CN1136819C - 用于矫正外科用的骨髓腔内钉 - Google Patents
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Abstract
用于矫正外科的骨髓腔内钉,包括:一个在内部具有至少一个固定装置的管体(1);一个所述固定装置用的作动元件;保持所述钉顶端的保持装置;其特征在于所述管体基本上为圆柱形,并具有非圆柱形的顶端;所述至少一个固定装置具有一个设有两条或两条以上的壳槽(32)的基本圆柱体(31),每条所述槽的形状被制成能安置一个钩(33),所述钩弧形尖端(34)指向该管体的外侧,并面向一个位于所述管体圆柱面上的长孔(6),在该固定装置相对于该管体滑动期间,所述钩(33)相对于壳槽(32)可移动;安装在管体内侧的所述作动元件通过手动工具操作所述至少一个固定装置(3)沿两个相反的方向作纵向滑动,使钩(33)露出或相应地使它们导入在该管体上形成的开口内;所述保持装置是一个相对于所述管体的非圆柱形顶端滑动而无转动的钻孔套筒(9),并具有至少一个弧形凸耳(91)用以与所述钉插入的骨头相接触,所述的套筒与一螺钉(2)配合,螺钉头搁在所述套筒上并拧入相应于非圆柱部分的管体内所形成的螺纹(12)中。
Description
发明领域
本发明涉及一种用于骨折复位矫正术的管状骨髓腔内钉。
发明背景
众所周知,在矫正外科方面,多数情况采用在骨本身钻髓状通道后,将称为“钉”的管状金属杆插入骨折后的骨中来治疗骨折,特别是治疗长骨的骨折。为防止碎片转动和在多段粉碎性骨折时骨的缩短,公知技术要用固定螺钉穿过适当的孔而与所述的钉相交。也由于通常难以使要被插入的螺钉靠钉孔定中心,故使钉子的插入尤其是在骨折后的骨碎片中钉本身的末端锁定均是相当复杂的手术。
另一个与先有技术有关的缺点是在骨折愈合期间,由穿过横向螺钉而锁定的钉实际上妨碍了骨折后的骨碎片在纵向的相对运动。事实上,因为骨折部分通常发生适度的生理吸收,故实际上不可能动态接合,这显然限制了先有技术的应用。因而,不可能使两块骨碎片在动态载荷下互相接近以使骨折的愈合期延长。
US-A-5,057,103公开了供长骨用的钉,它包括一个管壳,在管壳内部有一固定装置,用来固定断裂的骨头下部,以允许压实断裂骨头的各部分,并防止各骨折部分的转动和剪切。
然而,在骨折愈合期间,在断裂的各部分骨头可能变短的情况下,所述装置却不能压紧该断裂的骨头。
发明概述
本发明的目的就是克服上述缺点。本发明的目的之一是提供一种新型钉,它可避免骨碎片转动,且不需要用一系列横向螺钉来锁定钉本身。
另一个目的是提供一种钉,其上备有固定碎片所必须的所有装置。即使所述的钉装于骨折后的骨上,但当肢体承受轴向载荷,例如当体重加在肢体本身时,所述的钉不阻碍碎片本身的动态接合。
本发明的另一个目的是提供一种钉,当因任何理由而必要时,它可容易地从骨髓腔中取出。
上述目的及下文将叙述的其它目的是通过一种骨髓腔内钉来实现的,它包括:
一个在内部具有至少一个固定装置的管体;
一个所述固定装置用的作动元件;
保持所述钉顶端的保持装置;
其特征在于所述管体基本上为圆柱形,并具有非圆柱形的顶端;
所述至少一个固定装置具有一个设有两条或两条以上的壳槽的基本圆柱体,每条所述槽的形状被制成能安置一个钩,其弧形尖端指向该管体的外侧,并面向一个位于所述管体圆柱面上的长孔,在该固定装置相对于该管体滑动期间,所述钩相对于壳槽可移动;
安装在管体内侧的所述作动元件通过手动工具操作所述至少一个固定装置沿两个相反的方向作纵向滑动,使钩露出或相应地使它们导入在该管体上形成的开口内;
所述保持装置是一个相对于所述管体的非圆柱形顶端滑动而无转动的钻孔套筒,并具有至少一个弧形凸耳用以与所述钉插入的骨头相接触,所述的套筒与一螺钉配合,螺钉头搁在所述套筒上并拧入相应于非圆柱部分的管体内所形成的螺纹中。
更有利的是,按本发明,位于骨髓腔内钉内的固定装置用两个或更多个钩来锁定末端碎片部分,在该作动元件工作期间,该钩从骨髓钉中伸出。该骨髓腔内钉可装有一个或多个固定装置,例如两个,取决于必须治疗的骨折的类型。
就简单骨折(横向,斜向等)而言,在骨髓腔内钉内只用一个固定装置,且它的作用将包括碎片的下部分。两段碎片的接合是靠搁在骨髓腔内钉的邻近端的套筒上的螺钉的作用而实现的。所述的套筒其主体与在骨内的钉的非圆柱部分相耦合,此套筒用一或二个凸耳搁在骨的外表面,如此防止两段碎片转动并同时使碎片的下部分接近上部分,直到接合。
