先，制备芯孔，然后将螺钉插入芯孔中并拧入骨中。经过一定的时间段之后，在所述螺钉和骨之间发生融合。所述螺钉能作为牵引元件，以便通过所述螺钉将骨的粉碎部分或分裂部分连接在一起。为了免去芯孔的制备，尖端可以是自切割的(self-cutting)。
US2004/0122431描述了一种上述类型的骨螺钉，然而这种骨螺钉不具有头部。这种骨螺钉例如能与髓钉一起使用。US2005/0055026A1描述了一种上述类型的骨螺钉，其中头部是单独的部件并且能连接到管状螺纹锚杆。所述头部构造成连接到稳定杆。在一个实施例中，所述螺钉的管状螺纹锚杆在它的连接到头部的端部具有用于与螺丝起子接合的切口。
另外，已知所谓的注射螺钉(injection screw)(诸如在WO01/26568A1中所描述的)，注射螺钉用于将骨接合剂或者其它液体或膏状材料注射到骨中。这种螺钉具有在骨螺钉内延伸的相当细的插管。所述插管不适于用骨碎片或移植骨填充。
发明内容
本发明的目的是提供一种不利用制备的芯孔的情况下能够快速拧入骨中的骨螺钉。
上述目的通过根据权利要求1所述的骨螺钉实现。其它研发成果在从属权利要求中给出。
根据本发明的骨螺钉是自切割的。当骨螺钉拧入骨中时，切割齿接合骨并产生孔。来自螺钉插入部位的骨材料填充管状主体的腔。因此，不需要制备芯孔。不需要预先用骨材料填充管状主体。因此，与骨螺钉必须预先填充并插入预先制备好的芯孔中的情况相比，植入上述骨螺钉的过程花费更少的时间。此外，所述骨材料比预先填充的骨材料具有更为完好的结构，这可以促进愈合过程。
所述骨螺钉特别地适用于结实的健康骨或者脆弱的骨质疏松骨，因为在拧入骨螺钉时发生的结构破坏能被保持到最小的程度。
通过使用插入用的导丝程序，所述骨螺钉能够在微创外科手术中使用。
附图说明
从借助附图对本发明的各个实施例的描述中，本发明的其它特征和优点将变得明了。附图中：
图1示出根据第一实施例的骨螺钉的透视图。
图2示出根据图1的骨螺钉的俯视图。
图3示出根据图1的骨螺钉的、沿包含该骨螺钉的纵向轴线L的平面截取的剖视图。
图4示出图1的骨螺钉的侧视图。
图5示出根据第二实施例的骨螺钉的透视图。
图6示出图5的骨螺钉的俯视图。
图7示出图5的骨螺钉的、沿包含该骨螺钉的纵向轴线L的平面截取的剖视图。
图8示出图5的骨螺钉的侧视图。
图9示出图5-8的骨螺钉连同导丝和插入工具的透视图。
图10示出包括接合结构的工具的剖视图。
具体实施方式
如图1-4中所示的根据第一实施例的骨螺钉包括管状主体1，该管状主体1具有开口的第一端2和开口的第二端3以及中心纵向轴线L。在第一端2，管状主体的自由边缘包括多个切割齿4，切割齿4构造成在骨中切割出孔。在管状主体的外壁的一部分中(如在该实施例中所示的，该部分靠近第一端2)，管状主体包括所谓的骨螺纹5。骨螺纹5构造成在骨螺钉拧入骨中时切入骨中。虽然附图示出具有基本为锯齿形的骨螺纹，但是可以使用所有类型的已知的骨螺纹。切割齿4从第一端2的边缘与纵向轴线L同轴地延伸。在所示的实施例中，所述切割齿基本为锯齿形。这种形状包括陡峭的齿侧4a和较浅的齿侧4b，其中所述陡峭的齿侧4a相对于圆周线以大于45°的角度沿着所述自由边缘延伸，所述较浅的齿侧4b相对于所述自由边缘以大于0°直到45°的角度延伸。为了使得螺钉的插入变得容易，所述陡峭的齿侧都在同一个圆周方向上定向。所述切割齿构造成在骨中切割出环状孔。骨材料保留在所述孔内。保留在切割齿之间的骨材料被容纳在管状主体中。所述骨材料可以由碎片组成，或者所述骨材料可以是塞状粘附物或二者。