正如以下的更清楚的图解说明,套筒可相对骨髓腔内钉上端滑动这个事实即甚至在骨折愈合期间也能达到碎片的接合。因为,肢体的轴向动态载荷使下段碎片推向上段碎片,这可能是由于套筒与骨髓腔内钉上端之间的相对运动的结果。
附图说明
在以下所讨论的由附图表示的本发明的说明中,本发明的其他的特征和细节会变得更加明确,其中:
-图1表示本发明的钉体在简单骨折的股骨中的应用;
-图2表示接合后图1的股骨;
-图3表示装有2个固定装置的本发明的钉体在接合前的多段粉碎性骨折的股骨中的状况;
-图4表示接合后图3的股骨;
-图4a表示用图2的钉接合,并用横向螺钉固定的图3和4的股骨;
-图5是本发明的骨髓腔内钉体所装有的固定装置和作动元件的部件分解图;
-图6表示只包括一个固定装置的本发明的钉体的剖视图;
-图7是图6的变型,其中,固定装置的位置要使钩尖端的露出与图6所示的相反;
-图8表示用于如图4a所示的多段粉碎性骨干骨折的带一横向螺钉的本发明钉体的剖视图;
-图9是该钉的套筒所装的凸耳的放大顶视图;
-图10和11表示2个按本发明的钉的剖视图,每个分别装有两个收敛和扩散指向的固定装置;
-图12表示用于股骨的转子下完全骨折(per-subtrochantericfracture)的本发明的钉体的一个特殊实施例;
-图12a表示用于图12所示同样骨折的该钉的一特殊实施例;
-图13表示用于基部颈骨折的本发明钉体;
-图14和15分别表示与本发明钉体相关的套筒和螺钉的应用的分解图和剖视图;
-图16表示沿图12XV1-XV1线的横向钉的剖视图。
优选实施例说明
参考上述附图,特别参考图5和6,可见本发明的钉体,其剖视图示于图6,包括一管体,整体上以1表示,其端部11为外八角形,它由管体1的外径机加工而成。所述管体1的内侧备有2段螺纹,一段与外八角形区11相以应,所述的螺纹以12表示,并如下文所说明的那样用于与螺钉2螺纹连接。另一段螺纹位于管体1的内部,并以13表示。此螺纹仅占管体的一部分并精确地位于131到132基准点之间的区域,固定装置3将被拧在其中。
所述的固定装置,整体上以3表示并详见于图5,它包括一圆柱体31,其上备有4条壳槽32,在图5的部件分解图中仅能见到2条,每条所述壳槽适于以容纳33表示的钩,所述的钩为弧形并有一尖端34且有基本上为圆形段35的相对端,该端装入根据壳槽32制成的孔36中。该圆柱体31也包括一螺纹孔37,适于容纳作动元件4,确保固定装置在两个方向的纵向运动。在其相对端,圆柱体31备有一放螺丝起子的槽,以38表示。固定装置与整体上以4表示的作动元件共同起作用,如图5所示,作动元件分别包括一双直径段41和42的螺杆,在此实施例中,较大直径的螺纹段41为右螺纹,而较小直径的螺纹段42为左螺纹。螺纹段41拧在管体1的内螺纹13中,而螺纹段42拧在固定装置3的螺纹孔37中。
作动元件4直接与跟钩33组成一整体的固定装置3相耦合,并插入管体1中。如图6和7所示,与管体1非圆柱段相对的下端部由一螺纹塞5封闭。此塞也起到在其操纵期间停止固定装置滑动的作用,实际上它作为行程的端点。
参考图6和图7,当钩33的尖端34接近管体1表面上的孔6时,例如通过将螺丝起子尖端伸入管体31的槽38中而使固定装置3转动,就能使固定装置准确地指向,使每个钩的尖端34由孔6伸出。
很明显,用该图中未示出的手动工具,例如用一六角板手,在作动元件4的六角孔43中进行连续操作,即可确保所述的作动元件转动,并因此而使固定装置3随所述作动元件的转动方向而在两个方向移动。
参考图6,当作动元件4沿箭头方向运动时,固定装置被向上拉,因此,如图2所示钩33从孔6中伸出,图2表示本发明的钉体用于简单骨折的股骨。在此情况,钉的钩33由孔6向上延伸,钉的型式如图6所示的类型。在简单骨折的情况,钩33向钉外侧并因此相对骨的固定位置的延伸发生在骨的末端部分及在两段碎片接合前。实际上,用本发明的钉体完成的手术的程序主要包括将钉导入预先准备好的骨髓道中。接着操作作动元件,使固定装置锁定末端碎片段。于是,图2中由7和8所指的两段碎片通过由螺钉2向钻孔套筒9施加的压力而相互接近,套筒备有一与管体1的端部11相同形状的孔,在此情况为八角形孔,且套筒体放在骨内。由于这样,钻孔套筒9只能纵向向下滑动,但不能转动。如果套筒向下滑,与钻孔套筒9上部形成一整体的凸耳91则靠在骨8的外部。用此方法,螺钉2的任何拧动都只能使钉的整个管体1向上运动,并因此使两段碎片7和8相接合,如图2所示。因此,在简单骨折的情况,如图1和2所示,用单个固定装置3插入本发明的钉体就足够了,因为所述装置确保碎片7的锁定,而碎片段8的转动则由钻孔套筒9的凸耳91的外部作用而锁定。
在患者恢复期间,两段碎片所承受的轴向动态载荷改进了它们的接合,所述的接合由于有本发明的钉体而得到促进,因为钉体能在钻孔套筒9的槽中滑动,故事实上整个钉能举起。
在多段粉碎性骨折的情况,如图3和4所示,钉必须备有至少2个固定装置3。更准确地说,可以看出用于图3和4所示的骨折,本发明钉体是示于图11的钉,其中,有2个相互相对且分别由作动元件40和401操作的固定装置30和301。图10表示又一变型,其中,钉也装有2个固定装置30和301,然而,它们是收敛地指向而不是如图11所示的扩展地指向。对多段粉碎性骨折所能得到的双锁定所确保的优点,如上所述,是显而易见的。图3表示用带双固定装置的钉的多段粉碎性骨折。显然,第一个装置30必须首先操作,然后,骨碎片被接合,然后必须完成第二固定装置的第二延伸或锁定。最后,钉最终被钻孔套筒9固定,适当地使凸耳91定向。
如果,为了安全起见,有必要用横向螺钉20对本发明的钉体实施最接近的锁定,这很容易做到,因为本发明的钉体也备有插入所述螺钉的横向孔21,如图4a和图8剖视图所示。
在股骨骨折的情况,如图12所示的那些,表明转子下的完全骨折,两个分别由10和101所指的本发明的钉可被插入股骨中。在此情况,钉10随骨的形状而稍微弯曲,并仅装有一个固定装置30,用作末端锁定。另一个钉101,也仅装有一个固定装置30,用以代替普通头螺钉,以便确保由处在远离骨折的骨头部分上的钩固定该装置。必然看到使用钉101防止了接近骨折的部位的转动。还必然看到钉101与钉10之间的转动由一插在钉101外表面上的降低后的凹槽104中的杆102来防止,此凹槽与钉10的横向孔103上的同样的槽105相对应。这可从图16有中看到该图沿XV1-XV1线表示了钉101的剖面。
图12a表示本发明的代替该套筒的带角板71的钉体。该板是一根基本上平的纵向杆72,将它靠在股骨上,并与管体73相连,管体73与钉的非圆柱部分相耦合,并将螺钉2搁在其上以达到骨折的接合。
图13表示本发明的钉体在基部颈骨折的推广。在这种情况下,重要的是在部位8中利用钉钩的固定发生在股骨的较长直径的部位,因此,必须使用一种有钩尖端的钉,此尖端朝向钉本身的端部,即示于图7的钉子型式。而在图1 2所涉及的手术中则使用如图6所示的一种钉子形式。图14和15表示专用套筒的形状制成像一个膨胀垫圈50,并有两个对称的凸耳91和一非圆柱形孔53,所述的套筒通过拧在钉100的管件上的螺钉52的头51的压力而靠在碎片段7、8的表面上。
Claims (10)
1.用于矫正外科的骨髓腔内钉,它包括:
一个在内部具有至少一个固定装置的管体(1);
一个所述固定装置用的作动元件;
保持所述钉顶端的保持装置;
其特征在于所述管体基本上为圆柱形,并具有非圆柱形的顶端;
所述至少一个固定装置具有一个设有两条或两条以上的壳槽(32)的基本圆柱体(31),每条所述槽的形状被制成能安置一个钩(33),所述钩弧形尖端(34)指向该管体的外侧,并面向一个位于所述管体圆柱面上的长孔(6),在该固定装置相对于该管体滑动期间,所述钩(33)相对于壳槽(32)可移动;
安装在管体内侧的所述作动元件通过手动工具操作所述至少一个固定装置(3)沿两个相反的方向作纵向滑动,使钩(33)露出或相应地使它们导入在该管体上形成的开口内;
所述保持装置是一个相对于所述管体的非圆柱形顶端滑动而无转动的钻孔套筒(9),并具有至少一个弧形凸耳(91)用以与所述钉插入的骨头相接触,所述的套筒与一螺钉(2)配合,螺钉头搁在所述套筒上并拧入相应于非圆柱部分的管体内所形成的螺纹(12)中。
2.按权利要求1所述的骨髓腔内钉,其特征在于,在每个固定装置(3)的每个钩(33)穿过管体上的孔(6)的运动期间,钩(33)从槽(32)中升高,使与弧形尖端(34)相对的端部(35)插入所述槽底部一端的径向孔(36)中。
3.按权利要求1或2所述的骨髓腔内钉,其特征在于,所述固定装置的作动元件(4)是一个带双直径(41,42)的螺杆,较小直径(42)设有第一螺纹,适于与位于固定装置(3)端部的螺纹孔(37)相耦合,较大直径(41)设有第二螺纹,与第一螺纹相反,适于与管体内壁上的相应螺纹(13)相啮合,还备有一个适于容纳操纵扳手头的轴向腔(43)。
4.按权利要求1所述的骨髓腔内钉,其特征在于,它设有一横向孔(21),适于容纳螺钉(20),该螺钉保证进一步锁定。