切割齿的沿着径向方向的厚度可以比管状主体的壁厚大(未示出)。这导致在管状主体内形成一个扩大的空间以便容纳骨材料。
切割齿的高度、形状和数量可以变化。构造成切割骨使得骨材料保留在管状主体内部的所有类型的切割齿都是合适的。
在管状主体的壁中，设置有多个开口6，以允许骨材料和骨螺钉周围的血管的生长。所述开口示出为菱形的并且完全延伸穿过管状主体1的壁。所述开口布置在骨螺纹5的螺纹牙顶5a之间。可以想到开口6的任何其它各种形状和布置。
邻近第二开口端3形成有管状主体1的不带螺纹的部分30。部分30在它的内壁上包括沿圆周方向均等地间隔开的多个凹槽31，凹槽31形成用于螺丝起子或其它工具的接合结构。凹槽31从开口端3的边缘延伸到距离该开口端3一定距离处。管状主体1在具有接合结构的部分30中的壁厚与其余管状主体1的壁厚相比可以被增强。图中所示的凹槽形成用于星形螺丝起子的星形接合结构。然而，可以想到任何其它形状的接合结构，诸如六角形承窝、方形承窝或者任何其它多边形承窝。
虽然管状主体示出为圆柱形状，但是可以想到其它的形状。例如，管状主体1靠近第一端2可以具有颠倒的渐缩形部分，该颠倒的渐缩形部分远离第一端2渐缩。由管状主体提供的腔具有适合容纳骨材料的容积。管状主体的壁厚优选小于螺钉芯体直径的大约15％。
骨螺钉的所有部分均由生物相容材料制成，所述生物相容材料诸如生物相容金属(例如不锈钢或钛)、生物相容金属合金(例如镍钛诺)或者生物相容塑料材料(例如PEEK)。
另外，骨螺钉的管状主体或其它部分能涂覆有促进生长的物质或者能被粗糙化以便促进骨或血管的生长。
使用中，通过用螺丝起子接合所述接合结构31而将根据第一实施例的骨螺钉插入骨中。切割齿4产生用于螺钉的孔，并且螺纹5便于将骨螺钉进一步推进到孔中。由切割齿4碎掉的(scraped-off)骨材料填充管状主体1的内部。在经过一定时间段之后，管状主体中的骨材料与骨螺钉周围的骨材料融合，从而骨螺钉刚性地与骨相连接。
因为所述骨螺钉不具有头部，所以所述骨螺钉不用作被融合以复位骨折骨的张力螺钉。根据该实施例的骨螺钉用于关节的固定，例如用于小面关节的固定。
在图5-8中示出第二实施例的骨螺钉。第二实施例与第一实施例的不同之处在于用于工具的接合结构的设计。所有其它部分与第一实施例的相同，并且用相同的附图标记表示。对这些相同的部分不再进行重复的描述。
根据第二实施例的骨螺钉邻近它的开口的第二端3具有不带螺纹的部分300，该部分300包括多个槽口310，槽口310从开口端的边缘沿着管状主体1的纵向方向延伸到一定距离处。槽口310完全延伸穿过壁，从而这些槽口形成接合结构，该接合结构能够与工具的相应接合结构(例如工具的销钉)相接合。槽口310的形状示出为矩形。然而，可以想到允许在工具的接合结构与槽口接合时传递扭矩的任何其它形状。槽口的数量和尺寸可以变化。
图9和10示出带有工具100和导丝8的根据第二实施例的骨螺钉。工具100例如是圆柱形的，其适于与骨螺钉的接合结构配合。在前表面101设置多个销钉102，所述销钉102构造成接合骨螺钉的接合结构的凹槽310。而且，设置有沟槽103，骨螺钉的管状主体的开口端3的自由边缘可以插入该沟槽103中，以便于应用工具100。销102以相等间隔布置在所述沟槽中，并且不从前表面101中突出或者不从前表面101中突出太多。工具100还包括同轴引导孔104，用于引导所述导丝8穿过其中。工具100的长度使得导丝8由工具100以合适的方式引导。