5.按权利要求1所述的骨髓腔内钉,其特征在于,与钻孔套筒(9)接合的管体(1)的顶端部被制成平行六面体形。
6.按权利要求1所述的骨髓腔内钉,其特征在于,它设有两个固定装置(30,301),位于相对方向,使相应的钩互相收敛地或扩散地伸出。
7.按权利要求1所述的骨髓腔内钉,其特征在于,在其下端设有一封闭塞(5)。
8.按权利要求1所述的骨髓腔内钉,其特征在于,该套筒的形状制成带两个对称凸耳(91)的膨胀垫圈(50),适于搁在所要接的骨上。
9.按权利要求1所述的骨髓腔内钉,其特征在于,套筒采取一角板(71)的形状,它基本上是一个平的纵向杆(72),搁在股骨上,并与管体(73)相连,管体与钉的非圆柱形部分相耦合,并使与所述钉相互作用的螺钉(2)的头搁在其上。
10.按权利要求1所述的骨髓腔内钉(10),其特征在于,它设有横向孔(103),第二钉(101)穿过它而插入,所述的第二钉(101)的转动由杆(102)防止,该杆装于所述横向孔(103)的槽(105)上及在所述第二钉外表面上的纵向凹槽(104)中。
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Application Number | Priority Date | Filing Date | Title |
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ITVI96A000054 | 1996-04-05 | ||
IT96VI000054A IT1287271B1 (it) | 1996-04-05 | 1996-04-05 | Chiodo endomidollare per l'osteosintesi delle fratture delle ossa lunghe |
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CN1219857A CN1219857A (zh) | 1999-06-16 |
CN1136819C true CN1136819C (zh) | 2004-02-04 |
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CNB971950644A Expired - Fee Related CN1136819C (zh) | 1996-04-05 | 1997-04-03 | 用于矫正外科用的骨髓腔内钉 |
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EP (1) | EP0892624B1 (zh) |
JP (1) | JP3169967B2 (zh) |
CN (1) | CN1136819C (zh) |
AT (1) | ATE208588T1 (zh) |
AU (1) | AU725703B2 (zh) |
BR (1) | BR9708761A (zh) |
CA (1) | CA2249664C (zh) |
DE (1) | DE69708280T2 (zh) |
DK (1) | DK0892624T3 (zh) |
ES (1) | ES2166539T3 (zh) |
IT (1) | IT1287271B1 (zh) |
PT (1) | PT892624E (zh) |
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BR112019018698A2 (pt) * | 2017-03-10 | 2020-04-07 | Exactech Inc | porção proximal de um implante, kit e suporte de cabeça umeral, para fixação de fratura |
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US11246634B2 (en) * | 2017-05-02 | 2022-02-15 | Orthopediatrics Corp. | End cap for intramedullary nail |
US10888435B2 (en) | 2017-10-05 | 2021-01-12 | Spine Wave, Inc. | Modular inserter for anterior cervical cage |
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CN107661140A (zh) * | 2017-11-28 | 2018-02-06 | 广东工业大学 | 一种弹性倒钩医用骨螺钉 |
US10945850B2 (en) * | 2018-10-25 | 2021-03-16 | Revision Technologies Llc | Interconnected implants and methods |
RU202086U1 (ru) * | 2020-04-03 | 2021-01-29 | федеральное государственное бюджетное образовательное учреждение высшего образования "Тамбовский государственный университет имени Г.Р. Державина" | Анкерный винт для остеосинтеза |
CN112451073B (zh) * | 2020-11-26 | 2022-03-08 | 合肥市第二人民医院 | 一种锁骨髓内钉固定锚及锁骨髓内钉固定装置 |
RU2766408C1 (ru) * | 2021-09-13 | 2022-03-15 | федеральное государственное автономное образовательное учреждение высшего образования «Казанский (Приволжский) федеральный университет» (ФГАОУ ВО КФУ) | Интрамедуллярный расширяющийся стержень для остеосинтеза трубчатых костей c дополнительной стабилизацией |
CN113974810B (zh) * | 2021-12-06 | 2023-07-21 | 韩杰 | 一种预防股骨折后骨头坏死装置 |
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CH453570A (de) * | 1967-06-19 | 1968-06-14 | Joseph Dr Steinhaeser | Marknagel für operative Behandlung von Schaftfrakturen an Röhrenknochen |
DE2260839C2 (de) * | 1972-12-13 | 1975-02-13 | Ludger Dr. 4403 Hiltrup Schilgen | Vorrichtung zur Behandlung von getrennten Röhrenknochen mittels Druckosteosynthese |
ES207117Y (es) * | 1974-10-25 | 1976-07-01 | Pares Avila | Dispositivo de fijacion interno para fracturas oseas. |
US4632101A (en) * | 1985-01-31 | 1986-12-30 | Yosef Freedland | Orthopedic fastener |
US4862883A (en) * | 1988-04-21 | 1989-09-05 | Yosef Freeland | Interlocking intramedullary nail |
US5057103A (en) * | 1990-05-01 | 1991-10-15 | Davis Emsley A | Compressive intramedullary nail |
IT1265965B1 (it) * | 1994-05-20 | 1996-12-16 | Francesco Saverio Santori | Dispositivo endomillare per la chiodatura di ossa lunghe. |
-
1996
- 1996-04-05 IT IT96VI000054A patent/IT1287271B1/it active IP Right Grant