虽然示出所述工具为圆柱形的，但是所述工具可以具有与骨螺钉的接合结构配合的任何其它形状或者任何其它接合结构。例如，接合结构可以设计成与根据第一实施例的骨螺钉的接合结构相接合。
如图9和10中所示的带有工具和导丝的骨螺钉能够用在微创外科手术(MIS)中。首先，将工具100所引导的导丝插入管状主体1中，如图9所示。然后，经由患者的皮肤引入导丝8并推进导丝8穿过组织，直到导丝到达必须放置骨螺钉的位置。然后，将导丝插入骨中直到合适的方向和深度。然后，沿着导丝8引导骨螺钉延伸穿过直到骨螺钉到达骨的表面。接着，通过使工具100旋转从而在导丝引导下将骨螺钉拧入骨中。切割齿4产生用于螺钉的孔，并且骨螺纹5便于将骨螺钉进一步推进到所述孔中。
由切割齿4碎掉的骨材料填充管状主体1的内部。当骨螺钉被最终植入时，收回导丝。在经过一段时间之后，管状主体中的骨材料与骨螺钉周围的骨材料融合，从而骨螺钉与骨刚性地相连接。所述骨螺钉可以用作根据第一实施例的、特别地用于稳定关节的骨螺钉。

Claims (15)

1.一种骨螺钉，包括：
管状主体(1)，所述管状主体(1)在它的外壁的至少一部分中具有骨螺纹(5)，所述管状主体具有开口的第一端(2)和开口的第二端(3)；
其中在所述开口的第一端(2)设置有多个切割齿(4)，并且在所述开口的第二端(3)设置有用于与拧入工具(100)接合的接合结构(31，310)。
2.根据权利要求1所述的骨螺钉，其中所述切割齿(4)与所述管状主体的中心轴线(L)同轴地延伸。
3.根据权利要求1或2所述的骨螺钉，其中所述切割齿(4)构造成在所述管状主体(1)拧入骨中时切割出孔。
4.根据权利要求1或2所述的骨螺钉，其中所述切割齿(4)具有基本为锯齿的形状。
5.根据权利要求1或2所述的骨螺钉，其中所述切割齿(4)在径向方向比所述管状主体的壁更厚。
6.根据权利要求1或2所述的骨螺钉，其中所述切割齿(4)形成所述开口的第一端(2)的边缘。
7.根据权利要求1或2所述的骨螺钉，其中所述管状主体的壁厚比所述管状主体的外径小大约15％。
8.根据权利要求1或2所述的骨螺钉，其中所述接合结构包括多个凹槽(310)，所述凹槽(310)从所述开口的第二端(3)、与所述管状主体的中心纵向轴线(L)基本同轴地延伸穿过所述管状主体的壁。
9.根据权利要求1或2所述的骨螺钉，其中所述接合结构包括多边形凹槽或者是从所述开口的第二端(3)延伸进所述管状主体的内壁中的星形凹槽(31)。
10.根据权利要求1或2所述的骨螺钉，其中所述管状主体的壁包括多个开口(6)。
11.根据权利要求1或2所述的骨螺钉，其中所述管状主体包括不带螺纹的部分。
12.根据权利要求1或2所述的骨螺钉，其中设置有导丝(8)，所述导丝(8)能插入所述管状主体中，以用于引导所述骨螺钉的插入。
13.根据权利要求1或2所述的骨螺钉，其中所述管状主体(1)是圆柱形的。
14.一种用于插入根据权利要求1-13之一所述的骨螺钉的工具，其中所述工具包括接合结构(102，103)，所述工具的接合结构(102，103)与所述骨螺钉的接合结构(31，310)接合并且构造成用于引导导丝。
15.根据权利要求14所述的工具，其中所述工具包括用于引导所述导丝穿过其中的引导孔(104)。
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