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1997
- 1997-04-03 CA CA002249664A patent/CA2249664C/en not_active Expired - Fee Related
- 1997-04-03 US US09/155,640 patent/US6077264A/en not_active Expired - Fee Related
- 1997-04-03 ES ES97919316T patent/ES2166539T3/es not_active Expired - Lifetime
- 1997-04-03 EP EP97919316A patent/EP0892624B1/en not_active Expired - Lifetime
- 1997-04-03 PT PT97919316T patent/PT892624E/pt unknown
- 1997-04-03 RU RU98120054A patent/RU2149598C1/ru active
- 1997-04-03 CN CNB971950644A patent/CN1136819C/zh not_active Expired - Fee Related
- 1997-04-03 DK DK97919316T patent/DK0892624T3/da active
- 1997-04-03 DE DE69708280T patent/DE69708280T2/de not_active Expired - Fee Related
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- 1997-04-03 WO PCT/EP1997/001675 patent/WO1997037606A1/en active IP Right Grant
- 1997-04-03 AT AT97919316T patent/ATE208588T1/de not_active IP Right Cessation
- 1997-04-03 JP JP53582597A patent/JP3169967B2/ja not_active Expired - Fee Related
- 1997-04-03 AU AU23835/97A patent/AU725703B2/en not_active Ceased
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US6077264A (en) | 2000-06-20 |
DK0892624T3 (da) | 2002-03-11 |
AU725703B2 (en) | 2000-10-19 |
AU2383597A (en) | 1997-10-29 |
EP0892624B1 (en) | 2001-11-14 |
RU2149598C1 (ru) | 2000-05-27 |
ITVI960054A1 (it) | 1997-10-05 |
PT892624E (pt) | 2002-05-31 |
JP3169967B2 (ja) | 2001-05-28 |
CA2249664C (en) | 2002-03-05 |
JP2000507475A (ja) | 2000-06-20 |
WO1997037606A1 (en) | 1997-10-16 |
IT1287271B1 (it) | 1998-08-04 |
ITVI960054A0 (it) | 1996-04-05 |
CN1219857A (zh) | 1999-06-16 |
EP0892624A1 (en) | 1999-01-27 |
ATE208588T1 (de) | 2001-11-15 |
DE69708280T2 (de) | 2002-07-18 |
ES2166539T3 (es) | 2002-04-16 |
CA2249664A1 (en) | 1997-10-16 |
DE69708280D1 (de) | 2001-12-20 |
BR9708761A (pt) | 2000-08-08 |
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